bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thriving A Life Span Theory
Authors: Haight Barbara K , Barba Beth E , Tesh Anita S , Courts Nancy F 
Published: May 2014

ABSTRACT
There is a need for aging theories to become holistic and multidisciplinary with a life span focus. A theory is the construction of explicit explanations in accounting for empirical findings. A good gerontological theory integrates knowledge, tells how and why phenomena are related, leads to prediction, and provides process and understanding. In addition, a good theory must be holistic and take into account all that impacts on a person throughout a lifetime of aging. Based on these criteria, the authors created the Theory of Thriving, with a holistic life span perspective for studying people in their environments as they age. This article proposes a theory for studying people over time in a holistic, encompassing manner.
Characteristics of Nursing Homes: Adopting Environmental Transformations
Authors: Tesh Anita S , McNutt Kathy , Courts Nancy F , Barba Beth E 
Published: May 2014

ABSTRACT
During the past few years, many nursing homes in North Carolina have formulated plans to transform or enhance their environments to make the facilities more desirable places to live and work. The purpose of this study was to compare characteristics of facilities adopting one specific model for environmental transformation, the Eden Alternative™; with those adopting other environmental transformations or making no changes. Surveys were mailed to administrators of all (n = 378} certified nursing facilities in NC. A total of 167 surveys were returned, for a return rate of 44%. Of these, almost three fourths were planning or implementing some sort of environmental transformation. Thirty-seven facilities (22%) indicated they were currently adopting the Eden Alternative, and 47 (28%) were planning to adopt it. Twenty-six facilities (16%) reported they were currently adopting an environmental transformation other than the Eden Alternative, and another 9 (5%) were planning to adopt another environmental transformation. The facilities adopting or planning environmental transformations other than the Eden Alternative reported adopting (or planning to adopt) various components of the Eden Alternative. Forty-six facilities (28%) indicated they had no plans for environmental transformation. Facilities making environmental transformations were found to be similar to those making no changes on most variables examined, supporting the conclusion that environmental transformation is feasible for facilities with a wide range of characteristics.
The North Carolina Eden Coalition: Facilitating Environmental Transformation
Authors: Hamilton Nadine , Tesh Anita S 
Published: May 2014

ABSTRACT
The Eden Alternative™, created by Harvard educated physician Dr. William Thomas, is a model for transforming skilled care facilities from institutions based on a medical model of care into human habitats that promote human growth. This change is accomplished through decen- : tralizing the organizational structure of the facility to empower front-line care-delivery staff, and through introduction of plants, animals, gardening, and children into the daily lives of residents. Because the Eden Alternative is a trademarked name, only facilities recognized by the Eden Alternative registry are allowed to use the name. However, any facility may adopt the philosophies embodied by the Eden Alternative, and implement the principles for transforming their facility.
In 1996, the North Carolina Division of Facility Services formed the North Carolina Eden Coalition (originally named the North Carolina Eden Alternative Coalition). This was the first organization of its kind in the country. The success of the Coalition has led it to , become a model for implementation in other states. Currently, North : : Carolina leads the country in the number of registered Eden Alternative facilities, and has a large number of other facilities that have instituted some form of environmental enhancement. The Coalition functions as a consumer-driven advisory and educational body rather than a formal regulatory standard body, and endorses implementation of the principles and philosophies embodied in the Eden Alternative. The Coalition has proved to be a successful, cooperative effort among regulators, providers, advocates, and other experts to implement the philosophies of the Eden Alternative without regulatory basis. Because the Coalition was formed under the auspices of the Division of Facility Services and operates with its ongoing cooperation, it is in an excellent position to clarify and influence policies and regulatory issues concerning transformation of long-term care environments in North Carolina.
This article explores the history, structure, function, mission, and goals of the North Carolina Eden Coalition. Examples of issues the Coalition has addressed in promoting environmental transformation in North Carolina's skilled care facilities are also included.
Snoezelen®: A Multisensory Environmental Intervention
Authors: Chitsey Amanda M , Haight Barbara K , Jones Melaina M 
Published: May 2014

