bluuebunny/crossref_metadata_2025_split huggingface dataset:
FEASIBILITY OF A COMMUNITY-LED VIRTUAL SELF-CARE PROGRAM FOR AFRICAN AMERICAN FAMILY CAREGIVERS
Authors: Keller Abiola , Norris Nia , Easter Bashir , Garr Andrea , Morgan Gail , Dicks-Williams Ramona , Galambos Colleen 
Published: December 2022

Abstract
As the population of older adults in the U.S. increases, the need for family caregivers will mirror this growth. Despite a greater intensity of caregiving, African American caregivers are less likely to access formal support services and engage in self-care practices. To address the self-care needs of African American family caregivers, a community-engaged approach was used to develop and implement a half-day virtual self-care program. The development of the program was guided by the Individual and Family Self-Management Theory. This study evaluates experiences of program attendees. The specific aims are to examine the acceptability and practicality of the virtual self-care program. Women who self-identified as African American and a caregiver (i.e., taking care of another adult) were personally invited to attend. All attendees were emailed an electronic survey containing Likert-type and open-ended questions. Responses were examined for patterns and key content-related categories using inductive content analysis. Eleven of the sixteen attendees responded to the survey. All eleven strongly agreed (64%) or agreed (36%) that the event met their expectations and/or needs. In addition to providing opportunity to take time to engage in self-care, the event created a virtual space for women to focus on themselves. Women spoke about three distinct ways the event met their needs: 1) learning and trying new things, 2) access to resources, and 3) having a shared experience. These findings suggest that virtual programs may be used as an additional resource to support the health of African American women who care for older adults.
THE WORST PART OF THE DAY: DAILY REFLECTIONS OF DEMENTIA FAMILY CAREGIVERS
Authors: Xiao Chunhong , Winstead Vicki , Pickering Carolyn 
Published: December 2022

Abstract
Family caregivers struggle with multi-dimensional demands in caring for persons living with dementia (PLWD). The challenges of caregiving combined with the requirements of daily life can impact the care of PLWD and the health and well-being of the caregivers. The purpose of this study was to describe caregivers’ perceptions of the worst part of their day in the context of daily caregiving challenges. Family caregivers completed online surveys reporting on various parts of their day. The survey included an optional open-ended question: “what was the worst part of your day?” Caregivers (N=165) completed diaries for 21 days resulting in 1,773 surveys that included a response to the optional open-ended question. A subset of data was analyzed using content analysis to identify initial codes and themes; further content analysis of the complete dataset was used to confirm and refine the identified codes and themes. Final analysis revealed 6 themes describing caregivers’ perceptions of the worst part of their day. These themes included days in which they had to: 1) cope with changes in their relationship with the PLWD, 2) manage their own health-related issues such as illness and lack of sleep, 3) struggle when there was a lack of help or support, 4) deal with daily life demands in the home along with the demands of caregiving, 5) cope with negative emotions such as sadness, grief, or anger over the disease process, 6) cope with physical exhaustion. The findings reflect daily stressors associated with caregiving for PLWD.
POOR SLEEP COMMON AMONG HOSPICE FAMILY CAREGIVERS AND ASSOCIATED WITH WORSE CAREGIVER HEALTH
Authors: Starr Lauren , Washington Karla , Pitzer Kyle , Demiris George , Oliver Debra Parker 
Published: December 2022

