bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the Quality of Dyadic Relationships on the Psychological Well-Being of Elderly Care-Recipients
Authors: Nunley Barbara L , Hall Lynne A , Rowles Graham D 
Published: May 2014

ABSTRACT
The purpose of this study was to examine the association of the quality of caregiver relationships with the psychological well-being of elderly care- recipients. Sociodemographic variables and characteristics of the care- recipient situation (e.g., self-rated physical health, amount of instrumental support needed) were explored as potential predictors of the psychological well-being of elderly individuals. A secondary analysis of data collected during inhome interviews with 37 community-dwelling older adults revealed no significant correlations between the quality of the primary intimate relationship and any dimension of psychological well-being. However, better self-rated health was associated with fewer depressive symptoms, higher morale, greater life satisfaction, and better quality of life. The more instrumental support needed by an individual, the greater their depressive symptoms and the lower their morale. The findings also revealed that the older the individual was, the greater the depressive symptoms were and the lower life satisfaction became. Self- rated physical health predicted each dimension of psychological well-being. The findings suggest that age, the amount of instrumental support needed, and perceptions of physical health are important indicators of the psychological well-being of elderly care- recipients.
How Accurate Are Chronic Wound Assessments Using Interactive Video Technology?
Authors: Gardner Sue E , Frantz Rita A , Specht Janet K Pringle , Johnson-Mekota Judy L , Buresh Kelli A , Wakefield Bonnie , Flanagan James 
Published: May 2014

ABSTRACT
This project examined the accuracy of chronic wound assessments made using an interactive, video telecommunications system (Teledoc™ 5000, NEC America, Inc., Irving, TX) by comparing a nurse expert's in-person wound assessments with wound assessments made from taped Tefedoc sessions. Wound assessments determined the absence or presence of nine wound characteristics instrumental in guiding treatment (e.g., tunneling, undermining, granulation tissue, necrotic tissue, epithelial tissue, purulent exudate, erythema, edema, induration). A sample of 13 paired wound observations was analyzed. The accuracy of the Teledoc technology was examined by calculating the amount of agreement between the inperson assessments and the taped Teledoc assessments for each of the nine characteristics. Agreement for eight of the nine wound characteristic exceeded 75%, suggesting this telehealth medium does not alter wound assessment data, which are essential in guiding treatment decisions. In addition to connecting the remotely based nurse with nursing expertise to improve patient care, telehealth technology seemed to increase the remotely-based nurses' knowledge of wound assessment and treatment as well.
EVALUATING THE COST of One Telehealth Application Connecting an Acute and Long-Term Care Setting
Authors: Specht Janet K Pringle , Wakefield Bonnie , Flanagan James 
Published: May 2014

ABSTRACT
This article describes a study of the costs of a pilot telemedicine chronic wound consultation clinic. Cost minimization analysis is the technique used to examine the costs of the clinic. The components of cost analysis include the fixed costs of personnel and equipment and the indirect costs of circuit and line charges. Cost avoidance is also examined. Cost avoidance evaluates what costs were avoided by the use of the telemedicine clinic. Additionally, the cost perspectives of the consulting agency, the referring agency, and the patient are examined. The average cost of a chronic wound consultation was $136.16 (acute care perspective). Costs of a traditional face-to-face consultation, if the residents were transported to the acute care facility would be $246.28. Fifteen telehealth consultations per month were used to determine per consultation costs for line charges and depreciation/maintenance costs. In this pilot study, a cost savings was realized and patients benefited. Increased volume will help to offset the cost of the equipment depreciation and maintenance and make telehealth chronic wound consultations more cost effective.
Nursing Home Placement: Factors Affecting Caregivers' Decisions to Place Family Members with Dementia
Authors: Hagen Brad 
Published: May 2014

ABSTRACT
Nurses who work with older adults with dementia in the community are aware of how difficult it can be for family _ members to make p lacement- related decisions, and need research -based information to help families make these decisions. This article presents the results of a qualitative research study intended to explore the factors influencing caregivers' decision-making process related to placi%Ji- ing an elderly family member with dementia in a nursing home. Using the study findings, the author suggests a theory which helps to explain some of the decision -making factors which appear to influence caregivers' abilities to make placement-related decisions. The nursing implications of this theory, and recommendations for future research, are > presented.
Measuring QUALITY OF CARE with an Inpatient Elderly Population: THE GERIATRIC RESOURCE NURSE MODEL
Authors: Turner Jean T , Lee Virginia , Fletcher Kathy , Hudson Kathy , Barton Dave 
Published: May 2014