ABSTRACT
Snoezelen® is a multisensory intervention delivered in a specially designed room with high-tech instruments. It is especially useful for end-stage patients with Alzheimer's disease. Snoezelen provides an enabling atmosphere in a failure-free environment. It has been a popular intervention in Great Britain and is just beginning to appear in the United States.
Decreasing Aggressive, Agitated, or Disruptive Behavior: PARTICIPATION IN A BEHAVIOR MANAGEMENT UNIT
Authors: DeYoung Sandra , Just Gloria , Harrison Ruth 
Published: May 2014

ABSTRACT
A 32-bed Behavior Management Unit was opened in a long-term care facility to care for dementia patients who exhibit aggressive, agitated, or disruptive (AAD) behaviors. The purpose of the study was to evaluate the effectiveness of the Behavior Management Program (BMP) in decreasing such behaviors. The sample consisted of all patients (N = 32) who resided in the unit for at least 3 months. The Nursing Home Behavior Problem Scale (NHBPS) was used to collect data.
Hypothesis 1, predicting participation in the BMP would decrease the total number of AAD behaviors was supported, with a significant decrease from the baseline to 6month measurements. Hypothesis 2, predicting participation in the BMP would decrease the frequency of occurrence of specific AAD behaviors was supported, with 7 behaviors being significantly reduced by 6 months.
Nurses in long-term care often treat patients with AAD behavior. Because staff members on general long-term care units and even in dementia units may not be experts in caring for patients with AAD behaviors, the implications of this study might be helpful. The interventions that were effective in reducing AAD behaviors included verbal distraction, time-outs, activity diversion, getting to know the patient well, and managing the environment.
TESTING THE EFFECT OF THE WALC Intervention on EXERCISE ADHERENCE in OLDER ADULTS
Authors: Resnick Barbara 
Published: May 2014

ABSTRACT
The purpose of this study was to test the feasibility of the WALC intervention (Walk; Address pain, fear, fatigue during exercise; Learn about exercise; Cue by self-modeling), and determine its effects on self-efficacy and outcome expectations, exercise activity and free living activity, physical and mental health status, and falls and fall-related injuries. A total of 17 sedentary older women with a mean age of 88 ± 3.7 years were randomly assigned to receive either the WALC intervention or routine care. Ninety percent of those in the treatment group initiated and engaged in a regular exercise program during the 6 months of the study. There was a statistically significant difference in self-efficacy expectations, exercise behavior, and overall activity between the two groups. Those in the treatment group had stronger self-efficacy expectations related to exercise; engaged in more exercise and more free living activity; and although not statistically significant, had stronger outcome expectations following exposure to the WALC intervention when compared with those who received routine care. To help older adults initiate and adhere to an exercise program, nurses can easily implement the WALC intervention in a variety of settings.
Staff Development and Long-term Care OF PATIENTS WITH DEMENTIA
Authors: Kaasalainen Sharon 
Published: May 2014

ABSTRACT
Staff development and training programs focusing on the care of patients with dementia is important in providing staff with the specialized knowledge and skills essential in the management of these patients. In this article, the nature of staff development is explored with an analysis of conceptual visions or definitions of staff development. Secondly, the Cervero (1985) framework for continuing professional education and behavioral change is used as a guide to describe the factors that influence the effectiveness of staff development (i.e., social system, individual learner characteristics, type or design of program). Next, the literature related to the outcomes of staff development programs is analyzed. In particular, do staff development programs lead to increased staff morale and job satisfaction and improved client care? An analysis of orientation and educational programs developed for staff working with patients with dementia in long-term care settings is conducted. Using aspects of the RSA evaluation model (Abruzzese, 1996), each program is examined in terms of its process, content, outcome, and impact, along with its feasibility in clinical settings. This critical analysis provides some direction for the development and evaluation of staff development programs in longterm care settings for those staff who work with patients with dementia.
Older Adults with Hip Fractures: TREATMENT OF PAIN FOLLOWING HOSPITALIZATION
Authors: Feldt Karen S , Finch Michael 
Published: May 2014