Abstract
Over 1.2 million hospice family caregivers in the United States are at risk for interrupted, insufficient sleep due to overnight caregiving responsibilities, anxiety or intrusive thoughts, and inadequate caregiving support. Insomnia contributes to health inequities yet is underrecognized and undertreated. The prevalence of insomnia among hospice family caregivers is not well understood. The purpose of this preliminary study was to describe insomnia prevalence among hospice family caregivers and identify factors that differentiate caregivers with sleep difficulties from caregivers without sleep difficulties. This observational study included 57 hospice family caregivers of cancer patients enrolled in a randomized clinical trial for caregivers [NCT02929108]. Results showed 49.1% of hospice family caregivers had subthreshold insomnia to severe clinical insomnia, as measured by the Insomnia Severity Index. Although social determinant of health variables did not differ based on caregiver insomnia status, caregivers with insomnia (5.0, median) self-rated their physical health significantly lower than caregivers without insomnia (8.0, median) (P&lt; 0.001). Directionally, the distance a caregiver lived from a care-recipient also differed by insomnia status, with 70% of caregivers with insomnia co-residing compared to 46% of caregivers without insomnia. Overall, 78.9% of hospice family caregivers had no caregiving support; anxiety and depression were highly prevalent. Clinicians should screen hospice family caregivers for sleep disorders and seek to improve caregiver health by offering sleep interventions tailored to the specific needs of hospice family caregivers and connecting caregivers to health resources for their own wellbeing. Policy makers must expand hospice benefits to include additional caregiver support.
BARRIERS AND FACILITATORS FOR ECONSULT: IMPROVING ACCESS TO SPECIALIST ADVICE IN LONG-TERM CARE
Authors: Fung Celeste 
Published: December 2022

Abstract
Long-term care (LTC) residents continue to receive most of their specialist care outside of the home. These visits present significant risks and burdens for residents. Such risks can be mitigated by eConsult, which facilitates timely, resident-specific, and practical recommendations between primary care providers (PCPs) and specialists to support clinical decision making, reduce unnecessary transfers, and positively impact resident care and quality of life. During focus groups in LTC homes where eConsult is used, PCPs, senior leadership, and a nurse champion recognized eConsult as having great value for residents, especially those with challenges travelling outside of the home. However, they also described LTC homes as under resourced, with minimal IT infrastructure and coupled with time constraints present barriers to eConsult adoption in LTC. Enabling factors (engaging clinician champions, establishing delegates, integration into existing workflows) similarly identified as supporting eConsult implementation more broadly were discussed.
COLLECTIVE TRAUMA AND PERSON-CENTERED PRACTICE IN NURSING HOMES
Authors: Morgan Jennifer , Chen Yun-Zih , Ahmad Waqar , Burgess Elisabeth 
Published: December 2022

Abstract
Nursing home staff have experienced multilayered collective trauma. Grief from experiencing numerous resident deaths, perceived threats to their safety, stress from understaffed working conditions, financial stress, and interpersonal conflict within overwhelmed teams may impact practice. COVID-19 precautions and pandemic working conditions may have provided additional barriers to implementing person-centered care. This study (N=379) descriptively analyzes data gathered from the staff of eleven Georgia nursing homes (summer 2021) to assess the perceived impact of COVID-19 on person-centered care practice. Approximately 40% of respondents agreed that 76-100% of resident members in nursing homes were infected with COVID-19. Over 75% of staff agreed that staff experienced anxiety related to COVID 19 precautions, COVID 19 precautions made it difficult for staff to give choice to residents, and the nursing home is more short-staffed. Conversely, more than 75% of staff reported that they were satisfied with their job, they received the appropriate training and support to be successful, nursing home managers treated direct care workers with respect and they were provided with the necessary PPE. Fewer staff (60-65%) reported that there never seemed to be enough time to get everything done, that COVID 19 precautions impacted their relationships with residents, they were provided with resources for emotional support or they received recognition for working through the pandemic. Future research is needed to understand the limiting and promoting factors for person-centered care as staff experience collective trauma.
THE VALUE PROPOSITION FOR DIVERSITY: CREATING A PIPELINE OF DIVERSITY IN THE LTSS SECTOR
Authors: Bryant Natasha , Hennessa Alexandra , Ruffin Adrienne , Stone Robyn 
Published: December 2022

