Increasing Communication Among Nursing Home Residents

In this preliminary, intrasubject study (N = 8), we examined the effects of communication skills training and the use of memory books by Nursing Assistants (NAs) on the social ecology of a nursing home. Through inservice and on-the-job training, NAs were taught to use communication skills and memory books during their interactions with residents with mild to moderate cognitive impairment (Mini Mental Status Examination, M = 16.25), but relatively intact communication abilities. An abbreviated staff motivational system called Behavioral Supervision (Burgio and Burgio, 1990. Int. J. Aging Hum. Deve. 30: 287–302.) was attempted to encourage performance of these skills on the nursing units. Results showed that, regardless of sporadic implementation of the intervention by nursing staff, the intervention improved communication between staff and residents during care routines, increased the amount of time other residents and visitors spent talking with target residents, and increased the rate of positive statements made by the target residents and others in their immediate environment. Results are discussed in terms of limitations of the staff motivational system and modifications made to the system in a larger ongoing intervention trial.     

Problem-Solving in the Nursing Home Environment: Age and Experience Differences in Emotional Reactions and Responses

This study examined age differences in the perception of problems occurring in a nursing home. A predominantly female sample (N = 120) varying in age and in exposure to nursing homes watched videotaped vignettes depicting a woman experiencing problems in a nursing home. For each vignette, research participants reported how they thought the protagonist felt, how she should respond, and how confident they would feel to respond similarly if faced with the same situation. Age, more than experience, was related to differences in perceptions, with older adults reporting that the protagonist felt sad more often than did younger adults, who perceived the protagonist as feeling angry. Younger age was associated with more action-oriented coping strategies. No age differences emerged for how well the participants felt they could handle the situation. Results suggest that nursing home employees differ from the residents in both their perceptions of the problems and recommended strategies used to deal with the problem.     

Factors Influencing Level of Stress During the Nursing Home Decision Process

This investigation examined whether characteristics of elders and their caregivers and facets of the nursing home decision-making context were associated with recalled levels of stress during nursing home decision-making. Employing a conceptual framework based upon the literature on caregiver stress and nursing home decision-making, we considered a number of factors that might influence sponsors' stress as decisions were being made about nursing home placements. We examined data from telephone interviews with a sample of 142 sponsors (responsible parties) of first-time, recently admitted nursing home residents. Higher levels of reported stress were directly associated with more factors triggering the decision to admit, higher levels of competing demands, and limited time. Employment was indirectly related to higher stress through its impact on demands. Hospitalization and being the spouse or an adult child of the resident were indirectly related to stress because they were associated with limited available time. The results offer some insights into the types of individuals who may be vulnerable to higher levels of stress and the kinds of interventions that might avert high stress in the nursing home decision process.     

Rationale for Individualizing Interventions to Promote Adjustment to the Nursing Home

This study was designed to determine whether certain variables were predictors of nursing home residents' membership in groups representing qualitative categories of nursing home adjustment. Responses of 186 residents to an open-ended question about how they handled the change to nursing home life were coded as very good, fair, or poor; an adjustment variable was created on the basis of this classification. Analysis of variance of random samples from each adjustment group showed that affect and social support varied significantly with adjustment. However, when discriminant analysis was applied, the three groups could not be differentiated using measure of affect, life satisfaction, social support, participation in the decisions leading to admission, nursing home satisfaction, or health. Based on the conclusion that adjustment to the nursing home is a unique experience for each individual, strategies were proposed for individualizing interventions to enable adjustment.     

养老机构冠心病患者服药依从性现状及影响因素

采用Morisky推荐的MAQ对锦州市养老机构中153名冠心痛患者的服药依从性进行测评,探讨冠心病患者的服药依从性现状及影响因素.结果显示,养老机构冠心病患者服药依从性差的比率为81.7％,影响服药依从性的因素为文化程度、服药种类、医疗背景、入住年限.养老机构的护理人员应对上述因素给予更多的关注,从而提高其服药依从性,进而提升其临床治疗效果.     

