scholarly journals Engaging Families in Function-Focused Care: Goal Attainment and Associated Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 762-762
Author(s):  
Marie Boltz ◽  
Joanne Roman Jones ◽  
Robin Hermann
Keyword(s):  
Physical Function ◽  
Family Caregivers ◽  
Patient Outcomes ◽  
Goal Attainment ◽  
Secondary Analysis ◽  
Self Care ◽  
Cognitive Stimulation ◽  
Hospital Experience ◽  
Hospital Acquired ◽  
Family Centered

Abstract Partnering with families to develop function-focused plans for hospitalized persons with dementia (PWD) improves both the hospital experience and patient outcomes. This secondary analysis included patients enrolled in the intervention arm of the on-going Family-centered Function-focused Care (Fam-FFC).study. This study examined the goals co-established by family caregivers, PWD, and nurses to prevent hospital-acquired complications and promote functional and cognitive recovery. The influence of goal attainment upon delirium and physical function at discharge was also examined. The majority of patients (N=162) were female (65%), black (53%) with a mean age of 82.7 (SD= 8.2). Goal attainment ranged from -2 to 2; mean = -0.24 (SD= 0.75). The goals (N=432) represent three main areas: mobility, self-care, and cognitive stimulation. Controlling for age and admission function, goal attainment was associated with less discharge delirium (F=3.2, p = .022) but not discharge function. Results support the contribution of function-focused care to improving delirium outcomes.

scholarly journals Engagement of Family in a Goal Setting Strategy: Impact Upon 30-Day Hospital Readmissions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 375-375
Author(s):  
Marie Boltz ◽  
Ashley Kuzmik ◽  
Barbara Resnick ◽  
Irene Best ◽  
Jacqueline Mogle
Keyword(s):  
Family Caregivers ◽  
Goal Setting ◽  
Goal Attainment ◽  
Hospital Readmissions ◽  
Family Engagement ◽  
Intervention Group ◽  
Day Hospital ◽  
Care Partners ◽  
Goal Attainment Scale ◽  
Family Centered

Abstract Family-centered Function-focused Care (Fam-FFC) works with family caregivers as care partners in the assessment, function-promoting goal setting, implementation, and evaluation of goal attainment during hospitalization and immediate post-acute period. ANCOVA technique examined the preliminary impact of Fam-FFC upon 30-day hospital readmissions and logistic regression tested the association of goal attainment, measured with the Goal Attainment Scale (GAS) with 30-day hospital readmissions. The majority of the patients were Black (50%), female (62%), had a mean age of 81.6 (SD=8.4), mean Barthel Index of 60.29 (SD=27.7), and mean MoCA of 10.67 (SD=7.0). Goals represented six main categories: mobility, cognition, self-care, toileting, sleep, and pain management. Patients in the intervention group had less 30-day hospitalizations (F= 4.6, p=.033) and goal attainment was significantly associated with less recidivism (B=.179, Wald= 2.8 (1), p= .045). FamFFC shows promise in reducing 30-day hospital readmissions; results support the contribution of family engagement and use of GAS

scholarly journals Shared Care Contributions to Self-Care and Quality of Life in Chronic Cardiac Patients

2016 ◽  
Vol 38 (7) ◽  
pp. 837-857 ◽  
Author(s):  
Margaret Sebern ◽  
Roger Brown ◽  
Patricia Flatley-Brennan
Keyword(s):  
Quality Of Life ◽  
Family Caregivers ◽  
Patient Outcomes ◽  
Cardiac Disease ◽  
Composite Index ◽  
Self Care ◽  
Secondary Data ◽  
Shared Care ◽  
Equation Modeling

Shared care is an interpersonal interaction system composed of communication, decision making, and reciprocity; it is used by patients and family caregivers (care dyads) to exchange social support. This study’s purpose was to describe the contributions of shared care to outcomes for individuals with cardiac disease. A secondary data analysis was used to answer the following questions. What is the association between elements of shared care and patient outcomes? Do dyad perceptions of shared care differentially contribute to patient outcomes? Participants in this study were 93 individuals with a cardiac disease and 93 family caregivers. Composite index structured equation modeling was the analytic tool. Caregiver communication and reciprocity were related to patient mental quality of life. Patient communication and reciprocity were related to their own mental and physical quality of life and self-care confidence. Findings from this study contribute a better understanding of how care dyads are integral to patient outcomes.