ABSTRACT
This study examined pain experiences and treatment for older adults in long-term care or rehabilitation settings 3 weeks after surgical repair of a hip fracture. Pain report and pain treatment for cognitively intact residents were compared with cognitively impaired residents. Two thirds of all participants reported pain. Most rated pain as slight or mild in severity. Pain report was similar for cognitively impaired and intact participants. Pain was reported as severe or worse by 17% of the residents. Nursing care pians documented comfort as a goal for fewer than half the participants. Almost 40% (n ~ 23) of the participants were receiving no pain medication 3 weeks postoperatively, five of these rated their pain as moderate or severe. Pain documentation, including effective nonpharmacological treatments, needs to be improved for cognitively impaired and intact older adults who are recovering from hip fracture surgery.
Written and Computerized Care Plans
Authors: Daly Jeanette M , Buckwalter Kathleen , Maas Meridean 
Published: May 2014

ORGANIZATIONAL PROCESSES AND EFFECT ON PATIENT OUTCOMES
ABSTRACT
The purpose of this study was to determine how use of a standardized nomenclature for nursing diagnosis and intervention statements on the computerized nursing care plan in a long-term care (LTC) facility would affect patient outcomes, as well as organizational processes and outcomes. An experimental design was used to compare the effects of two methods of documentation: Computer care plan and paper care plan. Twenty participants (10 in each group) were randomly assigned to either group. No statistically significant differences were found by group for demographic data.
Repeated measures ANOVA was computed for each of the study variables with type of care plan, written or computerized, as the independent variable. There were no statistically significant differences between participants, group (care plan), within subjects (across time), or interaction (group and time) effects for the dependent variables: Level of care, activities of daily living, perception of pain, cognitive abilities, number of medications, number of bowel medications, number of constipation episodes, weight, percent of meals eaten, and incidence of alteration in skin integrity. There were significantly more nursing interventions and activities on the computerized care plan, although this care plan took longer to develop at each of the three time periods. Results from this study suggest that use of a computerized plan of care increases the number of documented nursing activities and interventions, but further research is warranted to determine if this potential advantage can be translated into improved patient and organizational outcomes in the long-term care setting.
Advance Directives: Why Community-based Older Adults do not Discuss Their Wishes
Authors: Inman Lisa 
Published: May 2014

ABSTRACT
Health care providers and family members need direction when making health decisions for individuals who are unable. Advance directives allow individuals to maintain control of health care decisions. Despite that the majority of the population supports the right to express wishes related to end-of-life care, few implement advance directives. The purpose of this study was to determine reasons why community-based older adults discuss, do not discuss, or formalize advance directives. A convenience sample of 55 adults age 50 or older, participated in the study by answering a 31 -question self-report questionnaire. Death or serious illness of a loved one was the most influential factor prompting formulation of an advance directive. However, the majority of the population has not expressed their health care wishes in the form of advance directives. Therefore, continuing to educate and encourage discussion of advance directives is imperative.
Self-Transcendent Views and Behaviors: Exploring Growth in Caregivers of Adults with Dementia
Authors: Acton Gayle J 
Published: May 2014

ABSTRACT
Literature suggests difficult life experiences such as fear, loss, and grief can provide an impetus for moving from self-centeredness toward a broader personal identity and self-transcendence. Caring for a family member with dementia may provide the context for such a movement; thus, the purpose of this study was to investigate self-transcendent views and behaviors in family caregivers of adults with dementia. A naturalistic field study design was used to collect data from individuals caring for family members with dementia. Findings showed little evidence of self-transcendent views and behaviors and little opportunity for caregivers to engage in activities that might facilitate self -transcendence. Conclusions of the study reveal social isolation, ambivalence, burden of care, and emotional fragility may inhibit the development of selftranscendence and interfere with healthy growth and development in family caregivers.
Turnover Reinterpreted: CNAS TALK ABOUT WHY THEY LEAVE
Authors: Bowers Barbara J , Esmond Sarah , Jacobson Nora 
Published: May 2014

