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McKenzie C, Smith-Tamaray M, Conway E, Flanagan K. "Time is a Big Factor": Aged-Care Workforce Perspectives on Communication Partner Training for Working With Residents With Dementia. J Appl Gerontol 2024:7334648241255080. [PMID: 38770598 DOI: 10.1177/07334648241255080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Many individuals who reside in permanent residential aged care (RAC) have a diagnosis of dementia, with the majority experiencing a communication disorder. Existing literature has placed an emphasis on the need for staff to undertake communication partner training. This study aimed to investigate the preferences of RAC staff, and their perceived barriers and facilitators to workplace training. Through an exploratory cross-sectional online survey, a sample of RAC workers in Australia were recruited (n = 104). Descriptive statistics revealed that the majority of participants preferred training to be delivered face to face and being paid for participation. Through content analysis of open-ended questions, seven categories were identified regarding perceived barriers and facilitators for communication partner training in the workplace. These included staff shortages, time pressures, remuneration and training delivery method, and quality of the educators. Additionally, management attitudes were pertinent. These findings may inform the development and outcomes of future communication partner training in RAC.
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Affiliation(s)
| | | | - Erin Conway
- Australian Catholic University, Brisbane Campus, Banyo, QLD, Australia
| | - Kieran Flanagan
- Australian Catholic University, Brisbane Campus, Banyo, QLD, Australia
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Zhou X, Wong H. Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio. BMC Geriatr 2024; 24:431. [PMID: 38750411 PMCID: PMC11097439 DOI: 10.1186/s12877-024-05029-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.
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Affiliation(s)
- Xiaofan Zhou
- School of Sociology, Central China Normal University, Wuhan, China.
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
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Madsø KG, Pachana NA, Nordhus IH. Development of the Observable Well-Being in Living With Dementia-Scale. Am J Alzheimers Dis Other Demen 2023; 38:15333175231171990. [PMID: 37269060 PMCID: PMC10624086 DOI: 10.1177/15333175231171990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Observable Well-being in Living with Dementia-Scale was developed to address conceptual and methodological issues in current observational scales for music therapy. Creative interventions may receive lowered scores, as existing instruments rely heavily on verbal behavior. Methods were (1) Systematic review of observational instruments: (2) field work with music therapy and sociable interactions to operationalize the items; (3) field testing assessing feasibility and preliminary psychometric properties; (4) focus groups with experts to investigate content validity; (5) final field test and revision. 2199 OWLS-ratings were conducted in 11 participants. Hypotheses of construct validity and responsiveness were supported (r = .33 -.65). Inter-rater reliability was good (84% agreement between coders, Cohen's Kappa = .82), and intra-rater reliability was excellent (98% agreement, Cohen's Kappa = .98). Focus groups with 8 experts supported the relevance of the items and suggested further refinements to increase comprehensiveness. The final field-tested OWLS showed improved inter-rater reliability and usability.