ABSTRACT
Nurses provide health services to an increasing number of older adults in acute care settings. Acute care nurses are committed to giving patients the highest quality care while recognizing the importance of delivering care in a cost-effective manner. In this study, a unitbased, nurse-centered geriatric program is evaluated. The program is designed to enhance the knowledge and skill of staff nurses in providing care to elderfy patients.
Both quantitative and qualitative methods are used to assess geriatric resource nurses' (GRNs) influence on quality and cost outcomes of the elderly participants. Patients age 65 years and older were randomly selected from two general medical units of a major academic tertiary care center in the southeastern United States. Data were collected during an 18-month period in 1996 and 1997, A total of 129 participants provided data for quantitative analysis. A subset of 34 participants (17 from the unit where GRNs were on staff and 17 from a control unit) was interviewed about their experience during hospitalization. This information was analyzed for common themes and trends using appropriate qualitative techniques.
Demographic variables and common measures of illness severity and complexity showed comparable patient populations on the two units. However, results of quantitative analyses indicated significant differences between groups on admission for several of the health status measures. Participants on the unit without GRNs were found to have more problems with pain, incontinence, and mobility. Administrative measures showed the number of patients readmitted to the hospital within 31 days of discharge and the length of stay associated with this initiai readmission were significantly lower on the unit with GRNs. The use of vest-type physical restraints was also less frequent on this unit.
Elderly patients in both groups indicated they have special needs related to normal aging changes and chronic illnesses, resulting in higher levels of fragility and decreased energy reserves. They identified specific functional areas for which help was needed. These include assistance with bathing, eating, sleeping, mobility, and elimination. Fewer participants on the intervention unit reported decline in activities of daily living (ADL) function during hospitalization than did control participants. Participants in both groups stressed the importance of nurses' demonstrating understanding and caring when working with older individuals.
Subjective Responses to Caregiving for a Spouse with Dementia
Authors: Narayan Suzanne , Lewis Marsha , Tornatore Jane , Hepburn Kenneth , Corcoran-Perry Sheila 
Published: May 2014

ABSTRACT
Family members, typically spouses, serve as the primary caregivers for individuals with dementia. While it is recognized that caregivers experience both positive and negative subjective responses to caregiving, relatively little research has been done on the relationship between these types of responses. The objectives of the study were to examine the relationships between and among spouse caregivers' positive and negative subjective responses to caregiving, and increase understanding of the experience of being a spouse caregiver for a person with dementia. Fifty spouse caregivers completed quantitative measures of positive subjective responses (Positive Aspects of Caregiving and Caregiver Competence) and negative subjective responses (Relational Deprivation, Role Captivity, and Loss of Self). Additionally, participants were interviewed concerning their caregiving experiences. Positive Aspects of Caregiving and Caregiving Competence were significantly related to each other (p < .01 ), as were the three measures of negative subjective responses (p< .01). No significant correlations were found between any measures of a positive and a negative subjective response, suggesting the two types of responses are independent. Duration of caregiving was significantly related to Positive Aspects of Caregiving (p < .05), Caregiver Competence (p < .05), and Relational Deprivation (p < .01). Qualitative interview data revealed that participants simultaneously experienced caregiving as self-affirming, while also enduring losses and difficulties resulting from their caregiving role. Integrating the positive and negative aspects of the whole of caregiving is important to understand the caregiving experience and to design interventions to support caregivers.
Delirium in Elderly Patients: An Overview of the State of the Science
Authors: Foreman Marquis D , Wakefield Bonnie , Culp Kennith , Milisen Koen 
Published: May 2014

ABSTRACT
Delirium is a common and potentially preventable and reversible cause of functional disability, morbidity, mortality, and increased health care use among elderly individuals. Much has been learned about delirium in the past decade. Highlighted in this article are recent advances in the diagnosis of delirium, delirium in long-term care, use of health care resources, outcomes of delirium, etiologies, and interventions to prevent and treat delirium. Suggestions for future research also are proposed.
ACHIEVING RESTRAINT-FREE CARE of Acutely Confused Older Adults
Authors: Sullivan-Marx Eileen M 
Published: May 2014

ABSTRACT
Restraint-free care has emerged as an indicator of quality care for older adults in all settings. The most difficult challenges to achieving this goal are care of hospitalized older adults who are functionally dependent and cognitively impaired. The purpose of this article is to report findings from a descriptive study of restrained hip fracture patients, and discuss approaches to achieving restraintfree care. Rate of restraint use was 33.2% among hospitalized hip fracture patients during an 11-year period in 20 metropolitan teaching hospitals. Restrained patients were older men who resided in nursing homes prior to hospitalization. Clinically, restrained patients had a diagnosis of dementia, were noted to be confused or disoriented by nursing staff, and were dependent in activities of daily living. An individualized approach to care is the best method to avoid use of physical restraints for patients with acute confusion and cognitive impairment.
Clinical Implications of Respiratory System Changes in Aging
Authors: Sheahan Sharon L , Musialowski Regina 
Published: May 2014

