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Felix HC, Brown CC, Narcisse MR, Vincenzo JL, Weech-Maldonado R, Bradway CK. Characteristics of nursing homes with high percentages of falls and falls with injuries among residents with obesity. Geriatr Nurs 2023; 53:191-197. [PMID: 37540915 PMCID: PMC10976471 DOI: 10.1016/j.gerinurse.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Obesity among United States nursing home (NH) residents is increasing. These residents have special care needs, which increases their risk for falls and falls with injuries. NH are responsible for ensuring the health of their residents, including minimizing falls. However, given the special care needs of residents with obesity, different factors may be important for developing programs to minimize falls among this group. AIM We aimed to identify NH characteristics associated with falls and falls with injuries among residents with obesity. METHOD We used resident assessment data and logistic regression analysis. RESULTS We found that rates of falls and falls with injuries among residents with obesity varied significantly based on for-profit status, size, acuity index, obesity rate among residents, and registered nurse hours per patient day. CONCLUSION Recommendations are made as to how NH may be able to lower risk for falls and falls with injuries among their residents with obesity.
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Affiliation(s)
- Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, USA.
| | - Clare C Brown
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences, 2708 South 48th Street, Springdale, Arkansas 72762, USA
| | - Jennifer L Vincenzo
- College of Health Professions, University of Arkansas for Medical Sciences, 1125 North College Avenue, Fayetteville, Arkansas 72703, USA
| | - Robert Weech-Maldonado
- School of Health Professions, University of Alabama at Birmingham, 1720 2nd Avenue South, SHPB 558, Birmingham, AL 35294, USA
| | - Christine K Bradway
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Room 312, Philadelphia, PA 19104-4217, USA
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Wallace LG, Bradway CK, Cacchione PZ. The relationship between sensory loss and health literacy in older adults: A systematic review. Geriatr Nurs 2022; 47:1-12. [PMID: 35779376 PMCID: PMC9585533 DOI: 10.1016/j.gerinurse.2022.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES As sensory loss may impact the ability to receive and apply health information, a relationship between sensory loss and health literacy may exist. The purpose of this systematic review was to explore the relationship between hearing, vision and dual sensory loss and health literacy in older adults. METHODS Studies examining the relationship between sensory loss and health literacy in older adult populations using a validated health literacy instrument were included. The search was conducted in the CINAHL, PubMed, Scopus, AgeLine and REHABdata databases in May-June 2021. RESULTS Nine studies were included. Findings revealed a positive association between hearing and vision loss and low health literacy. DISCUSSION This review highlights a relationship between hearing and vision loss and low health literacy. The small number of studies and overall heterogeneity of study methods limits strength of this evidence. Individuals with sensory loss may benefit from additional clinician support in receiving and applying health information.
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Affiliation(s)
- Laura G Wallace
- University of Pennsylvania School of Nursing; Jonas Scholars; Leonard Davis Institute of Health Economics; NewCourtland Center for Transitions and Health at the University of Pennsylvania.
| | - Christine K Bradway
- University of Pennsylvania School of Nursing; NewCourtland Center for Transitions and Health at the University of Pennsylvania
| | - Pamela Z Cacchione
- University of Pennsylvania School of Nursing; Jonas Scholars; Leonard Davis Institute of Health Economics; NewCourtland Center for Transitions and Health at the University of Pennsylvania
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Brady SS, Bavendam TG, Bradway CK, Conroy B, Dowling-Castronovo A, Epperson CN, Hijaz AK, Hsi RS, Huss K, Kim M, Lazar J, Lee RK, Liu CK, Loizou CN, Miran S, Mody L, Norton JM, Reynolds WS, Sutcliffe S, Zhang N, Hokanson JA. Noncancerous Genitourinary Conditions as a Public Health Priority: Conceptualizing the Hidden Burden. Urology 2022; 166:39-49. [PMID: 34536410 PMCID: PMC8924010 DOI: 10.1016/j.urology.2021.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/07/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide a conceptual framework to guide investigations into burdens of noncancerous genitourinary conditions (NCGUCs), which are extensive and poorly understood. METHODS The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop of diverse, interdisciplinary researchers and health professionals to identify known and hidden burdens of NCGUCs that must be measured to estimate the comprehensive burden. Following the meeting, a subgroup of attendees (authors of this article) continued to meet to conceptualize burden. RESULTS The Hidden Burden of Noncancerous Genitourinary Conditions Framework includes impacts across multiple levels of well-being and social ecology, including individual (ie, biologic factors, lived experience, behaviors), interpersonal (eg, romantic partners, family members), organizational/institutional (eg, schools, workplaces), community (eg, public restroom infrastructure), societal (eg, health care and insurance systems, national workforce/economic output), and ecosystem (eg, landfill waste) effects. The framework acknowledges that NCGUCs can be a manifestation of underlying biological dysfunction, while also leading to biological impacts (generation and exacerbation of health conditions, treatment side effects). CONCLUSION NCGUCs confer a large, poorly understood burden to individuals and society. An evidence-base to describe the comprehensive burden is needed. Measurement of NCGUC burdens should incorporate multiple levels of well-being and social ecology, a life course perspective, and potential interactions between NCGUCs and genetics, sex, race, and gender. This approach would elucidate accumulated impacts and potential health inequities in experienced burdens. Uncovering the hidden burden of NCGUCs may draw attention and resources (eg, new research and improved treatments) to this important domain of health.
