ORCID Profile
0000-0003-3004-9019
Current Organisations
Global Graphene Group
,
Griffith University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Aged Care Nursing | Public Health and Health Services | Residential Client Care | Nursing | Medical and Health Sciences not elsewhere classified | Health And Community Services | Clinical Nursing: Tertiary (Rehabilitative) | Public Health And Health Services Not Elsewhere Classified | Performing Arts and Creative Writing | Drama, Theatre and Performance Studies
ANZSRC Socio-Economic Objective (SEO)
Health related to ageing | The aged | Education and Training not elsewhere classified | Occupational training | Changing work patterns | Nursing | Health not elsewhere classified | Evaluation of health outcomes |
Related Links
Publications
Frequency of Physical Activity Done with a Companion: Changes Over Seven Years in Adults Aged 60+ Living in an Australian Capital City
Publisher: SAGE Publications
Date: 28-02-2023
DOI: 10.1177/08982643231158424
Abstract: Objectives:This study examined how often adults 60+ years were physically active with a partner, close family, friends, and neighbors, over 7 years. Methods: Data from 2062 adults living in an Australian capital city were collected using a mail survey at four time points and analyzed using multinomial logistic regression. Results: A partner was the most frequent companion at all time points. From baseline to 7 years, the greatest decline was activity with family 1–4x/month (.79 [.64–.98]) and ≥5x/month (.54 [.36–.80]). There were also decreases in activity 1–4x/month with a partner (OR = .75, [.62–.92]), friends (.55 [.44–.68]), and neighbors (.79 [.64–.98]). Physical activity with friends or neighbors ≥5x/month did not decline. Discussion: Findings extend understanding of physical activity and activity companions among older adults. More research is needed to understand factors contributing to changes in activity done with companions.
Potential of telepresence robots to enhance social connectedness in older adults with dementia: An integrative review of feasibility
Publisher: Cambridge University Press (CUP)
Date: 07-09-2017
DOI: 10.1017/S1041610217001776
Abstract: Socially assistive robots are increasingly used as a therapeutic tool for people with dementia, as a means to improve quality of life through social connection. This paper presents a mixed-method integrative review of telepresence robots used to improve social connection of people with dementia by enabling real-time communication with their carers. A systematic search of Medline, ProQuest, PubMed, Scopus, Web of Science, CINAHL, EMBASE, and the Cochrane library was conducted to gather available evidence on the use of telepresence robots, specifically videoconferencing, to improve social connectedness, in people with dementia. A narrative synthesis was used to analyze the included studies. A review of 1,035 records, identified four eligible peer-reviewed publications, reporting findings about three different mobile telepresence robots. The study designs included qualitative and mixed-methods approaches, focusing primarily on examining the feasibility and acceptability of the telepresence robots within the context of dementia care. These studies reported both positive outcomes of using telepresence robots to connect people with dementia to others, as well as barriers, such as a lack of experience in using a robot and technological issues. Although limited, the current literature suggests that telepresence robots have potential utility for improving social connectedness of people with dementia and their carers. However, more systematic feasibility studies are needed to inform the development of telepresence robots followed by clinical trials to establish efficacy within dementia care.
Suicidal ideation in family carers of people with dementia
Publisher: Informa UK Limited
Date: 10-07-2016
DOI: 10.1080/13607863.2015.1063109
Abstract: Two small studies have suggested that family carers of people with dementia may be a high-risk group for suicide. The objective of this study was to further explore the rate of suicidal ideation in a large s le of carers and identify psychosocial risk and protective factors. A cross-sectional survey was conducted with 566 family carers. The survey included measures of suicidality, self-efficacy, physical health, depression, anxiety, hopelessness, optimism, burden, coping strategies, and social support. Sixteen percent of carers had contemplated suicide more than once in the previous year. There were univariate differences between suicidal and non-suicidal carers on self-efficacy, social support, coping, burden, depression, anxiety, hopelessness, optimism, reasons for living, and symptoms of dementia, as well as age and income management. In a multivariate model, age, depression, and reasons for living predicted suicidal ideation. In tests for mediation, satisfaction with social support and dysfunctional coping had indirect effects on suicidal ideation via depression. Family carers of people with dementia have high rates of suicidal ideation, with depression a risk factor and increasing age and reasons for living as protective factors. Depression and reasons for living should be targeted in interventions to reduce suicide risk in dementia carers.
Exploring Australian dietitians' experiences and preparedness for working in residential aged care facilities
Publisher: Wiley
Date: 25-09-2023
DOI: 10.1111/JHN.13234
Consumer and Provider Perspectives on Technologies Used Within Aged Care: An Australian Qualitative Needs Assessment Survey.
Publisher: SAGE Publications
Date: 10-08-2022
DOI: 10.1177/07334648221120082
Abstract: We undertook a qualitative assessment of aged care technology needs from the perspective of consumers and providers using a cross-sectional survey that assumed a largely open-response format. We recruited a convenience s le of in iduals aged 18 years or older, lived in Australia, and self-identified as either an older adult ( n = 133), an informal caregiver of an older adult ( n = 27), and/or clinician, healthcare practitioner, and aged care provider ( n = 148). Survey responses were analyzed using a descriptive qualitative content analysis approach to interpret meaning from written survey responses. We identified seven themes reporting that technologies used in aged care do not appear to be meeting end-user needs. Supporting the Technology Acceptance Model, consumers and providers perceive usefulness of the technology and its actual ease of use as drivers of acceptance toward gerontechnology. Ten recommendations are proposed to support technology use and the quality of aged care.
The effectiveness of Swedish massage with aromatic ginger oil in treating chronic low back pain in older adults: A randomized controlled trial
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.CTIM.2013.11.002
Abstract: To investigate the effects of Swedish massage with aromatic ginger oil (SMGO) on chronic low back pain and disability in older adults compared with traditional Thai massage (TTM). Randomized controlled trial. Massage clinic in Ratchaburi province, Thailand. 164 patients were screened 140 were eligible, and randomized to either SMGO (n=70) or TTM (n=70). Trained staff provided participants with a 30-min SMGO or TTM twice a week for five weeks. The Visual Analogue Scale (VAS) assessed immediate effect (after each massage) and the short form McGill Pain Questionnaire (MPQ) assessed effectiveness of massage in short-term (six weeks) and long-term (15 weeks). Disability improvement was measured by the Owestry Disability Questionnaire (ODQ) at baseline, short- and long-term. Both SMGO and TTM led to significant improvements in pain intensity (p<0.05) and disability (p<0.05) across the period of assessments, indicating immediate, short- and long-term effectiveness. SMGO was more effective than TTM in reducing pain (p=0.04) and improving disability at short- and long-term assessments (p=0.04). These findings suggest that the integration of either SMGO or TTM therapy as additional options to provide holistic care to older people with chronic low back pain could be considered by health professionals. Further research into the use of ginger as an adjunct to massage therapy, particularly TTM, is recommended.
Seated Tai Chi versus usual activities in older people using wheelchairs: A randomized controlled trial
Publisher: Elsevier BV
Date: 02-2016
Achieving a National Sample of Nursing Homes: Balancing Probability Techniques and Practicalities
Publisher: SLACK, Inc.
Date: 03-2016
DOI: 10.3928/19404921-20151019-03
Abstract: S ling design is critical to the quality of quantitative research, yet it does not always receive appropriate attention in nursing research. The current article details how balancing probability techniques with practical considerations produced a representative s le of Australian nursing homes (NHs). Budgetary, logistical, and statistical constraints were managed by excluding some NHs (e.g., those too difficult to access) from the s ling frame a stratified, random s ling methodology yielded a final s le of 53 NHs from a population of 2,774. In testing the adequacy of representation of the study population, chi-square tests for goodness of fit generated nonsignificant results for distribution by distance from major city and type of organization. A significant result for state/territory was expected and easily corrected for by the application of weights. The current article provides recommendations for conducting high-quality, probability-based s les and stresses the importance of testing the representativeness of achieved s les. [Res Gerontol Nurs. 2016 9(2):58–65.]
Dementia and loneliness: An Australian perspective
Publisher: Wiley
Date: 03-2011
DOI: 10.1111/J.1365-2702.2010.03549.X
Abstract: Aim. To explore the perceptions of loneliness according to people with early‐stage dementia, living in community and long‐term care and also the views of their family carers. Background. Research that specifically explores the influence of loneliness on dementia is limited and indicates the prevalence of loneliness and the negative relationship between loneliness and cognitive decline. There is a paucity of research that explores loneliness from the perspective of the person with dementia. Design. A descriptive exploratory qualitative approach was used. Methods. Data were collected through semi‐structured audio‐taped interviews. A purposive s le of 70 people with a diagnosis or probable dementia and 73 family carers were recruited from community and long‐term care from South East Queensland, Australia. Results. Four themes were identified: staying connected to others losing the ability to socially engage experiencing loneliness and overcoming loneliness. The results emphasise the importance of familiar human relationships in reducing the feelings of loneliness in people experiencing dementia. Conclusions. People with dementia are at risk of loneliness, but placing them with unfamiliar people and environments may not improve their situation. Relevance to clinical practice. Better refinement of care that takes into account the potential for loneliness and an understanding of premorbid social tendency may assist in the implementation of in idualised and evidence‐based strategies to assist people with dementia to lead a better quality of life. To maintain well‐being, the social needs of the person with dementia as well as the family need to be considered.
Validity of the Compassionate Engagement and Action Scales with family carers of older adults: confirmatory factor analyses
Publisher: Cambridge University Press (CUP)
Date: 15-09-2020
DOI: 10.1017/S1041610220001738
Abstract: To confirm the factor validity of the Compassionate Engagement and Action Scales (CEAS), as set out in the original development study, when used with a s le of family carers of older adults. A series of confirmatory factor analyses were undertaken to test the previously proposed factor solutions of each scale. As part of a larger cross-sectional survey, the scales were completed online or via hard copy between July and December 2019. An international s le of 171 family carers of adults aged 65 years or older. The CEAS are three measures that in idually assess Compassion for Self, Compassion to Others, and Compassion from Others. All scales measure two aspects, “engagement” and “actions” (two-factor solution), and Compassion for Self also measures two further dimensions within engagement: “sensitivity to suffering” and “engagement with suffering” (three-factor solution). Results were largely consistent with the two-factor solutions proposed for the three orientations of compassion, with acceptable fit and good internal reliability. There was some support for the three-factor solution of Compassion for Self however, despite model fit comparable to the two-factor solution, internal reliability of the delineated “engagement” dimensions was low, and there was a weak factor loading for item 5 that measured distress tolerance. Use of the CEAS with family carers of older adults is promising. Further research is recommended with larger s les and to explore distress tolerance as a competency within conceptualization and measurement of compassion.
Impact of short duration, high-flow H2 annealing on graphene synthesis and surface morphology with high spatial resolution assessment of coverage
Publisher: Elsevier BV
Date: 12-2017
Delivering a Music Intervention in a Randomized Controlled Trial Involving Older People With Dementia: Musician Experiences and Reflections
Publisher: International Association for Music and Medicine
Date: 15-07-2010
Unstructured interviews: challenges when participants have a major depressive illness
Publisher: Wiley
Date: 08-2002
DOI: 10.1046/J.1365-2648.2002.02273.X
Abstract: There is debate about undertaking sensitive research with vulnerable populations. Primarily, the literature has focused on informed consent, confidentiality and the principle of beneficence, with little discussion about data collection methods. This paper discusses the challenges of conducting unstructured interviews when participants have a major depressive illness. Issues arose during a phenomenological study that explored the meaning of being nurtured with seven people who were hospitalized for depression. The depressive illness and treatment were found to impact on participants' articulation and recalling of their experience, and raised ethical concerns about their informed consent. Personal engagement with participants raised the ethical issue of research vs. therapy. Furthermore, participants being in a hospital complicated the necessity for privacy. The methodological issue of bracketing of assumptions was deemed to be important to 'see' the phenomenological relevance of patients' experiences. Knowledge and experience are required when conducting unstructured interviews. Debates about the challenges of unstructured interviewing needs to be highlighted in research texts to assist novice researchers. Support from an experienced research mentor would assist novice interviewers through the interview process and provide post-interview debriefing.
Assessing quality of life of older people with dementia in long‐term care: a comparison of two self‐report measures
Publisher: Wiley
Date: 18-05-2011
DOI: 10.1111/J.1365-2702.2011.03688.X
Abstract: Aims and objectives. This study sought to compare two well‐known and well‐used self‐report quality of life questionnaires in terms of completion rates, reliability and assessment of quality of life. Background. People with dementia have a meaningful experience of quality of life and several disease‐specific instruments have been designed to capture self‐report assessments. Design. A quantitative survey design, with a convenience s le of older people with dementia from four long‐term care facilities. Method. Sixty‐one participants were recruited for survey on the Dementia Quality of Life questionnaire and the Quality of Life in Alzheimer’s Disease questionnaire. Results. The Quality of Life in Alzheimer’s Disease questionnaire had a higher rate of completion (98·4%) than the Dementia Quality of Life questionnaire (68·9%). Those unable to complete the latter measure had significantly greater cognitive impairment ( F 1,59 = 30·35, p 0·001) than those completing the measure. Internal reliability was good for the Quality of Life in Alzheimer’s Disease questionnaire (0·86), but there were varying levels found for the five Dementia Quality of Life questionnaire subscales (0·79–0·48). The Quality of Life in Alzheimer’s Disease questionnaire was significantly correlated with all the Dementia Quality of Life questionnaire subscales and overall item. Conclusions. Although it is recognised that there is no superior instrument in assessing quality of life, this study found both the Quality of Life in Alzheimer’s Disease questionnaire and Dementia Quality of Life questionnaire to be useful self‐report instruments. Relevance to clinical practice. Assessment of quality of life should include the perspective of the person with dementia. The Quality of Life in Alzheimer’s Disease questionnaire and Dementia Quality of Life questionnaire appear to measure similar aspects of quality of life. Where assessments are sought from participants with more advanced cognitive and functional impairment, it may be favourable to employ the Quality of Life in Alzheimer’s Disease questionnaire.
Editorial: Quality of life: dementia and dignity
Publisher: Wiley
Date: 15-08-2010
Influencers on quality of life as reported by people living with dementia in long-term care: A descriptive exploratory approach
Publisher: Springer Science and Business Media LLC
Date: 23-04-2015
Effectiveness of a Virtual Reality Forest on People With Dementia: A Mixed Methods Pilot Study
Publisher: Oxford University Press (OUP)
Date: 15-03-2017
Abstract: To measure and describe the effectiveness of a Virtual Reality Forest (VRF) on engagement, apathy, and mood states of people with dementia, and explore the experiences of staff, people with dementia and their families. A mixed-methods study conducted between February and May 2016. Ten residents with dementia, 10 family members, and 9 care staff were recruited from 2 residential aged care facilities, operated by one care provider, located in Victoria, Australia. Residents participated in one facilitated VRF session. Residents' mood, apathy, and engagement were measured by the Observed Emotion Rating Scale, Person-Environment Apathy Rating Scale, and Types of Engagement. All participants were interviewed. Overall, the VRF was perceived by residents, family members, and staff to have a positive effect. During the VRF experience, residents experienced more pleasure (p = .008) and a greater level of alertness (p < .001). They also experienced a greater level of fear/anxiety during the forest experience than the comparative normative s le (p = .016). This initial, small-scale study represents the first to introduce the VRF activity and describe the impact on people with dementia. The VRF was perceived to have a positive effect on people with dementia, although, compared to the normative s le, a greater level of fear/anxiety during the VRF was experienced. This study suggests virtual reality may have the potential to improve quality of life, and the outcomes can be used to inform the development of future Virtual Reality activities for people with dementia.
A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter
Publisher: Informa UK Limited
Date: 03-07-2020
Physical Activity and Psychological Well-Being in Older University Office Workers: Survey Findings
Publisher: SAGE Publications
Date: 30-08-2018
Abstract: Prolonged sitting time has been reported among university workers which can have adverse health effects. The aim of this study was to examine the sitting time, physical activity, and psychological well-being reported by older university office workers. An online self-reported survey was distributed to all office workers 55 years and older at one university in Australia. Sixty-six office workers were recruited. They reported an average sitting time of 7.5 hours per day on weekdays. In all, 72.7% of the s le reported both moderate and high physical activity levels. A high percentage of the office workers reported depression (25.8%) and anxiety (12.1%). Lower education levels were significantly related to higher perceived stress and more depressive symptomatology ( p = .03 and .02, respectively). Significant associations were found between stress, depression, and anxiety ( p .001) among this group of workers.
Can lifelike baby dolls reduce symptoms of anxiety, agitation, or aggression for people with dementia in long-term care? Findings from a pilot randomised controlled trial
Publisher: Informa UK Limited
Date: 24-11-2018
Nutrition and dementia care: Informing dietetic practice
Publisher: Wiley
Date: 11-09-2015
Quality of life or ‘quality moments of life’: considering the impact of relational clowning for people living with dementia
Publisher: Informa UK Limited
Date: 02-01-2019
Asymmetric configuration of pseudocapacitive composite and rGO electrodes for enhanced capacitive deionization
Publisher: Royal Society of Chemistry (RSC)
Date: 2020
DOI: 10.1039/C9EW01033E
Abstract: Three different asymmetric electrode configurations were set up in CDI experiments. Each electrode pair's performance on salt adsorption capacity and average salt adsorption rate was investigated and compared.
Older people maintaining mental health well‐being through resilience: an appreciative inquiry study in four countries
Publisher: Wiley
Date: 17-05-2010
The Effect of Using PARO for People Living With Dementia and Chronic Pain: A Pilot Randomized Controlled Trial
Publisher: Elsevier BV
Date: 08-2007
Alzheimer's disease research progress in Australia: The Alzheimer's Association International Conference Satellite Symposium in Sydney
Publisher: Wiley
Date: 31-05-2021
DOI: 10.1002/ALZ.12380
Abstract: The Alzheimer's Association International Conference held its sixth Satellite Symposium in Sydney, Australia in 2019, highlighting the leadership of Australian researchers in advancing the understanding of and treatment developments for Alzheimer's disease (AD) and other dementias. This leadership includes the Australian Imaging, Biomarker, and Lifestyle Flagship Study of Ageing (AIBL), which has fueled the identification and development of many biomarkers and novel therapeutics. Two multimodal lifestyle intervention studies have been launched in Australia and Australian researchers have played leadership roles in other global studies in erse populations. Australian researchers have also played an instrumental role in efforts to understand mechanisms underlying vascular contributions to cognitive impairment and dementia and through the Women's Healthy Aging Project have elucidated hormonal and other factors that contribute to the increased risk of AD in women. Alleviating the behavioral and psychological symptoms of dementia has also been a strong research and clinical focus in Australia.
Exploring the effect of foot massage on agitated behaviours in older people with dementia: A pilot study
Publisher: Wiley
Date: 26-04-2011
DOI: 10.1111/J.1741-6612.2010.00504.X
Abstract: To explore the effects of foot massage on agitated behaviours in older people with dementia living in long-term care. Seventeen men and 5 women (mean age 84.7 years), with a diagnosis of dementia and a history of clinically significant agitation, received a 10-minute foot massage each day for 14 days. The short form of the Cohen-Mansfield Agitation Inventory (CMAI-SF) and the Revised Memory and Behavior Problems Checklist (RMBPC) were completed at baseline, post-test and 2-weeks follow up. CMAI-SF and RMBPC scores were significantly reduced at post-test and remained significantly lower than baseline at follow up. This study provides preliminary evidence suggesting that limited short-duration foot massage reduces agitation and related behavioural problems in people with dementia, and that these behaviour changes are maintained after the massage ceases. A randomised controlled trial is required to confirm these findings.
Feasibility study protocol of the PainChek app to assess the efficacy of a social robot intervention for people with dementia
Publisher: Wiley
Date: 26-11-2022
DOI: 10.1111/JAN.15106
Abstract: This study aims to test the feasibility of the PainChek app to assess pain for people with dementia living in residential aged care facilities (RACFs). It will also identify the optimal dosage and efficacy of a social robot (personal assistant robot [PARO]) intervention on chronic pain for people with dementia. This is a feasibility randomized controlled trial with three groups. Forty‐five residents living with dementia and chronic pain will be recruited from one RACF. The intervention consists of an in idual 15‐min non‐facilitated session with a PARO robot twice a day (Group 1), a PARO robot once a day (Group 2), or a Plush‐Toy (non‐robotic PARO) once a day (Group 3) from Monday to Friday for 4 weeks. Participants will be followed at 4 and 8 weeks after baseline assessments. The primary outcome will be the feasibility of using the PainChek app to measure changes in pain levels before and after each session. Secondary outcomes include staff‐rated pain levels, neuropsychiatric symptoms, quality of life and changes in psychotropic and analgesic medication use. Participants, staff and family perceptions of using PARO and the PainChek app will be collected after the 4‐week intervention. This study will test the use of the PainChek app and PARO to improve pain management for people with dementia. Results from this study will help determine its usefulness, feasibility and acceptability for pain management in people with dementia living in RACFs. As pain is a significant problem for people with dementia, this project will generate evidence on the use of the PainChek to measure the efficacy of a social robot intervention that has the potential to improve the quality of pain care in people with dementia. Australian and New Zealand Clinical Trials Registry number (ACTRN12621000837820) date registered 30/06/2021.
Counselling processes to address psychological distress following childbirth: Perceptions of women
Publisher: Elsevier BV
Date: 09-2004
Effectiveness of psychosocial interventions in reducing grief experienced by family carers of people with dementia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
DOI: 10.11124/JBISRIR-2016-003017
Abstract: Family carers of people living and dying with dementia experience grief. The prevalence, predictors and associated factors of grief in this population have been identified, and psychosocial interventions to decrease grief symptoms have been implemented. However, the effect of psychosocial interventions on family carers’ grief, loss or bereavement has not been examined. To synthesize the existing evidence regarding the impact of psychosocial interventions to assist adjustment to grief, pre- and post-bereavement, for family carers of people with dementia. Family carers of older persons with dementia ( years). Psychosocial interventions in health and social care facilities, and community settings designed to assist family carers adjust to grief during the dementia trajectory and/or following death. No treatment, standard care or treatment as usual, or an alternative intervention. Experimental and epidemiological study designs. Grief in family carers including anticipatory, complicated and prolonged grief disorder measured with validated instruments. A three-step strategy sought to identify both published and unpublished studies from 1995. Assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The standardized data extraction tool from JBI-MAStARI was used by two reviewers independently. Statistical pooling of results was not possible due to the heterogeneity of the interventions and the outcome measures. Data were extracted from three studies. Study designs were a randomized controlled trial a pre-test, multiple post-test quasi-experimental and a single group, repeated measures. The interventions were multi-component, had durations of nine to 26 weeks and were delivered while care recipients were alive. All studies were undertaken in the United States. There were 327 family carers, of which 197 received a psychosocial intervention. Family carers were predominantly female (84.7%), Caucasian (73.4%) and caring for their spouse (44.3%). All care recipients had dementia 68.5% had Alzheimer's disease. Two studies measured anticipatory grief, and the third study reported normal and complicated grief. Moderate benefits to anticipatory grief were evident upon completion of the “Easing the Way” intervention (effect size −0.43, P = 0.03). After controlling for research design and control variables, for every hour increase in the interventions focusing on family carers’ cognitive skills, there were associated decreases in carers’ normal grief (parameter estimate [PE] = −0.81, P = 0.02) and complicated grief (PE = −0.87, P = 0.03). For every hour increase in the interventions focusing on carer behavior, there was an associated decrease in carers’ complicated grief (PE = −1.32, P = 0.04). For every hour increase in the interventions focusing on care recipient behavior, there was an associated decrease in carers’ complicated grief (PE = −2.91, P = 0.04). There is little evidence upon which to base practice with regard to interventions to reduce any aspects of grief. Findings suggest that different pre-death interventions might be warranted depending upon a family carer's unique clinical presentation and combination of risk factors. Cognitive skills training provided while the care recipient is alive may positively impact normal and complicated grief following the death of the care recipient. When the cognitive skills training is provided in conjunction with behaviorally oriented interventions that improve the wellbeing of the carer and care recipient, carers’ complicated grief symptoms may be reduced.
Confirmatory analysis of a health state classification system for people living with dementia: a qualitative approach
Publisher: SAGE Publications
Date: 03-08-2019
Abstract: This paper aims to confirm the content validity of the domains identified during the development of the Alzheimer’s disease – five dimensions (AD-5D) algorithm for the quality of life – Alzheimer’s disease (QOL-AD) and to identify the rationale for stated quality of life preferences. Focus groups were conducted to elicit the priorities for quality of life in dementia from three perspectives: the person with dementia family caregivers and the community. Participants were recruited through industry research partners (long-term care providers) based on knowledge of their experience with dementia. Three focus groups were conducted – one each in Brisbane, Sydney and Adelaide, Australia – between November 2016 and February 2017. Each focus group included participants providing a different perspective on dementia – people with dementia ( n = 3), caregivers ( n = 9) and general community members or relatives of residents of a long-term care facility ( n = 10), although some groups contained one participant with a different perspective. The focus groups were used to validate the AD-5D domains and examine quality of life preferences across the three perspectives. Thematic analysis was used to identify the priorities underlying preference selection. All activities affecting the quality of life for people with dementia could be mapped to one of the five AD-5D domains: memory, mood, physical health, living situation and ability to do things for fun. The domains considered most important for quality of life differed between people with dementia, their caregivers and members of the community, with memory the least important domain for all three groups. The rationale for priorities also varied between groups. This study confirmed the content validity of the selection of the AD-5D domains and identified multiple differences in the reasons behind stated priorities for quality of life for people with dementia, their caregivers and community members.
