scholarly journals Do Nursing Home Residents With Dementia Receive Pain Interventions?

2019 ◽  
Vol 34 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Taeko Nakashima ◽  
Yuchi Young ◽  
Wan-Hsiang Hsu
Keyword(s):  
New York ◽  
Nursing Home ◽  
Assessment Tool ◽  
New York State ◽  
Nursing Home Residents ◽  
Secondary Data ◽  
Cross Sectional ◽  
Data Set ◽  
Frequency Distributions ◽  
Pain Intervention

This study compares pain interventions received by nursing home residents with and without dementia. Secondary data analyses of cross-sectional data from 50,673 nursing home residents in New York State were collected by the Minimum Data Set 3.0. Frequency distributions and bivariate analyses with χ2 tests were used to organize and summarize the data. Logistic regression analyses were performed to quantify the relationship between dementia and pain interventions. Our results show that residents with dementia had significantly fewer pain assessments and less reported pain presence than their counterparts. After adjusting for covariates, the results indicate that residents with dementia were significantly less likely to receive pro re nata and nonmedication pain intervention. However, there were no significant differences in scheduled pain medication between the 2 groups. To address the gap, we need more research to design a pain assessment tool that can differentiate severity of pain so that appropriate interventions can be applied.

scholarly journals Pressure Ulcer Prevalence Among Black and White Nursing Home Residents in New York State

Medical Care ◽  
2010 ◽  
Vol 48 (3) ◽  
pp. 233-239 ◽  
Author(s):  
Shubing Cai ◽  
Dana B. Mukamel ◽  
Helena Temkin-Greener
Keyword(s):  
New York ◽  
Nursing Home ◽  
Pressure Ulcer ◽  
New York State ◽  
Nursing Home Residents ◽  
York State ◽  
Black And White

Heart Check: The Development and Evolution of an Organizational Heart Health Assessment

2002 ◽  
Vol 17 (2) ◽  
pp. 132-153 ◽  
Author(s):  
Thomas Golaszewski ◽  
Brian Fisher
Keyword(s):  
New York ◽  
Organizational Support ◽  
Assessment Tool ◽  
New York State ◽  
Health Assessment ◽  
Reliability And Validity ◽  
Nutrition Support ◽  
Future Research ◽  
Heart Health ◽  
Cross Sectional

Purpose. The purpose of this article is to document the development, testing, and application of an organizational assessment tool used to measure employer support for heart health. Additional information is presented on its future research and applications plan. Design. This article represents the pooling of results from multiple studies using a variety of designs, including pilot tests, cross-sectional analyses, and quasi-experiments. Setting. Worksites covering the spectrum of employers across industry types and size, and throughout all of New York State. Subjects. Over 10,000 New York employees and 1000 New York employers are represented in the multiple phases of this research. Measures. Heart Check is a 226-item inventory designed to measure such features in the worksite as organizational foundations, administrative supports, tobacco control, nutrition support, physical activity support, stress management, screening services, and company demographics. Additional side studies used professional judgments and behavioral surveys. Results. As an assessment tool Heart Check shows evidence for reliability and validity. Applications of the instrument show characteristics that define high-scoring companies, quasi standards for New York employers, and, when applied during interventions, positive changes in organizational support levels. Conclusions. A relatively inexpensive, easy-to-use, and metrically tested instrument exists for measuring the construct of organizational support for employee heart health. The instrument shows promise as part of a system to enhance heart health through public health-based interventions in the workplace.

scholarly journals Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Ge ◽  
Weiwei Liu ◽  
Minhui Liu ◽  
Siyuan Tang ◽  
Yongjin Lu ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Assessment Tool ◽  
Frailty Index ◽  
Mainland China ◽  
Nursing Home Residents ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Cutoff Points ◽  
Discriminatory Performance