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Affiliation(s)
- Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
| | - Tamara G Bavendam
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Christine K Bradway
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Britt Conroy
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Cynthia Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
| | - Adonis K Hijaz
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Ryan S Hsi
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Karen Huss
- Division of Extramural Science Programs, Symptom Science and Genetics, Self-Management Office, National Institute of Nursing Research, Bethesda, MD
| | - Michelle Kim
- Department of Urology, Massachusetts General Hospital, Boston, MA
| | - Jason Lazar
- Department of Medicine, SUNY Downstate Health Sciences University, New York, NY
| | - Richard K Lee
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Christine K Liu
- Section of Geriatrics, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA; Geriatric Research and Education Clinical Center, Palo Alto VA Health Care System, Palo Alto, CA; Section of Geriatrics, Department of Medicine, Boston University, Boston, MA
| | | | - Saadia Miran
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Lona Mody
- Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI and VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Jenna M Norton
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Nicole Zhang
- The Valley Foundation School of Nursing, College of Health and Human Sciences, San Jose State University, San Jose, CA
| | - James A Hokanson
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI
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Sefcik JS, Felix HC, Narcisse MR, Vincenzo JL, Weech-Maldonado R, Brown CC, Bradway CK. Nursing home directors of nursing experiences regarding safety among residents with obesity. Geriatr Nurs 2022; 47:254-264. [PMID: 36007426 PMCID: PMC9979081 DOI: 10.1016/j.gerinurse.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 11/04/2022]
Abstract
The prevalence of nursing home (NH) residents with obesity is rising. Perspectives of NH Directors of Nursing (DONs) who oversee care trajectories for residents with obesity is lacking. This study aimed to describe the experiences of NH DONs regarding care and safety for NH residents with obesity. An adapted version of Donabedian's structure-process-outcome model guided this qualitative descriptive study. Semi-structured interviews were conducted with 15 DONs. Data were analyzed using directed content analysis, and findings are presented under the model's constructs. We learned that admission decisions for NH referrals of patients with obesity are complex due to reimbursement issues, available space and resources, and resident characteristics. DONs described the need to coach and mentor Certified Nursing Assistants to provide safe quality care and that more staff education is needed. We identified novel findings regarding the challenges of short-term residents' experience transitioning out of care due to limited resources.
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Affiliation(s)
- Justine S. Sefcik
- College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Room 377, Philadelphia, PA 19102, USA,Corresponding author. (J.S. Sefcik)
| | - Holly C. Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-12, Little Rock AR 72205, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences, 2708 S. 48th Street, Springdale, AR 72762, USA
| | - Jennifer L. Vincenzo
- Department of Physical Therapy, College of Health Professions, University of Arkansas for Medical Sciences, 1125 N. College Ave, Fayetteville, AR 72703, USA
| | - Robert Weech-Maldonado
- Department of Health Services Administration, University of Alabama at Birmingham, 1720 2nd Ave. S., Birmingham, AL 35294, USA
| | - Clare C. Brown
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-12, Little Rock AR 72205, USA
| | - Christine K. Bradway
- Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
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Abstract
Home health care is a growing treatment option for older adults who wish to remain in their homes and communities. However, the growing number of older adults with severe obesity presents a challenge for home health professionals. This study utilizes survey data from 128 home health care agencies in Arkansas and Pennsylvania to explore home health care agencies' decision-making in admitting patients with severe obesity. The responding agencies indicated that concerns about adequate staffing levels were the primary barriers to entry for severe obesity patients. Existing research on the intersection of obesity and home health care is sparse, and this study adds an organizational perspective to the scant literature on the topic. Additional research on this topic is advised to accommodate the expected growth in home health care utilization and rising obesity rates among older adults.