Best practice for the management of older people with dementia in the acute care setting: a review of the literature
Publisher: Wiley
Date: 14-05-2008
DOI: 10.1111/J.1748-3743.2008.00114.X
Abstract: Aim. This paper reviews the theoretical and research-based literature related to the management of people with chronic confusion as a consequence of dementia in the acute care setting. Background. People aged 65 years and over are at increased risk of poor outcomes when admitted to the acute care setting as a result of comorbity and mismanagement of their chronic confusion. The challenge of caring for people with dementia in acute care is one that requires special attention. Results. The theoretical literature outlines a number of principles of care necessary for best practice in the care of people with dementia. A number of different models of care are reported in the literature and some evaluative research has been undertaken to assess the benefits of the different models. Conclusion. There are a number of interventions that if put into place in acute care may improve care of people with dementia and reduce the burden of care. There is emerging evidence that interventions such as staff education, skilled expertise, standardized care protocols and environmental modification help to meet the needs of people with dementia in acute hospital settings. This paper adds to our current understanding of management of dementia in the acute care setting, an area that demonstrates the need to move from descriptive to intervention studies to ensure evidence for care of persons with a dementing condition.
Experiences and nutrition support strategies in dementia care
Publisher: Wiley
Date: 21-02-2015
Healthy Beat Acupunch exercise program: Validation and feasibility study for older adults with reduced physical capacity or probable sarcopenia
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.EXPLORE.2020.05.010
Abstract: This research aims to validate the Healthy Beat Acupunch (HBA) exercise program, determine the feasibility of the HBA exercise program protocol and gain an understanding of the effects on well-being for older adults with sarcopenia. Design, Setting & Intervention: Validation of the HBA exercise program was conducted using two rounds of Delphi communication among eight experts. A one-group, pre-post experimental study was conducted with 17 older adults with probable sarcopenia and/or low gait speed at an Australian retirement village. The HBA exercise program lasted 40 min per session, three sessions per week for four weeks. Muscle mass, muscle strength, gait speed and health-related quality of life were assessed before and after the intervention. The HBA exercise program was evaluated via a questionnaire and in idual interviews. Experts validated the HBA exercise program and deemed it to be simple, safe, suitable and helpful for practice by older adults with sarcopenia. Participants enjoyed the HBA exercise program, planned to continue and would recommend to friends. Frequency, duration and size of the exercise class were appropriate, and they appreciated the trainer's support and directions when mastering the exercise motions. Improvement in participants' gait speed was found post-exercise intervention (p<.005). The HBA exercise program is appropriate for practice by older adults, particularly those with reduced physical capacity and probable sarcopenia with possible benefits of improved gait speed. Future studies need to consider and overcome the limitations (i.e. study design, s le size) and challenge (participant recruitment) encountered in this research.
Eutectic mixture of local anaesthetics (EMLA®) as a primary dressing on painful chronic leg ulcers: A pilot randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 07-07-2018
Recognition of the complexity facing residential care homes: a practitioner inquiry
Publisher: Cambridge University Press (CUP)
Date: 15-02-2018
DOI: 10.1017/S1463423618000105
Abstract: To explore the experiences and challenges for residential care home staff when managing the healthcare needs of their residents, in particular those living with dementia. Increasing number of older people, with complex health and social care needs are living in residential care homes. Yet there is limited appreciation of why staff sometimes struggle to manage residents’ healthcare needs, or understanding of their working relationship with district nurses (DNs), whose responsibility it is to provide nursing support. This PhD study, in a metropolitan area in the United Kingdom, was conducted by an experienced DN and involved three phases. This paper focuses on the first two phases. Phase 1 data included: semi-structured interviews ( n =8), reflective field notes based on non-participant observation, documentary analysis of policies, procedures and assessment tools and other contextual data from one care home (case study site). The practitioner researcher reflected on the findings from the case study, in relation to her own knowledge and experience as a DN, focusing in particular on findings that were familiar, or which surprised. In Phase 2 she fed these findings back to other care homes ( n =11) to check whether the findings from the single case study were unique or resonated with others. She gathered their feedback through semi-structured interviews with senior care staff ( n =14). Data were analysed using thematic data analysis. Findings highlight the complexity facing residential care homes: high levels of healthcare needs amongst residents, the demands of caring for residents living with dementia, variations in the knowledge and skill set of care staff, inequity in the level of healthcare support, the challenges of building a good relationship with DNs, and funding pressures facing care homes. Any, or all of these factors can prevent care home staff from managing the healthcare needs of their residents.
Attitudes toward dementia-related aggression among staff in Japanese aged care settings
Publisher: Wiley
Date: 12-02-2009
DOI: 10.1111/J.1365-2702.2008.02479.X
Abstract: This study investigated attitudes of Japanese aged care staff toward aggression by people with dementia. Relationships between staff attitudes, professional characteristics and clinical practice were explored. Aggressive behaviour is often demonstrated by people with dementia and may be influenced by many factors including an inability by the in idual to appropriately express their needs, difficulties with assessment, as well as organisational and practice issues. Survey. Twenty-seven facilities/organisations located in the western and middle parts of Japan were surveyed. Staff (n = 675) employed in these facilities provided personal and professional information and completed the Attitudes Towards Aggression Scale. Staff who were older, had more clinical experience, higher education and/or a higher position reported more positive attitudes towards patient aggression. Staff with negative attitudes towards patients who are aggressive reported using chemical and/or physical restraint more often than staff with positive attitudes. Dementia education as well as restraint policy will be useful in addressing negative staff attitudes, in particular it may help to reverse the myth that restraint is necessary for staff protection. Furthermore, staff counseling may help to reduce stressors and to change staff negative attitudes towards people with dementia who display aggression. The findings show that negative staff attitudes may adversely affect clinical decision making and patient care. Measuring attitudes can identify areas requiring education or skill development and enable changes in attitudes to be monitored over time.
'You've got to keep account of heads all the time': staff perceptions of caring for people with dementia
Publisher: SAGE Publications
Date: 09-2011
Abstract: Research aim: Little is known regarding the pressures of working within dementia care units, as the majority of literature has focused broadly on long-term care rather than the provision of specialised dementia care. This study aimed to explore the perceptions of staff in relation to their capacity to manage behaviour and care needs of people with dementia living within the dementia-specific environment. In idual interviews were conducted with 35 care staff from three dementia care units in Brisbane, Australia. Major findings: Four themes were identified: role definition, relationships, workplace environment, and workforce issues. Although the findings highlight the importance of peer support for staff when managing difficult situations, questions regarding the quality of peer support and its impact on care provision were raised. Conclusions: Dementia units are complex systems with well-motivated and educated staff contributing to the effectiveness of the care. An understanding of care staff, perceptions of their role and its effects on care practices can help to identify appropriate support structures and training strategies, thereby improving job satisfaction for staff and quality of life for the residents with dementia.
Engagement of a Person with Dementia Scale: Establishing Content Validity and Psychometric Properties
Publisher: Wiley
Date: 04-07-2018
DOI: 10.1111/JAN.13717
Abstract: To develop and psychometrically test the Engagement of a Person with Dementia Scale. It is important to study engagement in people with dementia when exploring the effectiveness of psychosocial interventions that can promote meaningful activity, stimulation and well-being, through an increase in positive emotions and an improvement in quality of life. The Engagement of a Person with Dementia Scale was developed based on current literature and previous research work on a video coding tool to ascertain the effect of psychosocial interventions on engagement in people with dementia. Using the Delphi technique, the content validity of the scale was evaluated by 15 dementia experts and formal/informal dementia carers. Psychometric properties of the scale were evaluated using 131 videos of people with dementia presented with PARO-a therapeutic, interactive, robotic seal-in long-term aged care facilities. A 10-item scale was established following the rewording, combining and elimination of prospective items, with revisions made to the instructions for using and scoring the scale. An overall consensus with agreement for the scale was established among the panel of experts. The scale demonstrated robust internal consistency, inter-rater and test-retest reliability and convergent and discriminant validity. This study successfully developed the Engagement of a Person with Dementia Scale, with established content validity and psychometric properties. The scale assesses the behavioural and emotional expressions and responses of engagement by people with dementia when partaking in a psychosocial activity in five areas: affective, visual, verbal, behavioural and social engagement.
The impact of early psychosocial intervention on self‐efficacy of care recipient/carer dyads living with early‐stage dementia—A mixed‐methods study
Publisher: Wiley
Date: 13-07-2018
DOI: 10.1111/JAN.13710
Abstract: To evaluate the effect of a targeted community-based psychosocial intervention on self-efficacy outcomes for care recipient/carer dyads living with early-stage dementia. There is increasing interest in the role of self-efficacy and self-management structures in determining positive outcomes for people with dementia. The assumption is that care recipient/carer dyads who receive early support to identify and adjust to dementia-related changes will cope better in the long term. An explanatory sequential mixed-method design was employed. Primarily quantitative with qualitative data providing a supportive secondary role to expand on and illuminate the quantitative findings. Eighty-eight dyads were recruited and allocated on a regional basis to an intervention or control group. Intervention group dyads received the Early Diagnosis Dyadic Intervention. Control group dyads received two information manuals. Quantitative data were collected at three time points. Qualitative data were collected via evaluation questionnaires and semistructured interviews. Intervention structure, content, and delivery were acceptable to the dyads but few quantitative self-efficacy findings reached statistical significance. Improvements in self-efficacy were evident in the postintervention evaluation qualitative responses where dyads expressed greater confidence in identifying and accessing community support. There is an urgent need for effective psychosocial interventions to help reduce the impact of dementia symptoms on patients, carers, and society. This study makes an important contribution to our understanding of the capacity of psychosocial interventions to improve self-efficacy outcomes for care recipient/carer dyads with early-stage dementia while also illustrating the challenges associated with measuring self-efficacy in the early stages of the condition.
Implementing PainChek and PARO to Support Pain Assessment and Management in Residents with Dementia: A Qualitative Study
Publisher: Elsevier BV
Date: 04-2023
Social participation and family carers of people living with dementia in Australia
Publisher: Hindawi Limited
Date: 04-12-2014
DOI: 10.1111/HSC.12163
Abstract: This paper reports on a study exploring the experiences and meaning of social participation for family carers of people living with dementia. Participants were 33 family carers (17 spouses and 16 adult children) of older adults diagnosed with dementia (any stage or type) who responded to advertisements by the national Alzheimer's association, Alzheimer's Australia. Data were collected through semi-structured face-to-face and/or telephone interviews using an interview guide, which included prompts such as 'Tell me about what social participation means to you', and 'How did this change…'. The methods of grounded theory were drawn upon to guide s ling and analysis of data, which continued until theoretical saturation was achieved and occurred over the period September 2011 to March 2012. Data arising from the interviews were analysed line-by-line and coded and categorised using the constant comparative method, with codes clustered into themes and with abstraction from the themes to arrive at the core process. The core category arising from the data was adaptation, which encompassed four main themes: autonomy to choose the impact of care-giving employing strategies and establishing meaningful connections. Carers went through a process whereby the ways in which they had previously participated socially were compromised, which often prompted an exploration of new ways in which to remain socially engaged.
Facing the challenge of adapting to a life ‘alone’ in old age: the influence of losses
Publisher: Wiley
Date: 24-04-2012
DOI: 10.1111/J.1365-2648.2012.06018.X
Abstract: The aim of this study is to explore older people's approaches to living a life characterized by losses and 'aloneness' and how this relates to loneliness. Loneliness is closely related to social status and health condition. Older people are vulnerable to experiences of loneliness due to losses, which follow the ageing process. A qualitative interpretative design was used. Older people, aged 65 and above, living at home, in retirement villages, or in long-term care settings in Australia, Norway, and UK participated. Seventy-eight persons were included. Data were collected through open-ended interviews during autumn of 2006 and spring of 2007. The interviews were audio taped, transcribed, and analysed applying a hermeneutic, interpretative process. Analyses revealed great differences in the way participants handled their life situation. Interviewees describing themselves as 'not lonely' viewed losses as normal, and they participated in meaningful activities, connected to other people and thrived in their own company. Those describing themselves as 'lonely' on the other hand, strove to create meaning in their lives, were overwhelmed by losses, had problems finding meaningful activities and difficulty keeping up social relations. Loneliness was associated with overwhelming losses, inactivity, meaninglessness, and social isolation. The contrasting findings between 'not lonely' and 'lonely' older people have implications for nursing in that nurses must seek to identify those who need help in managing their loneliness and give guidance and support. More research is needed to develop interventions that are effective in reducing loneliness.
Discipline and passion: meaning, masochism and mythology in popular medical romances.
Publisher: Wiley
Date: 12-1995
DOI: 10.1111/J.1440-1800.1995.TB00147.X
Abstract: This paper is an interpretive analysis of the discourses within popular romance literature, with a particular focus on the genre that includes constructions of the images of nurses and nursing. An historical contrast is made along with examinations of the uses and meanings encompassed within this body of literature, and its messages for women as nurses as it reflects/creates societal change. Deviations from the formulaic nature of these works are explored. Discipline and passion are the recurring themes evident throughout in juxtapositions of romance and power differentials in the hospital/medical scene. The soft-core, sado-masochistic images evident in many titles are explored in a way that raises questions about sexuality, romance, nursing mythology, and the future of this sub-genre of the popular romance.
A theoretical model of efficacy beliefs, functional status and quality of life for older people during rehabilitation: testing causal relationships
Publisher: Wiley
Date: 19-12-2012
DOI: 10.1111/JAN.12063
Abstract: Structural equation modelling tested hypothesized causal relationships between age, gender, pain, depression, self-efficacy, outcome expectations, functional status and quality of life in older Australians post-orthopaedics surgery across three stages of their rehabilitation. Self-efficacy is important in forming personal beliefs about capabilities to perform functional activities, which is believed to maintain in idual's quality of life. Research examining how efficacy beliefs influence functional status in older people following orthopaedic events is limited. A descriptive, longitudinal method was used for this study. A convenience s le of 101 older people with orthopaedic surgery to lower extremities was recruited from private rehabilitation units in Brisbane, Australia. Data were collected from September 2008-November 2009. Standardized questionnaires were used to measure efficacy beliefs, functional status, and quality of life. Structural equation modelling revealed that depression, efficacy beliefs, age, and gender significantly influenced quality of life, as self-efficacy and gender have a direct relationship on functional status. Across three stages in the model, outcome expectation at stage 2 was the most significant predictor of functional recovery after discharge. Older men with higher quality of life at admission was positively related to self-efficacy and negatively associated with depression at stage 2: quality of life influenced outcome expectations and pain positively at stage 3. Rehabilitation programmes play a significant role in assisting older people in resuming functional activities and quality of life following orthopaedic surgery. Enhancing self-efficacy may facilitate older people's participation and adherence to rehabilitation programmes during hospitalization and following discharge.
Use of complementary medicines and lifestyle approaches by people living with dementia: Exploring experiences, motivations and attitudes
Publisher: Wiley
Date: 27-06-2021
DOI: 10.1111/OPN.12378
Abstract: Lack of effective treatments for chronic conditions is associated with high rates of complementary medicine (CM) use. However, little is known about CM use for dementia. The aim of this study was to explore the experiences, motivations, and attitudes towards CM use by people living with dementia in an Australian setting. This study had a qualitative research design quantitative demographic information was also collected. In‐depth interviews were conducted with people living with dementia and their caregivers ( N = 18). A thematic (inductive) analysis approach was taken to interpret data. Three in four participants used CM for dementia, spending ~AUD$100/month (USD$70/month). Within three overarching themes, a range of sub‐themes was identified: (1) CM knowledge and use : people living with dementia and caregivers understanding of CM, types of CM used, and CM usage patterns (2) Self ‐ determined reasons for use / non ‐ use : maintain or improve quality of life, hope, management of dementia symptoms, level of awareness, willingness and evidence, perceptions on efficacy and safety of CM, experiences of conventional medicine, and holistic approach to wellness (3) External determinants of use : information on CM, relationship influences on CM use, and experiences with General Practitioners (GPs) and CM. Findings highlight that CM use is widespread and positively viewed by people living with dementia and their caregivers. Decisions regarding CM use were based on personal opinions. Findings have important implications for conversations with health professionals regarding CM use by people living with dementia to improve communication, health literacy, and reduce the risk of adverse effects through polypharmacy. This study showed that CM is a valued approach for dementia management by people living with dementia, their families, and healthcare providers. Future international research is required to evaluate the efficacy and safety of these approaches and promote accurate advice in nursing care.
Working effectively with clients who self-injure using a solution focused approach
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.IENJ.2008.05.007
Abstract: In Australia, the most common service used by self-injurers is the emergency department. Even though nurses are the key clinician available to such patients, nurses have usually received no special training to identify and address the needs of these clients. Building on the knowledge that emergency nurses feel ill-prepared, lack clear frameworks for practice and are thus vulnerable to subtle discourse tensions such as managing versus caring, and diagnosing versus understanding, an intervention was conducted and evaluated to enhance understanding and build proactive nursing skills. It was centred on a nursing philosophy known as solution focused nursing (SFN) - a model of care developed by author to orient care away from a deficit model. Deficit models tend to be reactive and centred on presenting problems. SFN is designed to move nurses' perspective towards a proactive, strengths orientation, the aim of which is to assist them to instill hope in the client and motivate him/her to take the next steps needed for change and recovery. Nurses in two Australian emergency departments completed questionnaires before and after participating in SFN training focused on working with complex clients who self-harm. A comparison group of nurses also completed questionnaires. Results indicated some benefits of the intervention there were improvements in participants' perception that nursing is strengths oriented and in nurses' satisfaction with their skills. Yet, there were no significant improvement in nurses' reports of their professional self-concept. There is merit in: broadening access to the intervention, so that more nurses in other contexts can learn a strengths model of care and apply it to their practice and extending the research to measure sustained learning outcomes and improvements to practice.
Using Salivary Cortisol as an Objective Measure of Physiological Stress in People With Dementia and Chronic Pain: A Pilot Feasibility Study
Publisher: SAGE Publications
Date: 18-06-0015
Abstract: Pain can elevate stress in people with dementia. Although salivary cortisol is used as a biomarker of stress in people with dementia, few studies have reported the feasibility of collection methods to assess salivary cortisol in nursing home residents with both dementia and chronic pain. To explore the feasibility of collecting cortisol via salivary swab as an indicator of stress in people with dementia and chronic pain. Participants ( N = 43) aged ≥ 65 years and living with dementia and chronic pain were randomly assigned to the PARO (in idual, nonfacilitated, 30-min sessions with the robotic seal PARO, 5 days per week for 6 weeks) or usual-care group using computer-generated random numbers. Salivary cortisol was collected in the early morning before the intervention (Week 0) and at the completion of the intervention (Week 6) for comparison. There were multiple challenges associated with saliva collection and analysis, including cognitive impairment of participants, ability to obtain repeated s les with saliva volume adequate for assay, and overall cost. Ultimately, adequate saliva was collected from only 8 participants (both pre- and post-intervention) for assay and quantitative analysis. Considering the multiple challenges involved in obtaining valid saliva s les in this population, salivary cortisol may not be a feasible biomarker of physiological stress in people with dementia and chronic pain.
Family carers' perspectives of managing activities of daily living and use of mHealth applications in dementia care: A qualitative study
Publisher: Wiley
Date: 03-09-2019
DOI: 10.1111/JOCN.15030
Abstract: To examine the needs, barriers and challenges experienced by family carers of people with dementia concerning the management of their care recipients' functional disabilities, and their experiences and opinions of using mobile health (mHealth) applications in health information seeking. Functional disability is a significant problem among people with dementia and management can be challenging for family carers. Evidence suggests that mHealth applications can support knowledge needs of patients and families. A qualitative descriptive exploratory study. In-depth interviews were conducted with a purposive s le of family carers using a semi-structured interview guide. An inductive thematic analysis method was used. The COREQ reporting guideline was followed. Five spousal and five child carers participated in this study. Four key themes were identified: (a) Challenges faced that contribute to psychological distress and burden (b) Essential role of support systems in dementia care (c) Information and educational needs of family carers, and (d) Experiences and attitudes of mHealth applications as an educational and supportive resource. Providing functional care is demanding, challenging and stressful, and leads to carer burden. The complexity of dementia is a barrier in the organisation of functional care and access to a support network is vital to care provision. The information needs of family carers can potentially be addressed through an mHealth application. This study provides important information on family carers' needs, and the barriers and challenges related to functional care for people with dementia. Findings from this study can assist nurses and other health professionals in the planning of educational and supportive programs for family carers. Furthermore, the use of mHealth applications could positively contribute to the delivery of these programs.
Conducting randomized controlled trials with older people with dementia in long‐term care: Challenges and lessons learnt
Publisher: Wiley
Date: 20-01-2011
Effects of non-facilitated meaningful activities for people with dementia in long-term care facilities: A systematic review
Publisher: Elsevier BV
Date: 11-2020
Care staff attitudes and experiences of working with older people with dementia
Publisher: Wiley
Date: 08-10-2010
DOI: 10.1111/J.1741-6612.2010.00470.X
Abstract: To determine care staff attitudes to dementia, assess levels of job satisfaction and explore how these attitudes and experience may relate to each other. Forty-nine staff from four long-term care facilities were surveyed using the Approaches to Dementia Questionnaire and the Staff Experience of Working with Demented Residents Questionnaire. Attitudes were positive, focusing most on 'person-centred' care (4.35) as opposed to 'hopefulness' (3.66). Job satisfaction was also good, being highest in terms of 'resident contact' (2.92) but lowest for work 'environment' (2.12). Care staff attitudes to dementia were positively correlated with job satisfaction (r= 0.366, n= 48, P= 0.011), particularly for attitudes focused on 'person-centred' care (r= 0.393, n= 48, P= 0.006). Findings suggest an important relationship between care staff attitudes and levels of job satisfaction. More work is needed to specify this relationship.
Family carers’ expectations regarding dementia care services and support in China: A qualitative study
Publisher: SAGE Publications
Date: 14-06-2022
DOI: 10.1177/14713012221106817
Abstract: In China, approximately 85% of people with dementia are cared for by family carers. However, limited research has been conducted to examine family carers’ expectations regarding what they perceive is required for optimal care. Therefore, this study aimed to explore family carers’ expectations regarding dementia care support and services in China. A qualitative study employing semi-structured interviews, with data collected from three public tertiary hospitals where the primary family carers of people with dementia ( N = 21) were recruited from May to December 2019. Purposive maximum variation s ling was used to recruit participants. Data was interpreted both inductively and deductively using thematic analysis. Four themes were identified. The family carers reported minimal support regarding dementia care, and they held little hope of receiving support. However, most carers expressed their limited expectations, such as financial support from the government and respite care services from the community. Carers believed that care was their duty, and some of them were unwilling to move their relative with dementia into a nursing home. Health and the three-tier long-term care systems in China are inadequately prepared for the challenges of dementia care, suggesting the need to develop health and social services and improve support for family carers to enable improved care for people with dementia.
Mediating Roles of Adherence Attitude and Patient Education on Antidepressant Use in Patients With Depression
Publisher: Hindawi Limited
Date: 02-06-2011
DOI: 10.1111/J.1744-6163.2010.00257.X
Abstract: The purpose of this study was to examine the roles of adherence attitude to antidepressants and patient education as mediators in mediating patients' attitudes toward antidepressant use. A s le of 201 outpatients, 50 years of age or older, with major depressive disorder, completed a drug use questionnaire, attitudes toward and patient education about antidepressants questionnaire, and Adherence Attitude Inventory. Attitudes toward antidepressants were positively associated to antidepressant use, an association explained by the mediating variable, patient education about antidepressants. Adherence attitudes to antidepressants were a mediator that accounted to a significant degree for the causal relationship between attitudes toward antidepressants and antidepressant use. Adequate patient education and an understanding of patients' adherence attitude to antidepressant use are needed in nursing practice to reduce patients' uncertainty about treatment and increase successful treatment.
Mindfulness- and compassion-based interventions for family carers of older adults: A scoping review
Publisher: Elsevier BV
Date: 04-2021
DOI: 10.1016/J.IJNURSTU.2019.103495
Abstract: To provide an overview of the current use of mindfulness- and compassion-based interventions with family carers of older adults, to aid primary healthcare practitioners in their decision-making around referral to wider healthcare services. The study was guided by four research questions: what interventions are currently used whom they are used with why they are used and their evidence-base in terms of acceptability and effectiveness. A scoping study using the methodological frameworks of Arksey and O'Malley and Levac et al. Searches of electronic databases (MEDLINE, CINHAL, PsycINFO), reference lists of relevant articles, and journal websites were conducted in June 2019. Search terms were developed via an iterative process, and included medical subject headings and keywords relating to mindfulness and compassion, interventions, and family carers. Articles were included if: written in English published in a peer-reviewed journal employed quantitative, qualitative, or mixed-method research designs and described a mindfulness- and/or compassion-based intervention for adults identified as a family carer of an older adult. Data from included studies were charted (using a purposively-designed template), and descriptively analysed in relation to the study's research questions. From 2005 unique records, 32 primary studies were included. Seven types of mindfulness- or compassion-based interventions were broadly described within studies, including: mindfulness-based stress reduction (n = 13), mindfulness-based cognitive therapy (n = 3), meditation interventions (n = 9), acceptance and commitment therapy (n = 1), dialectical behaviour therapy (n = 1), compassion-focused therapy (n = 1), and study-specific interventions involving a combination of mindfulness and/or compassion (n = 4). Studies s led a total of n = 991 participants and targeted six family carer sub-groups: dementia (n = 23), cancer (n = 5), amyotrophic lateral sclerosis (n = 1), chronic conditions (n = 1), cirrhosis (n = 1), and Parkinson's disease (n = 1). A variety of health outcomes were assessed across interventions, with the most common being depression (n = 26), anxiety (n = 15), burden (n = 15), quality of life (n = 14), and stress (n = 11). The evidence-base for each intervention was insufficient and too heterogeneous to make clear statements regarding effectiveness. However, based on these findings, interventions show some potential utility in supporting family carers in their role and, given a collective rate of attrition (18%), may do so in a way that is acceptable to carers. This scoping study highlighted the nascent use of mindfulness- and compassion-based interventions with family carers of older adults, and provided important substantive detail about what each intervention entails. Based on current evidence, a number of implications for research and practice are presented.