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Affiliation(s)
- Kristine G. Madsø
- NKS Olaviken Gerontopsychiatric Hospital, Askøy, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Nancy A. Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Inger H. Nordhus
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
- Department of Behavioral Medicine, University of Oslo, Oslo, Norway
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Fick DM, Shrestha P. Delirium in Persons With Dementia: Integrating the 4Ms of Age-Friendly Care as a Set Into the Care of Older People. J Gerontol Nurs 2022; 48:3-6. [PMID: 36169297 DOI: 10.3928/00989134-20220909-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Donna M Fick
- Journal of Gerontological Nursing, Elouise Ross Eberly Endowed Professor, Ross and Carol Nese College of Nursing Pennsylvania State University Director, Tressa Nese and Helen Diskevich Center of Geriatric Nursing Excellence State College, Pennsylvania
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Zhao Y, Liu L, Ding Y, Chan HYL. Effect of a culturally sensitive DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in China: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 116:105434. [PMID: 35728332 DOI: 10.1016/j.nedt.2022.105434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/27/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Existing educational programmes for building capacity in dementia care are developed in the Western culture; their applicability and cultural relevancy to other cultures is questionable. There is a dearth of culturally specific dementia-care educational programme for Chinese communities. OBJECTIVES To evaluate a culturally specific DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in mainland China. DESIGN A multi-site quasi-experimental study. METHODS Nursing homes were pair-matched and allocated into intervention (n = 5) and control group (n = 5). The DECENT programme was delivered face-to-face using multiple pedagogies for 60-90 min per session by a trained educator once per week over 8 weeks. The primary outcome was the sense of competence in dementia care. The secondary outcomes were dementia knowledge, attitudes towards people with dementia, person-centred care in nursing homes and the severity of behavioral and psychological symptoms of dementia of residents with dementia and staff-perceived disturbance. They were measured at baseline (T0), immediately post-intervention (T1) and 3 months after the intervention (T2). RESULTS The intervention group has significantly greater improvement than control group in sense of competence both at T1 (B = 5.24, p < .001) and T2 (B = 4.43, p = .013). Regarding dementia knowledge and person-centred care, intervention group only showed greater improvement than control group at T1 (B = 3.18, p = .001; B = 5.75, p = .018, respectively), but not at T2 (p = .089 and .104, respectively). Group differences in attitudes and severity of behavioral and psychological symptoms of dementia and staff-perceived disturbance were not significant at both time points. CONCLUSIONS The DECENT programme is applicable and beneficial in improving staff's sense of competence in dementia care in Chinese communities, but reinforcement strategies are needed to sustain the effect for maintaining the learnt knowledge and changed person-centred care practice.
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Affiliation(s)
- Yayi Zhao
- School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing, 210000, Jiangsu Province, China.
| | - Li Liu
- Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha, 410000, Hunan Province, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, Jiangning District, 210000, Jiangsu Province, China.
| | - Helen Y L Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, 999077, Hong Kong Special Administrative Region.
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Kolanowski A, Zhu S, Van Haitsma K, Resnick B, Boltz M, Galik E, Behrens L, Eshraghi K, Ellis J. 12-month trajectory and predictors of affect balance in nursing home residents living with dementia. Aging Ment Health 2022; 26:1686-1692. [PMID: 34253099 PMCID: PMC8752645 DOI: 10.1080/13607863.2021.1947964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives:Emotional expressions in late-stage dementia have traditionally been studied within a deficit paradigm. Moving the narrative of the dementia trajectory from a solely negative pathological experience to one that acknowledges the potential for positive experiences aligns with international recommendations for living well with dementia. The purpose of this study was to extend prior research by examining the pattern of well-being using affect balance, the ratio of positive to negative affect, in nursing home residents living with dementia over 12 months and its association to factors that could potentially influence resident well-being.Method:This study was a secondary analysis of baseline, 4 and 12-month data from a pragmatic clinical trial. A total of 536 residents with moderate to severe cognitive impairments from 55 nursing homes were included in the multivariable linear mixed model regression analyses.Results:Resident function, the number of registered nurse hours devoted to care in the facility, and the quality of staff interaction predicted higher affect balance over time after controlling for other variables.Conclusion:The findings provide support for the utility of affect balance as a meaningful outcome measure of well-being for persons living with dementia. In addition, results point to specific interventions (i.e. maintaining/improving resident function, providing adequate nurse staffing levels, and improving staff communications skills) that can serve as the focus for both research and practice to help residents live well with dementia. Clinicaltrials.gov (NCT03014570).