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Affiliation(s)
- Robert F Schuldt
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock, Arkansas, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock, Arkansas, USA
| | - Christine K Bradway
- Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania, USA
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Abstract
Objectives: Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating depression in older adults, they have been slowly adopted by Home Health Care (HHC) agencies. Therefore, this study was conducted to determine how HHC agencies perceive and use telehealth technology for depression care among homebound older adult patients. Methods: Five-hundred-and-sixteen staff from the National Association for Homecare & Hospice (NAHC) member home health care agencies completed the online survey. Questions were asked of HHC staff regarding performance expectancy, effort expectancy, social influences, facilitating conditions, telehealth use and intention to use/continue to use telehealth. Results: The majority had a neutral or positive perception towards telehealth. However, participants from agencies that have yet to use telehealth (mean: 3.25, SD: 1.56) reported a less intention to use the technology for depression care versus those from agencies that did (mean: 4.64, SD: 1.37). This may be partially explained by the finding that only 32% perceived themselves as having the knowledge and 25% as having resources to use telehealth. Additionally, facilitating conditions and social influences were significant predictors of intention to use/continue to use telehealth for depression care (p-values < .01). Conclusion: Overall, staff had a neutral or positive perception towards telehealth. Factors such as fewer years of experience in using telehealth and a small annual budget may explain a negative perception towards telehealth. Therefore, further education and resources are needed to support telehealth use. Future studies may consider comparing telehealth programs and identifying supporting policies.
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Affiliation(s)
- Eun Hae Kim
- a School of Social Work , Texas State University , San Marcos , TX , USA
| | - Zvi D Gellis
- b School of Social Policy & Practice , University of Pennsylvania , Philadelphia , PA , USA
| | | | - Bonnie Kenaley
- d School of Social Work , Boise State University , Boise , ID , USA
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Sefcik JS, Bradway CK, Cacchione PZ. Transportation of Older Adults: Common Behaviors Interfering With Safety. Res Gerontol Nurs 2019; 12:184-192. [PMID: 31158297 DOI: 10.3928/19404921-20190522-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/27/2019] [Indexed: 11/20/2022]
Abstract
There is a dearth of evidence on safely transporting frail older adults in the community. Therefore, the purpose of the current study was to gain a better understanding of behavioral expression exhibited by older adults during van transportation and to learn what actions van assistants and van drivers take to prevent or address behavioral expressions, which can create potential challenges to safe transportation. A qualitative descriptive approach was used and included four focus groups of van assistants and van drivers (N = 32) at one urban Program of All-Inclusive Care for the Elderly (PACE), which routinely transports approximately 90% of enrollees to and from the PACE center. Conventional content analysis was used to analyze the data. Four themes emerged. The first two themes were common behaviors: Removing Seat Belts and Verbal Behaviors. The remaining two themes addressed unusual behaviors that left lasting impressions: Physical Aggression and Conflict Between Passengers. Van assistants and van drivers used redirection and reassurance as preventive interventions to keep everyone safe. Transportation of PACE enrollees requires well-trained and astute van assistants and van drivers skilled with preventing and diffusing potentially unsafe behaviors. [Res Gerontol Nurs. 2019; 12(4):184-192.].
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Abstract
Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.
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Affiliation(s)
- Timothy Joseph Sowicz
- 1 University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 2 VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
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Puentes WJ, Bradway CK, Aselage M. Older adult mental health: Teaching senior-level baccalaureate nursing students what they need to know. J Gerontol Nurs 2010; 36:44-53. [PMID: 20608592 DOI: 10.3928/00989134-20100528-99] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2010] [Indexed: 11/20/2022]
Abstract
Within the older adult population, certain idiosyncratic aspects of mental illness add to the challenges of helping clients manage these disorders. Older adults are more likely than younger populations to experience physiologically based comorbidities, a dynamic that further strains coping capacities. Barriers to the provision of comprehensive mental health nursing care for older adults include myths and stigmas about aging and mental health. Nurse educators are challenged to move students toward a more positive, empirically based approach to the care of older adults' mental health. In this article, background information supporting the importance of working to improve students' knowledge of and attitudes toward mental illness in older adults is provided. Specific teaching strategies in the areas of older adult mental health, dementia, and delirium are discussed. Resources to support the incorporation of these strategies into nursing curricula are described.
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Affiliation(s)
- William J Puentes
- University of Medicine & Dentistry of New Jersey, School of Nursing, University Educational Center, Stratford, New Jersey 08084, USA.
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Cotter VT, Bradway CK, Cross D, Melissa A. T. Clinical evaluation tools for dual track adult and gerontology nurse practitioner students. ACTA ACUST UNITED AC 2009; 21:658-62. [DOI: 10.1111/j.1745-7599.2009.00463.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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