Self‐compassion as an applicable intervention target for family carers of older adults: A conceptual commentary
Publisher: Wiley
Date: 29-01-2020
DOI: 10.1002/GPS.5257
A qualitative 5-country comparison of the perceived impacts of COVID-19 on people living with dementia and unpaid carers
Publisher: Springer Science and Business Media LLC
Date: 11-02-2022
DOI: 10.1186/S12877-022-02821-1
Abstract: Emerging evidence shows an impact of the COVID-19 pandemic on people living with dementia and informal carers, without any evidence-based global comparison to date. The aim of this international study was to explore and compare the perceived impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries. Informal carers and people living with dementia who were residing in the community in the UK, Australia, Italy, India, and Poland were interviewed remotely between April and December 2020. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using inductive thematic analysis. Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support (2) Technology and issues accessing remote support (3) Emotional impact and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly affected people with dementia and carers across all five countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were very limited in benefit and usability for those with dementia. As a result, carers appeared to notice reduced cognitive and physical health in people with dementia. Particular differences were noted between India and Poland vs. the UK, Italy, and Australia, with less impact on care provision in the former due to limited uptake of support services pre-pandemic based on cultural settings. The pandemic has lified dementia as a global public health problem, and people affected by the condition need support to better access vital support services to live well.
'Nowadays you don't even see your neighbours': Loneliness in the everyday lives of older Australians
Publisher: Hindawi Limited
Date: 04-2010
DOI: 10.1111/J.1365-2524.2010.00923.X
Abstract: Loneliness is a pressing social issue for older people globally. Despite this, there is a paucity of studies on how older people themselves perceive loneliness and how service providers can support them. This study sought to address the gap using in-depth and semi-structured interviews with 60 older people and eight focus groups with aged care service providers in Australia in 2007. A purposive s ling strategy was employed to incorporate maximum participant variation. People 65 years and over were recruited from four large service providers in two Australian states. Our findings show that loneliness is influenced by private, relational and temporal dimensions and whether older people feel that they have, or are seen by others as having, a sense of connectedness with the wider community. Participants expressed the importance of maintaining social contact and having a sense of connection and belonging to the community. Our study highlights both the significance of gathering the views of older people to generate an understanding about loneliness and the need to recognise loneliness as a erse and complex experience, bound to the context in which it is understood and perceived and not synonymous with social isolation. Such an understanding can be used to both evaluate and improve upon programmes that address loneliness and to help maintain an integration of older people in the community.
Relationships in consumer‐directed care: An integrative literature review
Publisher: Wiley
Date: 06-07-2017
DOI: 10.1111/AJAG.12444
Abstract: To undertake an integrative review of the literature on relationships between community aged care recipients, family carers and care providers under consumer-directed care (CDC). Seven databases were systematically searched. Peer-reviewed and grey literature on CDC between 1998 and 2014 were assessed using an integrative literature review (ILR) framework. Search terms included CDC, self-directed care, direct payments, community aged care, community dwelling and older adults. Full-text copies were assessed against the inclusion criteria. Fifteen studies met the inclusion criteria. This ILR found no research with a specific focus on caregiving relationships for older adults. The literature did however identify relational issues such as support, planning and provider attitude as fundamental to the success of CDC. Relationships within the caregiving triad have important implications for the way CDC is enacted, particularly when the care recipient has dementia, suggesting this population as a priority for future research.
Using a therapeutic companion robot for dementia symptoms in long-term care: reflections from a cluster-RCT
Publisher: Informa UK Limited
Date: 28-12-2017
DOI: 10.1080/13607863.2017.1421617
Abstract: We undertook a cluster-randomised controlled trial exploring the effect of a therapeutic companion robot (PARO) compared to a look-alike plush toy and usual care on dementia symptoms of long-term care residents. Complementing the reported quantitative outcomes , this paper provides critical reflection and commentary on in idual participant responses to PARO, observed through video recordings , with a view to informing clinical practice and research. A descriptive, qualitative design with five participants selected from the PARO intervention arm of the trial. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). The five participants and their responses to PARO are presented in terms of three issues: i.) Different pre-intervention clinical presentations and different responses ii.) Same in idual, different response - the need for continual assessment and review and iii.) The ethics of giving and retrieving PARO. Implications for clinical practice and future research are discussed in relation to each issue. The findings suggest that one approach does not fit all, and that there is considerable variation in responses to PARO. A number of recommendations are discussed to aid the delivery of psychosocial interventions with PARO in practice, as well as to guide future research.
Thai nurses' beliefs about breastfeeding and postpartum practices
Publisher: Wiley
Date: 06-06-2003
DOI: 10.1046/J.1365-2702.2003.00719.X
Abstract: Cultural beliefs are important determinants of health care behaviours. Nurses have an important influence on infant feeding decisions and maternal postpartum care, but little is known about the extent to which their practice is influenced by traditional beliefs and/or recent innovations driven by evidence-based research. The aim of this study was to investigate Thai nurses' traditional beliefs about breastfeeding and related postpartum care, and their impact on nursing practice. A survey of 372 nurses working in hospitals and health services in Ubon Ratchathani, Thailand was undertaken. Questionnaire items were developed from a review of the literature and exploratory interviews with Thai women. Descriptive statistics were used to represent the incidence of particular beliefs and behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional beliefs and practices. There were discrepancies between nurses' beliefs and contemporary evidence-based practices. Many nurses supported traditional Thai postpartum practices such as food restrictions and encouraging hot baths. Some traditional beliefs supported by nurses may be detrimental to women and babies such as "lying by fire", discarding of colostrum, and giving boiled water to neonates. Only half the nurses reported that they encouraged mothers to breastfeed immediately following birth. The study was undertaken in the North-East of Thailand, where the population is known to have strong belief systems. Reliability and content validity of the tool would be enhanced through replication studies and qualitative investigations of other breastfeeding issues. There is a need for professional development strategies such as peer review and mentoring to address inadequate knowledge and outdated practices of some health professionals, as well as continuity of care models to assess quality care outcomes that are culturally appropriate.
The impact of early‐stage dementia on community‐dwelling care recipient/carer dyads’ capacity to self‐manage
Publisher: Wiley
Date: 19-09-2018
DOI: 10.1111/JOCN.14657
Abstract: To explore the impact of early-stage dementia on care recipient/carer dyads' confidence or belief in their capacity to manage the behavioural and functional changes associated with dementia and to access appropriate support networks. Living with dementia has predominantly been explored from the carer perspective and focused on the stress and burden of supporting a person with dementia. There has been a shift towards a more positive discourse to accommodate the role of self-efficacy in supporting self-management by people living with dementia. However, little has been reported on the dyadic experience of self-efficacy in managing life with dementia. A qualitative study using an interpretive descriptive approach. Semi-structured interviews were conducted with 13 dyads in the early stages of dementia. The collected data underwent a process of thematic analysis. The study followed the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Dyadic adjustment to dementia was dynamic, involving shifts between loss and adaptation. Threats to self-efficacy, declining autonomy and stigma, were significant causes of concern for both members of the dyad. Dyadic self-efficacy was demonstrated through recognition of and adaptation to dementia-related changes and development of coping strategies to integrate impairment into everyday life. Solution-focused approaches that improve knowledge and skills enable the dyad to adjust. The considerable impact of stigma on self-efficacy indicates that supportive disclosure strategies developed in mental health may also have a role to play in dementia interventions. Nurses play a significant role in advising and supporting care recipient/carer dyads with dementia, and a better understanding of the dyadic perspective provides them with essential information to support self-management. A proactive approach including information and support, offered at the beginning of the condition/care trajectory, may have the potential to delay progression into more dependent stages.
Seated T'ai Chi in Older Taiwanese People Using Wheelchairs: A Randomized Controlled Trial Investigating Mood States and Self-Efficacy
Publisher: Mary Ann Liebert Inc
Date: 12-2016
Abstract: There is growing interest in t'ai chi, but little research has addressed whether t'ai chi is effective in older people using wheelchairs for mobilization. The aim of this study was to compare the effects of seated t'ai chi exercise and usual standard activities on mood states and self-efficacy in older people living in a long-term care facility and using wheelchairs for mobilization. Randomized controlled trial (trial registration no. ACTRN12613000029796). One long-term-care facility in Taiwan. Sixty participants were randomly assigned by a computer-generated random sequence to a t'ai chi group (n = 30) or a usual exercise and entertainment activities group (n = 30). Seated t'ai chi exercise for 40 minutes three times a week for 26 weeks was provided. Mood states (Profile of Mood States Short Form [POMS-SF]) and self-efficacy (Self-Efficacy for Exercise [SEE]). At week 26, participants in the t'ai chi group reported significantly lower mood states on the fatigue-inertia dimension of the POMS-SF (mean score ± standard deviation, 3.56 ± 3.71) than did the control group (mean score, 7.16 ± 6.36) (F [1, 58] = 7.15 p < 0.05). The t'ai chi group recorded significantly higher SEE levels (mean, 35.66 ± 36.83) than did those in the control group (mean, 15.30 ± 26.43) (F [1, 58] = 6.05 p < 0.05). The findings highlight the importance of t'ai chi for a reduction in the fatigue-inertia mood state and an increase in self-efficacy for older people using wheelchairs.
Tai Chi Combined With Resistance Training for Adults Aged 50 Years and Older: A Systematic Review
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2020
DOI: 10.1519/JPT.0000000000000218
Abstract: Despite Tai Chi and resistance training being recommended as suitable exercise for older adults, there are no systematic reviews synthesizing the effectiveness of a combination of Tai Chi and resistance training on health promotion of older adults. This study aimed to review the existing literature regarding the effect of Tai Chi and resistance training on physical health, mental health, pain, health-related quality of life, and age-related impairment in adults aged 50 years and older. A systematic review was conducted to report the health outcomes of Tai Chi combined with resistance training research in adults aged 50 years and older. Articles were identified by searching PubMed, Scopus, Web of Science, CINAHL, MEDLINE, Physiotherapy Evidence Database (PEDro), and the Cochrane library using search terms representing “Tai Chi” and “resistance” and “older adults.” Quantitative experimental studies with participants aged 50 years and older, where one of the interventions was Tai Chi and resistance training, were included. The literature search yielded 648 articles from which 7 met the inclusion criteria. Collectively, the studies involved 703 participants aged 50 years and older, including healthy older adults, older adults with history of falls, postmenopausal women, and people diagnosed with end-stage hip osteoarthritis. Studies included different Tai Chi forms in combination with various types of resistance training. Training sessions were 2 to 7.5 h/wk and lasted between 12 weeks and 12 months. After long-term Tai Chi and resistance training, the participants showed significant improvement in upper and lower extremity muscle strength, aerobic endurance, balance, and mobility. However, 1 study failed to show improvement in Functional Movement Screening compared with traditional Tai Chi and nonexercise groups. No study examined the effects of Tai Chi and resistance training on health-related quality of life, fear of falling, or mental health in adults aged 50 years and older. The review supports that Tai Chi in combination with resistance training improves physical function and muscle strength in adults aged 50 years and older.
ENGAGEMENT OF A PERSON WITH DEMENTIA SCALE: ASSESSING CONTENT VALIDITY VIA THE DELPHI TECHNIQUE
Publisher: Oxford University Press (OUP)
Date: 11-2016
Authors’ response to Atee et al
Publisher: Elsevier BV
Date: 03-2021
The impact of ICT-based telecare technology on quality of life of people with dementia: Review of the literature
Publisher: IEEE
Date: 06-2013
Social robots helping people with dementia: Assessing efficacy of social robots in the nursing home environment
Publisher: IEEE
Date: 06-2013
Risk time framing for wellbeing in older people: a multi-national appreciative inquiry
Publisher: Emerald
Date: 08-01-2018
DOI: 10.1108/JMHTEP-12-2016-0060
Abstract: The purpose of this paper is to explore the experience of older people and their sense of developing wellbeing, including consideration of the strategies they employ to respond to perceived risk. An Appreciative Inquiry study was used, which collected data with 58 participants in focus group and in idual interviews. Interviews focussed on ways in which older people in South Africa, Australia, Germany and the UK understand and seek to maintain wellbeing. The changing time horizons of older people lead to perceptions of risk and concerns that embrace societal as well as in idual concerns. Often, this leads to a sense of societal responsibility and desire for social change, which is frustrated by a perceived exclusion from participation in society. In mental health practice and education, it is imperative to embrace the shift from ageist concerns (with later life viewed as risky and tragic in itself) towards a greater sensitivity for older people’s resilience, the strategies they deploy to maintain this, and their desire for more control and respect for their potential to contribute to society. Variation in time horizons leads to changes in temporal accounting, which may be under-utilised by society. Consequently, societies may not recognise and support the resilience of older people to the detriment of older people as in iduals and to the wider society.
Qualitative evaluation of a delirium prevention and management programme
Publisher: Wiley
Date: 17-04-2017
DOI: 10.1111/JOCN.13799
Abstract: To evaluate the effect of an educational programme on registered nurses' knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants' perspectives. Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses. A descriptive qualitative study was used. A delirium educational programme based on adult learning principles was provided to the participants. A purposive s le of 12 registered nurses who participated in the educational programme undertook in idual interviews. Content analysis was conducted to identify unique and common themes indicative of registered nurse perceptions. Registered nurses reported improved knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. Active learning in the programme facilitated the participants' learning processes. This active learning included deep learning, collaborative learning and application of new concepts to practice. Most participants felt that they had inadequate management support to apply their new knowledge in practice, and this included staff resource and policies and protocols. The qualitative findings indicated that the delirium education had benefited the participants by improving their knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. This study provided an understanding of the strengths and limitations of the educational programme delivered to registered nurses in South Korea. Registered nurses in South Korea should need not only appropriate education, but also adequate resources, policies and guidelines as well as support from managers and from all other healthcare professionals.
Staff perceptions of an infection control programme in long-term aged care
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1071/HI04126
'I can actually talk to them now': Qualitative results of an educational intervention for emergency nurses caring for clients who self-injure
Publisher: Wiley
Date: 07-09-2009
DOI: 10.1111/J.1365-2702.2008.02540.X
Abstract: This Australian study evaluated the effectiveness of a solution-focused education intervention in extending and improving emergency nursing responses to patients who present because of self-injury. Emergency nurses commonly report lack of training and feeling unskilled in managing people who present because of self-harm. Most educational interventions have provided content knowledge, yet rarely have they focused on conveying the value of health promotion strategies such as proactive skills and coping strategies. A mixed method pretest-posttest group design was used. Nurses (n = 36) were interviewed to examine differences in professional identity, awareness of self-injury and clinical reasoning. The qualitative results are presented in this paper and these showed improvements in knowledge and understanding of self-harm, self-belief in nurses' capacity to positively influence clients and the value of health promotion skills. The intervention produced a positive attitudinal shift towards clients and an expressed intention to act in ways that were more person-centred and change oriented. The solution-focused education intervention appears to show promise as an intervention for enabling nurses to value their unique contribution to providing a health service that is more proactive and health-promoting. Interactive education bringing psychosocial skills to technical nursing staff builds confidence, competence and more person-focused care.
In their own words: How family carers of people with dementia understand resilience
Publisher: MDPI AG
Date: 21-08-2017
DOI: 10.3390/BS7030057
Playfully engaging people living with dementia: Searching for Yum Cha moments
Publisher: Informa UK Limited
Date: 12-2013
Feeling that life is not worth living (death thoughts) among middle-aged, Australian women providing unpaid care
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.MATURITAS.2014.01.013
Abstract: To identify the proportion of female carers who experience death thoughts and the factors associated with these thoughts, using data from the Australian Longitudinal Study on Women's Health (ALSWH). A cross-sectional analysis of the fifth ALSWH survey was conducted. 10,528 middle-aged women provided data on caring and death thoughts, 3077 were carers and 2005 of those were included in the multivariate analysis. 7.1% of female carers had felt life was not worth living in the previous week and were classified as having experienced death thoughts, compared with 5.7% of non-carers (p=.01). Carers with death thoughts had poorer physical and mental health, higher levels of anxiety, lower levels of optimism, and reported less social support (p<.01). In a multivariate model social support, mental health, carer satisfaction, and depressive symptoms significantly predicted death thoughts. Carers with clinically significant depressive symptoms were four times more likely to experience death thoughts than those without. Carers who were satisfied with their role were 50% less likely to have experienced death thoughts than those who were dissatisfied. A small but significant proportion of female carers experience death thoughts and may be at risk for suicide. These findings add to the growing body of evidence on suicide-related thoughts and behaviours in carers and have implications for health professionals and service providers.
A SOCIAL ROBOT CALLED PARO AND ITS EFFECT ON PEOPLE LIVING WITH DEMENTIA
Publisher: Oxford University Press (OUP)
Date: 30-06-2017
Review on 2D MXene and graphene electrodes in capacitive deionization
Publisher: Elsevier BV
Date: 11-2022
Attitudes toward and education about complementary and alternative medicine among adult patients with depression in Taiwan
Publisher: Wiley
Date: 12-03-2010
DOI: 10.1111/J.1365-2702.2009.02848.X
Abstract: Aims. To investigate patients’ attitudes toward complementary and alternative medicine, the education nurses provided about complementary and alternative medicine for treating depression and to test whether such education mediates the effect of complementary and alternative medicine use and attitudes toward complementary and alternative medicine. Background. Although we know that attitudes influence behaviour, very few studies simultaneously explore the relationship between attitudes, education and complementary and alternative medicine use. Design. Survey. Methods. This study was conducted as part of a larger survey, using face‐to‐face survey interviews with 206 adult patients aged 50 years or over and hospitalised in conventional hospitals in Taiwan for treatment of depression. The attitudes toward complementary and alternative medicine and patient education about complementary and alternative medicine instruments were specially developed for the study. Results. Participants expressed slightly favourable attitudes toward complementary and alternative medicine. Many participants (50%) expressed that they were willing to try any potential treatment for depression. They believed that complementary and alternative medicine helped them to feel better and to live a happier life. However, 66·5% of participants reported that they had inadequate knowledge of complementary and alternative medicine. Participants with a higher monthly income, longer depression duration and religious beliefs hold more positive attitudes toward complementary and alternative medicine. Most participants were not satisfied with the education they received about complementary and alternative medicine. Patient education about complementary and alternative medicine was found to be a mediator for the use of complementary and alternative medicine. Conclusion. Patient education from nurses may predict patients’ attitudes toward complementary and alternative medicine. Continuing nursing education is needed to enable nurses to respond knowledgeably to concerns patients may have about complementary and alternative medicine and treatment options. Relevance to clinical practice. This study highlights the potential role of patient education about complementary and alternative medicine as an effective way of adjusting patients’ attitudes toward complementary and alternative medicine and to link both patients’ preferences for complementary and alternative medicine and health professionals’ concerns about the proper use of complementary and alternative medicine for depression management and adverse drug interactions.
The Partnering with Patients Model of Nursing Interventions: A First Step to a Practice Theory
Publisher: MDPI AG
Date: 24-04-2015
Suicidal ideation and resilience in family carers of people with dementia: A pilot qualitative study
Publisher: Informa UK Limited
Date: 23-04-2013
DOI: 10.1080/13607863.2013.789001
Abstract: Family carers of people with dementia have higher than average rates of depression, anxiety and hopelessness. While these are all risk factors for suicide, there has been no research on suicidal ideation in this population. The aims of this pilot study were to conduct an initial exploration of carers' experiences of suicidality and identify factors associated with risk and resilience, which could be used to guide further research. A descriptive qualitative approach was taken. In-depth interviews were conducted with nine carers of people with dementia (four male, five female) and transcripts were analysed thematically. Three themes were identified in the data - 'experiences of suicidal ideation', 'risk factors' and 'resilience'. Four of the nine participants had experienced suicidal thoughts and two had made preparations for a suicidal act. Risk factors included pre-existing mental health problems, physical health conditions, and conflict with other family or care staff. Factors positively associated with resilience included the use of positive coping strategies, faith, social support and personal characteristics. Some people contemplate suicide while caring for a family member with dementia. Further research is required to confirm the rate of suicidal ideation in the caring population and the relative contribution of factors associated with risk and resilience. In the meantime, service providers and health professionals should be taking steps to identify and support carers currently experiencing suicidal thoughts.
Strategies for tuning hierarchical porosity of 3D rGO to optimize ion electrosorption
Publisher: IOP Publishing
Date: 08-07-2019
Therapeutic use of the humanoid robot, Telenoid, with older adults: A critical interpretive synthesis review
Publisher: Informa UK Limited
Date: 28-04-2022
DOI: 10.1080/10400435.2022.2060375
Abstract: This review sought to critically evaluate the use of the teleoperated humanoid robotic communications device, Telenoid, for therapeutic purposes with older adults, and identify and highlight key considerations for future research and clinical practice within gerontechnology. A critical interpretive synthesis was conducted, with nine electronic databases and online sources searched using the keyword "Telenoid." Studies were included in the review if they were: written in English reported primary research employed a qualitative, quantitative, or mixed-method design and described or measured effects, experiences, or perceptions of using Telenoid for therapeutic purposes with older adults. Critical engagement with the studies identified key themes, as well as opportunities to advance future research. Ten studies involving Telenoid were identified, with eight focused on older adults living with dementia. Study findings centered around two themes: effects (including positive effects and negative reactions), and challenges and considerations (including technical issues, operator training, acceptability, and dosage). Although several issues currently challenge the use of Telenoid, available studies show some therapeutic potential of using Telenoid with older adults, including those living with dementia, particularly for communication and mood. Higher-quality studies are required to advance understanding, and considerations for the field are outlined to aid development.
Homicidal ideation in family carers of people with dementia
Publisher: Informa UK Limited
Date: 20-07-2016
DOI: 10.1080/13607863.2015.1065793
Abstract: Family carers of people with dementia have higher than average rates of suicidal ideation, but there has been no research on homicidal ideation in this population. The aim of this study was to explore thoughts of homicide in family carers of people with dementia. A descriptive qualitative approach was taken. Twenty-one Australian carers (7 men, 14 women) participated in in idual, in-depth interviews and the transcripts were analysed thematically. Seven themes were identified in the data - active thoughts of homicide understanding homicidal thoughts in others passive thoughts of death euthanasia homicidal thoughts in other caregiving situations abuse and disclosing thoughts of harm. Two of the 21 participants had actively contemplated the homicide of their care recipient, four expressed a passive desire for the care recipient's death, and four reported physically or verbally abusing the care recipient. Only one carer had previously disclosed these experiences. Homicidal ideation is a real and significant phenomenon among family carers of people with dementia. Service providers and health professionals are encouraged to identify and support carers contemplating homicide, but to do so in a way that recognises the broader social context of carer burden.
Family carers’ needs related to management of functional disability in dementia care and use of mHealth applications in health information seeking: An online survey
Publisher: Elsevier BV
Date: 06-2019
Reducing dementia-related aggression through a staff education intervention
Publisher: SAGE Publications
Date: 05-2007
Abstract: This article presents findings from a research study that examined the impact of a staff education programme on aggression as displayed by people with dementia living in residential aged care. The staff education programme was designed to change staff attitudes and perceptions towards their care management of the person with dementia. A simple interrupted time series, with the resident acting as his/her own comparison, was used to measure residents' aggressive behaviour both before and after the education intervention — Emotional Responses as Quality Indicators (ERIC). Forty-three residents and 85 staff were involved in the study. Staff attitudes to their work were assessed before and six weeks after the education intervention using the Attitude to Elderly Severely Mentally Infirm Care Scale. Findings indicate that people with dementia display cues about impending physical aggression, but such cues are often ignored by staff, as they may not see or understand anger as a legitimate human emotion within the context of the disease process.
Nursing Older People: Issues and Innovations
Publisher: Informa UK Limited
Date: 09-1999
Effectiveness of psychosocial interventions in reducing grief experienced by family carers of people with dementia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Care staff perceptions of a social robot called Paro and a look-alike Plush Toy
Publisher: Informa UK Limited
Date: 14-12-2018
DOI: 10.1080/13607863.2016.1262820
Abstract: Social robots such as Paro, a therapeutic companion robot, have recently been introduced into dementia care as a means to reduce behavioural and psychological symptoms of dementia. The purpose of this study was to explore care staff perceptions of Paro and a look-alike non-robotic animal, including benefits and limitations in dementia care. The study assumed a descriptive qualitative approach, nested within a large cluster-randomised controlled trial. We interviewed a subs le of 20 facility care staff, from nine long-term care facilities in Southeast Queensland, Australia. Thematic analysis of the data, which was inductive and data-driven, was undertaken with the assistance of the qualitative software, ATLAS.ti®. The findings refer to four categories: increasing excitement for Paro and decreasing enthusiasm for Plush Toy value and function of Paro opportunities for engagement and alternatives vs. robustness. Staff caring for people with dementia preferred Paro compared to a look-alike Plush Toy. Staff identified that Paro had the potential to improve quality of life for people with dementia, whereas the Plush Toy had limitations when compared to Paro. However, participants expressed concern that the cost of Paro could reduce opportunities for use within aged care.