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Affiliation(s)
| | - Shijun Zhu
- Associate Professor & Statistician, University of Maryland School of Nursing, 655 West Lombard Street, Suite 402K, Baltimore, MD 21201
| | | | - Barbara Resnick
- Sonya Ziporkin Gershowitz Chair in Gerontology, School of Nursing, University of Maryland, Baltimore MD 21218
| | - Marie Boltz
- Professor and Elouise Ross Eberly and Robert Eberly Endowed Chair, College of Nursing, Penn State, University Park, Pa. 16802
| | - Elizabeth Galik
- Professor, School of Nursing, University of Maryland, Baltimore MD 21218
| | - Liza Behrens
- Project Director, College of Nursing, Penn State, University Park, Pa. 16802
| | - Karen Eshraghi
- Project Director, College of Nursing, Penn State, University Park, Pa. 16802
| | - Jeanette Ellis
- Project Director, School of Nursing, University of Maryland, Baltimore MD 21218
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Sefcik JS, Boltz M, Dellapina M, Gitlin LN. Are Interventions for Formal Caregivers Effective for Improving Dementia Care? A Systematic Review of Systematic Reviews. Innov Aging 2022; 6:igac005. [PMID: 35496650 PMCID: PMC9042653 DOI: 10.1093/geroni/igac005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Objectives Several systematic reviews exist that examine the efficacy of educational interventions in randomized controlled trials (RCTs) designed to improve formal caregivers’ knowledge and skills and/or the outcomes of persons living with dementia. The aim of this article is to summarize existing systematic reviews to assess the effectiveness of educational interventions tested in RCTs and directed at formal caregivers. Research Design and Methods Smith et al.’s methodology guided this systematic review of systematic reviews. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) for quality appraisals. Reviews were included if they contained interventions with an RCT design that focused on changing staff behavior and/or practice toward persons living with dementia, in any setting and for any health care discipline. Results We identified six systematic reviews, one rated as high-quality on the AMSTAR 2. Most interventions were directed at nursing staff, in long-term care facilities, focused on agitation, and were atheoretical. There is insufficient evidence to guide implementation of currently tested interventions; however, training in communication skills, person-centered care, and dementia-care mapping with supervision show promise for improving agitation. Discussion and Implications There’s a critical need for additional research with well-designed RCTs, and clear reporting of protocols and findings to inform the field on how best to train and support the workforce. Although there is no conclusive evidence on what interventions are most effective, it could be argued that providing training using interventions with modest evidence of impact is better than no training at all until the evidence base is strengthened.
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Affiliation(s)
- Justine S Sefcik
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Marie Boltz
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Maria Dellapina
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
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Woods D, Navarro AE, LaBorde P, Dawson M, Shipway S. Social Isolation and Nursing Leadership in Long-term Care: Moving Forward after COVID-19. Nurs Clin North Am 2022; 57:273-286. [PMID: 35659988 PMCID: PMC8860631 DOI: 10.1016/j.cnur.2022.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Madsø KG, Flo-Groeneboom E, Pachana NA, Nordhus IH. Assessing Momentary Well-Being in People Living With Dementia: A Systematic Review of Observational Instruments. Front Psychol 2021; 12:742510. [PMID: 34887803 PMCID: PMC8649635 DOI: 10.3389/fpsyg.2021.742510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
Optimizing the possibility to lead good lives is at the core of treatment and care for people with dementia. This may be monitored by assessing well-being and quality of life. However, cognitive impairment following dementia may complicate recall-based assessment with questionnaires, and proxy-ratings from family-caregivers do not correspond well to self-reports. Thus, using observational measures represents a potentially advanced option. Systematic reviews evaluating measurement properties, interpretability and feasibility of observational instruments assessing well-being in people living with dementia are lacking. Thus, this review performed systematic searches to find peer reviewed validated instruments of relevance in the databases MEDLINE, EMBASE, PsycINFO, Web of Science, CINAHL and ProQuest. Twenty-two instruments assessing well-being were included for evaluation of measurement properties based on the systematic approach of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The evaluation included risk of bias on study level, and assessment of measurement properties on instrument level including content validity, construct validity, structural validity, internal consistency, measurement invariance, cross-cultural validity, measurement error and inter-rater/intra-rater/test-retest reliability and responsiveness. Additionally, the feasibility and interpretability of the measures were evaluated. No single instrument could be recommended based on existing publications. Thus, we provide general recommendations about further assessment and development of these instruments. Finally, we describe the most promising instruments and offer guidance with respect to their implementation and use in clinical and research contexts.
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Affiliation(s)
- Kristine Gustavsen Madsø
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- NKS Olaviken Gerontopsychiatric Hospital, Bergen, Norway
| | | | - Nancy A. Pachana
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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