Abstract
The long-term services and supports (LTSS) sector is a microcosm of systemic racism that exits in our society. Nationally, half of frontline professional caregivers are nonwhite, while mid- and executive-level managers and board members are predominately white. Research has identified this lack of diversity in management and leadership as a major contributor to turnover and recruitment challenges among frontline staff. We will summarize the findings from three applied research activities: 1) DEI survey of chief executive officers (CEOs) of multi-setting LTSS organizations; 2) interviews with chief diversity officers and CEOs on current workplace DEI efforts and the challenges; and 3) interviews with leaders of color who have had experience with the LTSS sector. Not-for-profit multisite organizations and life plan communities lack diversity among the senior leadership team and board members (12% are people of color). A DEI initiative is more likely to be successful if it has buy-in from the CEO and board members, aligns with the organization’s strategic plan and mission, is integrated into the organizational culture, and is assessed regularly to measure its impact and identify needed adjustments. Leaders of color in aging services acknowledge the barriers – lack of diversity among leaders and residents and the microaggressions that people of color experience - that make it challenging for people of color to work in the field. They recommend increasing diversity among senior leaders, investing in enhancing DEI, and spreading awareness of the LTSS field and its career opportunities to communities of color.
REFLECTIONS OF ADULTS TRANSITIONING TO LONG-TERM CARE FACILITIES: LOOKING BACK AND LOOKING FORWARD
Authors: Chang Pei-Fen , Hersch Gayle 
Published: December 2022

Abstract
Making a transition to a long-term care facility (LTCF) is often difficult for older adults. This study's intent was to explore ways in which life experiences and culture of older persons facilitate a successful transition to a LTCF. Eighteen participants were interviewed using a semi-structured interview guide to understand significant life events and personal factors impacting their lives. Interview data were analyzed using NVivo software to organize and manage emerging themes. The analysis revealed three related themes: person, current environments, and lifelong occupations. Within each major theme, subthemes were identified providing greater detail of how adaptive strategies are utilized to make such transitions positive. Participants were enabled to reflect upon their strengths and strategies available to adapt to these new residential settings. These perspectives are beneficial for healthcare practitioners to understand so as to personalize care and individualize the person's adjustment to a 'new' home.
SOCIAL INTERACTION AND PSYCHOLOGICAL WELL-BEING OF PERSONS LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Lee Kyung Hee , Lee Ji Yeon 
Published: December 2022

Abstract
Although social interaction might play a critical role to improve psychological well-being of old adults with dementia in long-term care, lack of social interaction between staff and residents has been reported. The purpose of this study was to examine whether social interaction is associated with psychological well-being of persons living with dementia during care in long-term care. We analyzed 258 videos from 30 participants with dementia. Each participant was taken nine videos at 0, 3, and 6 months at three care events (i.e., personal care, mealtime, and activity). Social interaction was assessed by quality (i.e., positive, neutral, and negative), type (i.e., verbal, nonverbal, and both), and presence of interaction (i.e., no and yes). Psychological well-being was measured by positive and negative emotional expressions. A mixed model was chosen for the data analysis since these repeatedly measured observation data were nested within subjects. Mixed models showed that positive and neutral interactions were significantly associated with positive emotional expressions of residents after controlling covariates while negative interaction was significantly associated with negative emotional expressions. There was no significance between interaction type and emotional expressions. This study highlights the importance of positive care staff interactions in dementia care. In addition, the institutional efforts to create an environment to reduce negative interactions can be of great help in promoting the psychological well-being of persons living with dementia.
HOSPITAL TRANSFERS: PERSPECTIVES OF NURSING HOME RESIDENTS AND NURSES
Authors: Ahmetovic Alma , Drucker Claire , Huber Lesa , Unroe Kathleen , Hickman Susan 
Published: December 2022

Abstract
Between 1 million and 2.2 million nursing home residents are transferred to a hospital emergency department each year. These transfers are costly, have negative health outcomes, and can increase the morbidity and mortality of residents. The purpose of this study was to examine the transfer process between the nursing home and the hospital from the perspective of nursing home residents and nurses, focusing on how decisions were made to transfer residents. Using a qualitative descriptive method, 22 participants were recruited from four nursing homes located in rural Indiana. Purposive sampling, semi-structured interviews, and conventional content analysis were used to collect and analyze narratives obtained from residents and nurses about their experiences with a recent transfer. The participants described four aspects of the transfer process: transfer decisions, transport experiences, hospital stays, and returns to the nursing home. The most common reason for transfers was an acute exacerbation of a chronic condition, and the decision to transfer was often made by a nurse. Most residents found aspects of the transfer aversive or upsetting. The return to the nursing home was typically welcomed but often challenging due to problems with mobility, medications, and cognitive changes. Participants also provided several recommendations for avoiding potentially preventable transfers including adding “in-house” diagnostic testing and treatment equipment, improving staff competencies in managing acute exacerbations, increasing staffing, improving communication among staff, and increasing staff familiarity with resident histories and preferences. The findings have several clinical and policy implications for preventing or decreasing the negative effects of hospital transfers.
EFFECTS OF DANCE INTERVENTIONS ON COGNITION IN OLDER ADULTS: A META-ANALYSIS
Authors: Rittiwong Tanapa , Wongyara Nattaya , Schneider Joanne 
Published: December 2022