The Effect of Therapeutic Touch on the Comfort and Anxiety of Nursing Home Residents

Journal of Religion and Health - Nurses are increasingly using energy therapies such as therapeutic touch (TT) in many countries. This research aimed at finding out the effects of TT on comfort and...     

Functional Analytic Psychotherapy for Nursing Home Residents: A Single-Subject Investigation of Session-by-Session Changes

Nursing home settings contain unique environmental factors that may promote the acquisition and maintenance of problematic interpersonal behaviors. Functional Analytic Psychotherapy (FAP) is a contextually-based behavior therapy that can be used to modify problematic interpersonal behaviors via carefully provided and contingent in-session responses of the therapist to client behaviors. Thus, FAP would appear to be a particularly well-suited intervention approach for nursing home residents. To date, the effects of FAP have not been reported for nursing home residents. The current single case study assessed the effects of FAP on three nursing home residents using a single-subject AB design. The AB design consisted of a 2-weeks baseline phase followed by a 4-week FAP treatment phase. The nursing home residents completed pre-treatment and post-treatment measures of interpersonal relating. Client interpersonal behaviors were also recorded during each session and coded into two categories: Maladaptive in-session behaviors and adaptive in-session behaviors. Using the reliable change index and Swanson’s dsw to evaluate questionnaire outcomes, results indicated that all three participants reported a significant change in interpersonal functioning. Analysis of in-session behavior indicated that there were significant decreases in maladaptive behaviors and an increase in adaptive behaviors for two clients. Finally, observed in-session behavior changes were congruent with self-reported changes in interpersonal behavior. These results indicate that FAP was an effective intervention for these nursing home residents.     

Religiosity and Depression Among Nursing Home Residents: Results of a Survey of Ten States

ABSTRACT

This study extends the growing literature on religiosity and mental health to include those in long-term care. A distress deterrent model and moderator/exacerbator model of religiosity's effects on depression are compared in a sample of 1449 nursing home residents from ten states. Both direct and interactive effects of religiosity in response to health, non-family, and family relationship stressors were tested using regression analysis. Direct effects of religious activity supporting the distress deterrent model were found only among white men. Moderation effects of prior church attendance on a non-family relationship stressor were found among white women. Exacerbation effects of family conflict on depression were found only among whites. Among blacks, strength of faith moderated the depressive effects of both health and non-family relationship stressors. Differential results by race and gender are discussed in light of prior research on religiosity and depression in the community dwelling elderly.     

Repetitive Thought Impairs Sleep Quality: An Experience Sampling Study

Although previous research has suggested that presleep negative cognitive activities are associated with poor sleep quality, there is little evidence regarding the association between negative thoughts and sleep in real-life settings. The present study used experience sampling and long-term sleep monitoring with actigraphy to investigate the relationships among negative repetitive thought, mood, and sleep problems. During a 1-week sampling period, 43 undergraduate students recorded their thought content and mood eight times a day at semirandom intervals. In addition to these subjective reports, participants wore actigraphs on their wrists in order to measure sleep parameters. Analyses using multilevel modeling showed that repetitive thought in the evening was significantly associated with longer sleep-onset latency, decreased sleep efficiency, and reduced total sleep time. Furthermore, impaired sleep quality was significantly associated with reduced positive affect the next morning, and decreased positive affect was indirectly associated with increased repetitive thought in the evening. These findings suggest the existence of a self-reinforcing cycle involving repetitive thought, mood, and impaired sleep quality, highlighting the importance of cognitive and emotional factors in enhancement and maintenance of good-quality sleep.     