Abstract Background FRAIL-NH has been commonly used to assess frailty in nursing home residents and validated in many ethnic populations; however, it has not been validated in mainland China, where such an assessment tool is lacking. This study aimed to (1) assess the discriminatory performance of FRAIL-NH in two-class frailty (non-frail+ pre-frail vs. frail) and three-class frailty (non-frail vs. pre-frail vs. frail), based on the Frailty Index (FI), (2) determine the appropriate cutoff points for FRAIL-NH that distinguish two-class and three-class frailty, and (3) examine the agreement in classification between FRAIL-NH and FI. Methods A cross-sectional study of 302 residents aged 60 years or older from six nursing homes in Changsha was conducted. The FRAIL-NH scale and 34-item FI were used to measure frailty. Two-way and three-way receiver operating characteristic (ROC) curves were used to estimate the performance of FRAIL-NH. Cohen’s Kappa statistics were used to examine the agreement between these two measures. Results The agreement between FRAIL-NH and FI ranged from 0.33 to 0.55. Regardless of what FI cutoff points were based on, the volume under the ROC surface (VUS) for FRAIL-NH from the three-way ROC were higher than the VUS of a useless test (1/6), and the area under the ROC curve (AUC) for FRAIL-NH from the two-way ROC were higher than the clinically meaningless value (0.5). When using FI cutoff points of 0.20 for pre-frail and 0.45 for frail, FRAIL-NH cutoff points of 1 and 9 in classifying three-class frailty had the highest VUS and the largest correct classification rates. Whichever FI was chosen, the performance of FRAIL-NH in distinguishing between pre-frailty and frailty, and between non-frailty and pre-frailty was equivalent. According to FRAIL-NH, the proportion of individuals with frailty misclassified as pre-frailty was higher than that of individuals with non-frailty misclassified as pre-frailty. Conclusion FRAIL-NH can be used as a preliminary frailty screening tool in nursing homes in mainland China. FI should be further used especially for those classified as pre-frailty by FRAIL-NH. It is not advisable to simply combine adjacent two classes of FRAIL-NH to create a new frailty variable in research settings.

scholarly journals Fatigue and Mood States in Nursing Home and Nonambulatory Home-Based Patients with Multiple Sclerosis

2017 ◽  
Vol 19 (6) ◽  
pp. 297-302 ◽  
Author(s):  
Zilfah Younus ◽  
Caila B. Vaughn ◽  
Shaik Ahmed Sanai ◽  
Katelyn S. Kavak ◽  
Sahil Gupta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
New York ◽  
Nursing Home ◽  
New York State ◽  
Mood States ◽  
Cross Sectional ◽  
Home Group ◽  
Home Based ◽  
Nursing Home Patients ◽  
Home Based Care

Background: Multiple sclerosis (MS) is a chronic, progressively disabling condition of the central nervous system. We sought to evaluate and compare mood states in patients with MS with increased disability residing in nursing homes and those receiving home-based care. Methods: We conducted a cross-sectional analysis of the New York State Multiple Sclerosis Consortium to identify patients with MS using a Kurtzke Expanded Disability Status Scale (EDSS) score of 7.0 or greater. The nursing home group was compared with home-based care patients regarding self-reported levels of loneliness, pessimism, tension, panic, irritation, morbid thoughts, feelings of guilt, and fatigue using independent-samples t tests and χ2 tests. Multivariate logistic regression analyses were used to investigate risk-adjusted differences in mood states. Results: Ninety-four of 924 patients with EDSS scores of at least 7.0 lived in a nursing home (10.2%). Nursing home patients were less likely to use disease-modifying therapy and had higher mean EDSS scores compared with home-based patients. However, nursing home patients were less likely than home-based patients to report fatigue (odds ratio [OR] for no fatigue, 3.8; 95% CI, 2.1–7.2), feeling tense (OR for no tension, 1.7; 95% CI, 1.1–2.7), and having feelings of pessimism (OR for no pessimism, 1.8; 95% CI, 1.2–2.8). Conclusions: The nursing home patients with MS were less likely to report fatigue, pessimism, and tension than those receiving home-based care. Further studies should examine ways of facilitating a greater degree of autonomy and decision-making control in MS patients receiving home-based care.

scholarly journals Assessing the well-being of residents in nursing facilities

2021 ◽  
Author(s):  
Nadja Schott ◽  
Bettina Johnen ◽  
Thomas Jürgen Klotzbier
Keyword(s):  
Nursing Home ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Reliability And Validity ◽  
Well Being ◽  
Nursing Home Population ◽  
Cross Sectional ◽  
Language Version ◽  
Cultural Adaption

Abstract Purpose Well-adapted and validated well-being (WB) instruments for the nursing home population are scarce. To our knowledge, the Laurens Well-Being Inventory for Gerontopsychiatry (LWIG) is a practical and reliable well-being assessment tool that has never been validated for German nursing home populations. Therefore, the purpose of our study was to (1) translate and cross-culturally adapt the LWIG to a German context and (2) test the reliability and validity of the German LWIG in a group of older nursing home residents using the Rasch model. Methods This study has a cross-sectional, descriptive study design. Cross-cultural adaption of the LWIG-GER from English to German was performed according to a standardized method. The data obtained from 104 long-term nursing home residents (57 women, 47 men) aged 60–99 years (mean 79.5, standard deviation ±9.11) were analyzed for psychometric testing (exploratory and confirmatory factor analysis, item fit, McDonald’s ω, convergent validity, and known-group validity, Rasch). Results The final LWIG-GER consists of 19 items with three subscales, including “psychological WB”, “social WB”, and “physical WB”. The LWIG-GER showed good overall reliability with McDonald’s ω of 0.83; the LWIG-GER dimensions’ scores were significantly correlated with depression, functional performance, activities, fear of falling, and education. Conclusions Our findings suggest that the German language version of the LWIG is a reliable and valid tool for measuring WB in nursing home residents. Furthermore, we propose that the LWIG-GER questionnaire can broaden and deepen our understanding of residents’ perception of quality of care and their environment.