ABSTRACT
This study's purpose was to contribute to the development of a theory of turnover by understanding how CNAs employed in long-term care facilities conceptualize the factors that cause them to leave their jobs. Using grounded dimensional analysis, the authors conducted in-depth interviews with CNAs currently and formerly employed by three nursing homes. The CNAs' perception that they are unappreciated and undervalued by the organizations for which they work contributes significantly to turnover. The origins of this perception lie in policies and practices that lead CNAs to feel personally and professionally dismissed. The authors suggest how long-term care facilities might change their staffing and personnel policies to better demonstrate respect and appreciation, thus reducing turnover and enhancing the quality of work and care.
Cognitive Function in Community-Dwelling Elderly Women: ATTENTIONAL DEMANDS AND CAPACITY TO DIRECT ATTENTION
Authors: Jansen Debra A , Keller Mary L 
Published: May 2014

ABSTRACT
As individuals get older, their capacity to direct attention (CDA) appears to decline. The decline in CDA may be caused by age-related changes in the brain and demands on attentional mechanisms. These demands require older adults to expend significant attentional effort to maintain focus and achieve mental clarity while negotiating activities of daily life. The purpose of this study was to examine the relationship between attentional demands and CDA among a convenience sample of 72 community-dwelling older women with normal mental status. Findings indicate attentional demands correlated significantly with CDA and accounted for a significant proportion of the variance. No relationship was found between depressive symptoms and CDA. Implications for practice are nursing interventions aimed at decreasing attentional demands, thereby supporting attentional processes and functioning by communitydwelling older adults.
Disruptive Behaviors of Older Adults in an Institutional Setting
Authors: Souder Elaine , O'Sullivan Patricia 
Published: May 2014

Staff Time Required to Manage Disruptions
ABSTRACT
This study, as part of a larger project, examined the actual time recorded by nursing staff to manage 36 disruptive behaviors in older adults who are institutionalized. Disruptive behaviors were defined as socially unacceptable or isolating, observable actions with negative consequences. A prospective study was conducted using a sample of 153 patients in a Veterans Affairs institution (mean age = 72.6, SD = 10.8). Data related to time to manage disruptive behaviors were collected during 21 consecutive shifts for each patient. Nursing staff did not always intervene in all disruptive behaviors that occurred. When they did intervene, total time to manage a disruptive behavior ranged from 5.7 to 201 .5 minutes (mean = 23.1 minutes, SD = 31 .9).
Exercise Training Program for Older Adults Incentives and Disincentives for Participation
Authors: Schneider Joanne Kraenzle , Eveker Ann , Bronder Deborah Rilling , Meiner Sue E , Binder Ellen F 
Published: May 2014

ABSTRACT
The purpose of this study was to describe the incentives and disincentives for participating in an exercise training program for community-dwelling individuals 78 and older. One hundred forty-seven women and 62 men participated in this descriptive study, and ages ranged from 78 to 95 years (mean 82.7, ± 4.1). Individuals were interviewed by phone about their decision to participate in an exercise program. Qualitative responses were analyzed using content analysis. Three main incentive themes emerged: Health Benefits, Psychological Benefits, and Positive Program Features. Disincentive themes included Competing Commitments, Doubts about Exercise, and Negative Program Features. To better tailor an exercise program to the needs of this older age group, nurses working with older adults should keep in mind the lifestyle, agespecific obligations, and set of values affecting this cohort's participation.
Exploring Professional Caregivers' Perceptions Balancing Self-Care with Care for Patients with Alzheimer's Disease
Authors: McCarty Ellen F , Drebing Charles 
Published: May 2014