Abstract

Background
Dance interventions have been shown to improve cognition in older adults. However, no meta-analysis evaluates that effect. Objective: We examined the effects of dance on cognition in older adults and examined the moderating effects of participant, methods, and intervention characteristics.

Methods
We searched 14 databases using the search terms: dance AND cognition AND older adults. Researchers of primary studies compared dance with control groups of adults≥60 years old, measured cognition, and wrote in English. Two researchers independently coded studies and discussed to achieve consensus. Using the random-effects model, we computed effect sizes (ES) using Hedges’ g with 95%CIs along with heterogeneity statistics and conducted moderator analyses.

Results
Twenty-five studies included 1,908 participants (70.9±5.2years old). Dance had a strong, positive effect on both global cognition (ES=0.52, 95%CI [0.25, 0.78], p=.000) and memory (ES=0.56, 95%CI [0.08, 1.04], p=.022) and a moderate effect on executive function (ES=0.35, 95%CI [0.06, 0.65], p=.019) and attention (ES=0.21, 95%CI [0.06, 0.36], p=.005). Several variables moderated the relationship including the country, dancing in pairs or not, or with partners vs. non-partners. Methodological quality indicators that moderated the relationship was computing a priori power and comparing participant characteristics at baseline. Weeks of dancing and minutes/session also moderated the relationship.

Conclusion
Dance can significantly improve cognition in older adults. Healthcare providers might use dance interventions as an alternative treatment to improve cognition in older adults. Future researchers should explore the effects of type of dances on cognition and measure outcome changes over time.
EMBRACING SPIRITUALITY IN THE WORK OF FRONTLINE NURSING HOME STAFF
Authors: Lopez Ruth Palan , Hendricksen Meghan , Roach Ashley , Rogers Anita Hendrix , Mitchell Susan 
Published: December 2022

Abstract
Good end-of-life care for nursing home (NH) residents and their families provides for spiritual support, however, the role that spirituality plays in the work of NH staff has not been well described. To understand more about spirituality and NH staff, we examined interview data generated from the Assessment of Disparities and Variation for Alzheimer Disease Nursing Home Care at End of Life (ADVANCE) study, a large qualitative study conducted in 14 NHs to examine differences in end-of-life care for residents with advanced dementia. We examined semi-structured interview data from nurses (Registered Nurses and Licensed Practical Nurses) (n=45) and certified nursing assistants (CNAs) (n=25) who described the role of spirituality or God in response to questions around their experience caring for residents with advanced dementia. Data were analyzed using the constant comparative method. Most participants were female (93%). Thirty-four identified as Black, 29 as white, and 7 as other racial groups. The average age was 47.8 years, and the average years of experience was 16.2 years. Participants reported several religious affiliations including Baptist (23); Agnostic/Atheist (2), Catholic (7), Methodist (4), Muslim (1), Other/Unaffiliated/Refused (18), Pentecostal (4), and Christian (9). We found that for many nurses and CNAs, God played an important role in their work including providing meaning and purpose, providing them with resilience to cope with frequently losing residents that they consider “family.” The voices of the participants were powerful and provide important insights into potential strategies to retain and support these essential, front-line providers.
THE ASSOCIATION BETWEEN ACCESS TO MEDICAL CARE AND RESIDENT OUTCOMES IN NURSING HOMES
Authors: Bali Krittika 
Published: December 2022