ABSTRACT
Nurses must consider the many age-related respiratory system changes when assessing and managing respiratory-related symptoms of older individuals. This article reviews upper and lower respiratory tract changes and provides tips for clinical management of the older person. Pertinent respiratory symptom assessment scales are described. Smoking cessation and other health promotion counseling is discussed.
Redesigning Nighttime Care FOR PERSONAL CARE RESIDENTS
Authors: O'Rourke Deanne J , Klaasen Kathleen S , Sloan Jeff A 
Published: May 2014

ABSTRACT
This study investigated the effects of non-disruptive nighttime care for residents in a personal care setting. The sample consisted of 18 personal care home residents in an urban, 388bed, long-term care facility located in Winnipeg, Manitoba, Canada. The study used a quasiexperimental, single-arm design, exposing all residents to both intervention and control conditions. Independent variables were the current nighttime routine of regular rounds to turn and change residents, and a non-disruptive plan of care in which residents were checked hourly by staff and necessary care was provided when they were awake. Outcome variables included total sleep from evening bedtime to morning awakening, longest period of uninterrupted sleep at night, amount of time spent sleeping during the day, self-reported restfulness of cognitively intact residents, and skin condition. Findings suggested that the non-disruptive nighttime care routine increased total sleep by an average of 30 minutes a night for each resident. The amount of uninterrupted sleep increased by approximately 45 minutes with the new routine. No significant differences were noted in the amount of time spent sleeping during the day. There was no evidence of skin breakdown during any phase of the study. Clinical implications of this study demonstrate a need for gerontological nurses to re-evaluate nighttime care routines in personal care settings.
MEN Providing Care to Older Adults in the Home
Authors: Houde Susan Crocker 
Published: May 2014

ABSTRACT
Men are important providers of care to older adults who are functionally impaired in the home setting. Some results from research studies suggest that the male caregiver may provide different types of care and have different responses to caregiving than female caregivers. This article provides an overview of research related to the role of the male caregiver and discusses implications for supportive interventions. The need for more research related to the needs of the male caregivers and the value of traditional interventions for this group are addressed.
Family Caregivers' Attitudes Toward Aging, Caregiving, and Nursing Home Placement
Authors: Courts Nancy Fleming , Barba Beth E , Tesh Anita 
Published: May 2014

ABSTRACT
Nursing home placement (NHP) is stressful both for older adults and for their family caregivers. This descriptive survey research investigated family caregivers' attitudes toward aging, their emotional appraisal of nursing home placement, and their reactions to caregiving roles. Eighty-eight survey packets were mailed and 35 usable packets were returned for a response rate of 39.5%. Sixty-four percent of the respondents were age 65 or older. Respondents reported that they felt "privileged to care" for their residents and that caregiving had little impact on their personal schedules. Further, they did not feel abandoned by other family members. Fifty percent reported feelings of sadness when thinking about nursing home placement though they indicated that they were mostly pleased. The respondents had mostly positive attitudes about aging. It may be that those who responded to the survey were coping at a high level. Caregiver reactions might differ in the group that did not respond. Included are specific nursing implications and needs for further research.
"I hated those darn chickens...": The Power in Stories for Older Adults and Nurses
Authors: Hirst Sandra P , Raffin Shelley 
Published: May 2014

ABSTRACT
Attention to stories provides a holistic view of an older adult and offers the potential for quality nursing intervention. Explored in this article is the power of stories to advance the well being of older adults and the implications for gerontological nurses of a commitment to support storytelling in this population.
Perceptions of Older Latino Adults Regarding Physical Fitness, Physical Activity, and Exercise
Authors: Melillo Karen Devereaux , Williamson Eileen , Houde Susan Crocker , Futrell May , Read Catherine Y , Campasano Marie 
Published: May 2014

ABSTRACT
Healthy People 2000 has identified the importance of physical activity for healthy aging, but little is known about what motivates older individuals, older Latino adults, in particular, to be physically active. The purpose of this research was to examine the perceptions of older Latino adults toward physical fitness, physical activity, and exercise. This study used a qualitative focus group design. The sample of Latino adults age 60 and older resided in Northeast Massachusetts and was recruited from community settings which serve older Latino adults. Three focus groups, consisting of four to eight individuals in each group, were conducted and audiotaped. Data analysis used a combination of open, axial, and selective coding procedures. Focus group participants viewed physical fitness as being able to do anything; the mind and body working together; and feeling "light," being healthy. Support was viewed as a motivator of physical activity and exercise and included community resources, group support, cultural unity, and health provider assistance. Barriers of fear and a feeling of inappropriateness were identified by focus group participants. Although the study was exploratory and the sample size small, it provides useful cultural knowledge and information for community health and gerontological nurses. Knowledge about older Latino adults' perceptions of motivators and barriers to physical activity and exercise is a necessary first step for nurses to prescribe activities that will help improve functional independence and quality of life. Nurses can serve as links for older Latino adults in accessing community resources. Sociocultural factors that influence Latino adult perceptions must be assessed if health promotion program planning is to be tailored to meet individual and group needs.
The Effect of Physical Restraints on Fall Rates in Older Adults Who Are Institutionalized
Authors: Dunn Karen S 
Published: May 2014