Goal Attainment and Treatment Compliance in a Cognitive-Behavioral Telephone Intervention for Family Caregivers of Persons with Dementia

GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 115-125 ◽  
Author(s):  
Gabriele Wilz ◽  
Denise Schinköthe ◽  
Renate Soellner
Keyword(s):  
Family Caregivers ◽  
Mentally Ill ◽  
Goal Attainment ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Treatment Success ◽  
Treatment Compliance ◽  
Control Group ◽  
Telephone Intervention ◽  
Effective Interventions

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.

scholarly journals Focus on Function in Hospitalized Persons With Dementia: The Impact of Hospital-Acquired Complications

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 762-762
Author(s):  
Marie Boltz ◽  
Lorraine Mion
Keyword(s):  
Acute Care ◽  
Goal Attainment ◽  
Functional Decline ◽  
Policy And Practice ◽  
Increased Risk ◽  
Research Findings ◽  
Pharmacologic Management ◽  
Hospitalized Older Adults ◽  
Hospital Acquired ◽  
The Impact

Abstract Persons with dementia (PWD) are two-three times more likely to be hospitalized as persons without dementia and comprise one fourth of hospitalized older adults. Hospitalization often has a dramatic impact upon the health and disposition of the older PWD. They are at increased risk for hospital acquired complications (HAC) such as functional decline, behavioral symptoms of distress, and delirium, all of which contribute to increased disability, mortality, and long-term nursing home stays. Despite the unprecedented number of PWD admitted to acute care, little attention has focused on their specialized needs and HAC, and how they impact functional recovery. The purpose of this symposium is to describe the incidence of common HACs, and factors that influence their occurrence and presentation in PWD. Utilizing baseline findings from the Family-centered Function-focused Care (Fam-FFC) trial, the presentations will address this objective and discuss the ramifications for functional and cognitive post-acute recovery in PWD. The first presentation will describe the incidence and pharmacologic management of pain in PWD, and its association with common HACs. The second presentation will describe physical activity in PWD on medical units and the validity of the Motionwatch8 actigraphy. The third session will describe differences in common HACs between white and black PWD. The final presentation will examine function-focused goals developed in collaboration with family caregivers and patients, and the functional outcomes associated with goal attainment. Our discussant, Dr. Lorraine Mion, will synthesize the research findings and lead a discussion of future directions for policy and practice in dementia-capable acute care.

scholarly journals Supporting home hospice family caregivers: Insights from different perspectives

2017 ◽  
Vol 16 (2) ◽  
pp. 209-219 ◽  
Author(s):  
Lee Ellington ◽  
Kristin G. Cloyes ◽  
Jiayun Xu ◽  
Lanell Bellury ◽  
Patricia H. Berry ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Hospice Care ◽  
Critical Role ◽  
Further Education ◽  
Hospice Nurses ◽  
Caregiver Support ◽  
Team Members ◽  
Expert Teaching ◽  
Family Centered ◽  
Thought Leaders

ABSTRACTObjective:Our intention was to describe and compare the perspectives of national hospice thought leaders, hospice nurses, and former family caregivers on factors that promote or threaten family caregiver perceptions of support.Method:Nationally recognized hospice thought leaders (n = 11), hospice nurses (n = 13), and former family caregivers (n = 14) participated. Interviews and focus groups were audiotaped and transcribed. Data were coded inductively, and codes were hierarchically grouped by topic. Emergent categories were summarized descriptively and compared across groups.Results:Four categories linked responses from the three participant groups (95%, 366/384 codes): (1) essentials of skilled communication (30.6%), (2) importance of building authentic relationships (28%), (3) value of expert teaching (22.4%), and (4) critical role of teamwork (18.3%). The thought leaders emphasized communication (44.6%), caregivers stressed expert teaching (51%), and nurses highlighted teamwork (35.8%). Nurses discussed teamwork significantly more than caregivers (z = 2.2786), thought leaders discussed communication more than caregivers (z = 2.8551), and caregivers discussed expert teaching more than thought leaders (z = 2.1693) and nurses (z = 2.4718; all values of p < 0.05).Significance of Results:Our findings suggest differences in priorities for caregiver support across family caregivers, hospice nurses, and thought leaders. Hospice teams may benefit from further education and training to help cross the schism of family-centered hospice care as a clinical ideal to one where hospice team members can fully support and empower family caregivers as a hospice team member.

Factors Associated with Intermittent, Constant, and Mixed Pain in People with Knee Osteoarthritis

2021 ◽  
Author(s):  
Fatme Hoteit ◽  
Debbie Erhmann Feldman ◽  
Lisa C. Carlesso
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Cross Sectional ◽  
System Sensitivity ◽  
Factors Associated ◽  
Lower Likelihood ◽  
Paindetect Questionnaire ◽  
Mixed Pain

