Seeing the Whole Person: Feasibility of Using the Omaha System to Describe Strengths of Older Adults With Chronic Illness

2014 ◽  
Vol 28 (4) ◽  
pp. 299-315 ◽  
Author(s):  
Karen A. Monsen ◽  
Diane E. Holland ◽  
Ping W. Fung-Houger ◽  
Catherine E. Vanderboom
Keyword(s):  
Older Adults ◽  
Chronic Illness ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Well Being ◽  
Chronic Illnesses ◽  
Assessment Tools ◽  
Whole Person ◽  
Omaha System ◽  
Standardized Terminology

A promising strategy for enhancing care and self-management of chronic illness is an integrative, whole-person approach that recognizes and values well-being. Assessment tools are needed that will enable health care professionals to perceive patients as whole persons, with strengths as well as problems. The purpose of this study was to examine the feasibility of using a standardized terminology (theOmaha System) to describe strengths of older adults with chronic illness. The Omaha System assessment currently consists of identifying signs/symptoms for 42 health concepts. Researchers mapped self-reported strengths phrases to Omaha System concepts using existing narratives of 32 older adults with 12–15 comorbid conditions. Results demonstrated the feasibility of describing strengths of patients with chronic illness. Exploratory analysis showed that there were 0–9 strengths per patient, with unique strengths profiles for 30 of 32 patients. Given that older adults with multiple chronic illnesses also have strengths that can be classified and quantified using the Omaha System, there is potential to use the Omaha System as a whole-person assessment tool that enables perception of both problems and strengths. Further research is needed to enhance the Omaha System to formally represent strengths-based as well as a problem-focused perspectives.

scholarly journals Associations of chronic illnesses and socio-demographic factors with health-related quality of life of older adults in Nigeria: A cross-sectional study

2020 ◽  
Vol 54 (3) ◽  
pp. 164-172
Author(s):  
Joel Faronbi ◽  
Aishat Ajadi ◽  
Robbert Gobbens
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Chronic Illness ◽  
Cross Sectional Study ◽  
Chronic Illnesses ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Background: The increase in life expectancy has brought about a higher prevalence of chronic illnesses among older people.Objectives: To identify common chronic illnesses among older adults, to examine the influence of such conditions on their Health-Related Quality of Life (HRQoL), and to determine factors predicting their HRQoL.Method: A population-based cross-sectional study was conducted involving 377 individuals aged 60 years and above who were selected using multi-stage sampling techniques in Olorunda Local Government, Osun State, Nigeria. Data were collected using an interviewer-administered questionnaire comprising socio-demographic characteristics, chronic illnesses, and the World Health Organization quality of life instrument (WHOQOL-BREF) containing physical health, psychological, social relationships, and environmental domains.Results: About half (51.5%) of the respondents reported at least one chronic illness which has lasted for 1–5 years (43.3%). The prevalence of hypertension was 36.1%, diabetes 13.9% and arthritis 13.4%. Respondents with chronic illness had significantly lower HRQoL overall and in the physical health, social relationships and the environmental domains (all p<0.05) compared to those without a chronic illness. Factors that predicted HRQoL include age, marital status, level of education, the presence of chronic illness and prognosis of the condition.Conclusion: This study concluded that chronic illness is prevalent in Nigerian older people and significantly influence their HRQoL. Age, marital status, and level of education were associated with HRQoL in this group.Keywords: Chronic illness, Health-Related Quality of Life, Older adults, Socio-demographic factorsFunding: Postdoctoral fellowship from Consortium for Advanced Research Training in Afric

scholarly journals EXAMINING DISCREPANCIES IN SOCIAL ROBOT VERSUS HUMAN ASSESSMENTS OF GERIATRIC WELL-BEING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S329-S329
Author(s):  
Erin Harrington ◽  
Ha Do ◽  
Alex J Bishop ◽  
Celinda Reese-Melancon ◽  
and Weihua Sheng
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Social Connectedness ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Well Being ◽  
Falls Prevention ◽  
Assessment Tools ◽  
Assessment Scores ◽  
Loneliness Scale