A Death in the Family: Report of a Single-Session Trauma Group for Nursing Home Residents and Staff

This article describes a single-session trauma-debriefing group conducted at a nursing home following the death of a resident on an outing. The group had as its core an existing weekly therapy group in the facility, with the addition of affected staff, family, and other residents who were on the outing. The treatment illustrates four principles relevant to counseling and psychotherapy in nursing homes: 1) recognition of death; 2) treatment in and of the milieu; 3) flexibility and structure; and 4) dealing with countertransference. Along the way, we see how the residents are capable of giving, and not merely receiving.     

Health and Care Related Risk Factors for Suicide Among Nursing Home Residents: A Data Linkage Study

This study aimed to examine associations between health status and care needs of nursing home residents and risk of death from suicide compared to other causes through a retrospective data linkage cohort study examining nursing home resident deaths in Australia between 2000 and 2013. Data linkage was performed between aged care assessment tools—Resident Classification System and Aged Care Funding Instrument—and the National Coronial Information System. A competing risks survival analysis was performed to determine the association between care assessment variables (activities of daily living (ADL), behavior, and complex health care) and the risk of death from suicide and any other cause. Of the 146 nursing home residents who died from suicide, 130 (89%) were matched to their assessment data, with comparable information available for 95 residents (65%). Residents who required high levels of care with ADL, physical health care, and cognitive and behavioral issues had a higher risk of dying from all other causes, yet lower risk of dying from suicide. The study findings demonstrate the feasibility and value of linking these two data sets; highlight a need for improved data collection processes; and support a person‐centered care approach for prevention of suicide among nursing home residents.     

Facilitators and Barriers to Engagement in Home Visitation

Abstract

Given previous findings indicating a positive association between home visitation participation rates and family outcomes, the present study explored reasons for and barriers to engagement in the first six months of these parenting programs. Social support, psychoeducation, and tangible assistance emerged as consistent themes across informants as reasons for participation. Perceived invasiveness of the assessments, maternal concerns about being reported to child protective services, and mismatches between maternal needs and home visitor attributes emerged as recurrent themes regarding barriers to participation. Results of these qualitative analyses converge with previous quantitative research regarding factors associated with home visitation delivery and suggest new areas in need of further inquiry by researchers and practitioners to increase engagement.     

多元文化护理的伦理审视

多元文化护理作为当代护理发展的方向, 其伦理内涵植根于后现代主义思潮和对话伦理的理论背景, 并以关怀伦理为基础。无论在中国还是在西方, 有关“关怀”的伦理思想都有丰富的论述, 而以西方女性主义关怀伦理学最为系统。护理学强调关怀, 多元文化护理更是对“关怀”全面而深入的实践。关怀伦理给了多元文化护理诸多启发, 实践多元文化护理应当进一步学会关怀, 实施尊重原则、同情原则、责任原则、宽容原则、情境原则和沟通原则, 体现关怀在知、情、意、信、行方面的具体要求。     

Psychometric Properties and the Predictive Validity of the Insomnia Daytime Worry Scale: A Pilot Study

The relationship between presleep worry and insomnia has been investigated in previous studies, but less attention has been given to the role of daytime worry and symptoms of insomnia. The aims of the current study were (a) to assess the psychometric properties of a novel scale measuring insomnia-specific worry during daytime and (b) to examine whether levels of daytime worry predict severity of insomnia symptoms. Participants (N = 353) completed the Insomnia Daytime Worry Scale (IDWS) and the Insomnia Severity Index. An explorative principal-axis factor analysis extracted two factors from the IDWS, accounting for 70.5% of the variance. The IDWS demonstrated good reliability. The total score of IDWS and both factors predicted levels of insomnia severity in two separate hierarchical regression analyses. This preliminary evidence suggests that the IDWS is a valid and reliable scale to measure daytime worry in insomnia.     