Abstract
The nursing home population is vulnerable and medically complex, yet little is known about models of medical service provision and associated quality outcomes. The goal of this study is to examine the association between physician (MD) and nurse practitioner (NP) accessibility and practice sensitive outcomes. This project used data from the Translating Research in Elder Care (TREC) longitudinal study and the routinely collected Resident Assessment Instrument – Minimum Data Set version 2.0 (RAI-MDS 2.0) to test the association between the availability of MDs and NPs in nursing homes (NH) and clinically-relevant resident outcomes of antipsychotic medication (APM) use without indication of psychosis, physical restraint use, hospitalization and emergency department (ED) transfers, and polypharmacy. Eight models were created using logistic regression to test the association between the access measures of daily presence of MD or NP on unit and MDs being involved in care planning and each of the four resident outcomes. The sample consisted of 10,888 residents across 320 units in 92 facilities. Staff from 277 (86%) units reported an MD or NP visited daily and 318 (99%) units reported that the MD or NP could be reached when needed. Following adjustment for multiple confounding variables, there were no associations between either measure of access and any of the resident outcomes. Although we did not find any associations between our measures of access and resident outcomes, additional research which more directly measures physician and NP activities in the NH is required.
LONGITUDINAL CHANGES IN LEADERSHIP, JOB STRAIN, AND SOCIAL SUPPORT OVER FIVE YEARS IN NURSING HOMES
Authors: Backman Annica , Lindkvist Marie , Lovheim Hugo , Edvardsson David 
Published: December 2022

Abstract
Nursing home leadership has been described as crucial for staff job strain and social support but longitudinal data are lacking. This study aimed to explore changes in nursing home managers’ leadership, staff characteristics, job strain and social support by comparing matched units in a five-year follow-up study. Repeated cross-sectional, valid and reliable, measures of leadership, person-centered care, psychosocial climate and demographic variables were collected from managers and staff n=3605 in 2014 and n=2985 staff in 2019. Descriptive statistics and regression analyses with generalized estimating equations were used. The results showed that associations between leadership and staff job strain and social support increased in strength over time. This indicates that leadership has the potential to reduce staff job strain and increase the perception of social support among staff, and the significance of leadership increases over time. It was also shown that workforce characteristics had changed with higher proportion of enrolled nurses and a smaller proportion of nurse’s assistants at follow-up. An increase was also shown in staff reporting that the job required too much work effort, and perceived deteriorating collegiality and work atmosphere at follow-up.
HEALTH BENEFITS OF TAEKWONDO INTERVENTION IN OLDER ADULTS LIVING IN NURSING HOMES
Authors: Kim Yongseop , Kim Junhyoung , Seo Dongchul , Han Sua 
Published: December 2022

Abstract
Physical inactivity is prevalent among nursing home residents, and it contributes to loss of lower body muscle mass, which raises the risk of falling for the older adult population. Accumulative evidence shows that engaging in leisure-time physical activity improves physical functions, mental health, and cognitive capacities and provides social benefits in older adults. Taekwondo, a form of Korean traditional martial arts, has the potential to improve the health benefits among nursing home residents in the United States. Thus, the aim of this study was to explore the health advantages for nursing home residents of participation in a Taekwondo program modified to accommodate their physical and cognitive conditions. An observational research method was incorporated to explore the health benefits of Taekwondo. 10 prospective participants (5 females, 5 males; mean age = 80 years) from the local nursing home facility participated in in-depth semi-structured interviews. The researchers employed Strauss and Corbin's (1998) grand-tour and mini-tour question strategies, as well as Creswell's (2009) five phases of data gathering and analysis. The constant comparative approach was utilized to analyze the data in this study. As a consequence of participating in Taekwondo, four key themes were recognized as health benefits: (a) supporting mental health, (b) increasing physical functions, (c) stimulating cognitive capacities, and (d) facilitating healthy social connection. The findings of this study suggest that Taekwondo might be utilized as a therapeutic intervention to improve physical activity and reduce the negative psychological effects of nursing home confinement.