Increasing engagement in activity of residents in old people's homes by providing recreational materials

This project investigated whether the level of engagement in two special Homes for the elderly could be increased by providing a regular recreational session, where the residents had the opportunity to use various extra recreational materials and to interact with the organiser of the session. The residents' level of engagement during the sessions was consistently higher than under baseline conditions. This indicates that the low engagement of the residents is at least partly due to lack of opportunity to engage, rather than to the specific disabilities of the residents. The methodological approach used in this study is suggested as a useful, objective way of evaluating the effects of, and preferences for, various types of recreational activities that might be offered to elderly people in residential care.     

Depression and engagement in a residential home for the elderly

Traditional residential care environments for the elderly have been criticized because of the observed low levels of residents' engagement. Behavioural models of depression suggest an inverse relationship between engagement in pleasant activities and depression. The present study examined the relationship between depression and engagement in the residents of a home for the elderly. Correlational analyses indicated no relationship between level of depression and level of engagement but an association was found between level of depression and engagement in activities subjectively most enjoyed. There was considerable variation in the residents' perception of their behaviour; some residents viewed active engagement negatively whilst clearly enjoying behaviour that is technically disengaged. It is suggested that the results of the study emphasize the importance both of individual differences in behaviour and of covert behaviour. Implications for the engagement concept are discussed. In particular it is suggested that programmes in care environments aimed at increasing engagement in order to enhance the quality of life should focus more on the individual and on his perception of his behaviour.     

Depressed nursing home residents' activity participation and affect as a function of staff engagement

Behavioral interventions for depression target activity engagement and increased positive reinforcement, particularly from social interaction. Nursing homes provide limited opportunity for meaningful social engagement, and have a high prevalence of depression. Often residents obtain most of their social contacts from staff members. We present intra-individual correlations among positive staff engagement, resident affect, and resident activity participation from behavior stream observations of residents who were participants in an ongoing trial of an intervention for depression. Sixteen residents were observed 6 times weekly for 8 to 45 weeks, 5 minutes per observation. Positive staff engagement during the observations was significantly correlated with resident interest and pleasure. Positive staff engagement was related to resident participation in organized group activity; however, residents tended to be more engaged and show more pleasure when in informal group activities, especially those residents receiving the behavioral treatment. Positive staff engagement was not related to time in activities of daily living. Results have implications for understanding mechanisms and potential targets of interventions for depression.     

Increasing organ donor registration rates by providing an immediate and complete registration opportunity: an experimental assessment of the IIFF model

The IIFF model of organ donation holds that the simultaneous presence of four factors directly influence donor registration: (1) immediate and complete registration opportunity (ICRO), (2) information, (3) focused engagement, and (4) favorable activation. Two field experiments examined the impact of an ICRO on organ donation registration. In Study 1, participants were at town halls where they knew organ donation was to be discussed. Registration cards were distributed and then collected at the end of the session in half of the town halls. For the other half, participants were asked to mail in completed cards. In three US cities, participants given an ICRO registered at a significantly greater rate (z?=?4.865, p?相似文献   

Independent use of activity materials by the elderly in a residential setting

A lottery was implemented to encourage the elderly clients of a residential home to use activity materials any time they wished, independently of staff intervention and the institutional routine of the home. During baseline, there were minimal levels of independent use of activity materials by residents. Various conditions were implemented but only the introduction of a £20 lottery prize brought about a significant increase in the frequency of independent use of activity materials. A follow‐up suggested that the reinforcing properties of the activity materials themselves eventually maintained the target behavior.     

Perceived activity and functional capacity in a rural elderly population.

This research examined 65 rural elderly residents' perception of their physical activity as compared to their functional capacity. Men's, but not women's, perceptions of their physical activity were correlated with their functional capacity.     

Health stresses and depressive symptomatology in the elderly: the importance of health engagement control strategies.

The study presents cross-sectional (N = 127) and longitudinal (n = 111) analyses examining relations between health engagement control strategies (HECSs), depressive symptoms, and health stresses in elderly individuals. HECS was measured as people's behavioral and cognitive investments toward attaining health goals. HECS was related to low levels of depressive symptoms, particularly among people experiencing acute physical symptoms. Moreover, HECS predicted reduction of depressive symptoms over time, and depressive symptomatology predicted negative change in HECS. The findings show that active investments of HECSs significantly moderate the negative affective consequences of health threats. Individuals who are characterized by low levels of HECS and high levels of depressive symptoms may be at increased risk of accelerated decline in their physical and mental health.     

Perceived neighborhood environments and physical activity in an elderly sample

Increasing evidence indicates the importance of environmental variables in explaining physical activity. This study evaluated sex differences in perception of home and neighborhood environmental support and assessed which neighborhood environmental variables were associated with reported physical activity of elderly people. A sample of 126 women (M age = 79.1 +/- 6.6 yr.) and 55 men (M age = 76.6 +/- 7.7 yr.) were healthy, community-dwelling individuals. A questionnaire about environmental variables was administered. Physical activity was assessed on the Baecke Questionnaire. Logistic regression analysis showed that Neighborhood Safety was related to total physical activity, activity in leisure time, and sport activities. Men were also likely to be more active in leisure time than women. Neighborhood Personal Safety was associated with physical activity of these elderly people, showing a potential influence of the environmental domain in physical activity.     

Developing an informational tool for ethical engagement in medical tourism

Background

Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism.