Breastfeeding Duration in an Australian Population: The Influence of Modifiable Antenatal Factors
Publisher: SAGE Publications
Date: 02-2004
Abstract: Despite well-documented health benefits of breastfeeding for mothers and babies, most women discontinue breastfeeding before the recommended 12 months to 2 years. The purpose of this study was to assess the effect of modifiable antenatal variables on breastfeeding outcomes. A prospective, longitudinal study was conducted with 300 pregnant, Australian women. Questionnaires containing variables of interest were administered to women during their last trimester infant feeding method was assessed at 1 week and 4 months postpartum. Intended breastfeeding duration and breastfeeding self-efficacy were identified as the most significant modifiable variables predictive of breastfeeding outcomes. Mothers who intended to breastfeed for 6 months were 2.4 times as likely to have discontinued breastfeeding at 4 months compared to those who intended to breastfeed for 12 months (35.7% vs 87.5%). Similarly, mothers with high breastfeeding self-efficacy were more likely to be breastfeeding compared to mothers with low self-efficacy (79.3% vs 50.0%). J Hum Lact. 20(1):30-38.
Loneliness: An under explored concept in people with dementia
Publisher: Wiley
Date: 09-2009
Foot massage versus quiet presence on agitation and mood in people with dementia: A randomised controlled trial
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.IJNURSTU.2013.10.019
Abstract: There is increasing interest in using complementary and alternative treatments to manage behavioural and psychological symptoms of dementia such as agitation, aggression and depressed mood. To compare the effect of foot massage (intervention) and quiet presence (control) on agitation and mood in people with dementia. A randomised controlled trial using a within-subjects, crossover design. Five long-term care facilities in Brisbane, Australia. The primary outcome was the Cohen-Mansfield Agitation Inventory (CMAI) and the secondary outcome was the Observed Emotion Rating Scale (OERS). The screening and data collection research assistants, families, and care staff were blinded to participant allocation. Participants of the study were 55 long-term care residents aged 74-103 years (mean age 86.5), with moderate to severe dementia and a history of agitated behaviour according to the Pittsburgh Agitation Scale. A computer-program randomised participants to 10-min foot massage (intervention) or quiet presence (control), every weekday for 3 weeks. A carry-over effect was identified in the data, and so the data was treated as a parallel groups RCT. The mean total CMAI increased in both groups (reflecting an increase in agitation) with this increase greater in the quiet presence group than the foot massage group (p=0.03). There was a trend towards a difference on OERS General Alertness, with a positive change in alertness for participants in the foot massage group (indicating reduced alertness) and a negative change for participants in the quiet presence group (indicating increased alertness) (F(1,51)=3.88, p=0.05, partial ή(2)=0.07). The findings highlight the need for further research on the specific conditions under which massage might promote relaxation and improve mood for people with dementia. The unfamiliar research assistants and variations in usual activity may have contributed to the increase in agitation and this needs further research. ACTRN12612000658819.
Use of Antidepressants and Complementary and Alternative Medicine Among Outpatients With Depression in Taiwan
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.APNU.2008.03.004
Abstract: Understanding use of complementary and alternative medicine (CAM) and antidepressants during patient's recovery for depression is important to enhance their psychological functioning and promote positive health care outcomes. This study investigated the use of antidepressant treatment and CAM in outpatients with depression 1 month after discharge from psychiatric hospitalization. Telephone surveys were conducted. Of the 201 participants, 50.2% reported using CAM 1 month after discharge. Nearly 41% (n = 82) used a combination of both antidepressant treatment and CAM after hospital discharge. The most commonly used CAMs were spiritual healing, relaxation techniques, and herbal medicine. Symptom relief was the top reason participants used CAM for depression. A number of factors were associated with higher odds of using CAM. CAM is often considered as a valued component of holistic care plan after discharge. It is important for nurses to identify the CAM approaches patients are using so that this information can assist in the education of patients and family about the benefits of contemporary treatments for depression, possible interactions when combining treatments, and the CAM and conventional medicine that can be helpful to relieve depression symptoms and psychological distress.
Quetiapine adverse events in older adults in Australia.
Publisher: Wiley
Date: 21-07-2016
DOI: 10.1111/AJAG.12347
Abstract: To characterise quetiapine reported adverse drug events (ADEs) in older Australians in terms of type, frequency, severity and outcome, and to compare these characteristics with those of younger Australians. Basic descriptive analyses were used to examine patient characteristics. The characteristics of reported ADEs were compared between older and younger Australians using odds ratios and chi-squared tests. The most frequently reported ADEs in older people were nervous system disorders (23.7%). There were significantly more reports of skin and subcutaneous ADEs and hepatobiliary ADEs for older people than for younger people. More severe ADEs were reported in older people with death more likely to occur in older than in younger people CONCLUSION: Significant differences between older and younger people in terms of reported ADEs, severity and mortality were found. There is a need for further prospective studies in older people on quetiapine to confirm the findings of this study.
Using G oogle A dwords to recruit family carers of people with dementia
Publisher: Wiley
Date: 12-09-2013
DOI: 10.1111/AJAG.12100
Abstract: Online advertising is a new frontier in research recruitment and Google Adwords (GA) is one method of online advertising. Only a handful of studies, however, have described its cost and effectiveness and none have focused on older adults. The aim of this paper is to describe a GA c aign used to recruit family carers of people with dementia and provide insight for researchers planning to use GA to recruit other older adults. A GA c aign was used to recruit family carers of people with dementia to a cross-sectional study of wellbeing. The ads were viewed more than 450,000 times in a six-week period, but only 49 surveys were completed, at a cost of $122 per survey. GA has promise, but much remains to be understood about how to maximize its potential in ageing research. Recommendations for the design of future GA c aigns are provided.
Hope: a construct central to living with chronic obstructive pulmonary disease
Publisher: Wiley
Date: 04-11-2009
DOI: 10.1111/J.1748-3743.2009.00185.X
Abstract: Background. Hope plays an integral role in health and illness and may assist in iduals to cope in difficult and adverse circumstances, for instance when living with an illness such as chronic obstructive pulmonary disease (COPD), which can demand continuous adaptation. Aim. This paper reports the meaning of hope in people living with COPD as described by seven participants involved in a home-based pulmonary maintenance program. Methods. Using an interpretive phenomenological approach a purposive s le of seven participants were interviewed to understand participants' experiences of the phenomena of hope. An interpretative description is provided. Results. Thematic analysis revealed a number of themes, including that hope persists despite chronic illness and the unpredictable dilemmas of living with COPD. Many benefits were found to be gained from involvement in a home-based pulmonary maintenance program, including increasing exercise capacity, hope and wellbeing. Conclusion. Despite the limitations imposed by living with COPD participants revealed a determination to live as normal a life as possible. The pulmonary maintenance program was pivotal in assisting participants to improve exercise capacity, hope and wellbeing. Nurses may have a role to play in helping people with COPD maintain or regain hope.
Improving medication adherence in people with dementia through a technological design
Publisher: Wiley
Date: 11-09-2019
DOI: 10.1002/JPPR.1551
Cultural Influence on Nurses’ Pain Observations Related to Dementia: An Integrative Review
Publisher: Elsevier BV
Date: 08-2023
An exploration of mental health nursing models of care in a Queensland psychiatric hospital
Publisher: Wiley
Date: 16-01-2008
DOI: 10.1111/J.1447-0349.2007.00507.X
Abstract: This qualitative study that took place in 2006 in a publicly funded Queensland psychiatric hospital explored nursing models of care from multiple points of view. Eleven participants were interviewed. Two were post-acute consumers, three were nurse unit managers, one was an enrolled nurse, and the remaining five were registered nurses. Even though participants valued an approach that was different to a medical model, in the absence of an explicit nursing approach, the predominantly illness-care culture led nurses to resort to problem-focused care. Relying on implicit models of care created inconsistencies and precluded the nursing strategies from being systematically evaluated, revised, or extended. Various changes were identified and included the desire for further consultation and staff development so that an explicit model of care could be introduced and evaluated.
Evaluation of a Companion Robot for Individuals With Dementia: Quantitative Findings of the MARIO Project in an Irish Residential Care Setting
Publisher: SLACK, Inc.
Date: 07-2019
DOI: 10.3928/00989134-20190531-01
Abstract: The current study focuses on the short-term effect of MARIO, a social robot, on quality of life, depression, and perceived social support in persons with dementia (PWD) and evaluates their acceptability of MARIO. Ten PWD in one nursing home took part in a 4-week pilot study, where each participant had up to 12 sessions with MARIO. Sessions comprised engagement in music, news, reminiscence, games, and calendar applications. Standardized questionnaires were administered before and after the 4-week period. Participants had a sustained interest in MARIO during their interactions and an acceptance of MARIO's appearance, sound, and applications. Consequently, participants spent more time socially engaged. No statistically significant differences were found in quality of life, depression, and perceived social support. PWD can engage with a social robot in a real-world nursing home. Future research should incorporate a larger s le and longer intervention period. [ Journal of Gerontological Nursing, 45 (7), 36–45.]
Development of an mHealth application for family carers of people with dementia: A study protocol
Publisher: Elsevier BV
Date: 04-2019
Quality of life and dementia
Publisher: SAGE Publications
Date: 05-2007
Abstract: Although we know that quality of life (QOL) can greatly influence a person's well-being, the measurement of QOL in in iduals with dementia has, unfortunately, been largely ignored as a result of conceptual, logistical and measurement difficulties inherent in this population. To enable the voice of the person with dementia to be heard, a triangulated approach was adopted using survey data that aimed to assess the quality of life-Alzheimer's disease (QOL-AD) in Australian residential aged care and unstructured interviews with a small s le of participants ( n = 33). This article presents the survey results and demonstrates there were significant differences in QOL-AD scores between length of stay in the care setting groups, interpersonal relationship quality and self-esteem. Groups with greater physical impairment had lower QOL scores. It is concluded that the participants in this study were able to provide meaningful commentary on their QOL and that the findings may be useful when planning education of care staff and may contribute to theoretical models of dementia care.
The effectiveness of smart home technologies to support the health outcomes of community-dwelling older adults living with dementia: A scoping review
Publisher: Elsevier BV
Date: 09-2021
Evaluating the capabilities model of dementia care: a non-randomized controlled trial exploring resident quality of life and care staff attitudes and experiences
Publisher: Cambridge University Press (CUP)
Date: 10-03-2016
DOI: 10.1017/S1041610216000296
Abstract: This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia. A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life – Alzheimer's Disease questionnaire (QOL-AD). LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months ( p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months ( p = 0.012). Although the study has a number of limitations the CMDC appears to be an effective model of dementia care – more so than usual LTC practice. The CMDC requires further evaluation with participants from a erse range of LTC facilities and stages of cognitive impairment.
Models of mental health care for older adults: a review of the literature
Publisher: Wiley
Date: 06-2007
DOI: 10.1111/J.1748-3743.2007.00062.X
Abstract: Aim. This paper reviews literature that draws on models of mental health care for older adults. Background. It is predicted that as a consequence of the aging of the population the incidence of mental health disorders, common in older populations, will also rise. Many such disorders can be successfully managed if detected early. Assessment and management requires collaboration between health professionals who are skilled and educated in the management of older adults with mental illness and the use of models of care appropriate to this population. Results. The paucity of research in this area is demonstrated. Conclusion. The need for mental health nurses to challenge current models of mental health care for older adults is identified so that they take on an expanded and developed specialist role in care of older adults with mental illness.
Use of technology by people with dementia and informal carers during COVID‐19: A cross‐country comparison
Publisher: Wiley
Date: 25-08-2022
DOI: 10.1002/GPS.5801
Abstract: Considering the adverse outcomes of COVID‐19, it is essential to provide adequate support and care for people with dementia and informal carers. Technology can reduce the distress associated with social distancing rules and the decreased access to in‐person services. This study aimed to explore the use of technology and its perceived effects across different settings and countries. The s le was composed of 127 informal carers and 15 people with dementia from the UK, Italy, Australia and Poland. Semi‐structured interviews explored participants' experiences of using technology and their perceived effects. Transcripts were analysed by researchers in each country using an inductive approach. Three overarching themes were developed: (1) Technology kept us alive during COVID‐19 (2) Remote care was anything but easy (3) Perceived technology limitations. Many similarities emerged between countries supporting the role of technology for being socially engaged, having a routine, and staying active. However, the benefits of technology for health and psychosocial care were more limited. Across countries, barriers to the access and use of technology included lack of digital literacy, dementia severity, and lack of appropriate digital environments. Help and supervision from carers were also necessary and sometimes perceived as an additional burden. Technology can effectively reduce the shrinking world that may be lified by the pandemic, thus preserving people with dementia's social skills and maintaining family connections. However, for more extensive and well‐adapted use of technology in dementia care, actions should be taken to overcome the barriers to the access and use of technology by older and vulnerable people globally.
Evaluation of an education intervention to implement a capability model of dementia care
Publisher: SAGE Publications
Date: 19-03-2013
Abstract: This paper outlines an intervention protocol used to educate carers in a project that implemented and evaluated a capability model of dementia care (CMDC) in three long-term aged care facilities. It outlines an evaluation of the content of the education and processes used to deliver the intervention through an analysis of surveys and reflective field notes. The education protocol was designed for adult learners and grounded in the six assumptions of Knowles' learning theory. Results suggest the education protocol positively impacted on the knowledge, skills and attitudes of participants towards providing quality dementia care to residents in long-term care. The paper also acknowledges the challenges involved in sustaining a practice change through an educational intervention.
Medication Adherence in Older Patients With Dementia: A Systematic Literature Review.
Publisher: SAGE Publications
Date: 24-05-2017
Abstract: Older patients with dementia are often unable to take their medications as prescribed due to cognitive and physical impairment. To review the evidence on medication adherence in older patients with dementia in terms of the level of adherence, outcomes, contributing factors, and available interventions. A systematic literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searched databases included CINAHL, Cochrane Library, DARE, MEDLINE, and PubMed. Eighteen studies reported levels of medication adherence or discontinuation and related factors. Medication adherence ranged from 17% to 42%, and medication discontinuation before the end of treatment ranged from 37% to 80%. Nonadherence was associated with an increased risk of hospitalization or death, while increasing age, choice of medication, use of concomitant medications, and medicines’ costs were reported to decrease medication adherence. Telehealth home monitoring and treatment modification were the only interventions reported in the literature to improve medication adherence in this population. Older patients with dementia have a low level of medication adherence. Future research should focus on the development and implementation of interventions to help older patients with dementia and their caregivers make better use of medications.
Sources older people draw on to nurture, strengthen and improve self‐efficacy in managing home rehabilitation following orthopaedic surgery
Publisher: Wiley
Date: 10-2012
DOI: 10.1111/J.1365-2702.2012.04252.X
Abstract: To explore how older people maintained and improved their self-efficacy in managing home rehabilitation and their adherence to rehabilitation exercise programmes following orthopaedic surgery. Successful postoperative orthopaedic rehabilitation for older people depends on building their confidence about adherence to exercise programmes designed to improve their functional performance. Many older people, however, do not reach a satisfactory level of functional ability before discharge and some fail to adhere to their rehabilitation exercise programme at home. This contributes to a reduced quality of life. Although many studies report the influences of self-efficacy, little is known about the factors that help rebuild self-efficacy beliefs towards postdischarge exercise following orthopaedic surgery. A descriptive exploratory qualitative study. Semi-structured interviews were used with 15 older people who had returned to their homes following orthopaedic surgery. Findings emphasise the importance of social support from family, friends and community to nurture self-efficacy. Accessing personal beliefs and attitudes, adaptive strategies and goal setting were all sources and ways participants rebuilt their confidence and motivation in regard to adhering to a rehabilitation programme. Facilitating self-efficacy assists older people to manage home rehabilitation and planning care with family and friends to create a support system in early discharge planning allows a safer and smoother recovery. Rehabilitation programmes and education should encourage an understanding of self-efficacy as a means to improve in idual functional performance.
Physical Activity Participation and Psychological Wellbeing in University Office Workers in China and Australia: An Online Survey
Publisher: MDPI AG
Date: 23-11-2021
DOI: 10.3390/HEALTHCARE9121618
Abstract: Background and purpose: Physical inactivity and prolonged sitting have associations with adverse health. University office workers are at a high risk of psychological and pain issues. This study aimed to explore the differences in sitting time, levels of physical activity participation, stress, depression, anxiety, and pain among university office workers in China and Australia. Methods: Online surveys were distributed to university office workers over 55 years at two universities in China and Australia, respectively. Results: A total of 185 participants completed the online survey (119 in China and 66 in Australia). Significant differences were found in sitting time during workdays between the two countries (p 0.05) with a longer sitting time in the Australian respondents (7.5 h/day) than those in China (4.6 h/day). Additionally, there were also significant differences in terms of levels of depression and pain symptoms within the two countries (p 0.05). The Australian respondents reported high levels of depression and pain (M = 7.38, SD = 5.86 and M = 3.65, SD = 2.21, respectively) than those in China (M = 5.71, SD = 4.87 and M = 1.89, SD = 1.89, respectively). The gender, education level, and sitting time of participants were found to be associated with pain scores (p 0.05). A significant association between marital status and pain scores was found among the Australian respondents (p 0.05). Conclusions: Future studies with a larger population are needed to validate the results and to further explore the association between physical activity participation and psychological wellbeing among university office workers.
The effectiveness of nurse‐led interventions for preventing urinary tract infections in older adults in residential aged care facilities: A systematic review
Publisher: Wiley
Date: 05-02-2020
DOI: 10.1111/JOCN.15198
Abstract: To explore the effectiveness of nurse-led interventions to prevent urinary tract infections in older adults living in residential aged care facilities. While most empirical studies focus on the treatment of urinary tract infections, few studies have examined the effectiveness of nurse-led interventions in preventing urinary tract infections. Systematic review. Eight electronic databases were searched for relevant studies published between 2008-2018. The inclusion criteria were as follows: (a) a focus on older adults, (b) evaluation of nurse-led interventions, focusing on prevention of urinary tract infection, (c) implemented in residential aged care facilities, and (d) outcomes reported as incidence or prevalence of urinary tract infection. The selected papers were critically appraised using the Mixed Methods Appraisal Tool. The data were analysed with narrative synthesis, and findings were reported following the PRISMA guidelines. A review of 1,614 titles and abstracts identified four studies that met the inclusion criteria. Three types of nurse-led interventions were identified: (a) the appointment of advanced practice nurses, (b) those focused on a single specific nursing intervention, and (c) implementation of a multicomponent nursing intervention. All included studies reported at least some positive outcomes. However, the included studies were highly heterogeneous and it was impossible to determine the most effective intervention approach. Nurses are leaders in health care and are well placed to lead prevention of urinary tract infections in residential aged care however, evidence of the effectiveness of a nurse-led approach is limited. High-quality randomised controlled trials are warranted to address the knowledge gap and advance practice in this area. When developing an effective nurse-led intervention programme, the programme should be grounded in nurse-led principles and consider the complex staffing factors to ensure that nurse-led programmes are tailored to an effective level.
Assessing Engagement in People With Dementia: A New Approach to Assessment Using Video Analysis
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.APNU.2015.06.019
Abstract: The study of engagement in people with dementia is important to determine the effectiveness of interventions that aim to promote meaningful activity. However, the assessment of engagement for people with dementia in relation to our current work that uses social robots is fraught with challenges. The Video Coding - Incorporating Observed Emotion (VC-IOE) protocol that focuses on six dimensions of engagement: emotional, verbal, visual, behavioral, collective and signs of agitation was therefore developed. This paper provides an overview of the concept of engagement in dementia and outlines the development of the VC-IOE to assess engagement in people with dementia when interacting with social robots.
Interventions to build resilience in family carers of people living with dementia: a systematic review protocol
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2015
Application and student evaluation of a Clinical Progression Portfolio: A pilot
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.NEPR.2009.11.010
Abstract: Clinical practicums are often limited by a lack of meaningful communication between nursing students and registered nurses (RNs). This pilot study evaluated the utility of the Clinical Progression Portfolio (CPP) to enable students to learn how to initiate engagement with their RNs and to develop their capacity as students to learn. The study employed a descriptive survey design, with a convenience s le of second-year Bachelor of Nursing (BN) students in Brisbane, Australia. Questionnaires were completed by 129 students from 20 clinical practicum groups. Students who used the CPP were more favourable in their usefulness ratings (-rpb=0.531, p<0.001) and, furthermore, those that used the CPP most frequently were also more favourable (r=0.555, p<0.001). Students thought the CPP helped clarify learning and target appropriate practicum opportunities. When used, the CPP was an important part of practicum, used frequently and considered useful. The CPP format met the needs of students as it was pocket-sized. Overall, students reported that the CPP was a useful learning and communication tool as it provided them direction in how they might maximise opportunities to address their learning needs.
Eminent Editor
Publisher: Informa UK Limited
Date: 03-1997
Abstract: The emergence of community-based primary health care programs is considered to be one way of improving the health of the community, including the older population. While community-based programs are considered to provide worthwhile resources to a range of in iduals, regular evaluation of these services is required to ensure the services are meeting the needs of the community. This paper discusses 'The 60 and Better Program' as a means of improving the health of the older population. It is argued that as the program aims to empower the older population and to promote equity and access, the program is meeting the major principles of primary health care, and thus working towards improving and maintaining the health of the target group of the older population. It is further argued that the nurse has a major role in encouraging older members of our community to become active in programs such as "The 60 and Better Program'.
Health Professionals' Recommendations for a Dementia Plan for China.
Publisher: SAGE Publications
Date: 08-06-2022
DOI: 10.1177/07334648211022090
Abstract: There is no specific national dementia plan concerning people with dementia in China. The purpose of this study was to explore health professionals' recommendations for a dementia plan for China to meet the needs of people with dementia. Semi-structured interviews were conducted with 24 doctors and nurses using purposive maximum variation s ling. Data were interpreted inductively using thematic analysis. Four themes were identified. Themes on policy recommendations emphasized a need to support people with dementia and those who care for them, including the development of community daycare centers, specialized dementia care units in hospitals, and specialized nursing homes. Improvement in dementia care in China is needed, including services across all care settings. Programs to train and support family caregivers and help health professionals to detect, diagnose and treat dementia are crucial. Further support for the families of people with dementia is required.
‘We don’t even have Wi-Fi’: a descriptive study exploring current use and availability of communication technologies in residential aged care
Publisher: Informa UK Limited
Date: 05-12-2017
DOI: 10.1080/10376178.2017.1411203
Abstract: There has been significant growth in communication technologies. However, it is unknown to what extent RACFs accommodate such technologies. To explore the use and availability of communication technologies for use by residents within RACFs in Queensland, Australia. A descriptive, structured telephone survey. Every 10th alphabetically listed facility from a total s le of n = 462 were telephoned and staff were invited to complete the survey. Forty-one out of a total of 93 RACFs completed the survey. The telephone was by far the primary form of communication used by residents to communicate with family and friends (n = 40 97.6%). Conversely, the use of web-connection communication software (Skype or similar) was uncommon. The use and availability of communication technologies is limited within RACFs, highlighting a significant lag in the uptake within the sector.
Health Professional and Workers Attitudes Towards the Use of Social Robots for Older Adults in Long-Term Care
Publisher: Springer Science and Business Media LLC
Date: 07-12-2019
Examining dietitians' knowledge, skills and attitudes regarding working with older adults in residential aged care facilities and home care services: An integrative review
Publisher: Wiley
Date: 22-08-2022
DOI: 10.1111/JHN.13073
Abstract: The Australian 2021 Royal Commission identified that the dietetic workforce needs to grow in size and capacity to support nutrition care in older adults. However, little is known about dietitians' knowledge, skills and attitudes (KSA) regarding working with older adults in residential aged care facilities (RACFs) or their homes. This review describes dietitians' KSA regarding older adults in RACFs and home care services. A systematic literature search was conducted in August 2021 to identify studies examining any aspect of dietitians or student dietitians' KSA working in RACFs and home care services. No restrictions were applied to methodological design, language, location or publication year. Studies were assessed for quality using the Johanna Briggs Institute Quality Appraisal Tools. Study findings were analysed thematically using meta‐synthesis. All 17 studies that met the inclusion criteria explored dietitians' attitudes towards their role, three studies examined perceived knowledge, although no studies objectively explored dietitians' skill levels. Five themes were developed inductively: (1) recognising their contribution as dietitians (2) lacking clarity about the boundaries of their role (3) all team members have a role to play in nutrition care (4) assumptions and biases about working with older people and (5) needing to build capacity in the workforce. Dietitians have mixed attitudes about working in RACFs and home care services. Future directions include evaluating dietitians' role in RACFs, reviewing education and training and practical opportunities for student dietitians, and assessing the impact of more dietitian support on an older person's dietary intake and nutrition.
Informal care of older adults with chronic life-limiting illness in Africa: An integrative review
Publisher: SAGE Publications
Date: 06-04-2020
Abstract: Informal care is recognised as a significant resource in the care of older adults living with a chronic life-limiting illness. This review aims to assess the existing literature on how informal care can support older people living with chronic life-limiting illness in Africa. An integrative review framework was used. Three themes emerged to focus on chronic illness management as a social and clinical matter cultural obligations contingent on the availability of people and resources and burden of care relieved by connection with the church. Social policies should be structured to support caregivers and older adults to strengthen the ties between community social organisations and their families.
Self-Compassion, Health Outcomes, and Family Carers of Older Adults: An Integrative Review
Publisher: Informa UK Limited
Date: 07-01-2019
DOI: 10.1080/07317115.2018.1560383
Abstract: This review sought to synthesize published evidence about the role of self-compassion on health outcomes for family carers of older adults, to describe the current state of knowledge. Using an integrative review method that permitted any research design, eight databases were searched. Extensive searching of gray literature sources was also undertaken. Studies included in the review underwent processes of methodological quality assessment (Mixed Methods Appraisal Tool - Version 2011), data extraction, analysis, and syntheses. Four studies were included: two randomized controlled trials, a descriptive cross-sectional survey, and a qualitative study. There was preliminary evidence to show the potential of self-compassion to help family carers cope and reduce levels of burden. However, efficacy of self-compassion interventions to improve family carer health outcomes could not be determined. Self-compassion in family carers of older adults is a new and emerging research area, and there is very little published evidence about how self-compassion might be developed to improve health outcomes for family carers. To inform clinical understanding within this population, future quality research is needed, particularly regarding proof-of-concept, moderating effects of carer and care recipient factors, reliability of self-compassion measures, and the development and testing of self-compassion based interventions.
Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JAMDA.2017.03.018
Abstract: To test the effects of in idual, nonfacilitated sessions with PARO (version 9), when compared against a look-alike plush toy and usual care, on the emotional and behavioral symptoms of dementia for people living in long-term care facilities. Parallel, 3-group, cluster-randomized controlled trial conducted between June 14, 2014, and May 16, 2015. Twenty-eight long-term care facilities operated by 20 care organizations located in South-East Queensland, Australia. Four hundred fifteen participants aged ≥60 years, with a documented diagnosis of dementia. Stratified by private/not-for-profit status and randomized using a computer-generated sequence, 9 facilities were randomized to the PARO group (in idual, nonfacilitated, 15-minute sessions 3 times per week for 10 weeks) 10 to plush toy (same, but given PARO with robotic features disabled) and 9 to usual care. Treatment allocation was masked to assessors. Primary outcomes were changes in levels of engagement, mood states, and agitation after a 10-week intervention, assessed by coded video observations (baseline, weeks 1, 5, 10, and 15) and Cohen-Mansfield Agitation Inventory-Short Form (baseline, weeks 10 and 15). Analyses followed intention-to-treat, using repeated measures mixed effects models. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). Video data showed that participants in the PARO group were more verbally [3.61, 95% confidence interval (CI): 6.40-0.81, P = .011] and visually engaged (13.06, 95% CI: 17.05-9.06, P < .0001) than participants in plush toy. Both PARO (-3.09, 95% CI: -0.45 to -5.72, P = .022) and plush toy (-3.58, 95% CI: -1.26 to -5.91, P = .002) had significantly greater reduced neutral affect compared with usual care, whilst PARO was more effective than usual care in improving pleasure (1.12, 95% CI: 1.94-0.29, P = .008). Videos showed that PARO was more effective than usual care in improving agitation (3.33, 95% CI: 5.79-0.86, P = .008). When measured using the CMAI-SF, there was no difference between groups. Although more effective than usual care in improving mood states and agitation, PARO was only more effective than a plush toy in encouraging engagement.
The effect of massage on agitated behaviours in older people with dementia: a literature review
Publisher: Wiley
Date: 20-11-2012
DOI: 10.1111/J.1365-2702.2012.04234.X
Abstract: To review the literature on massage used to manage agitated behaviours in older people with dementia, assess its efficacy as a non-pharmacological approach and provide recommendations for future research. Agitation has traditionally been managed with chemical or physical restraint. There has been a growing interest in complementary therapies such as massage. A literature review. Cooper's five-stage model of synthesising research guided the review process. The search terms 'massage', 'agitation' and 'dementia' were defined, and 10 databases were searched in October 2011. No date limitations were applied, although searches were limited to articles written in English. For relevant records, full-text copies were obtained and assessed in terms of inclusion criteria and methodological quality using the Validity Rating Tool (VRT). Data were extracted using a form constructed with reference to the checklist of items to consider in data extraction, produced by the Cochrane Handbook for Systematic Reviews of Interventions. Thirteen studies met the inclusion criteria and were assessed on the VRT. One study was considered of adequate methodological quality to be included in the review. This prospective study found that massage significantly reduced levels of agitation in 52 cognitively impaired residents in two long-term care facilities. There is a severe paucity of research that considers the effects of massage on managing agitated behaviours in older people with dementia. Whilst conclusions cannot be drawn from the one study included in this review, it did provide evidence to support the use of massage as a non-pharmacological approach to managing agitation in older people with dementia. More research, of better methodological quality, is needed. There is a need for health practitioners to be aware of the limited evidence for massage as an intervention for agitation and to provide opportunities to validate massage practice.
The perceptions of informal carers of older people with dementia about the role of their pharmacists
Publisher: Oxford University Press (OUP)
Date: 31-07-2021
DOI: 10.1093/IJPP/RIAB040
Abstract: As medication experts, pharmacists can play a significant role in helping people living with dementia and their informal carers make the best use of medications. However, little is known about this population’s needs and expectations of their pharmacists. The objective of this study was to report informal carers’ perceptions about the role of their pharmacists. In a previous study, informal carers were interviewed to explore factors influencing medication adherence in older people living with dementia. The interview transcripts from the previous study were analysed thematically using an inductive approach to explore carers’ perceptions about the role of community pharmacists in helping carers and people living with dementia use medications as prescribed. The interviews of 20 informal carers were analysed. Carers were primarily females (85%), married (60%), completed university (60%) and unemployed (70%). The majority of care recipients had comorbidities (75%), and the number of medications ranged from 1 to 20. Three significant roles emerged: (1) provision of medication information, (2) advising on medication organisation and (3) conducting medication reviews. Informal carers face several challenges in administering the medications to older people living with dementia. Pharmacists are expected to play a more active role in helping people living with dementia, and their carers make safe and effective use of medications.
RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.JAMDA.2016.05.009
Abstract: This article has been retracted: please see Elsevier Policy on Article Withdrawal (bout/our-business olicies/article-withdrawal). This article has been retracted at the request of the Editors-in-Chief. The authors have plagiarized part of a report that had already appeared in Delamaire M-L, Lafortune G. Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries. OECD Health Working Papers No. 54. Paris: Organisation for Economic Co-operation and Development, 2010. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
Promoting value in dementia care: Staff, resident and family experience of the capabilities model of dementia care
Publisher: Informa UK Limited
Date: 07-2013
DOI: 10.1080/13607863.2012.758233
Abstract: This Australian study examined in idual experiences of the implementation of the Capabilities Model of Dementia Care (CMDC) and subsequent outcomes for the care of residents with dementia living in long-term care. Furthermore, this study aimed to explore those factors that facilitated and inhibited the implementation of the new model of care. The CMDC was developed and then tested in a non-randomised clinical trial. Staff, residents and family experiences of their involvement and perceptions of the model were captured at the end of 12 months. Semi-structured interviews and focus groups were conducted with the 25 participants (12 nursing staff, 6 residents with dementia, 7 family members). Questions varied depending on the participant group but were designed to assess experiences of and changes to care during the intervention. Inductive thematic analysis was used to identify the experiences of the implementation of the CMDC. Five themes included: general reflections on nursing care, implementation of the CMDC intervention, positive outcomes of the CMDC intervention, challenges in the implementation of the CMDC, difficulty sustaining care and tensions between participants' perspectives of care. Positive change resulted from implementation of the CMDC, however, staff mentorship was identified as a key to sustaining changes in practice.
Long‐term mechanical ventilation in a critical care unit: existing in an uneveryday world
Publisher: Wiley
Date: 22-02-2006
DOI: 10.1111/J.1365-2648.2006.03757.X
Abstract: This paper reports a study to describe and interpret the meaning of being on long-term mechanical ventilation. Patients who require mechanical ventilation in a critical care unit for prolonged periods of time are typically sicker than those who are ventilated for shorter periods. Despite advances in treatment modalities for critically ill patients, many still require long-term mechanical ventilation for 7 days or more. Therefore, caring for a long-term ventilated patient is often an everyday occurrence for critical care nurses however, there is insufficient evidence of the meaning of this experience from a patient perspective. We used an ontological phenomenological approach informed by the ideas of Heidegger. Data were collected using unstructured audio-taped interviews with nine former patients from critical care units unit in Queensland, Australia. The data were collected between January 2000 and December 2001 and analysed thematically using the method developed by van Manen. Thematic analysis revealed four themes. This paper presents the findings from the theme titled 'existing in an uneveryday world', which revealed what it meant for participants to exist, live through and survive the many physiological and psychological effects arising from their critical illness episode. For the most part, this was an unpleasant and frightening experience that involved bizarre nightmares and inability to distinguish time, place and the familiar body disagreeable effects from the technology used and patient care activities and reliance on external agents for survival. In addition, participants reported how they questioned their chances of surviving the critical illness ordeal. There is a need for further research in the areas of sedative and analgesic management in critically ill patients, methods of communicating with intubated and mechanically ventilated patients, and debriefing and follow-up support services for survivors.
Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries
Publisher: Springer Science and Business Media LLC
Date: 24-02-2018
A randomised controlled trial of the use of aromatherapy and hand massage to reduce disruptive behaviour in people with dementia
Publisher: Springer Science and Business Media LLC
Date: 10-07-2013
Abstract: Aromatherapy and hand massage therapies have been reported to have some benefit for people with dementia who display behavioural symptoms however there are a number of limitations of reported studies. The aim is to investigate the effect of aromatherapy (3% lavender oil spray) with and without hand massage on disruptive behaviour in people with dementia living in long-term care. In a single blinded randomised controlled trial 67 people with a diagnosis of dementia and a history of disruptive behaviour, from three long-term care facilities were recruited and randomised using a random number table into three groups: (1) Combination (aromatherapy and hand massage) (n = 22), (2) Aromatherapy (n = 23), (3) Placebo control (water spray) (n = 22). The intervention was given twice daily for six weeks. Data on residents’ behaviour (CMAI) and cognition (MMSE) were collected before, during and after the intervention. Despite a downward trend in behaviours displayed not one of the interventions significantly reduced disruptive behaviour. Further large-scale placebo controlled studies are required where antipsychotic medication is controlled and a comparison of the methods of application of aromatherapy are investigated. ACTRN12612000917831
The Effectiveness of EMLA as a Primary Dressing on Painful Chronic Leg Ulcers: Effects on Wound Healing and Health-Related Quality of Life
Publisher: SAGE Publications
Date: 24-08-2017
Abstract: This study aimed to evaluate the effect of EMLA 5% cream applied to painful chronic leg ulcers (CLUs) as a primary dressing on wound healing and health-related quality of life (HRQoL). A pilot, parallel-group, nonblinded, randomized controlled trial was conducted in 6 community nursing procedure clinics in New South Wales, Australia. A total of 60 participants with painful CLUs of varied etiology were randomly assigned to the intervention (EMLA daily for 4 weeks as a primary dressing, followed by usual care) or usual care only. Wound size and HRQoL were measured at baseline, end of the intervention period (week 4), and week 12. At baseline, wound sizes were similar for both the intervention and control groups. During the intervention period, there was no significant difference in wound sizes between groups (intervention group: median (cm 2 ) = 2.4, IQR = 1.3-12.7 control group: median (cm 2 ) = 5.0, IQR = 2.5-9.9 P = .05). Mean HRQoL scores for all subscales at baseline and weeks 4 and 12 were similar between groups except for Wellbeing, which was significantly higher in the intervention group at the end of the 4-week intervention period (intervention group: mean = 52.41, SD = 24.50 control group: mean = 38.15, SD = 21.25 P = .03 d = 0.62). The trial findings suggest that daily applications of EMLA as a primary dressing do not inhibit wound healing and may improve patient well-being. Studies with larger s les are required to more comprehensively evaluate the impact of this treatment on wound healing and HRQoL.
Barriers and enablers to embedding fundamental nursing care for older patients—Implications of a mixed methods study for nursing leadership
Publisher: Wiley
Date: 14-03-2022
DOI: 10.1111/JAN.15194
Abstract: To understand the enablers and barriers for delivering fundamental care to hospitalized older patients. Explanatory sequential mixed methods design, with qualitative data used to elaborate quantitative results. Set in one medical and one surgical unit of a tertiary hospital in southeast Queensland, Australia. Observations of nursing practice using the Work S ling Technique were conducted over two 2‐week periods in 2019. Data were analyzed and presented to groups of nurses who appraised the findings of the observations. There were 1176 and 1278 observations of care in the medical unit over two time periods and 1380 and 1398 observations over the same period in the surgical unit. Fundamental care activities were recorded in approximately 26% (i.e. medical) and 22% (i.e. surgical) of all observations. Indirect care was highest, recorded in 41% (i.e. medical) and 43% (i.e. surgical) of observations. Nurses prioritized the completion of reportable activities, which is perceived as a potential enabler of fundamental care. Potential barriers to fundamental care included frequent delays in indirect care and difficulty balancing care requirements across a group of patients when patients have high fundamental care needs. The cultural acceptance of missed nursing care has the potential to erode public confidence in health systems, where assistance with fundamental care is expected. Relational styles of nurse leadership should focus on: (1) making fundamental care important work in the nurses’ scope thereby offering an opportunity for organizational change, (2) promoting education, demonstrating the serious implications of missed fundamental care for older patients and (3) investigating work interruptions. Fundamental care is necessary to arrest the risk of functional decline and associated hospital‐acquired complications in older patients. However, nurses commonly report fundamental care as missed or omitted care. Understanding the challenges of implementing fundamental care can assist in the development of nurse leadership strategies to improve older patients’ care. Fundamental care was observed between 22% (i.e. surgical) and 26% (i.e. medical) of all observations. Nurses explained that they were focused on prioritizing and completing reported activities, experienced frequent delays when delivering indirect care and found balancing care requirements across groups of patients more challenging when patients had fundamental care needs. Clinical nurses working in acute health services with increasing populations of older patients can lead improvements to fundamental care provision through relational leadership styles to demonstrate how this work is in nurses’ scope of practice, promote education about the serious implications of missed fundamental care and investigate the root cause of work interruptions.
Patient experience of source isolation: Lessons for clinical practice
Publisher: Informa UK Limited
Date: 10-2011
Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is now the leading antimicrobial-resistant organism of concern to clinicians worldwide. Preventing and controlling the increase and spread of MRSA within the health-care environment is therefore an important function of the infection control team. The prevention and control of MRSA requires strict use of both Standard and Additional Precautions, which include good hand hygiene practices, judicious antimicrobial prescribing, and source isolation. While few would dispute the need for these precautions for preventing the spread of MRSA and other infections, their use may result in adverse physical and psychological effects for the patient. In an age of quality and safety of health care, ensuring infection control practice such as source isolation and contact precautions adhere to fundamental human rights is paramount. This paper presents a review of the literature on the patient experience of source isolation for MRSA or other infectious diseases. The review yielded five major interconnected themes: (1) psychological effects of isolation (2) coping with isolation (3) social isolation (4) communication and information provision and (5) physical environment and quality of care. It found that the experience of isolation by patients has both negative and positive elements. Isolation may result in detrimental psychological effects including anxiety, stress and depression, but may also result in the patient receiving less or substandard care. However, patients may also benefit from the quietness and privacy of single rooms. Nurses and other healthcare workers must look for ways to improve the experience of isolation and contact precautions of patients in source isolation. Opportunities exist in particular in improving the environment and the patient's self-control of the situation and in providing adequate information.
A randomized controlled trial exploring the effect of music on agitated behaviours and anxiety in older people with dementia
Publisher: Informa UK Limited
Date: 11-2010
Use of Complementary and Alternative Medicine among adult patients for depression in Taiwan
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.JAD.2008.03.010
Abstract: This descriptive exploratory study investigated the prevalence and type of Complementary and Alternative Medicine (CAM) use among older Taiwanese patients with a diagnosis of depression. Self-report questionnaire. A convenience s le of 206 in-patients (98% response rate) completed the survey. Nearly 70% (69.9%) reported using at least one form of CAM in the past 12 months. Twenty-one kinds of CAM were identified in the treatment of depression, the most common being herbal medicines, spiritual healing, and folk remedies. Only one-third (35.4%, n=73) had discussed CAM use with their psychiatrists. Participants with mild to moderate depression tended to use more CAM than participants with severe depression (GDS-SF: Cramer's V=-.233 HDRS: Cramer's V=.201). This study confirms the high prevalence of CAM use among older adults with a diagnosis of depression in Taiwan. The popularity of CAM appears to be a consequence of people's preference for a more holistic approach to health care. CAM use needs to be explicitly discussed between patients and health professionals as part of ongoing assessment, patient education and management.
Effectiveness of a counseling intervention after a traumatic childbirth: A randomized controlled trial
Publisher: Wiley
Date: 22-02-2005
DOI: 10.1111/J.0730-7659.2005.00340.X
Abstract: Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms. Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant. A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling. A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.
Nurses' attitudes towards clients who self-harm
Publisher: Wiley
Date: 18-11-2002
DOI: 10.1046/J.1365-2648.2002.02412.X
Abstract: Deliberate self-harm is frequently encountered by emergency department (ED) nurses. However, clients are often dissatisfied with the care provided and clinicians feel ambivalent, helpless or frustrated when working with clients who self-harm. The aim of the study was to develop and test a scale to identify relevant dimensions of ED nurses' attitudes to clients who present with self-injury. Items on Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) were drawn from a literature review and focus group discussions with ED nurses. The tool was piloted with 20 ED nurses not working in the target agencies. A survey of nurses working within 23 major public and 14 major private EDs in Queensland, Australia (n = 1008) was then undertaken. A total of 352 questionnaires were returned (35% response). Analysis revealed four factors that reflected nurses' attitudes toward these clients. The factors related to nurses' perceived confidence in their assessment and referral skills ability to deal effectively with clients, empathic approach and ability to cope effectively with legal and hospital regulations that guide practice. There was a generally negative attitude towards clients who self-harm. Correlations were found between years of ED experience and total score on the ADSHQ, and years of ED experience and an empathic approach towards clients who deliberately self-harm. There is a need for continuing professional development activities to address negative attitudes and provide practical strategies to inform practice and clinical protocols.
Perceived Usability and Acceptability of Videoconferencing for Delivering Community-Based Rehabilitation to Individuals with Acquired Brain Injury: A Qualitative Investigation
Publisher: Cambridge University Press (CUP)
Date: 2020
DOI: 10.1017/S135561771900078X
Abstract: There is limited research on the use of telerehabilitation platforms in service delivery for people with acquired brain injury (ABI), especially technologies that support delivery of services into the home. This qualitative study aimed to explore the perspectives of rehabilitation coordinators, in iduals with ABI, and family caregivers on the usability and acceptability of videoconferencing (VC) in community-based rehabilitation. Participants’ experiences and perceptions of telerehabilitation and their impressions of a particular VC system were investigated. Guided by a theory on technology acceptance, semi-structured interviews were conducted with 30 participants from a community-based ABI service, including 13 multidisciplinary rehabilitation coordinators, 9 in iduals with ABI, and 8 family caregivers. During the interview, they were shown a paper prototype of a telehealth portal for VC that was available for use. Interview transcripts were coded by two researchers and analysed thematically. The VC was used on average for 2% of client consultations. Four major themes depicted factors influencing the uptake of VC platforms namely, the context or impetus for use, perceived benefits, potential problems and parameters around use, and balancing the service and user needs. Participants identified beneficial uses of VC in service delivery and strategies for promoting a positive user experience. Perceptions of the usability of VC to provide services in the home were largely positive however, consideration of use on a case-by-case basis and a trial implementation was recommended to enhance successful uptake into service delivery.
Self-Care Strategies Used by Taiwanese Adolescents for the Management of Dysmenorrhea
Publisher: Elsevier BV
Date: 04-2009
Topical analgesic and local anesthetic agents for pain associated with chronic leg ulcers: A systematic review
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2020
Assessing quality of life of older people with dementia: a comparison of quantitative self‐report and proxy accounts
Publisher: Wiley
Date: 28-12-2011
DOI: 10.1111/J.1365-2648.2011.05912.X
Abstract: This article reports on a study of quality of life of older people with dementia, as assessed by the person with dementia, family carer and care staff. People with dementia can give meaningful assessments of their quality of life, but these often differ from proxy ratings. In understanding this discrepancy, the influence of age, extent of cognitive impairment and activity limitation has been investigated. A lack of conclusive associations between quality of life ratings and these variables indicates a need for further research. Fifty-eight triads comprising the person with dementia, family carer and member of care staff from four long-term care facilities were surveyed on the quality of life-Alzheimer's Disease questionnaire between August and December 2007. There was an important difference in the quality of life-Alzheimer's disease questionnaire total mean scores between groups, with the person with dementia providing the highest ratings. Level of impairment in activities of daily living had an important effect on quality of life ratings, with proxies, particularly care staff, providing lower ratings when there was greater activity limitation. This was not replicated for assessments made by the person with dementia. Age or level of cognitive impairment did not influence any ratings. People with dementia can give assessments of their quality of life. However, discrepancy in ratings, with greater activity limitation affecting proxy ratings but not those made by the person with dementia, indicates the importance of including both self-report and proxy measures in research and care planning.
A randomized controlled trial of coenzyme Q10 for fatigue in the late-onset sequelae of poliomyelitis.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.CTIM.2015.09.002
Abstract: To determine if coenzyme Q(10) alleviates fatigue in the late-onset sequelae of poliomyelitis. Parallel-group, randomized, placebo-controlled trial. Coenzyme Q(10) has been shown to boost muscle energy metabolism in post-polio subjects but it does not promote muscle strength, endurance or function in polio survivors with post-poliomyelitis syndrome. However, the collective increased energy metabolism might contribute to a reduction in post-polio fatigue. Polio survivors from the Australian post-polio networks in Queensland and New South Wales who attribute a moderate to high level of fatigue to their diagnosed late-onset sequelae of poliomyelitis. Those with fatigue-associated comorbidities of diabetes, anaemia, hypothyroidism and fibromyalgia were excluded. Participants were assigned (1:1), with stratification of those who use energy-saving mobility aids, to receive 100 mg coenzyme Q(10) or matching placebo daily for 60 days. Participants and investigators were blinded to group allocation. Fatigue was assessed by the Multidimensional Assessment of Fatigue as the primary outcome and the Fatigue Severity Scale as secondary outcome. Of 103 participants, 54 were assigned to receive coenzyme Q(10) and 49 to receive the placebo. The difference in the mean score reductions between the two groups was not statistically significant for either fatigue measure. Oral supplementation with coenzyme Q(10) was safe and well-tolerated. A daily dose of 100 mg coenzyme Q(10) for 60 days does not alleviate the fatigue of the late-onset sequelae of poliomyelitis. The registration number for the clinical trial is ACTRN 12612000552886.
Solution focused nursing: An evaluation of current practice
Publisher: Elsevier BV
Date: 07-2006
DOI: 10.1016/J.NEDT.2005.12.004
Abstract: This Australian study explored the extent to which solution focused nursing (SFN), a new philosophy of care underpinning a Bachelor of Nursing Programme, was understood by students and staff. Students and faculty perceptions of teaching and learning were explored using survey and semi-structured interview methods. The results showed that students did not have strong views about whether solutions or problems contribute best to a definition of nursing knowledge, but there were some differences between the year groups. This was hypothesised to be related to the way SFN is or is not being taught. Teachers were generally positive about SFN but perceived that they needed more education on the philosophy to ensure it could be translated into their teaching. A teaching and learning package is recommended to be produced and made available to all teachers within the program.
Challenges to implementing an evidence‐based partnership model in an Australian residential care setting
Publisher: Wiley
Date: 09-2009
A cross-sectional examination of the prevalence of psychotropic medications for people living with dementia in Australian long-term care facilities: Issues of concern
Publisher: Cambridge University Press (CUP)
Date: 04-12-2018
DOI: 10.1017/S1041610217002447
Abstract: Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored. There have previously been no studies with nationally representative s les to investigate psychotropic administration in LTCs in Australia. This study determines the prevalence of psychotropic administration in a representative stratified random s le of 446 residents living with dementia from 53 Australian LTCs. Questionnaire and medical chart data in this study is drawn from a larger cross-sectional, mixed methods study on quality of life in Australian LTCs. It was found that 257 (58%) residents were prescribed psychotropic medications including: antipsychotics ( n = 160, 36%), benzodiazepines ( n = 136, 31%), antidepressants ( n = 117, 26%), and anti-dementia medications ( n = 9, 2%). BPSD were found to be very common in the s le, with 82% ( n = 364) of participants experiencing at least one BPSD. The most prevalent BPSD were depression ( n = 286, 70%) and agitation ( n = 299, 67%). Although detailed background information was not collected on in idual cases, the prevalence found is indicative of systematic industry-wide, over-prescription of psychotropic medications as a first-line treatment for BPSD. This study highlights a clear need for further research and interventions in this area.
The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial
Publisher: Springer Science and Business Media LLC
Date: 18-02-2013
Recommendations for staff education and training for older people with mental illness in long-term aged care
Publisher: Cambridge University Press (CUP)
Date: 15-09-2010
DOI: 10.1017/S1041610210001754
Abstract: Background: This paper was written as a result of the International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care. The appraisal presented here aims to (1) identify the best available evidence that underpins best practice for geriatric mental health education and training of staff working in long-term care, and (2) summarize the appraisal of the literature to provide recommendations for practice. Methods: An initial search of databases found 138 papers related to the search strategy. Selected papers were summarized and compared against set inclusion criteria. This resulted in 17 papers suitable for review. Results: The majority of papers focused on behavior skills training. A number of key factors were identified that determine the success of geriatric mental health education and training and recommendations are outlined. Conclusions: Methodological weaknesses are common and highlight the need for further replication studies using strong research designs.