ABSTRACT
With the are hundreds of studies about caregiver burden related to family caregivers that exist, little has been written about caregiver burden as it pertains to professional caregivers. The purpose of this study was to explore professional caregivers' perception and meaning associated with their caring for patients with Alzheimer's disease (AD). Twentytwo professional caregivers were interviewed. Content analysis was used to clarify respondents' interview data. Several themes emerged from the data related to beliefs about choosing and maintaining AD caregiving role, beliefs about self-efficacy, commitment and self-satisfaction, nature of family interaction of individuals with AD, grieving responses, and ability to maintain self-care through social support as well as solitary time. Implications include AD professional burden measurement; study related to recruitment, orientation, and staffing patterns; and effect on the quality of care provided to patients and their families.
Bladder Management in Adult Care Homes: Review of a Program in North Carolina
Authors: Kincade Jean E , Boyington Alice R , Lekan-Rutledge Deborah , Ashford-Works Carolyn , Dougherty Molly C , Busby-Whitehead Jan 
Published: May 2014

ABSTRACT
In North Carolina there are approximately 34,000 residents in adult care homes (ACHs). Approximately 40% of these residents have urinary incontinence, and others require assistance with toileting. High prevalence of cognitive impairment, few licensed staff, and low staff -to- resident ratios in ACHs make behavioral techniques used in community-dwelling populations and toileting programs used in nursing homes inappropriate for these residents. This program was implemented using a twolevel approach (facility and individual resident) and uses an education consultation approach for implementation.
BedSAFE: A Bed Safety Project for Frail Older Adults
Authors: Hoffman Stephanie B , Powell-Cope Gail , MacClellan Leah , Bero Kim 
Published: May 2014

ABSTRACT
In response to heightened awareness of patient safety, restraint reduction, and the potential for life-threatening entrapment caused by bed rails, a quality improvement program entitled BedSAFE was conducted to systematically and safely decrease the use of bed rails in three nursing home care units. This article describes an interdisciplinary process of individualized patient assessment, selection of appropriate alternatives for residents, compliance monitoring, training, and monitoring of patient outcomes including falls and injuries related to falls from bed.
Shifting Paradigms: Teaching Gerontological Nursing from a New Perspective
Authors: Quinn Mary Ellen , Berding Christine , Daniels Elizabeth , Gerlach Mary Jo , Harris Karen , Nugent Katherine , Green Cathy , Clarke Geraldine 
Published: May 2014

ABSTRACT
Gerontological health care is undergoing a revolution, much like that of the feminist movement of the 1960s. Fundamental changes in health care require revisions in nursing education to ensure appropriate care of older adults in the least restrictive environment. The purpose of this study is to promote the preparation of future nurses who have the knowledge and the skills necessary to provide nursing care for the growing cohorts of older adults. A theoretical rationale for a new perspective in nursing education is discussed. An experiential clinical learning activity based on the functional model of gerontological health care is examined. This home visit clinical learning activity provides nursing students with the opportunity to practice nursing reflective of the health care needs of older adults. Strategies for replication of this clinical learning activity are provided.
Maintaining the Square: How Older Adults with Parkinson's Disease Sustain Quality in Their Lives
Authors: Whitney Christina M 
Published: May 2014

ABSTRACT
In this article, the author's objective is to uncover the common practices that help sustain quality in the lives of older adults with Parkinson's disease. Interpretive phenomenology was the method used to gather and analyze the stones of six men and six women with idiopathic Parkinson's disease. The results show a constitutive pattern of Maintaining the Square. Five relational themes, including Learning How, Accepting Limitations, Seeking Knowledge, Engaging in Meaningful Experiences, and Living for Today, emerged from the participants' stories. The participants' ability to sustain continuity in their lives indicates their successful maintenance of the square. By identifying markers of continuity, they are able to maintain quality in their lives. As nurses, we can promote continuity in the lives of our patients if we take the time to learn what gives them meaning and purpose in life and then facilitate ways to help them maintain this connection.