Environmental Approach (environmental + approach)

Distribution by Scientific Domains

Selected Abstracts

Environmental approach to reducing agitation in older persons with dementia in a nursing home

Lesley Wilkes
Objective:,This paper reports the effects on challenging (agitated) behaviours, such as aggression, noisiness and wandering, when persons with dementia were relocated to a special unit. Methods:,The study was a simple interrupted time series quasi-experimental design. The dependent variable was agitated behaviour and the independent variables were residing in an old unit and in a Special Care Unit (SCU). Twenty-two persons with dementia from a nursing home were involved in this study. Subjects were assessed weekly for 1 month prior to the move to the SCU and weekly for 1 month at 3 and 6 months after the move. Data were entered into SPSS software and analysed. Results:,The most significant results from the study were that the verbally agitated behaviour of the subjects was reduced and sustained throughout the 6 months of the study after their move into a SCU. Conclusions:,This study has shown that environmental design does impact positively in the care of persons with dementia. [source]

Tropical storm impact in Central America

Sabino Palmieri
Abstract In this study of tropical storm impacts in Central America, the relationship between physical variables (available in ,real time') and damage is explored, and a simple tool for early approximate evaluation of the impact is developed. Land track and energy dissipation appear as the most interesting parameters that modulate the hurricane impact. Because of the difficulty of attaching a monetary estimate to the damage caused in a large number of cases (as is required in a statistical approach), an ,Impact Index' based on the logarithm of casualties is introduced. Thereafter, within a subset of events in which damage in monetary terms is known, a rough link between damage and the Impact Index is derived. Shortly after a new event, as soon as land track and energy dissipation are known, either by means of an empirical equation or using a contour graph, the Impact Index may be determined. Another empirical equation allows a rough estimate of damage in monetary units, but because this estimate is based on a limited number of cases, it must be treated with caution. The methodology is tested for a small set of independent cases. Vulnerability to tropical cyclones depends not only on natural factors but also on sociopolitical conditions. A coupled sociological and environmental approach is believed to be the best way to improve the early impact estimate methodology. Copyright 2006 Royal Meteorological Society. [source]

Nightingale's realist philosophy of science

Sam Porter RN
Abstract This paper examines Florence Nightingale's realist philosophy of science by comparing it to the contemporaneously dominant philosophy of positivism. It starts by adumbrating the tenets of positivism and continues by assessing the degree to which Nightingale accepted or rejected those tenets. It is argued that while she accepted much of positivism, on realist grounds she opposed its belief in phenomenalism, its rejection of speculative philosophy, its separation of fact and value, and its rejection of religion. Following an examination of how Nightingale's philosophy impinged on her approach to nursing and health care, the paper concludes with a comparison of her ideas with those of modern realism and a discussion of the contemporary salience of her ideas. It is argued that while some aspects of her approach may no longer provide an appropriate basis for modern nursing, her environmental approach, her transcendental realism, and her adherence to caring values may still be of use to contemporary nurses. [source]

Factors associated with constructive staff,family relationships in the care of older adults in the institutional setting

Emily Haesler BN PGradDipAdvNsg
Abstract Background, Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives, The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff,family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff,family relationships. Search strategy, A literature search was performed using the following databases for the years 1990,2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria, The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff,family relationships including organisational strategies, staff,family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis, All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Findings, Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however, this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and healthcare staff: communication, information, education and administrative support. Based on the evidence analysed in this systematic review, staff and family education on relationship development, power and control issues, communication skills and negotiating techniques is essential to promoting constructive staff,family relationships. Managerial support, such as addressing workloads and staffing issues; introducing care models focused on collaboration with families; and providing practical support for staff education, is essential to gaining sustained benefits from interventions designed to promote constructive family,staff relationships. [source]