Technology in aged care
Publisher: Informa UK Limited
Date: 03-08-2023
Development of a music intervention protocol and its effect on participant engagement: Experiences from a randomised controlled trial with older people with dementia
Publisher: Informa UK Limited
Date: 09-2010
The effect of music on quality of life and depression in older people with dementia: A randomized control trial
Publisher: Wiley
Date: 09-2009
Physical Activity, Health-Related Quality of Life, and Stress among the Chinese Adult Population during the COVID-19 Pandemic
Publisher: MDPI AG
Date: 07-09-2020
Abstract: The COVID-19 pandemic poses a threat to global public health due to home confinement policies impacting on physical activity engagement and overall health. This study aimed to explore physical activity participation, health-related quality of life (HRQoL), and levels of perceived stress among Chinese adults during the COVID-19 pandemic. An online survey was conducted between 25 February and 15 March 2020. A total of 645 surveys were completed. Participants reported increased sedentary time from pre-COVID-19 period to the COVID-19 pandemic period (p 0.05). Over 80% of the s le engaged in either low or moderate intensity physical activity. Participants’ average physical component summary score (PCS) and mental component summary score (MCS) for HRQoL were 75.3 (SD = 16.6) and 66.6 (SD = 19.3), respectively. More than half of participants (53.0%) reported moderate levels of stress. Significant correlations between physical activity participation, HRQoL, and levels of perceived stress were observed (p 0.05). Prolonged sitting time was also found to have a negative effect on HRQoL (p 0.05). During such periods of home confinement, public health strategies aimed at educating Chinese adults to enhance home-based physical activity may be necessary to maintain health on a population level.
The promise of technology in the future of dementia care
Publisher: Springer Science and Business Media LLC
Date: 09-05-2019
DOI: 10.1038/S41582-019-0188-Y
Abstract: Dementia is a leading cause of disability, and the prevalence of dementia is steadily increasing. Although people with dementia are living longer lives in the community, without adequate support for their declining physical and psychological needs, the majority of these in iduals end up in nursing homes. With no cure in sight, and in the context of population ageing, we must consider how to care for these in iduals in the future. Technologies that augment existing care can maintain a person comfortably in their community, maximize in idual autonomy and promote social participation. However, to date, such technologies have rarely been used in dementia care. This Perspectives article highlights the need for affordable and appropriate technologies to assist future dementia care, outlines some of the technologies currently available and describes the many challenges to integration of such technologies. Finally, guidelines are suggested for the development and implementation of new technologies in dementia care.
Quetiapine safety in older adults: a systematic literature review.
Publisher: Hindawi Limited
Date: 27-01-2016
DOI: 10.1111/JCPT.12357
Abstract: Quetiapine is a second-generation antipsychotic that is commonly prescribed for a range of approved and off-label indications in older adults. However, little is known about its safety in this population. The available evidence on quetiapine safety is based on studies on second-generation antipsychotics as a group, often in the general population and for approved indications. There are no systematic reviews on the safety of quetiapine in older adults, and therefore, there is a need for systematically assessing quetiapine safety in this group of patients to establish an appropriate safety profile for this vulnerable population. The aim of this paper was to review and describe adverse drug events associated with quetiapine use in older adults. A systematic literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched were CINAHL, PubMed, Medline, PsycInfo and the Cochrane Library. Sixty-nine papers met the inclusion criteria. The majority of the studies (n = 36, 52%) were observational, and 11 (16%) were randomized controlled trials (RCTs). Most of the reported indications (75%) were off-label. The most commonly reported adverse events were somnolence (25-39%), dizziness (15-27%), headache (10-23%), postural hypotension (6-18%) and weight gain (11-30%). From the included RCTs, comparing quetiapine with placebo, quetiapine resulted in significantly greater cognitive impairment, higher rates of falls and injury and increased mortality in patients with parkinsonism, but not in patients with dementia. Compared with risperidone and olanzapine, quetiapine had significantly lower risk of mortality, reduced rate of cerebrovascular events, increased rate of falls and injury and less metabolic disorders compared with olanzapine, but higher metabolic disorders compared with risperidone. This work provides full characterization of quetiapine safety in older people, which may help healthcare providers better anticipate, prevent and manage ADEs in this population.
Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-046600
Abstract: There are personal and societal benefits from caregiving however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge. A multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements. Participants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences. ACTRN12620000060943.
Family Involvement in Pain Management for People Living With Dementia: An Integrative Review
Publisher: SAGE Publications
Date: 27-07-2023
DOI: 10.1177/10748407221114502
Abstract: This review aimed to synthesize current evidence on family involvement in pain management for people living with dementia from the perceptions of family carers and health care professionals. An integrative review was conducted using CINAHL, Embase, PubMed, PsycINFO and Cochrane Library electronic databases. The Mixed Methods Appraisal Tool was used to appraise the articles, followed by thematic analysis. Twelve studies were included and four themes were identified: (1) The roles and responsibilities of family carers (2) Enablers and barriers for pain identification (3) Strategies and concerns for pain management and (4) Lack of staff education and communication with health care providers. Family carers play an important role in pain assessment and management for people living with dementia, but they cannot be actively involved in this process due to a lack of communication with health care providers. An integrated approach that includes education and communication with family carers and health care providers is needed.
The Role of Self-Compassion, Dispositional Mindfulness, and Emotion Regulation in the Psychological Health of Family Carers of Older Adults
Publisher: Informa UK Limited
Date: 02-12-2020
Exploring the Effect of Companion Robots on Emotional Expression in Older Adults with Dementia: A Pilot Randomized Controlled Trial
Publisher: SLACK, Inc.
Date: 05-2013
DOI: 10.3928/00989134-20130313-03
Abstract: This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia however, the need for a larger trial was identified.
Traditional postpartum practices among Thai women
Publisher: Wiley
Date: 02-2003
DOI: 10.1046/J.1365-2648.2003.02534.X
Abstract: Culture is often related to notions of well-being, illness, healing and health that inform in iduals in their day-to-day activities. The postpartum period is noted for traditional practices related to rest, healing and the consumption of food and drinks, but a contemporary view of these practices is needed. To gain an understanding of the traditional practices that Thai women follow in relation to postpartum care and the rationales underpinning such practices. This descriptive study surveyed 500 Thai women living in Ubon Ratchathani, Thailand and attending their first postpartum hospital clinic appointment. A self-completion questionnaire was specially developed and pilot tested, and then administered to women attending the clinic. Descriptive statistics were used in relation to the incidence of particular behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional practices. The majority of Thai women adhered to traditional postpartum practices related to the notion of regaining 'heat'. These included 'lying by fire', food restrictions, taking hot baths and consuming hot drinks. Other activities involved not exposing the body to heat loss by keeping covered, not sh ooing the hair, avoiding the wind and sexual abstinence. Younger, less educated, primiparous women were more likely to report traditional practices. Mothers and mothers-in-law were most influential in recommending these behaviours. Traditional postpartum practices are still dominant in contemporary Thai culture and are perpetuated by close female family relatives. Health professionals need to be aware of clients' culture and consider the extent to which professional care complements the mothers' traditional beliefs. Nurses need to educate women about the benefits of contemporary postpartum care and to provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.
What effect does an animal robot called CuDDler have on the engagement and emotional response of older people with Dementia?
Publisher: Springer Science and Business Media LLC
Date: 24-10-2016
South Korean Family Caregiver Involvement in Delirium Care: A Qualitative Descriptive Study
Publisher: SLACK, Inc.
Date: 12-2017
DOI: 10.3928/00989134-20170707-03
Abstract: The current study aimed to describe the effect of an educational program on RN-initiated efforts to involve family caregivers in delirium care. A descriptive qualitative study was performed. A purposive s le of 12 RNs who participated in a one group, pre–post evaluation of a delirium educational program, and a nominated s le of six family caregivers of patients who had been cared for by RNs in the program participated in in idual, in-depth interviews. The qualitative findings indicated that the inclusion of a delirium brochure in ward orientation on admission, with reinforcement during shift changes, and RN-initiated engagement with family caregivers promoted family caregiver involvement in delirium prevention. Further studies in South Korea are needed to determine which family-centered nursing care interventions are culturally appropriate and most effective for RNs and family caregivers in delirium care. [ Journal of Gerontological Nursing, 43 (12), 44–51.]
Dementia and its influence on quality of life and what it means to be valued: Family members’ perceptions
Publisher: SAGE Publications
Date: 14-02-2013
Abstract: This pragmatic, exploratory qualitative study, as part of a larger funded research project, sought to explore families’ perspectives on what it means to value a person with dementia and how this value might influence the quality of life of people with dementia. In-depth interviews were conducted with 20 family members who used one long-term care service provider in Australia. Families described the factors influencing a positive quality of life for the person with dementia as being related to the environment and, in particular, to the resident’s room, supportive staff and in idualised care that valued the person’s life experience. Family also reported a negative impact on quality of life when staff and the care facility neglected to provide an in idualised approach. This study highlights the importance of demonstrating the value of the person with dementia, the family role and partnerships of care.
Foot massage and physiological stress in people with dementia: A randomized controlled trial
Publisher: Mary Ann Liebert Inc
Date: 04-2014
Interventions to build resilience in family caregivers of people living with dementia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
The Relationship between Social Support for Physical Activity and Physical Activity across Nine Years in Adults Aged 60–65 Years at Baseline
Publisher: MDPI AG
Date: 03-03-2023
Abstract: Physical activity is consistently recognized as a key component of healthy aging. The current study aimed to investigate the prospective association between social support specific for physical activity (SSPA) and physical activity across nine years among adults aged 60–65 years at baseline (n = 1984). An observational longitudinal design was used, with mail surveys administered to a population-based s le across four waves. SSPA was measured using a score ranging from 5–25, and physical activity was assessed as time spent in walking, or engaging in moderate and vigorous activity, during the previous week. Data were analyzed using linear mixed-effects models. The results demonstrated a positive significant relationship between SSPA and physical activity, accounting for sociodemographic and health variables. Each unit of increase in SSPA was associated with 11 extra minutes of physical activity per week (p 0.001). There was a significant interaction between SSPA and wave at the final timepoint, such that the relationship was weaker (p = 0.017). The results highlight the value of even small increases in SSPA. SSPA could be targeted to promote physical activity among older adults, but may be more impactful in young-old adults. More research is needed to understand impactful sources of SSPA, underlying mechanisms between SSPA and physical activity, and potential moderation by age.
Are Gerontological Nurses Ready for the Expression of Sexuality by Individuals With Dementia?
Publisher: SLACK, Inc.
Date: 05-2018
Portable EEG monitoring for older adults with dementia and chronic pain - A feasibility study
Publisher: Elsevier BV
Date: 2021
Supporting autonomy of nursing home residents with dementia in the informed consent process
Publisher: SAGE Publications
Date: 07-03-2018
Abstract: In studies involving people with dementia, researchers have historically defaulted to seeking consent from a proxy, the assumption being that people with dementia are unable to provide their own informed consent. This choice denies people with dementia a voice in the consent process, thus disregarding their autonomy and agency. Recently, other options for improving the consent process have been explored. This study aimed to determine whether nursing home residents with dementia could demonstrate an ability to provide their own informed consent as determined by the Evaluation to Sign Consent instrument. As part of a larger study on the quality of life of nursing home residents, the Evaluation to Sign Consent was administered to 392 people diagnosed with dementia. Data on demographic variables, such as gender and age, as well as level of cognitive impairment, were also collected. Just over one-fifth (22%) of the residents with dementia were judged as having the capacity to provide their own informed consent to participate in this specific research project. Consistent with existing literature, capacity to consent was significantly, and negatively, associated with cognitive impairment. This study demonstrates that assuming all people diagnosed with dementia are unable to provide informed consent for research on the basis of cognitive test scores, or on clinical assessment alone, potentially denies them the autonomy to make a decision that they may be capable of making. Research involving people with mild-to-moderate dementia needs to consider evaluating whether potential participants have the capacity to provide their own consent.
Effect of an interactive therapeutic robotic animal on engagement, mood states, agitation and psychotropic drug use in people with dementia: a cluster-randomised controlled trial protocol: Table 1
Publisher: BMJ
Date: 08-2015
‘They rush you and push you too much … and you can't really get any good response off them’: A qualitative examination of family involvement in care of people with dementia in acute care
Publisher: Wiley
Date: 28-10-2015
DOI: 10.1111/AJAG.12251
Abstract: To explore the role and needs of the family carer across different acute care contexts and their level of involvement in the care of their relative with dementia in this setting. A pragmatic, exploratory-descriptive qualitative approach. A convenience s le of 30 family carers across three sites completed semi-structured interviews. Family carers wanted to be involved in the acute care of their family member with dementia. They acknowledged the importance of a central source of information, educated staff, guidelines on roles and processes, and positive communication, as well as respect from staff for the carer's knowledge of the older person and their needs. They also highlighted the need for medical staff to discuss with them the family member's treatment and care. There is a need for family-focused interventions to improve communication and involvement of family in the care of family members with dementia in the acute setting.
Pre Congress Programs
Publisher: Cambridge University Press (CUP)
Date: 12-2015
DOI: 10.1017/S1041610215002173
Abstract: Imaging is increasingly being used by clinicians to enhance accuracy of diagnosis and to give important information regarding co-morbid pathologies which have an impact on management and prognosis. Imaging changes are increasingly entering clinical diagnostic criteria, and consensus clinical criteria for all main subtypes of dementia now include information about imaging changes. In addition, many clinical guidelines for dementia emphasize the need for informed, appropriate application of different imaging modalities in varying clinical situations.
Effect of an interactive computerized psycho‐education system on patients suffering from depression
Publisher: Wiley
Date: 11-02-2008
DOI: 10.1111/J.1365-2702.2007.02085.X
Abstract: The aim of this study was to examine the effect of an Interactive Computerized Psycho-Education System on patients suffering from depression and to compare the use of an Interactive Computerized Psycho-Education System vs. traditional p hlet education approach. Depression management depends on pharmacological treatment and psychotherapy and on appropriate and timely patient education. Whilst multimedia learning concepts have been applied in areas such as education, this approach has not been widely used in psychiatric outpatient departments. A preliminary pre and post quasi-experimental design with patients with depression was employed at an hospital. Participants in the experimental group (n = 19) received an Interactive Computerized Psycho-Education System intervention programme (Interactive Computerized Psycho-Education System and the educational manual). Participants in the control group (n = 13) were exposed only to the traditional p hlet education approach (consultation from psychiatrists and information sheets). Primary outcome was depression knowledge scores. Secondary outcomes were scores on the Compliance Behaviour Assessment Scale. In the experimental group (n = 19), the time spent working on the Interactive Computerized Psycho-Education System was about 30-180 minutes per session, with an average of 67 minutes. Participants in the experimental group had a considerably decreased incidence of medication non-compliance compared with participants in the control group. Knowledge scores of the experimental group ranged from 30-100, with an average score of 74.7. The Interactive Computerized Psycho-Education System is acceptable and may be as more effective than a traditional education approach to achieve adherence to medications for depression. Compared with a traditional approach, the combination of the Interactive Computerized Psycho-Education System and a nursing-consulting clinic may assist patients with depression to achieve and maintain better medication compliance in addition to improving their knowledge of depression.
The Use of Modified Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy Program for Family Caregivers of People Living with Dementia: A Feasibility Study
Publisher: Elsevier BV
Date: 10-2020
Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study
Publisher: Cambridge University Press (CUP)
Date: 22-04-2015
DOI: 10.1017/S1041610215000435
Abstract: Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL. The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random s le of 53 facilities are being recruited. A sub-s le of 12 residents is also taking part in qualitative interviews and observations. This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.
Planning and designing a self-compassion intervention for family carers of people living with dementia: a person-based and co-design approach
Publisher: Springer Science and Business Media LLC
Date: 14-01-2022
DOI: 10.1186/S12877-022-02754-9
Abstract: This article describes the research activities undertaken to plan and design a self-compassion intervention for family carers of people living with dementia using a person-based and co-design approach. In providing this ex le, our aim is two-fold: to highlight the value of using qualitative research and co-design processes within intervention development and to showcase systematic reporting of an intervention’s early planning and design stages. A person-based and co-design approach informed the planning and design of the self-compassion intervention. In Stage 1, qualitative interviews were undertaken with 14 family carers of people living with dementia and 14 professional stakeholders. In Stage 2, intervention guiding principles were developed, psychological theory was incorporated, and six family carers of people living with dementia were engaged as co-designers. Knowledge generated during intervention planning identified that the intervention should be situated within the concept of compassion more broadly address misperceptions, fears, blocks, and resistances to self-compassion and target feelings of shame, guilt, and self-criticism. Subsequent intervention design activities determined that the needs of family carers of people living with dementia were best met by tailoring an existing intervention, namely group-based Compassion-Focused Therapy. Our systematic approach highlights the value of incorporating in-depth qualitative research and co-design within the intervention development process to prioritise the perspectives and lived experiences of family carers of people living with dementia. The planning and design process outlined provides insight that is applicable to the development of our intervention and complex health interventions within gerontology and beyond.
Infection control in Queensland long-term care facilities
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1071/HI01122
Efficacy of Telerehabilitation for Adults with Traumatic Brain Injury: A Systematic Review
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
Social Robots for Depression in Older Adults: A Systematic Review
Publisher: Wiley
Date: 09-09-2018
DOI: 10.1111/JNU.12423
Abstract: In recent years, there has been an increase in the number of studies using social robots to improve psychological well-being. This systematic review investigates the effect of social robot interventions for depression in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method was used to identify and select existing studies. Nine electronic databases were searched for relevant studies. Methodological quality was assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Screening, data extraction, and synthesis were performed by three reviewers. Inclusion criteria covered original quantitative studies investigating social robots for depression in older adults. Seven studies were identified-six randomized controlled trials and one comparison study-with all classified as good quality. Social robot interventions consisted of companion, communication, and health-monitoring robots. Three studies presented promising outcomes for reducing depressive symptoms in older adults following social robot interventions, and three studies showed decreased, but nonsignificant, trends in depression scores. The results highlight the potential of social robot interventions for reducing depression in older adults. However, the evidence is not strong enough to formulate recommendations on clinical effectiveness. Social robots are being used with increasing frequency to potentially provide personal support to older adults living in long-term care facilities. Social robots can be used to help alleviate depressive symptoms when used in group activities.
Quality of life in people living with dementia in nursing homes
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster–Randomized Controlled Trial
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JAMDA.2017.10.008
Abstract: To examine the within-trial costs and cost-effectiveness of using PARO, compared with a plush toy and usual care, for reducing agitation and medication use in people with dementia in long-term care. An economic evaluation, nested within a cluster-randomized controlled trial. Twenty-eight facilities in South-East Queensland, Australia. A total of 415 residents, all aged 60 years or older, with documented diagnoses of dementia. Facilities were randomized to 1 of 3 groups: PARO (in idual, nonfacilitated 15-minute sessions, 3 afternoons per week for 10 weeks) plush toy (as per PARO but with artificial intelligence disabled) and usual care. The incremental cost per Cohen-Mansfield Agitation Inventory-Short Form (CMAI-SF) point averted from a provider's perspective. Australian New Zealand Clinical Trials Registry (BLINDED FOR REVIEW). For the within-trial costs, the PARO group was $50.47 more expensive per resident compared with usual care, whereas the plush toy group was $37.26 more expensive than usual care. There were no statistically significant between-group differences in agitation levels after the 10-week intervention. The point estimates of the incremental cost-effectiveness ratios were $13.01 for PARO and $12.85 for plush toy per CMAI-SF point averted relative to usual care. The plush toy used in this study offered marginally greater value for money than PARO in improving agitation. However, these costs are much lower than values estimated for psychosocial group activities and sensory interventions, suggesting that both a plush toy and the PARO are cost-effective psychosocial treatment options for agitation.
A Randomized Controlled Trial Exploring the Effect of Music on Quality of Life and Depression in Older People with Dementia
Publisher: SAGE Publications
Date: 07-2010
Abstract: This randomized controlled trial investigated the effect of live music on quality of life and depression in 47 older people with dementia using the Dementia Quality of Life and Geriatric Depression Scale. The control/reading group reported higher mid-point feelings of belonging than the music group ( F(1, 45) = 6.672, p .05). Sub-analyses of ≥ 50 per cent music session attendance found improvements in self-esteem over time ( F(2, 46) = 4.471, p .05). Participants with scores that were suggestive of increased depressive symptoms had fewer depressive symptoms over time ( F(2, 22) = 8.129, p .01). Findings suggest music and reading activities can improve self-esteem, belonging and depression in some older people with dementia.
How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study
Publisher: Wiley
Date: 02-12-2020
DOI: 10.1111/JOCN.15104
Abstract: Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain. To explore how people with mild to moderate dementia and chronic pain perceive PARO as an alternative intervention to manage their pain and mood. A descriptive qualitative approach nested within a pilot randomised controlled trial. Participants with dementia and chronic pain were recruited from three residential aged care facilities. They interacted with PARO for 30 min, 5 days a week over a 6-week period. A s le of 11 participants completed in idual semi-structured interviews at the end of the intervention. Data were collected from January 2018-January 2019. Inductive thematic analysis was undertaken. Reporting of findings followed the COREQ checklist. Four themes emerged from the data: (a) perceptions of PARO (b) therapeutic effects of PARO (c) limitations of PARO and (d) programme improvement. Residents with dementia expressed positive attitudes towards the use of PARO and acknowledged the therapeutic benefits of PARO on mood improvement and relaxation for pain relief but also mentioned the limitations of its weight, voice and characteristics. Residents' responses could also fluctuate during the intervention process, and in idual preferences need to be considered. The PARO intervention is a promising intervention to improve positive emotion, and there is some anecdotal evidence that pain may be decreased from the perspectives of people living with chronic pain and dementia. Long-term care staff may incorporate PARO therapy into daily dementia care. Understanding of in idual's preferences may enhance the implementation of PARO for pain management in this group.
Development of frailty measurement tools using administrative health data: A systematic review
Publisher: Elsevier BV
Date: 07-2020
A survey-based study of knowledge of Alzheimer's disease among health care staff
Publisher: Springer Science and Business Media LLC
Date: 02-01-2013
Abstract: Continued aging of the population is expected to be accompanied by substantial increases in the number of people with dementia and in the number of health care staff required to care for them. Adequate knowledge about dementia among health care staff is important to the quality of care delivered to this vulnerable population. The purpose of this study was to assess knowledge about dementia across a range of health care staff in a regional health service district. Knowledge levels were investigated via the validated 30-item Alzheimer’s Disease Knowledge Scale (ADKS). All health service district staff with e-mail access were invited to participate in an online survey. Knowledge levels were compared across demographic categories, professional groups, and by whether the respondent had any professional or personal experience caring for someone with dementia. The effect of dementia-specific training or education on knowledge level was also evaluated. A erse staff group (N = 360), in terms of age, professional group (nursing, medicine, allied health, support staff) and work setting from a regional health service in Queensland, Australia responded. Overall knowledge about Alzheimer’s disease was of a generally moderate level with significant differences being observed by professional group and whether the respondent had any professional or personal experience caring for someone with dementia. Knowledge was lower for some of the specific content domains of the ADKS, especially those that were more medically-oriented, such as ‘risk factors’ and ‘course of the disease.’ Knowledge was higher for those who had experienced dementia-specific training, such as attendance at a series of relevant workshops. Specific deficits in dementia knowledge were identified among Australian health care staff, and the results suggest dementia-specific training might improve knowledge. As one piece of an overall plan to improve health care delivery to people with dementia, this research supports the role of introducing systematic dementia-specific education or training.
Creating a dementia-friendly environment through the use of outdoor natural landscape design intervention in long-term care facilities: A narrative review
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.HEALTHPLACE.2019.102148
Abstract: There is an increasing volume of literature on the positive effects of outdoor natural landscapes on health and well-being. However, to date, there is a paucity of research on the effect of outdoor natural landscapes designed for people with dementia living in long-term care (LTC) facilities, in particular, those which have incorporated the characteristics of a dementia-friendly environment (DFE). This narrative literature review synthesizes current knowledge on the effect of outdoor natural landscape design, which is aligned with the characteristics of a DFE, to improve agitation, apathy and engagement of people with dementia living in LTC facilities. The reviewed studies predominantly support the positive effects of outdoor natural landscapes on agitation, apathy and engagement of people with dementia. However, there are concerns about the methodological approaches, principles incorporated in the applied outdoor natural landscapes' designs, and the environmental assessment. Further rigorous research is required to understand the impact of the outdoor natural landscapes, with the application of DFE characteristics in the design, on agitation, apathy and engagement of people with dementia living in LTC facilities.
A quasi-experimental design trial exploring the effect of a partnership intervention on family and staff well-being in long-term dementia care
Publisher: Informa UK Limited
Date: 11-2011
DOI: 10.1080/13607863.2011.583625
Abstract: This study sought to explore the effect of the family involvement in care (FIC) intervention on family and staff well-being over a nine-month period in a long-term care (LTC) facility providing dementia care. A quasi-experimental design with randomised allocation of two LTC sites but not the participants was employed. Family caregivers (n = 57) of residents with dementia and staff (n = 59) from two LTC facilities in Queensland, Australia, were recruited. Participants were assessed once pre-intervention and three times post-intervention for knowledge, stress and satisfaction outcomes. Between-group and within-group effects were analysed using ANOVAs at <0.05 level of significance. Pre- and post-intervention interviews from a purposive s le of family caregivers were also conducted to enhance understanding of FIC benefits. Beneficial intervention effects associated with family caregivers' knowledge of dementia were found (p < 0.001). Negative intervention effects were also found for family satisfaction outcomes in relation to staff consideration of their relatives and management effectiveness (p < 0.05). In addition, staff well-being and job satisfaction were found to be negatively affected by their perceived inappropriate behaviour of residents with dementia (p < 0.05). Participation in the FIC intervention improved family caregiver knowledge. The major barrier to the success of the partnership intervention in achieving beneficial long-term psychosocial effects for family and staff caregivers was lack of resources and leadership required to support collaboration between family and staff, mainly due to environment and structural changes. This study contributes to our understanding of the importance of partnerships in promoting family involvement in dementia care.