Purpose: To explore factors associated with intermittent, constant, and mixed pain in people with knee osteoarthritis. Method: We conducted a secondary analysis of a cross-sectional multicenter study with adults ≥ 40 years with knee osteoarthritis. Participants completed questionnaires on personal (e.g., demographics, comorbidities), physical (e.g., physical function), psychological (e.g., depressive symptoms), pain (e.g., qualities), and tests for physical performance and nervous system sensitivity. We qualified patients’ pain as intermittent, constant, or mixed using the Modified painDETECT Questionnaire and assessed associations with the variables using multinomial logistic regression. Results: The 279 participants had an average age of 63.8 years (SD = 9.6), BMI of 31.5 kg/m2 (SD = 8.7), and 58.6% were female. Older age (odds ratio [OR] 0.95; 95% CI: 0.90, 1.00) and higher self-reported physical function ([OR] 0.94; 95% CI: 0.91, 0.98) were associated with a lower likelihood of mixed pain compared with intermittent pain. Higher pain intensity ([OR] 1.25; 95% CI: 1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared with intermittent pain. Conclusions: This study provides initial data for associations of personal, pain, and physical function factors with different pain patterns. Awareness of these factors can help clinicians develop targeted strategies for managing patients’ pain.

scholarly journals Chest x-ray findings and outcomes of children with suspected ventilator .. associated pneumonia

2012 ◽  
Vol 52 (4) ◽  
pp. 233
Author(s):  
Neni Sumarni ◽  
Muhammad Sholeh Kosim ◽  
Mohammad Supriatna ◽  
Eddy Sudijanto
Keyword(s):  
Retrospective Study ◽  
Patient Outcomes ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray ◽  
Hospital Acquired ◽  
Pediatric Icu ◽  
The Relationship

Background Ventilator􀁖associated pneumonia (VAP) is anosocomial infection in patients who have received mechanicalventilation (MV), either by endotracheal intubation ortracheostomy, for more than 48 hours. YAP represents 80% ofall hospital􀁖acquired pneumonias. VAP incidence varies from5.1 %􀁖33.3%. The modified clinical pulmonary infection scoreis a criteria for diagnosing suspected YAP and typically includesradiographic evidence. YAP is associated with significantmorbidity and mortality.Objective To determine the relationship between chest x􀁖rayfindings and outcomes in children Mth suspected VAP.Methods This retrospective study was held in Dr. Kariadi Hospitalfrom January - December 2010. Data was collected from medicalrecords of pediatric ICU (PICU) patients with suspected VAP.Chest x􀁖ray findings and patient outcomes were recorded. X􀁖rayfindings were assessed by the on􀁖duty radiologist. Chi square testwas used for statistical analysis.Results Subjects were 30 children consisting of 14 males and 16females. Patient outcomes were 23 patients survived and 7 patientsdied. Chest x􀁖ray findings were categorized into the followinggroups and compared to patient survivability: diffuse infiltrates76.7% (OR􀁗0.694; P􀁗0.532; 95% CI 0.102 to 4.717), localhedinfiltrates 13.3% (OR􀁗4.200; P􀁗 0.225; 95% CI 0.470 t037.49),and no infiltrates 10% (OR􀁗 1.222; P􀁗 0.436; 95% CI 0.593 to0.926). None of the x􀁖ray findings had a significant correlationto patient outcomes.Conclusion There was no significant relationship between chestx􀁖ray findings and outcomes in children with suspected VAP.[Paediatr rndones. 2012;52:233-8].

scholarly journals Relationships Between Cognitive Dysfunction and Health-Related Quality of Life Among Older Persons in Taiwan: A Nationwide Population-Based Survey

2018 ◽  
Vol 34 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Hsin-Yun Liu ◽  
Wen-Che Tsai ◽  
Ming-Jang Chiu ◽  
Li-Yu Tang ◽  
Huey-Jane Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Secondary Analysis ◽  
Self Care ◽  
Population Based ◽  
Negatively Associated ◽  
Population Based Survey

Background: To examine the relationships between cognitive dysfunction status and quality of life. Methods: Secondary analysis of a nationwide population-based survey (≥65 years) in Taiwan. The 5-dimension EuroQoL questionnaire (EQ-5D) was completed by 10 013 participants. Results: Participants with mild cognitive impairment (MCI; odds ratio = 4.88), very mild dementia (VMD; 7.96), or dementia (32.85) were more likely than those with normal cognition to report self-care problems. Participants with MCI (3.86), VMD (9.26), or dementia (31.61) were more likely to have usual-activity problems, and those with MCI (3.04), VMD (3.82), or dementia (9.23) were more likely to have mobility problems. Participants with MCI (2.10 and 2.14), VMD (2.77 and 2.18), or dementia (3.04 and 3.02) were more likely to report pain/discomfort and anxiety/depression. Conclusion: Dementia was negatively associated with EQ-5D, especially self-care, usual activities, and mobility. Mild cognitive impairment or VMD was also negatively associated, with VMD more negatively associated. Developing interventions for patients with specific cognitive dysfunctions is critical.

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