scholarly journals Trends in antibiotics use among long-term US nursing-home residents

2020 ◽  
pp. 1-7
Author(s):  
Catherine C. Cohen ◽  
Andrew W. Dick ◽  
Mansi Agarwal ◽  
Tadeja Gracner ◽  
Susan Mitchell ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Nursing Home Residents ◽  
Antibiotic Use ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Data Set

Abstract Objectives: Antibiotics are overly prescribed in nursing homes. Recent antibiotic stewardship efforts attempt to reduce inappropriate use. Our objective was to describe antibiotic use from 2012 to 2016 among nursing-home residents with various health conditions. Design: Retrospective, repeated cross-sectional analysis. Setting and participants: All long-term residents in a random 10% sample of national nursing homes: 2,092,809 assessments from 319,615 nursing-home residents in 1,562 nursing homes. Measurements: We calculated a 1-day antibiotic prevalence using all annual and quarterly clinical assessments in the Minimum Data Set (MDS) from April 2012 through December 2016. We calculated prevalence of antibiotic use overall and within conditions of interest: Alzheimer’s disease and related dementias (ADRD), advanced cognitive impairment (ACI), and infections likely to be treated with antibiotics. We applied logistic regressions with nursing-home cluster, robust standard errors to assess changes in conditions and antibiotic use 2012–2016. Results: Overall, antibiotic use did not change (2012 vs 2016, adjusted odds ratio [AOR], 1.00; 95% CI, 0.97–1.03). Antibiotic use was higher in 2016 versus 2012 among assessments with any infection (AOR, 1.10; 95% CI, 1.04–1.16), urinary tract infection (AOR, 1.18; 95% CI, 1.12–1.25), and no infection (AOR, 1.13; 95% CI, 1.09–1.17). Results were similar by cognitive status. Conclusions: The increased proportion of assessments recording antibiotics but no infection may not be clinically appropriate. Higher antibiotic use among infected residents with advanced cognitive impairment is also concerning. Further efforts to understand mechanisms driving these trends and to promote antibiotic stewardship in nursing homes are warranted.

scholarly journals Predictors of Everyday Care Preference Importance Ratings for Veterans Living in the Nursing Home Setting

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 91-91
Author(s):  
Caroline Madrigal ◽  
Lan Jiang ◽  
Whitney Mills ◽  
Wen-Chih Wu ◽  
Diane Berish ◽  
...  
Keyword(s):  
Nursing Home ◽  
Functional Impairment ◽  
Cognitive Abilities ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Preference Assessment ◽  
Nursing Home Care ◽  
Data Set ◽  
Home Setting ◽  
Importance Ratings

Abstract Preference-based care is required by the Centers for Medicare and Medicaid Services and is linked to improved quality of nursing home care. The federally mandated Minimum Data Set (3.0) Preference Assessment Tool (PAT) is a 16-item standardized measure used to facilitate preference-based care through rating how important residents’ daily and activity preferences are. Little work has explored how Veterans’ unique demographic backgrounds and functional/cognitive abilities may influence how they rate their preferences (compared to general nursing home residents). Therefore, the purpose of this retrospective study was to explore the relationships between Veterans’ demographic/clinical characteristics and number of preference importance ratings. Our sample (n=194,068) consisted of Veterans admitted to community nursing homes after hospitalization at a Veterans Affairs facility for heart failure between 2010-2015. We used ordinal regression to explore predictors of preference importance ratings. Veterans were, on average, 78-years-old (SD=10.42) and mostly male (95%), white (81%), married (46%), cognitively intact (74%) with extensive functional impairment (60%) and minimal depressive symptoms (74%). Veterans rated an average of 12.47 preferences as important (SD=2.86; range=0-16). Veterans living with cognitive impairment, depression, and extensive functional impairment who were not married or separated had a lower number of important preferences (all p<0.0001). Veterans that were female, under the age of 85, and any race but white had a higher number of important preferences (all p<0.0001). Discussion will include implications for planning and delivering preference-based care for Veterans as well as next steps in research and practice to better understand and fulfill Veterans’ everyday care preferences.

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