沉浸式生死教育教学——参观殡仪馆

尝试在生死教育课程中开展了参观殡仪馆活动,理由有二,一是受到具身认知理论和沉浸理论两个教学理论的支持;二是生死教育课程本身的要求,即借鉴国外死亡教育的经验、落实“以死观生”的生死教育理念和帮助学生死亡脱敏的要求。在教学设计中,把参观活动分为一般沉浸活动和深度沉浸活动两种,学生参观后的自愿报告显示教学效果良好。参观殡仪馆活动可以在其他高校有条件地推广,但必须遵循两个重要原则,即心理建设原则和完全自愿原则。

     

临床共情与护理技术结合:人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

The Work–Home Interface: Linking Work‐Related Wellbeing and Volunteer Work

An abundance of research shows the benefits of participation in volunteer work for individuals, employers and the society as a whole. However, relatively little is known about the precursors of volunteer work. In this study, we aim to fill this gap by investigating to what extent work‐related well‐being can function as a driver of volunteer work. Moreover, building on the Conservations of Resources Theory (Hobfoll, 1989 , 2011 ), we propose that the relationship between work‐related well‐being (burnout and engagement) and volunteer work is mediated by the work–home interface (work–home enrichment and work–home conflict). This hypothesis was tested in a large Swiss sample (N = 1947). Consistent with our expectations, structural equation analyses revealed an indirect relationship between (i) work engagement and volunteer work via work–home enrichment and (ii) between burnout and volunteer work via work–home conflict. In conclusion, it seems that well‐being at work indeed functions as a precursor for volunteer work because of the consequences it has for the work–family interface. Copyright © 2016 John Wiley & Sons, Ltd.     

The Impact of International Migration on Home Churches: The Mar Thoma Syrian Christian Church in India

Based on qualitative, multisited research, this article examines the impacts of short‐ and long‐term international migration to the Middle East and the West on the Mar Thoma Syrian Christian demonination of Kerala. Migrants and their foreign‐born children have new demands and expectations, and significant financial contributions have led to adjustments in the orientation and functioning of the denomination and its clergy. Large‐scale emigration has also had indirect effects. International networks and the economic affluence of the population, along with a rise in social problems caused by migration and consumerism, have led to the rise of evangelical and charismatic transdenominational churches in Kerala that challenge the functioning of established Christian denominations such as the Mar Thoma. Church leaders have been trying to bring about changes to address these developments, but are constrained by the tradition, structure, and the mission of the churches. I draw on theories of organizational religious change and theories of transnationalism to explain the process of social change in Kerala, also addressing some limitations of these theories.     

护理核心期刊文献的研究伦理审查情况分析

为了解护理核心期刊发文中科研伦理审查现状,以期发挥核心期刊在研究伦理监督原则上的导向作用。检索中国知网数据库,共收集符合纳入标准的科研论文2 474篇,而获得伦理审批号的论文仅20篇(0.81%)。使用SPSS 22.0软件进行统计学处理,不同时期伦理审查情况之间对比,差异具有统计学意义(P<0.05)。在“基因编辑婴儿”事件之后,我国护理核心期刊伦理审查情况有所好转,但整体上护理科研人员伦理意识仍较为淡薄,伦理审查的执行效果不甚理想。建议期刊社规范伦理监督过程,加大伦理监管力度,完善护理研究伦理审查制度及监管体系,以提高护理研究伦理审查效果。     

The Electronic Home Note Program: An Internet-Based Intervention to Improve On-Task Behavior,Academic Performance,and Parental Review

The authors examined the effectiveness of the electronic home note program (EHNP). The program features an emailed version of the traditional home note intervention. In addition, the program uses motivational strategies for increasing rates of on-task behavior, academic productivity, and parent involvement. The authors used a multiple-probe, multiple-baseline design to evaluate implementation effects of the EHNP with four elementary-grade participants. Across all participants, there was an average Tau-U of 0.76 for on-task behavior, with gains maintained at two weeks postintervention. Inconsistent academic gains were found. Parent involvement was high, as most reviewed behavioral ratings data over the course of the intervention. Results also reflect high acceptability of the intervention program from parents, teachers, and participants.