ABSTRACT
Since the Omnibus Budget Reconciliation Act (OBRA) of 1987, there has been a significant reduction in the use of physical restraints to prevent falls in older adults who are institutionalized because of the developing awareness of the physical and psychological problems associated with them. The purpose of this ex post facto descriptive study was to determine if there is a difference in falls when physical restraints are allowed or prohibited in one older adult population. Data from incident reports from a purposive sample of 97 older adults in one long-term care facility were analyzed before and after the implementation of a restraint-free policy. The results indicated no significant difference in the number of falls before and after the policy change. However, there was a significantly lower number of falls with injuries and a significantly higher number of falls without injuries. These findings suggest older adults will continue to fall with or without the use of physical restraints because of changes associated with the aging process and risk factors. Removing physical barriers from older adults and allowing freedom of movement may decrease the severity of injury sustained in a fall.
Conceptualizing Resilience in Women Older Than 85
Authors: Felten Beverly Sigl , Hall Joanne M 
Published: May 2014

ABSTRACT
Resilience in women older than 85 is defined as the ability to achieve, retain, or regain a level of physical or emotional health after devastating illness or loss. This concept analysis of resilience in women older than 85 is based on the strategy suggested by Meléis. Resilience in women older than 85 is symbolized by a coiled wire, enclosed within a box similar to a jack-in-the-box. Environmental factors within the jack-in-the-box include frailty, determination, previous experience with hardship in learning how to cope, access to care, culturally based health beliefs, family support, self-care activities, caring for others, and functioning like efficiently working machines. External factors that influence the ability of the wire to recoil include the structure of the box itself and stress. More study is needed regarding diverse older women's experiences of resilience to develop a workable, clinically focused theory.
OVERCOMING ADVERSITY FROM ILLNESS OR LOSS
Barriers to Nutrition Care for Nursing Home Residents
Authors: Crogan Neva L , Shultz Jill A , Adams Carolyn E , Massey Linda K 
Published: May 2014

ABSTRACT
The prevalence of protein-calorie malnutrition (PCM) in nursing home residents has reached 85% in some nursing homes and is linked to increased mortality among residents. Separate survey questionnaires were developed and administered to 99 nursing assistants and 44 nurses (35 RNs, 9 LPNs) from five eastern Washington nursing homes. The purpose was to assess nurse (RN, LPN) and nursing assistant perceived beliefs and views related to nutritional needs of nursing home residents that have a potential impact on PCM of residents. Experienced nursing assistants did not view the nurse as an active participant during mealtime. Specific barriers such as a lack of time and training, too many residents working short staffed, poor food quality, and a lack of nurse-nursing-assistant teamwork may contribute to residents not getting enough food to eat. An education program addressing staff relationships and nutrition training of nursing assistants could improve the ability of nursing staff to ensure residents' food intake and improve the quality of life for residents in nursing homes.
Nurse Caregiver FEELINGS About Agitation in ALZHEIMER'S DISEASE
Authors: Roper Janice M , Shapira Jill , Beck Alicia 
Published: May 2014

ABSTRACT
This study examines the feelings of nurse caregivers of patients with Alzheimer's disease (AD) who are agitated. Methods included participant observation, examination of medical records, and ethnographic interviews of 17 nurse caregivers from one inpatient setting. Two patterns of feelings emerged from the data. One pattern was associated with caregiver expressions of personal identification with and vulnerability to AD. These nurses endorsed feelings of helplessness, hopelessness, and frustration when providing care to agitated AD patients. A second pattern situated nursing interactions within the realistic context of the patient's response to the illness. Caregiver feelings of confidence, competence, and satisfaction were associated with the second pattern. The relationship between the feeling states of nurse caregivers and their reported management of agitation in AD is discussed. Recognition and awareness of distressing feelings is a necessary first step for nurses to learn less personalized reactions to patients and respond more objectively to agitated behaviors.
CHRONIC PAIN IN THE OLDER PATIENT: Management Strategies
Authors: Herr Keela 
Published: May 2014

ABSTRACT
This is the second of a two-part series, which highlights issues and strategies related to pain assessment in older adults and current problems of pain management in older adults and analgesic regimens pertinent to this population. The complexities of assessing pain in older adults and assessment techniques for accomplishing a careful evaluation of pain were presented in the first part of this series, which was published in the January issue of the Journal of Cerontological Nursing (Vol. 28, No. 1). This article addresses issues and strategies related to management of pain, particularly analgesic use, in this challenging population.