She had a smile on her face as wide as the great Australian bite
Publisher: Oxford University Press (OUP)
Date: 19-11-2019
Abstract: Recent years have seen social robotic pets introduced as a means of treating behavioral and psychological symptoms of dementia, and many show promising potential. In this study, we sought to explore family members' perceptions of the Japanese-developed baby harp seal, Paro (version 9), and a look-alike, nonrobotic Plush Toy, when used by their relative with dementia for 15 min, 3 afternoons per week for 10 weeks. The study employed a descriptive qualitative approach, which was nested within a larger cluster randomized controlled trial. A convenience s le of 20 family members (n = 10 each from the Paro and Plush Toy conditions) with relatives in 9 long-term care facilities in Queensland, Australia, completed in idual semi-structured interviews (telephone or face-to-face). Inductive, data-driven thematic analysis of the data was undertaken with the assistance of the qualitative management software, ATLAS.ti®. Family members of long-term care residents with dementia expressed positive perceptions of the Paro, perceiving that it improved mood, reduced agitation, and provided opportunity for communication for their relative. Negative perceptions of the Plush Toy were given by family members, primarily because of its lack of movement and engagement. Family members were keen for their older relative with dementia to use a social robot that moved and engaged with them, and Plush Toys that were static and unresponsive were perceived as being unimportant in improving quality of life. However, the current cost of Paro was identified by family members as a major limitation to use.
Seeking connection
Publisher: Wiley
Date: 07-10-2009
DOI: 10.1111/J.1365-2702.2009.02878.X
Abstract: To outline the experiences of family caregivers in Brisbane, Australia who have placed a relative with dementia into long-term care. Whilst the aged care literature in Australia highlights the rising numbers of people with dementia admitted to long-term care, empirical research exploring family and staff relationships and their influence on quality of care remains limited. International research demonstrates that the transition to long-term care is stressful for families and the person with dementia, often resulting in ongoing family and staff conflict. The study utilised a descriptive qualitative design. A purposive s le of 10 participants from a large study that tested an education intervention took part in the qualitative phase of this mixed method, sequential design study. Semi-structured interviews and confirmatory thematic analysis were used to identify family caregiver experiences following placement of their relative in long-term care. The findings emphasise the increasing isolation and burden of care felt by families prior to admission, which often is perpetuated during long-term care placement and may present as dissatisfaction with care. Improving staff-family relationships has the potential to reduce conflict and to improve the long-term care environment, relieve the pressure of work overload, decrease staff frustration and reduce negative reactions to family caregivers. The findings highlight the crucial need for long-term care facilities to support families, as well as the person with dementia, through the transition to the care environment. The resulting improved family relationships with staff, based on negotiation and increasing knowledge of dementia care, can then provide potential to develop more specialised evidence-based dementia care and service delivery.
Factors influencing quality of life for people with dementia: A qualitative perspective
Publisher: Informa UK Limited
Date: 11-2011
DOI: 10.1080/13607863.2011.583620
Abstract: An exploration and understanding of quality of life (QOL) can help to enhance understanding and respect for people with dementia and assist in improving care and treatment of this population. This study sought to understand the factors that influence QOL for people living with dementia in long-term care (LTC), including an understanding of how they perceived they were valued. In-depth interviews were conducted with 32 older people with dementia from one service provider and across four large care settings, in two Australian states. While these residents were either satisfied or dissatisfied with elements of their life, the factors influencing a positive QOL were related to their relationship with family and other people, and 'things' such as needing some control over their life and, more importantly, needing to contribute to their community. Participants reported feeling of little use and therefore of limited value to society. This study proposes a need to understand how relationships might be maintained and strengthened following a move into LTC and highlights the importance of control and its influence on feeling valued.
Korean nurses’ attitudes towards older people with dementia in acute care settings
Publisher: Wiley
Date: 28-10-2010
DOI: 10.1111/J.1748-3743.2010.00254.X
Abstract: To identify and describe Korean nurses' attitudes towards older people with dementia in acute care settings and to examine the effect of selected socio-demographics and nursing work characteristics on attitudes. In Korea, older people receive health care services in acute care settings because long-term care settings are not the norm. Culturally, it is considered shameful to place parents or relatives in a long-term care facility. A descriptive survey design. Attitudes towards older people with dementia were measured in Korean registered nurses (n = 100) working in acute care settings of two hospitals in southern Korea in 2009. The Attitudes toward the Elderly with Dementia (AED) and the Approaches to Dementia Questionnaire (ADQ) were administered to participants. Moderately positive attitudes towards older people with dementia in the acute care setting were found. Two-thirds of the nurse participants (n = 65, 65.7%) working in medical wards demonstrated significantly more positive attitudes than those working in surgical wards (n = 34, 34.3%). Demographics including years of experience in the current unit and in the service, and nurses' position did not correlate significantly with their attitudes. The environment, work routine and technology may influence the likelihood of negative attitude towards people with dementia. IMPLICATIONS FOR PRACTICE. There may be conflict between nurses' cultural values and care practices in acute care settings. Therefore, there is a need for ongoing education of nurses in dementia care that may reduce the potential of such conflicts.
‘For me at 90, it’s going to be difficult’: feasibility of using iPad video-conferencing with older adults in long-term aged care
Publisher: Informa UK Limited
Date: 09-01-2019
A review of literature on debriefing or non-directive counselling to prevent postpartum emotional distress
Publisher: Elsevier BV
Date: 03-2002
Psychometric characteristics of the breastfeeding self‐efficacy scale: Data from an Australian sample
Publisher: Wiley
Date: 17-03-2003
DOI: 10.1002/NUR.10073
Abstract: Many new mothers discontinue breastfeeding prematurely because of difficulties encountered rather than maternal choice. Research has shown that a significant predictor of breastfeeding duration is a mother's confidence in her ability to breastfeed. To measure breastfeeding confidence, the Breastfeeding Self-Efficacy Scale (BSES) was developed and psychometrically tested at 1 week postpartum. The purpose of this methodological study was to psychometrically test the BSES antenatally and at 1 week and 4 months postpartum in a s le of Australian women and to determine predictive validity. The psychometric assessment of the original BSES study was replicated, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with a similar construct. Support for predictive validity was demonstrated through positive correlations and significant mean differences between antenatal BSES scores and infant-feeding method at 1 week and 4 months postpartum. The BSES is now considered ready for both research and clinical use (a) to identify new mothers with low breastfeeding confidence who require additional assistance, (b) to assess breastfeeding behaviors and cognitions in order to have in idualized confidence-building strategies, and (c) to assist in the evaluation of various nursing interventions.
Family caregivers’ perspectives on medication adherence challenges in older people with dementia: a qualitative study
Publisher: Informa UK Limited
Date: 21-11-2019
Baduanjin Exercise for Adults Aged 65 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
Publisher: SAGE Publications
Date: 24-12-2021
DOI: 10.1177/07334648211059324
Abstract: This study performed a systematic review and meta-analysis to evaluate the health effects of Baduanjin exercise on adults aged 65 years and older. Chinese and English databases were electronically searched using search terms related to the PICO model from inception through June 2021. The study quality assessment and meta-analysis were conducted using the PEDro scale and RevMan 5.4 software. Eleven included Chinese studies, published between 2015 and 2021, recruited participants from the mainland of China. The aggregated results showed significant benefits of Baduanjin on physical function, walking ability, balance, and anxiety. A long-term Baduanjin intervention could also improve quality of life and reduce falls and pain. Baduanjin appears to have the potential to improve the health of older adults, but conclusions are limited due to the lack of rigorous and robust studies within and outside of mainland China. Larger, well-designed RCTs are needed to confirm these findings.
Applying user-centred research design and evidence to develop and guide the use of technologies, including robots, in aged care
Publisher: Informa UK Limited
Date: 02-01-2018
An educational programme to improve acute care nurses' knowledge, attitudes and family caregiver involvement in care of people with cognitive impairment
Publisher: Wiley
Date: 11-10-2016
DOI: 10.1111/SCS.12377
Abstract: The population is ageing in South Korea, increasing the incidence of dementia and delirium. Despite this, registered nurses in South Korea tend to have poor understanding and limited involvement in the assessment of delirium. To evaluate the effect of an educational programme on acute care nurses' knowledge, attitudes and the potential for family caregiver involvement in care for older adults with cognitive impairment. A mixed-methods study that included a single group, pre-post design and in idual interviews was used. Forty registered nurses were recruited from four medical wards of one regional general hospital in South Korea. A 3-month educational programme on care for older adults with cognitive impairment tailored to the specific learning needs of nurses and guided by adult learning principles was provided to participants. A purposive s le of 12 registered nurses who participated in the quantitative component, and a nominated s le of six family caregivers whose older family members were cared for by participating nurses, joined in idual interviews. The educational programme had a positive impact on nurses' knowledge of cognitive impairment and attitudes towards older adults. The qualitative data indicated that the educational programme improved nurses' knowledge of cognitive impairment and their attitudes towards older adults with cognitive impairment. It also increased nurses' initial efforts to involve family caregivers in cognitive impairment care. Educational programmes are an effective means of improving nurses' knowledge and attitudes, but more research is required to explore the impact of such a programme on practice change and patient health-related outcomes including incidence of delirium, length of hospital stay and hospital-acquired complications.
Telepresence robots: Encouraging interactive communication between family carers and people with dementia
Publisher: Wiley
Date: 31-07-2020
DOI: 10.1111/AJAG.12713
Abstract: The aim of the study was to explore the feasibility of using telepresence robots to encourage interactive communication in dementia care, from the perspective of family carers. Qualitative findings from semi-structured interviews with six family carers. Generally, family carers reported a feeling of presence and connectedness when talking to their family member via the telepresence robots. They reported the robots as helping to enhance longer conversations and social connection with their family member. Telepresence may offer potential to encourage social connection, in particular where families are unable to make regular visits to the nursing home.
Exploring the gap between rhetoric and reality in dementia care in Australia: Could practice documents help bridge the great divide?
Publisher: SAGE Publications
Date: 07-11-2011
Abstract: Quality of care, and indeed, quality of life, for people living with dementia in long-term care is often underpinned by philosophies of care, such as person-centred care and relationship-centred care. The translation of these philosophies into practice is influenced by a range of in idual and organizational features, including the context in which such care occurs. Within modern care organizations, the context of care is evidenced through organizational documents. This study sought to identify the key documents guiding dementia care within one large Australian long-term care organization and to explore points of consistency and tension within the documented system of care. Results highlight a lack of consistency and clarity in the philosophy of dementia care and a disconnection between the key documents guiding practice. This disconnection creates tension for clinicians and carers, and may contribute to the gap between rhetoric and reality in dementia care. This study suggests that a congruent documented dementia system can help bridge the gap between espoused philosophies of care and everyday care practices.
How Did the COVID-19 Restrictions Impact People Living With Dementia and Their Informal Carers Within Community and Residential Aged Care Settings in Australia? A Qualitative Study
Publisher: SAGE Publications
Date: 08-06-2022
DOI: 10.1177/10748407221101638
Abstract: The aim of this study was to explore how formal social support changed after implementation of the COVID-19 public health measures and how these restrictions affected people living with dementia and their informal carers in Australia. Sixteen informal carers and two people living with dementia were interviewed between August and November 2020. Participants were asked about their experiences of the pandemic and the impact that the restrictions had on their lives and care. Thematic analysis identified four overarching themes describing (a) prepandemic limitations of the aged care system, (b) the aged care system’s response to the COVID-19 restrictions, (c) changes affecting informal carers, and (d) the challenges faced by people living with dementia. The findings highlighted the challenges faced by the Australian aged care system before the pandemic and the additional burden placed on informal carers who supported people living with dementia across residential and home settings during the pandemic.
Staff perspectives of relationships in aged care: A qualitative approach
Publisher: Wiley
Date: 15-03-2016
DOI: 10.1111/AJAG.12276
Abstract: To explore aged care staff perceptions and experience of their relationships with co-workers, older people and families via pragmatic exploratory interviews. Thirty-nine direct care staff from seven residential age care facilities and 12 community organisations were interviewed. Staff felt that their capacity to develop therapeutic relationships with older people and families was impeded by care tasks and concerns regarding professional boundaries. Positive relationships between staff-family and staff-staff are hindered by staff perceptions of undue care demands, high family expectations, and staff-staff conflict within a hierarchical context and between work shifts. A relationship-centred approach to care as well as staff training and education should be encouraged to assist the development of therapeutic relationships and the management of professional boundaries.
Determinants of medication adherence in older people with dementia from the caregivers' perspective.
Publisher: Cambridge University Press (CUP)
Date: 11-05-2018
DOI: 10.1017/S1041610218000583
Abstract: Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers’ perspective, and to identify influencing factors. Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale. Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61–0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77–0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient–provider relationship and less medical problems. Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.
A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care
Publisher: Cambridge University Press (CUP)
Date: 14-04-2020
DOI: 10.1017/S1041610220000459
Abstract: To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants’ experiences and perceptions after the intervention. A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and in idual interview. Twenty older adults with depression from four LTC facilities in Taiwan were recruited. Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week. The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. In idual qualitative interviews with thematic analysis followed. A repeated multivariate analysis of variance and Friedmanʼs test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life ( p .5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement (ii) increased social interaction with other people and (iii) companionship resulting in improved mental well-being. There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.
Pharmacotherapy of Persons with Dementia in Long-term Care in Australia: A Descriptive Audit of Central Nervous System Medications
Publisher: Bentham Science Publishers Ltd.
Date: 10-07-2017
Psychosocial interventions for dementia patients in long-term care
Publisher: Cambridge University Press (CUP)
Date: 03-09-2010
DOI: 10.1017/S1041610210001365
Abstract: Background: Psychosocial interventions in long-term care have the potential to improve the quality of care and quality of life of persons with dementia. Our aim is to explore the evidence and consensus on psychosocial interventions for persons with dementia in long-term care. Methods: This study comprises an appraisal of research reviews and of European, U.S. and Canadian dementia guidelines. Results: Twenty-eight reviews related to long-term care psychosocial interventions were selected. Behavioral management techniques (such as behavior therapy), cognitive stimulation, and physical activities (such as walking) were shown positively to affect behavior or physical condition, or to reduce depression. There are many other promising interventions, but methodological weaknesses did not allow conclusions to be drawn. The consensus presented in the guidelines emphasized the importance of care tailored to the needs and capabilities of persons with dementia and consideration of the in idual's life context. Conclusions: Long-term care offers the possibility for planned care through in idualized care plans, and consideration of the needs of persons with dementia and the in idual life context. While using recommendations based on evidence and consensus is important to shape future long-term care, further well-designed research is needed on psychosocial interventions in long-term care to strengthen the evidence base for such care.
Connecting the person with dementia and family: A feasibility study of a telepresence robot
Publisher: Springer Science and Business Media LLC
Date: 24-01-2014
Healthcare professionals' dementia knowledge and attitudes towards dementia care and family carers' perceptions of dementia care in China: An integrative review
Publisher: Wiley
Date: 31-08-2020
DOI: 10.1111/JOCN.15451
Abstract: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency (b) attitudes towards dementia care and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed.
Use of a think-aloud procedure to explore the relationship between clinical reasoning and solution-focused training in self-harm for emergency nurses
Publisher: Wiley
Date: 06-02-2009
DOI: 10.1111/J.1365-2850.2008.01339.X
Abstract: Self-harm is a risk factor for further episodes of self-harm and suicide. The most common service used by self-injurers is the emergency department. However, very often, nurses have received no special training to identify and address the needs of these patients. In addition this care context is typically biomedical and without psychosocial skills, nurses can tend to feel unprepared and lacking in confidence, particularly on the issue of self-harm. In a study that aimed to improve understanding and teach solution-focused skills to emergency nurses so that they may be more helpful with patients who self-harm, several outcome measures were considered, including knowledge, professional identity and clinical reasoning. The think-aloud procedure was used as a way of exploring and improving the solution-focused nature of nurses' clinical reasoning in a range of self-harm scenarios. A total of 28 emergency nurses completed the activity. Data were audiotaped, transcribed and analysed. The results indicated that significant improvements were noted in nurses' ability to consider the patients' psychosocial needs following the intervention. Thus this study has shown that interactive education not only improves attitude and confidence but enlarges nurses' reasoning skills to include psychosocial needs. This is likely to improve the quality of care provided to patients with mental health problems who present to emergency settings, reducing stigma for patients and providing the important first steps to enduring change - acknowledgment and respect.
Implementation of improvement strategies in palliative care: an integrative review
Publisher: Springer Science and Business Media LLC
Date: 26-07-2015
Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials
Publisher: Wiley
Date: 15-01-2019
DOI: 10.1111/JAN.13929
Abstract: To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia. A systematic review with meta-analysis of randomized controlled trials. Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018. Risk of bias assessment and meta-analysis were conducted according to the Cochrane methods using RevMan 5.3 and findings were generated using the GRADE profiler software. Eight studies met the inclusion criteria, but the quality of the current evidence was low to moderate. Results showed that psychosocial interventions significantly reduced the observational pain score and pain medication. Subgroup analyses indicated that sensory stimulation and in idual interventions showed a reduction in observational pain in people with dementia. Findings suggest that psychosocial interventions may be potentially effective alternatives for pain management in people with dementia. However, caution is needed in interpreting these results due to limited studies, risk of bias and heterogeneity across studies. Furthermore, well-designed research is needed on psychosocial interventions to strengthen quality of pain management in people with dementia. This review synthesized current evidence using psychosocial interventions to manage pain in people with dementia. Findings suggest that psychosocial interventions may lead to a potential reduction in pain and pain medication in people with dementia. Healthcare providers may wish to integrate psychosocial interventions as part of the multimodal approach to the management of pain in people living with dementia.
Health-related quality of life in older people with severe dementia: challenges for measurement and management
Publisher: Informa UK Limited
Date: 02-2013
DOI: 10.1586/ERP.12.84
Abstract: The current dementia epidemic, coupled with the absence of a cure for the disease, means that an increasing number of people with dementia are likely to experience the severe stage. Given that this final stage adversely impacts not only the person living with the disease (i.e., cognitive impairment and limited communication), but also their family members and caregivers (i.e., burden and stress), there is a pertinent need to understand the needs and desires of the person to help shape optimal care management practices. In this article, literature produced in the last 5 years, regarding measurement and management challenges encountered when researching health-related quality of life in older people with severe dementia, is reviewed. The paper aims to provide important, up-to-date insight into the type and amount of research undertaken with this population, including the measurement tools currently used and the challenges faced, and pose recommendations for future research.
Addressing loneliness in a retirement village community: A pilot test of a print‐delivered intervention
Publisher: Wiley
Date: 12-2010
DOI: 10.1111/J.1741-6612.2010.00442.X
Abstract: To explore perceptions of a self-help print-delivered intervention aimed at encouraging social well-being and addressing loneliness in a retirement village community. A total of 58 residents of an Australian retirement village received a series of five factsheets addressing various dimensions of loneliness. The factsheets raised awareness of the importance of social well-being and loneliness. However, the approach was considered difficult to update and was not appropriate for those from a non-English speaking background or with vision impairments. The non-face-to-face approach also was unable to address issues of loneliness associated with bereavement. This form of intervention offers a cost-effective way to raise awareness of loneliness and social well-being in a retirement village community when issues of updating and presentation of information are taken into consideration.
Experiences of compassion among family carers of older adults: Qualitative content analysis of survey free‐text comments
Publisher: Wiley
Date: 07-06-2021
DOI: 10.1111/SCS.13010
Abstract: To provide qualitative insight into the experiences of compassion (to self, to others and from others) among family carers of older adults by exploring the written responses provided within a cross‐sectional survey that asked about carers’ levels of compassion, mindfulness, emotion regulation, coping strategies and psychological health. Family carers of adults aged ≥65 years from around the world completed the survey between July and December 2019. To provide carers with an opportunity to describe experiences in their own words and expand on issues beyond the limits of closed‐response items, the survey included eight free‐text boxes. These appeared after each self‐report measure and at the end of the survey. From a total of 127 carers providing 504 written responses, inductive qualitative content analysis identified and evaluated 245 comments from 105 family carers’ that were about their experiences of compassion (to self, to others and from others). Some family carers perceived a lack of compassion, both for themselves and from others, and several barriers to carers’ openness to receiving compassion were identified. Factors influencing carers’ compassion to others in general included how carers were feeling themselves, the person it was directed towards and the situation. Within the caregiving relationship specifically, this included care recipients’ level of need and behaviour. Findings provide qualitative understanding about family carers’ realities of compassion (to self, to others and from others) within their role and highlight the applicability and warranted focus of compassion‐based approaches within family caregiving research and practice.
The effectiveness of Swedish massage and traditional Thai massage in treating chronic low back pain: A review of the literature
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.CTCP.2012.07.001
Abstract: To review the effectiveness of Swedish and traditional Thai massage in treating chronic low back pain. Thai and Swedish massage both appear to relieve lower back pain but their relative effectiveness has not been clearly established. A literature review of nine databases were searched and 13 papers found. Six papers meet the inclusion criteria and were summarised and reviewed. Both Thai and Swedish massages are reported to relieve chronic low back pain by enhancing physical functions providing pain relief, improving disability and range of motion, improving psychological functions reducing anxiety and improving mood. Although based on different theoretical frameworks, they appear to be equally effective in relieving chronic low back pain. Despite some evidence for the use of massage to relieve low back pain, methodological limitations highlight the need for further studies that compare Thai massage and Swedish massage.
Levels of physical activity and sleep patterns among older people with dementia living in long-term care facilities: A 24-h snapshot
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.MATURITAS.2017.05.015
Abstract: To objectively measure over a 24-h period the daytime and nighttime levels of physical activity and sleep patterns of older people with dementia living in long-term care facilities. Nested within a larger research program, this cross-sectional study involved 415 residents, aged ≥60 years, with a documented diagnosis of dementia, from 28 long-term care facilities in south-east Queensland, Australia. Residents wore SenseWear From a total of 415 residents monitored with the SenseWear These data can be used by long-term care clinicians to assist in planning interventions and care approaches which promote physical activity and good sleep practices, and are in idualized to physical and cognitive capabilities. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673).
The effectiveness of EMLA as a primary dressing on painful chronic leg ulcers: A pilot randomized controlled trial
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2017
Restraint use in residents with dementia living in residential aged care facilities: A scoping review
Publisher: Wiley
Date: 17-09-2022
DOI: 10.1111/JOCN.15487
Abstract: To provide an overview of restraint use in residents with dementia in the context of residential aged care facilities. Restraints are commonly used in people with dementia living in residential aged care facilities to manage behaviours and reduce injuries, but the concept of restraint use in people with dementia remains ambiguous, and current practices to reduce restraint use in long‐term care residents with dementia remain unclear. A scoping review using the methodological frameworks of Arskey and O’Malley and colleagues. Nine databases (CINAHL, MEDLINE, EMBASE, PubMed, Scopus, Web of Science, OVID, Cochrane Central Register of Controlled Trials and ProQuest) were searched from 2005 to 20 May 2019. Articles were included if they were written in English, peer‐reviewed and used any research method that described restraint use in residents with dementia living in residential care settings. The PRISMA‐ScR checklist was used. From 1,585 articles, 23 met the inclusion criteria. There is a lack of a clear definition of restraint use, and the prevalence of restraint use varied from 30.7% to 64.8% depending on the different operational concepts. People with dementia were at a higher risk for restraint use, and the decision‐making process for restraint use was largely ignored in the literature. The effect of staff educational interventions to reduce restraint use was inconsistent due to varying delivery duration and content. The prevalence of restraint use in people with dementia living in residential care settings remains high alongside the absence of a clear definition of restraint use. More research about the decision‐making process involved in using restraint and development of effective interventions are needed. Better education about the decision‐making regarding staff, conditions of residents and organisations for restraint use is needed to improve the care for people with dementia living in care settings.
The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
Publisher: Oxford University Press (OUP)
Date: 12-06-2019
Abstract: Social robots may promote the health of older adults by increasing their perceived emotional support and social interaction. This review aims to summarize the effectiveness of social robots on outcomes (psychological, physiological, quality of life, or medications) of older adults from randomized controlled trials (RCTs). A mixed-method systematic review of RCTs meeting the study inclusion criteria was undertaken. Eight databases were electronically searched up to September 2017. Participants' characteristics, intervention features, and outcome data were retrieved. The mean difference and standardized mean difference with 95% confidence intervals (CI) were synthesized to pool the effect size. A total of 13 articles from 11 RCTs were identified from 2,204 articles, of which 9 studies were included in the meta-analysis. Risk of bias was relatively high in allocation concealment and blinding. Social robots appeared to have positive impacts on agitation, anxiety, and quality of life for older adults but no statistical significance was found in the meta-analysis. However, results from a narrative review indicated that social robot interactions could improve engagement, interaction, and stress indicators, as well as reduce loneliness and the use of medications for older adults. Social robots appear to have the potential to improve the well-being of older adults, but conclusions are limited due to the lack of high-quality studies. More RCTs are recommended with larger s le sizes and rigorous study designs.