Methods

The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists.

Results

The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service.

     

Maintaining activity engagement: individual differences in the process of self-regulating motivation

ABSTRACT Typically, models of self-regulation include motivation in terms of goals. Motivation is proposed to differ among individuals as a consequence of the goals they hold as well as how much they value those goals and expect to attain them. We suggest that goal-defined motivation is only one source of motivation critical for sustained engagement. A second source is the motivation that arises from the degree of interest experienced in the process of goal pursuit. Our model integrates both sources of motivation within the goal-striving process and suggests that individuals may actively monitor and regulate them. Conceptualizing motivation in terms of a self-regulatory process provides an organizing framework for understanding how individuals might differ in whether they experience interest while working toward goals, whether they persist without interest, and whether and how they try to create interest. We first present the self-regulation of motivation model and then review research illustrating how the consideration of individual differences at different points in the process allows a better understanding of variability in people's choices, efforts, and persistence over time.     

Evaluating the predictive validity of a single stimulus engagement preference assessment.

Most preference assessments require individuals to choose among two or more stimuli. More recently, the duration of engagement with items has been used as an index of preference. In the current study, the predictive validity of a single stimulus engagement (SSE) preference assessment was evaluated with 4 individuals. Stimuli were presented singly for a brief period while engagement with that stimulus was recorded. Although SSE preference rankings closely matched paired stimulus preference assessment rankings for only 2 of the 4 participants, relative preference rankings based on duration of engagement predicted relative reinforcer effectiveness for all participants in a subsequent concurrent‐schedule reinforcer assessment. The SSE procedure took less time to administer than the paired stimulus procedure but produced less stable preference rankings across administrations. The SSE procedure may be appropriate for individuals who have difficulty selecting one stimulus from among two or more stimuli, and it may be well suited for evaluating activities that are difficult to present in a paired stimulus format.     

Dysfunctional isolation in the elderly: Increasing marital and family closeness through improved communication

Unique developmental crises in old age may lead to social withdrawal that negatively affects the individual and his/her marital and family relationships. Without an awareness of these aging dynamics, the therapist can inadvertently perpetuate these distancing behaviors which can exacerbate marital and family conflict. This paper discusses certain developmental crises which can result in increased isolation for the older adult, and suggests therapeutic interventions to facilitate increased closeness among family members.     

Evaluating the influence of time of day on activity engagement in persons with dementia

Dementia is a serious disease affecting a growing number of people. With the onset of dementia comes a decline in social activity engagement that can negatively impact multiple aspects of a person's life. Research suggests that time of day may influence a person with dementia's behavior, including activity engagement, but such research is limited. The purpose of this study was to evaluate the influence of time of day on engagement in activities in persons diagnosed with dementia. An alternating treatments design was used with three participants to measure activity engagement during two times of day, morning and afternoon, and during two activities, a moderately preferred and a low preferred. Results showed no differentiation in engagement between morning and afternoon activities for all three participants, with high levels of engagement during both times of day. For two participants, results showed no differentiation in engagement between moderately preferred and low preferred activities. For one participant, levels of engagement were higher during moderately preferred activities than during low preferred activities.     

The role of activity engagement in the relations between Openness/Intellect and cognition

The current project investigated why people with high levels of Openness/Intellect tend to have higher levels of cognitive functioning than people with lower levels of Openness/Intellect. We hypothesized that the positive relationship between Openness/Intellect and cognition might be attributable to more open people being more likely to engage in cognitively stimulating activities that are beneficial for cognitive functioning. Three conceptualizations of activity engagement based on: (a) self ratings of duration and intensity of engagement; (b) perceived routineness of one's activities; and (c) disposition to engage in cognitively stimulating activities, were investigated as possible mediators of the Openness/Intellect-cognition relations. Although several of the relevant simple correlations were of moderate size and statistically significant, we found little evidence that activity engagement mediated the relations between Openness/Intellect and cognition.     

Equality in health care: Christian engagement with a secular obsession.

A frenetic search for equality lies at the center of much secular and even "Christian" bioethics. In a secular world, if one does not believe in God, if this life is one's whole existence, it would seem that one could not settle for less than equal approbation, especially equality before the risks of suffering and death, which medicine promises to ameliorate. Yet, the concern for equality in health care is puzzling. After a modest level of access to health care there is little difference in average life expectancy. Are concerns for equality in health care even vaguely Christian? The pursuit of Christian perfection has never been correctly equated with state-imposed egalitarianism. Furthermore, an all-encompassing, secular, egalitarian health care system may provide equal access to significantly immoral medical treatments. In contrast to secular thought, the call of Christianity is a call to holiness, not a call to an egalitarianism that superficially resonates with certain elements of Christian thought.     

Challenges to providing a support group for HIV-positive prisoners in South Africa

In prison populations around the world, the prevalence of HIV is often higher than that of the general population. The prison population is at high risk for HIV infection, particularly through the sharing of contaminated needles and high-risk sexual activity. Counselling is regarded as a key element in the prevention and treatment of HIV infection. Support groups provide essential supportive counselling for HIV-positive individuals struggling to cope. This paper looks at the challenges to providing a support group for HIV-positive prisoners. The author's experience of attempting to provide a support group highlights two key challenges: organisational issues which lead to disruptions for the group; and challenges to ensuring confidentiality, a core ethical principle in HIV counselling.