Nursing Home Research Papers - Academia.edu (original) (raw)

The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and... more

The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in ...

Children First (C1), a nurse home visitation programme for first-time mothers, was implemented statewide in Oklahoma in mid-1997. The objective of this study was to compare the risks of low (< 2500 g) and very low birthweight (<... more

Children First (C1), a nurse home visitation programme for first-time mothers, was implemented statewide in Oklahoma in mid-1997. The objective of this study was to compare the risks of low (< 2500 g) and very low birthweight (< 1500 g), preterm (< 37 weeks) and very preterm (< 30 weeks) deliveries and infant mortality between mothers participating and not participating in C1. All 239,466 Oklahoma birth certificates were reviewed. The C1 and birth certificate databases were matched to identify C1 participants. Mother's age at delivery, education level, race, marital status, prior pregnancy loss or pregnancy risk factors, birthweight and gestational age at delivery were measured from the birth certificates. Death certificates were matched to the birth certificates to identify infant deaths. A Bayesian multivariable logistic regression was used to analyse the data. Among single mothers without pregnancy risk factors, the risks of all study outcomes were lower for parti...

During the 2002/2003 season, Italian sentinel-based network for surveillance of influenza, coordinated by Inter-university (Genoa-Milan-Trieste) Centre for Influenza Research (CIRI) registered an increasing incidence from week 9/2003... more

During the 2002/2003 season, Italian sentinel-based network for surveillance of influenza, coordinated by Inter-university (Genoa-Milan-Trieste) Centre for Influenza Research (CIRI) registered an increasing incidence from week 9/2003 (10.3 cases per 1000). The ...

Respect for autonomy is well known as a core element of normative views on good care. Most often it is interpreted in a liberal way, with a focus on independence and self-determination. In this article we argue that this interpretation is... more

Respect for autonomy is well known as a core element of normative views on good care. Most often it is interpreted in a liberal way, with a focus on independence and self-determination. In this article we argue that this interpretation is too narrow in the context of care in nursing homes. With the aim of developing an alternative view on respect for autonomy in this setting we described four interpretations and investigated the moral intuitions (i.e. moral judgements) of caregivers regarding these approaches. We found that these caregivers seemed to value different notions relating to respect for autonomy under different circumstances. There was no significant difference in moral judgements between men and women or between doctors and nurses. We conclude that a multidimensional understanding of this principle would best fit this context. We end this article with a description of a modest theory of respect for autonomy in nursing homes.

Aim. This paper is a report of a study assessing pressure ulcer incidence and factors affecting pressure ulcer development among older nursing home residents. Background. Previous researchers have shown that demographic, clinical, health... more

Aim. This paper is a report of a study assessing pressure ulcer incidence and factors affecting pressure ulcer development among older nursing home residents. Background. Previous researchers have shown that demographic, clinical, health status, risk and ...

To determine the interobserver reliability of radiologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;... more

To determine the interobserver reliability of radiologists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interpretations of mobile chest radiographs for nursing home-acquired pneumonia. A cross-sectional reliability study. Nursing homes and an acute care hospital. Four radiologists reviewed 40 mobile chest radiographs obtained from residents of nursing homes who met a clinical definition of lower respiratory tract infections. Radiologists were asked to interpret radiographs with respect to the film quality; presence, pattern, and extent of an infiltrate; and the presence of a pleural effusion or adenopathy. Interrater reliability was evaluated using the intraclass correlation coefficient derived from a 2-way random effects model. On average the radiologists reported that 6 of the 40 films were of very good or excellent quality and 16 of the 40 were of fair or poor quality. When the finding of an infiltrate was dichotomized (0 = no; 1 = possible, probable, or definite) all 4 radiologists agreed on 21 of the 37 chest radiographs. The intraclass correlation coefficient for the presence or absence of infiltrates was 0.54 (95% confidence intervals [CI] 0.38 to 0.69). For the 14 radiographs where infiltrates were observed by all radiologists, intraclass correlation coefficients for the presence of pleural effusions was 0.08 (95% CI -0.10 to 0.41), hilar adenopathy 0.54 (95% CI 0.29 to 0.79), and mediastinal adenopathy 0.49 (95% CI 0.21 to 0.76). In conclusion, the interrater agreement among radiologists for mobile chest radiographs in establishing the presence or absence of an infiltrate can be judged to be &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;fair.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; Treatment decisions need to include clinical findings and should not be made based on radiographic findings alone.

This research into the concept of support was undertaken because of the recurrent use of the concept in nursing research and especially because of the vital importance of support to family carers of older persons. To inductively develop a... more

This research into the concept of support was undertaken because of the recurrent use of the concept in nursing research and especially because of the vital importance of support to family carers of older persons. To inductively develop a definition of support, specifically in the context of family care of frail aged persons. The study followed the evolutionary method of concept analysis. The study was based on data from scientific publications, encyclopaedias and dictionaries. In order to secure a representative sample, highly systematic means of sampling were used. Working with the data underpinning this study, it was possible to put forward a definition of support for family carers who care for a frail aged person at home. The two major dimensions, as described under attributes, were merged into the following definition: "Support entails the provision of general tangibles such as information, education, economic aid, goods and external services. They are prerequisites for fa...

This research explored eldercare among Mexican American primary family caregivers from Dallas and Fort Worth, Texas. Although these caregivers expressed feelings of burden, their ethnocultural values of familism placed burden in a broader... more

This research explored eldercare among Mexican American primary family caregivers from Dallas and Fort Worth, Texas. Although these caregivers expressed feelings of burden, their ethnocultural values of familism placed burden in a broader cultural context in which caregiving was also viewed as an affirmation and fulfillment of core Mexican American cultural values. Mexican American familism includes expressions of family solidarity, ethnocultural determinants of informal caregiving, distrust of culturally alien institutions (particularly nursing homes), and a desire to care for the elderly within the family context regardless of the personal cost or consequences. In contrast to recent research, these findings suggest that it is premature to dismiss familism as a continuing and central influence in the lives of Mexican American family caregivers.

Knowledge about the quality of end-of-life care in the elderly patient in Europe is fragmented. The European Union Geriatric Medicine Society (EUGMS) Geriatric Palliative Medicine (GPM) Interest Group set as one of its goals to better... more

Knowledge about the quality of end-of-life care in the elderly patient in Europe is fragmented. The European Union Geriatric Medicine Society (EUGMS) Geriatric Palliative Medicine (GPM) Interest Group set as one of its goals to better characterize geriatric palliative care in Europe. The goal of the current study was to map the existing palliative care structures for geriatric patients, the available policies, legislation, and associations in geriatric palliative medicine in different countries of Europe. A questionnaire was sent to Geriatric and Palliative Medicine Societies of European countries through contact persons. The areas of interest were (1) availability of services for the management of geriatric patients by using vignette patients (advanced cancer, severe cardiac disease, and severe dementia), (2) policies, legislation of palliative care, and (3) associations involved in geriatric palliative medicine. Out of 21 countries contacted, 19 participated. Palliative care units and home care palliative consultation teams are available in most countries. In contrast, palliative care in long-term care facilities and in geriatric wards is less developed. A disparity was found between the available services and those most appropriate to take care of the three cases described in the vignettes, especially for the patient dying from non-malignant diseases. The survey also demonstrated that caregivers are not well prepared to care for the elderly palliative patient at home or in nursing homes. One of the challenges for the years to come will be to develop palliative care structures adapted to the needs of the elderly in Europe, but also to improve the education of health professionals in this field.