Developing a dementia-specific health state classification system for a new preference-based instrument AD-5D
Publisher: Springer Science and Business Media LLC
Date: 2017
Effect of a robotic seal on the motor activity and sleep patterns of older people with dementia, as measured by wearable technology: A cluster-randomised controlled trial
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.MATURITAS.2018.01.007
Abstract: The robotic seal, PARO, has been used as an alternative to animal-assisted therapies with residents with dementia in long-term care, yet understanding of its efficacy is limited by a paucity of research. We explored the effects of PARO on motor activity and sleep patterns, as measured by a wearable triaxial accelerometer. Cluster-randomised controlled trial, involving 28 facilities in Queensland, Australia. Nine facilities were randomised to the PARO group (in idual, non-facilitated, 15-min sessions three afternoons per week for 10 weeks), 10 to a plush toy (PARO with robotic features disabled) and nine to usual care. Changes in day- and nighttime motor activity and sleep after the 10-week intervention, as measured by SenseWear After 10 weeks, the PARO group showed a greater reduction in daytime step count than usual care (p = 0.023), and in nighttime step count (p = 0.028) and daytime physical activity (p = 0.026) compared with the plush toy group. At post-intervention, the PARO group showed a greater reduction in daytime step count than the plush toy group (p = 0.028), and at nighttime compared with both the plush toy group (p = 0.019) and the usual-care group (p = 0.046). The PARO group also had a greater reduction in nighttime physical activity than the usual-care group (p = 0.015). PARO may have some effect on motor activity of older people with dementia in long-term care, but not on sleep patterns. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673).
Development of the ‘Intimacy and Sexuality Expression Preference’ tool for residential aged care
Publisher: Elsevier BV
Date: 07-2021
Is quality of life being compromised in people with dementia in long‐term care?
Publisher: Wiley
Date: 15-08-2010
DOI: 10.1111/J.1748-3743.2010.00230.X
Abstract: To outline the importance of understanding quality of life (QOL) in people with dementia living in long-term care. To consider several key research questions and some of the challenges and impact of neglecting knowledge transfer. There is a gap between the knowledge in the broad dementia research literature and transfer of knowledge into practice. Quality of life research and transfer of research into practice is one means by which health professionals can inform health and social care policy and improve care practice. There are a number of unanswered research questions in relation to QOL in people with dementia living in long term care. A selection of questions discussed in this paper relate to the impact of staff knowledge of mental health assessment and the importance of therapeutic communication, cognitive training programs and social biography, in idual needs, weight and behavioural and psychological symptoms of dementia (BPSD), resident choice and the impact of the environment on QOL. Research methods used to assess QOL must not be too restrictive and mixed methods and data from multiple perspectives should be encouraged so that an extensive understanding is uncovered. Potential strategies to assist knowledge transfer in long-term care settings are needed.
The problem of arriving at a phenomenological description of memory loss
Publisher: Wiley
Date: 07-1997
DOI: 10.1046/J.1365-2648.1997.1997026120.X
Abstract: This paper discusses a methodological difficulty that arose when uncovering the conscious experience of being nurtured as an in-patient with depression on a psychiatric ward. It considers the problem of arriving at a phenomenological description of memory loss in a patient who had undergone electroconvulsive therapy (ECT). The paper begins by describing the prevalence of depression and its significance for nurses working in in-patient settings. Ex les of empirical research into memory loss in depression are used to show what researchers must set aside if they are to arrive at a phenomenological description of memory loss. The choice of a phenomenological approach to the wider study from which the methodological problem discussed here arose is then justified. The phenomena of memory is introduced to show the methodological significance of attempting to arrive at a phenomenological description of the statement made by one of the participants, a woman being treated as an in-patient for major depression. A possible description of the phenomena of memory loss based on the existential phenomenology of Sartre is offered to call into question the ability of researchers to bracket their assumptions. The significance for nurses of the wider study from which our ex le is taken is then described. Finally it is argued that despite the methodological difficulty described, a phenomenological perspective based on the philosophy of Husserl can point nurses in the direction of meeting the human needs of their patients.
Using telepresence for social connection: views of older people with dementia, families, and health professionals from a mixed methods pilot study
Publisher: Informa UK Limited
Date: 17-11-2019
Acute care management of older people with dementia: A qualitative perspective
Publisher: Wiley
Date: 05-10-2011
DOI: 10.1111/J.1365-2702.2010.03521.X
Abstract: Aim and objectives. This Australian study explored management for older people with dementia in an acute hospital setting. Background. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management however, few studies have examined this management from the perspective of hospital staff. Design. A descriptive qualitative approach was used. Method. Data were collected using semi‐structured audio‐taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. Results. Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well‐being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. Conclusion. Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence‐based approach. Staff education and environmental resources may improve the current situation so that people with dementia receive care that takes into account their in idual needs and human dignity. Relevance to clinical practice. Nurses can assist older people with dementia by encouraging evidence‐based care practices to become the part of hospital policy.
Sexuality & dementia: An eLearning resource to improve knowledge and attitudes of aged-care staff
Publisher: Informa UK Limited
Date: 24-06-2016
Teaching the care of older people in Australian nursing schools: Survey findings
Publisher: Elsevier BV
Date: 12-2022
Infection in residential aged care facilities
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1071/HI01111
Caring for older people with dementia: An exploratory study of staff knowledge and perception of training in three Australian dementia care facilities
Publisher: Wiley
Date: 17-10-2012
DOI: 10.1111/J.1741-6612.2012.00640.X
Abstract: To ascertain care staff's knowledge of dementia relating to aetiology and/or pathology, symptoms and care/treatment and explore their perceptions of the importance and adequacy of dementia education and training opportunities. Thirty-five care staff working in three secure dementia care facilities were recruited. Dementia knowledge was surveyed using the Staff Knowledge of Dementia Test (SKDT). Perceptions of dementia education and training were examined via semi-structured in idual interviews. An average of 21 out of 33 SKDT questions (SD = 4.0) was correctly answered. Knowledge discrepancy was attributed to participants' cultural and ethnic origin and the length of residency in Australia of migrant care staff. Participants acknowledged the importance of dementia education and training but were critical of the content relevancy to direct care practices. There is a need to improve care staff knowledge of dementia, and dementia education and training should include direct practical competencies required for effective care delivery.
Community practitioner involvement in collaborative research
Publisher: SAGE Publications
Date: 28-08-2015
Abstract: This paper focuses on the benefits and limitations of collaborative research in community-based service settings explored through the implementation of a psychosocial intervention. The study aimed to establish the effectiveness of working with dementia dyads (person with dementia and family caregiver) in the early stages of dementia and to recruit and train an existing practitioner workforce to deliver a psychosocial intervention designed to assist dementia dyads to manage the consequences of dementia. Seven intervention staff participated in post-intervention semi-structured interviews. Whilst staff recruitment and retention proved challenging the degree to which staff demonstrated the required communication skills and competence was an important component in dyad acceptability of the intervention. Participatory factors, collaborative development, selective recruitment, focused training and ongoing specialist support, can assist the implementation of practice-based research. However, intervention staff participation and therefore intervention delivery can be h ered by workplace culture and workforce demands.
Models of mental health care for older people: implications for practice
Publisher: Wiley
Date: 06-2007
Aged-care nurses’ knowledge of nursing documentation: an Australian perspective
Publisher: Wiley
Date: 05-06-2009
DOI: 10.1111/J.1365-2702.2008.02670.X
Abstract: This study investigated registered nurses' knowledge of documentation used in aged-care nursing home facilities in Queensland, Australia. The purpose of nursing documentation is to communicate health information, facilitate quality assurance and research, demonstrate nurses' accountability and, within Australia, to support funding of residents' care. Little is known about the relationship between RNs' knowledge of nursing documentation, the documentation process within residential aged care and the outcomes of the documentation. Cross-sectional, retrospective design. The study was conducted with a large s le of RNs (n = 360) located in 162 Queensland aged-care facilities. Participants completed a postage-return questionnaire in which they identified factors that influence their knowledge and understanding of documentation. Participants reported that they have considerable knowledge of nursing documentation. They also indicated that they were most knowledgeable about policies on documentation and writing discharge instructions. However, their knowledge of nursing assessments ranked fifth and they were least knowledgeable about reading reports each shift. The modified version of Edelstein's questionnaire provided a valid and reliable instrument for measuring RNs' knowledge of nursing documentation. A factor analysis of the 16 items in the Knowledge scale showed excellent reliability. The data indicated that RNs in aged-care facilities have high levels of knowledge about documentation. Specific recommendations relate to the implementation of comprehensive documentation education programs that reflect the needs of organisations and the level of RNs' skills and knowledge concerning documentation. Accurate nursing documentation is relevant to residents' care outcomes and to government funding allocations. Measuring RNs' knowledge of nursing documentation can identify factors that impede and facilitate their documentation of care.
Hospital discharge processes involving older adults living with dementia: An integrated literature review
Publisher: Wiley
Date: 15-01-2018
DOI: 10.1111/JOCN.14144
Abstract: To identify barriers and facilitators to engagement of people with dementia and family carers in planning for discharge from hospital. Hospital discharge can be particularly challenging for older people with dementia. To assist in the development of bespoke discharge processes that address the unique needs of older people with dementia, an integrated review of the literature was undertaken. A four-stage integrative review framework guided the review. Three search strategies were employed: a computerised database search, a hand search of reference lists and forward citation searching. Paired members of the research team reviewed eligible full-text papers. The methodological quality of each paper was assessed using the Mixed-Methods Assessment Tool, followed by data extraction and completion of summary tables. Within and across study analysis and synthesis of study findings was undertaken using thematic synthesis. Fifteen papers were included in the review. Most identified barriers to collaborative discharge processes related to distributed responsibility for discharge, risk averse approaches to discharge, limited family carer confidence, and limited validation of assumptions about family competency to manage at home. Facilitators included supported clinician and family carer engagement, and maintaining independence for activities of daily living. Reflective analysis of discharge decisions, focused on risk and possible risk aversion, can assist teams to evaluate the quality of their discharge decisions. The use of formal communication strategies such as a patient/family-held journal of the hospital experience and a structured family meeting early in the hospital admission can enhance family engagement in discharge planning. Prevention of functional and cognitive decline is emerging as critical to improving hospital discharge outcomes.
Why carers of frail older people are not using available respite services: An Australian study
Publisher: Wiley
Date: 14-06-2010
DOI: 10.1111/J.1365-2702.2009.03139.X
Abstract: Aim. The purpose of this study was to explore the limiting and motivating factors that influence carers’ use of respite services and the ability of currently available respite services to meet the needs of carers of frail older people. Background. The development of community carer support services, their availability and usage and the common barriers that affect or impact on carers’ use of community services in general and respite services in particular need to be examined to ensure they meet client needs. Design. A qualitative descriptive approach informed by critical social theory was used to expose the inequities inherent in community services. Methods. A qualitative examination of carer relationships with respite services was informed and guided by critical theory. Sixteen carers took part in four focus groups. A purposeful s ling strategy was adopted to engage with carers not currently using respite services. Study participants were recruited from a state‐wide carer support organisation and a community service organisation in Queensland, Australia. Results. Three themes emerged from the data: ‘Commitment’ characterised by reciprocity, role definition and role frustration, ‘Needing Help’ discussed in terms of trust, confidence in service, fear and resistance, and ‘Support’ discussed in relation to informal networking, misinformation and lack of knowledge. Conclusion. This study improves our understanding of the caring role, its significance in carer’s lives and how this shapes their formal service expectations and use. The findings suggest that further investigation of the factors involved in carers’ service expectations and service‐seeking is warranted to develop a deeper understanding of how care giving influences the ways carers seek help from formal services. Relevance to clinical practice. Service delivery changes towards a model of care, which engages and promotes user control and fosters genuine participatory relations between informal and professional carers may improve uptake of respite services.
Life stories and biography: A means of connecting family and staff to people with dementia
Publisher: Wiley
Date: 13-05-2010
DOI: 10.1111/J.1365-2702.2009.03116.X
Abstract: Aims. This article assesses the Family Biography Workshop (FBW) designed to support family and staff to co‐construct the history of the person with dementia in residential care. Background. Family–staff conflict in residential dementia care is a major stressor that disturbs effective relationships and contributes to stress. Biographical research has been found to improve communication and promote family–staff relations. Few studies focus on family biography as an approach that promotes positive relations that translate into inclusive care interactions. Design. A qualitative descriptive approach was used to assess the influence of participation in the FBW and the impact of developing biographical knowledge on family–staff caregiver attitudes, perceptions of roles, conflict and the subsequent management of stress using participatory care practices. Methods. The FBW process involved seven family caregivers, seven staff and one researcher working collaboratively through a series of six weekly two‐hour sessions, designed to help them build a biography of the person with dementia. Results. For family caregivers, reviving memories of their relatives as ‘ whole’ persons enabled some to ‘stand outside’ and see beyond the disease‐saturated context. For staff, ‘opening possibilities’ of ‘seeing’ the resident within the family context empowered them to engage in genuine participatory practices. Residents benefited from being connected as staffs’‘know how’ in initiating and engaging developed. Conclusion. Future research will examine the effects of the FBW on the dynamics of family–staff roles and relationships. This research aims to reduce stress from role inadequacy, task burden, poor relationships and improve staff attitudes towards family participation. Relevance to clinical practice. This study substantiated the FBW by revealing understanding of the meaning of biography work for family and relatives in care providing effective support that empowered staff to confidently relate and fostering engagement in inclusive care practices that encouraged residents’ initiatives.
Does Cognitive Impairment and Agitation in Dementia Influence Intervention Effectiveness? Findings From a Cluster-Randomized-Controlled Trial With the Therapeutic Robot, PARO
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JAMDA.2018.02.014
Abstract: To explore whether severity of cognitive impairment and agitation of older people with dementia predict outcomes in engagement, mood states, and agitation after a 10-week intervention with the robotic seal, PARO. Data from the PARO intervention-arm of a cluster-randomized controlled trial was used, which involved in idual, nonfacilitated, 15-minute sessions with PARO 3 afternoons per week for 10 weeks. One hundred thirty-eight residents-aged ≥60 years, with dementia-from 9 long-term care facilities. A series of stepwise multiple linear regressions were conducted. Dependent variables were participants' levels of engagement, mood states, and agitation at week 10 [assessed by video observation and Cohen Mansfield Agitation Inventory-Short Form (CMAI-SF)]. Predictor variables were baseline levels of cognitive impairment [assessed by Rowland Universal Dementia Assessment Scale (RUDAS)] and agitation (CMAI-SF). Five models were produced. The strongest finding was that participants with more severe agitation at baseline had higher levels of agitation at week 10 (R Participants with severe agitation had poor response to PARO. Lower levels of agitation and higher cognitive functioning were associated with better responses. In clinical practice, we recommend PARO should be restricted to people with low-moderate severity of agitation. Further research is needed to determine the optimal participant characteristics for response to PARO.
Feasibility of a Tai Chi with Thera-Band Training Program: A Pilot Study
Publisher: MDPI AG
Date: 16-11-2020
Abstract: Tai Chi, combined with Thera-band (TCTB) exercise may be associated with an improvement in health where it increases physical fitness, improves psychological well-being, and decreases pain. This paper aimed to determine the feasibility of TCTB exercise in older sedentary office workers. Forty office workers aged over 55 years participated in a pilot randomized controlled trial (i.e., 12-week TCTB exercise or Tai Chi exercise only). Feasibility of the TCTB exercise approach was ascertained through the recruitment and enrolment rate, acceptability of the study intervention by participants including retention and adherence rates, participants’ learning process, the appropriateness of data collection as well as the participants’ evaluation of the intervention. Recruitment took longer than planned, with a low recruitment rate of 2.0% (42/2020), but a high enrolment rate of 95.2% (40/42). Thirty-one participants (i.e., 77.5%) completed the intervention. Of those who completed the trial, the overall average attendance was reported as 85.2% 84.7% in the TCTB group and 85.7% in the Tai Chi only group. A total of 58.3% of participants (n = 21) could independently practice the TCTB or Tai Chi exercise motions at the end of the learning stage. There were no missing data except for the nine participants who withdrew during the intervention. No adverse events or effects were reported, and all participants were satisfied with the 12-week exercise intervention. Results support the feasibility of a large-scale randomized controlled trial to explore the efficacy of a TCTB program for improving health in older sedentary office workers.
Co-design of an mHealth application for family caregivers of people with dementia to address functional disability care needs
Publisher: Informa UK Limited
Date: 24-07-2021
Hospital healthcare professionals' knowledge of dementia and attitudes towards dementia care: A cross‐sectional study
Publisher: Wiley
Date: 19-12-2022
DOI: 10.1111/JOCN.15590
Abstract: To explore hospital healthcare professionals' knowledge and attitudes towards dementia care in China. Hospital healthcare professionals deliver most diagnosis and treatment for people with dementia in China. Literature shows that healthcare professionals' knowledge and attitudes are of great importance in providing optimum dementia care. However, there is limited research of healthcare professionals' dementia knowledge and attitudes within hospital contexts in China. A cross-sectional survey was conducted between April and December 2019. A self-report questionnaire composed of demographics and knowledge and attitude scales related to dementia was used for doctors and registered nurses working in settings where people with dementia are cared for in eleven public tertiary hospitals in Hebei Province, China. The STROBE checklist was adhered to in this study. In total, 603 healthcare professionals completed the study. The majority of respondents were registered nurses (71.3%). The overall mean knowledge score was 20.7 (SD = 2.9) out of a maximum possible score of 30. The overall mean score for attitudes was 91.3 (SD = 15.9) out of a maximum possible score of 140. Standard multiple linear regression analysis revealed that the highest level of education, the experience of searching for dementia-related information and willingness to receive dementia training or education were significant predictors of knowledge scores. The department, the experience of working with people with dementia, length of dementia care, interest in dementia care and training type were significant predictors of attitude scores. Deficits in the knowledge of dementia and a low level of positive attitude were identified among the healthcare professionals who work in hospital settings where people with dementia are cared for in China. Education and training in dementia care should be integrated into undergraduate nursing and medical programmes and provided for healthcare professionals after commencing employment.
The Impact of a Dementia-Friendly Garden Design on People With Dementia in a Residential Aged Care Facility: A Case Study
Publisher: SAGE Publications
Date: 15-12-2021
DOI: 10.1177/19375867211063489
Abstract: There is a paucity of evidence on the efficacy of garden design based on dementia-friendly environment (DFE) characteristics on the level of agitation, apathy, and engagement of people with dementia in residential aged care facilities (RACFs). To investigate the effect of a garden improved according to DFE characteristics on agitation, apathy, and engagement of people with dementia in one RACF. A case study design with a mixed-method approach was used. There was no significant improvement in the level of participants’ agitation following visits to the improved garden, χ 2 (2) = 5.167, p = .076. A high level of engagement was found in participants during the intervention (Week 1-1, p .01 Week 1-2, p .01 Week 2, p .01 Week 3, p .05 and Week 4, p .05) when compared to before intervention (Week 0). A higher level of apathy was found in participants at Week 0 when compared to during the intervention (Week 1-1, p .05 Week 1-2, p .01 Week 2, p .05 Week 3, p .01 and Week 4, p .01). Five themes emerged from participant interviews: the presence of sensory-provoking elements in the garden, meaningful engagement in the garden, accessibility of the garden, garden impacts, and garden experiences that demonstrated the effectiveness of the garden. The garden promoted engagement and decreased apathy of people with dementia living in the RACF with the researcher’s partial facilitation of the intervention sessions. The qualitative findings indicated the effectiveness of the garden in reducing agitation.
mHealth applications as an educational and supportive resource for family carers of people with dementia: An integrative review
Publisher: SAGE Publications
Date: 09-04-2019
Abstract: Family carers encounter several challenges related to caring for people with dementia, and they need support in managing care recipients’ health needs. This study aims to identify, appraise and synthesise the existing evidence on the use of mHealth/smartphone applications as an educational and supportive resource for family carers of people with dementia. An integrative literature review approach was used. Seven databases were searched. The search generated 117 articles, with seven meeting the inclusion criteria. Three categories and their attendant sub-categories emerged from the literature. The categories are ‘carer support’, ‘evaluation strategies’ and ‘barriers and challenges’. mHealth applications appear to be a feasible intervention for family carers of people with dementia despite the limited available research and barriers for their development and implementation. Further research on mHealth applications with strong methodological rigour and more research on mHealth applications as an educational and supportive resource for carers of people with dementia are needed.
Health Education Needs of Family Caregivers Supporting an Adolescent Relative With Schizophrenia or a Mood Disorder in Taiwan
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.APNU.2010.04.003
Abstract: This study, which is part of a larger research program, examined the health education needs of family caregivers providing care and support for an adolescent relative with schizophrenia or mood disorder in Taiwan. Family caregivers reported significant unmet information needs, and those with higher incomes or educational levels were more likely to report unmet educational needs. Caregivers using information resources consistently had high unmet educational needs. Results revealed the importance of assessing specific educational needs of families, as educational needs of caregivers differed according to diagnostic group, especially with regard to etiology, symptoms, and coping strategies.
Developing a dementia-specific preference-based quality of life measure (AD-5D) in Australia: A valuation study protocol
Publisher: BMJ
Date: 2018
DOI: 10.1136/BMJOPEN-2017-018996
Abstract: Generic instruments for assessing health-related quality of life may lack the sensitivity to detect changes in health specific to certain conditions, such as dementia. The Quality of Life in Alzheimer’s Disease (QOL-AD) is a widely used and well-validated condition-specific instrument for assessing health-related quality of life for people living with dementia, but it does not enable the calculation of quality-adjusted life years, the basis of cost utility analysis. This study will generate a preference-based scoring algorithm for a health state classification system -the Alzheimer’s Disease Five Dimensions (AD-5D) derived from the QOL-AD. Discrete choice experiments with duration (DCE TTO ) and best–worst scaling health state valuation tasks will be administered to a representative s le of 2000 members of the Australian general population via an online survey and to 250 dementia dyads (250 people with dementia and their carers) via face-to-face interview. A multinomial (conditional) logistic framework will be used to analyse responses and produce the utility algorithm for the AD-5D. The algorithms developed will enable prospective and retrospective economic evaluation of any treatment or intervention targeting people with dementia where the QOL-AD has been administered and will be available online. Results will be disseminated through journals that publish health economics articles and through professional conferences. This study has ethical approval.
An online learning community for clinical educators
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.NEPR.2005.10.002
Abstract: This paper describes a curriculum innovation that responds to the need for a clinical education course to prepare Australian clinical educators for their role in supporting students of nursing to develop clinical skills and gain confidence in the practice of nursing. The course is underpinned by two major theoretical approaches: learning community and transformative education. This paper reviews the literature on the strengths and challenges of online learning and describes the teaching and learning strategies, assessment, and online presentations that were designed to promote transformative learning and solidarity amongst participants.
Social Support for Physical Activity Over 9 Years in Adults Aged 60–65 Years at Baseline
Publisher: Human Kinetics
Date: 10-2023
Abstract: Physical activity is a leading determinant of health and well-being in older adults however, participation is low. Social support can significantly influence physical activity uptake and maintenance however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60–65 at baseline ( n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years ( p .001). Companionship had the greatest decline among types (17%–18%, p .001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults.
Counselling processes to address psychological distress following childbirth: Perceptions of midwives
Publisher: Elsevier BV
Date: 09-2004
Effect of Maternal Confidence on Breastfeeding Duration: An Application of Breastfeeding Self‐Efficacy Theory
Publisher: Wiley
Date: 12-2002
DOI: 10.1046/J.1523-536X.2002.00202.X
Abstract: Although much research has focused on identifying factors that influence breastfeeding initiation and duration, many high-risk factors are nonmodifiable demographic variables. Predisposing factors for low breastfeeding duration rates that are amenable to supportive interventions should be identified. The purpose of this study was to assess the effect of maternal confidence (breastfeeding self-efficacy) on breastfeeding duration. A prospective survey was conducted with 300 women in the last trimester of pregnancy recruited from the antenatal clinic of a large metropolitan hospital in Brisbane, Australia. Telephone interviews were conducted at 1 week and 4 months postpartum to assess infant feeding methods and breastfeeding confidence using the Breastfeeding Self-Efficacy Scale. Although 92 percent of participants initiated breastfeeding, by 4 months postpartum almost 40 percent discontinued and only 28.6 percent were breastfeeding exclusively the most common reason for discontinuation was insufficient milk supply. Antenatal and 1-week Breastfeeding Self-Efficacy Scale scores were significantly related to breastfeeding outcomes at 1 week and 4 months. Mothers with high breastfeeding self-efficacy were significantly more likely to be breastfeeding, and doing so exclusively, at 1 week and 4 months postpartum than mothers with low breastfeeding self-efficacy. Maternal breastfeeding self-efficacy is a significant predictor of breastfeeding duration and level. Integrating self-efficacy enhancing strategies may improve the quality of healthcare that healthcare professionals deliver and may increase a new mother's confidence in her ability to breastfeed, and to persevere if she does encounter difficulties.
Study of Queensland emergency department nurses' actions and formal and informal procedures for clients who self-harm
Publisher: Wiley
Date: 16-07-2002
DOI: 10.1046/J.1440-172X.2002.00359.X
Abstract: Emergency department nurses are often required to assess and manage the needs of people who self-harm. A survey of 352 nurses working within 23 major public and 14 major private emergency departments in Queensland, Australia, investigated the extent to which formal and informal procedures are available and the extent to which these procedures guide how nurses respond to clients who present with deliberate self-harm. The Risk Assessment Questionnaire was developed and found that nurses are frequently called to respond to clients presenting because of deliberate self-harm, but most have no formal training in this area. In some services there is a lack of formal and comprehensive procedures for assessment and treatment. Where procedures do exist, significant therapeutic areas related to assessment are not explored with clients. These findings have implications for continuing professional development activities, nursing education programs and clinical practice procedures.
Related Organisations
South Dakota School Of Mines And Technology
Location: United States of America
South Dakota School Of Mines And Technology (SDSMT)
Location: United States of America
Related Funding Activities
Linkage Projects - Grant ID: LP0774983
Start Date: 06-2007
End Date: 12-2009
Amount: $150,000.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP0560464
Start Date: 03-2006
End Date: 03-2009
Amount: $72,444.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP0775127
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End Date: 07-2010
Amount: $183,000.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP120100194
Start Date: 02-2012
End Date: 06-2016
Amount: $200,000.00
Funder: Australian Research Council
View Funded Activity