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Selected AbstractsBehavioral Symptoms in Residential Care/Assisted Living Facilities: Prevalence, Risk Factors, and Medication ManagementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Ann L. Gruber-Baldini PhD Objectives: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. Design: Cross-sectional study. Settings: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). Participants: A total of 2,078 RC/AL residents aged 65 and older. Measurement: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. Results: Approximately one-third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). Conclusion: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting. [source] Reports of information and support needs of daughters and sisters of women with breast cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2003ASSOCIATE PROFESSOR , K. CHALMERS RN, MSC(A) The aim of this study was to describe the information and support needs of women who have primary relatives with breast cancer. The Information and Support Needs Questionnaire (ISNQ) was developed and revised from previous qualitative and pilot studies. The ISNQ addressed concepts of the importance of, and the degree to which, 29 information and support needs related to breast cancer had been met. The study sample consisted of 261 community-residing women who had mothers, sisters, or a mother and sister(s) with breast cancer. Data were collected using a mailed survey. In addition to the ISNQ, additional items addressed family and health history, breast self-care practices, perception of the impact of the relative's breast cancer and other variables. Also included were established and well-validated measures of anxiety and depression. The findings document women's priority information and support needs. The information need most frequently identified as very important was information about personal risk of breast cancer. Other highly rated needs addressed risk factors for breast cancer and early detection measures. Generally, the women perceived that their information and support needs were not well met. These findings illuminate needs of women for more information and support when they have close family relatives with breast cancer and opportunities for primary care providers to assist women in addressing their needs. [source] The construct validity of the client questionnaire of the Wisconsin Quality of Life Index , a cross-validation studyINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2003Jean Caron Abstract The Wisconsin Quality of Life Index (W-QLI, Becker, Diamond and Sainfort, 1993) consists of eight scales: satisfaction with life domains, occupational activities, symptoms, physical health, social relations/support, finances, psychological wellbeing, and activities of daily living. The W-QLI has been modified to fit the characteristics of the Canadian population, the universal Canadian health system, and community and social services in Canada and the modified form was named CaW-QLI (Diaz, Mercier, Hachey, Caron, and Boyer, 1999). This study will verify the empirical basis of these theoretical dimensions by applying a cross-validation procedure on two samples, most of whose subjects have a serious mental illness. Confirmatory factor analyses and exploratory factor analyses using the principal component extraction technique with varimax rotation were applied. With the exception of the occupational activities domain, the remaining scales were correctly identified by the factor analyses on each sample. The occupational activities scale should be developed by additional items for representing this scale, which is too brief, and two other items should be revised in order to improve the quality of the instrument. Copyright © 2003 Whurr Publishers Ltd. [source] Instrument Development of the Confidence in Home Care Services Questionnaire for Use With Elders and Caregivers of Mexican DescentPUBLIC HEALTH NURSING, Issue 3 2006Janice D. Crist ABSTRACT Mexican American elders use home care services less than non-Hispanic white elders, and a larger study is testing whether lack of confidence in home care services, measured by the Community Service Attitude Inventory, is a factor. In order to further develop the questionnaire for use with Mexican American elders and caregivers, qualitative interviews were conducted with Mexican American elders (n=5), Mexican American caregivers (n=5), and home care providers (n=5). Content analysis of interviews supported 2 dimensions: confidence and fear/worry. The research team developed 29 items from the dimensions. Testing of the items (n=15) suggested content validity and two additional items. The revised questionnaire was translated and tested for language equivalence in Spanish and English, assisted by a local community advisory council (n=9). Through collaboration, bicultural/bilingual teams and community partners refined 1 instrument that can be used to measure one of many barriers to equity in health care services with vulnerable populations. Thematic findings may be incorporated into nurses' interventions as they offer home care services to families. [source] Testing equivalence of Spanish and English versions: The LaMonica,Oberst (revised) patient satisfaction with nursing care scale,RESEARCH IN NURSING & HEALTH, Issue 6 2002Jean W. Lange Abstract Despite recent emphasis on outcome measurement and an increasing proportion of Spanish speakers in the United States, most patient satisfaction studies exclude Spanish-speaking participants because Spanish versions of instruments are not available. A Spanish translation of the 15-item LaMonica,Oberst Patient Satisfaction Scale, completed by 64 Spanish-speaking patients living in the northeast and of predominantly Puerto Rican ancestry, produced two factors explaining 86.3% of score variation (,=.94 and .58). Evidence for equivalence to the English version and concurrent validity is presented. Generalizability and decision studies indicate that four additional items are needed on the dissatisfaction subscale to attain an acceptable dependability coefficient. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:438,451, 2002. [source] Creating a Shared Formulary in 7 Critical Access HospitalsTHE JOURNAL OF RURAL HEALTH, Issue 3 2010Douglas S. Wakefield PhD Abstract Purpose: This paper reports a case study of 7 Critical Access Hospitals' (CAH) and 1 rural referral hospital's successful collaboration to develop a shared formulary. Methods: Study methods included document reviews, interviews with key informants, and use of descriptive statistics. Findings: Through a systematic review and decision process, CAH formularies ranging in size from 667 to 1,351 items were compared, rationalized, and consolidated resulting in an 803-item shared formulary. While the individual CAHs were generally expected to list and stock the same 803 items in the shared formulary's pharmacy information system, they could individually determine the amount to be stocked for each item, as well as stock additional items not included on the shared formulary to reflect local provider preferences and services provided. Final stocked formulary items ranged from 592 to 786 items among the 7 CAHs. Major challenges and lessons learned in the course of developing a shared formulary related to: Meeting Logistics, Facilitator to Manage the Process, Organizing the Review Process, Management Support, Stakeholder Participation, Working Collaboratively, Decision-Making Process, Clarity of Charge, Meeting the Needs of Unique Services, Communicating with Providers, and Adjusting to a Shared Formulary. Conclusions: Collaborating in the development of a shared formulary allows for a greater range of decision-making expertise, shared workload, and an improved formulary. An organized and well-managed group decision-making process is essential to a successful collaboration. [source] ORIGINAL RESEARCH,PSYCHOLOGY: A New Evaluation Concept and Its Measurement: "Male Sexual Anticipating Cognitions"THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2006Mireille Bonierbale MD ABSTRACT Context., The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. Objective., This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. Design, Setting, and Patients., We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Results., Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of, the, mixed, and psychogenic components of ED. Bonierbale M, Clement A, Loundou A, Simeoni M-C, Barrau K, Hamidi K, Apter MJ, Lançon C, and Auquier P. A new evaluation concept and its measurement: "Male sexual anticipating cognitions." J Sex Med 2006;3:96,103. [source] | ||||||||||