Abstract Socially assistive robotic (SAR) technologies represent a viable tool for monitoring the safety and health of older adults. However, it is unclear whether SARs can comprehensively screen geriatric well-being as effectively as trained human clinicians. The purpose of this study was to compare SAR versus human assessment of geriatric well-being. Participants included 30 older adults (Mage = 73.40, SD = 7.88) who completed a robot-administered well-being assessment session during which human-administered evaluation was simultaneously performed. Standardized clinical screening assessment tools common in geriatric care were administered (e.g., Short Blessed Test (SBT), UCLA Loneliness Scale, Geriatric Depression Scale, PHQ-4, Iowa Fatigue Scale, Fall Risk). Multiple dependent sample t-tests were used to explore variability in assessment scores between SAR and human evaluation. Assessment scores significantly differed on several measures, including the SBT (t(29) = -9.33, p &lt; .001), UCLA Loneliness scale (t(19) = 2.37, p &lt; . 05), and fall risk assessment (t(29) = 3.03, p &lt; .01). Specifically, the SAR indicated that older adults were significantly more cognitively impaired, less lonely, and more likely to fall compared to the human administrator. Other observed differences and hypothesized explanations will be discussed in greater detail. The current study indicates that there is a divergence in geriatric assessment outcomes based on human versus SAR administration. Findings have implications relative to further developing SAR technology to align with human-based evaluations to enhance cognitive well-being, social connectedness, and falls prevention.

Social Relations and Mortality

2010 ◽  
Vol 15 (5) ◽  
pp. 649-659 ◽  
Author(s):  
Toni C. Antonucci ◽  
Kira S. Birditt ◽  
Noah J. Webster
Keyword(s):  
Older Adults ◽  
Chronic Illness ◽  
Relationship Quality ◽  
Social Relationships ◽  
Social Relations ◽  
Negative Relationship ◽  
Chronic Illnesses ◽  
Survival Analyses ◽  
Best Friend ◽  
Buffering Effects

Among older adults social relationships influence mortality, but it is less clear how. We examined associations between relationship quality with spouse, child, and best friend and mortality; and whether the associations varied in the presence of chronic illnesses. Survival analyses ( N = 514; 59 percent women aged ≥ 60) revealed sometimes counterintuitive main and buffering effects. Individuals who reported greater negative relationship quality with their children and friends lived longer. Buffering models suggest that relationships may exacerbate the effects of chronic illness on mortality and emphasize the importance of using a more nuanced approach when examining the effects of social relations on mortality.

scholarly journals Factors Influencing Physical Therapists' Use of Standardized Measures of Walking Capacity Poststroke Across the Care Continuum

2015 ◽  
Vol 95 (11) ◽  
pp. 1507-1517 ◽  
Author(s):  
Kira M. Pattison ◽  
Dina Brooks ◽  
Jill I. Cameron ◽  
Nancy M. Salbach
Keyword(s):  
Acute Care ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Physical Therapists ◽  
Assessment Tools ◽  
Standardized Assessment ◽  
Assessment Practice ◽  
Telephone Interviews ◽  
Walking Capacity ◽  
Field Notes

Background The use of standardized assessment tools is an element of evidence-informed rehabilitation, but physical therapists report administering these tools inconsistently poststroke. An in-depth understanding of physical therapists' approaches to walking assessment is needed to develop strategies to advance assessment practice. Objectives The objective of this study was to explore the methods physical therapists use to evaluate walking poststroke, reasons for selecting these methods, and the use of assessment results in clinical practice. Design A qualitative descriptive study involving semistructured telephone interviews was conducted. Methods Registered physical therapists assessing a minimum of 10 people with stroke per year in Ontario, Canada, were purposively recruited from acute care, rehabilitation, and outpatient settings. Interviews were audiotaped and transcribed verbatim. Transcripts were coded line by line by the interviewer. Credibility was optimized through triangulation of analysts, audit trail, and collection of field notes. Results Study participants worked in acute care (n=8), rehabilitation (n=11), or outpatient (n=9) settings and reported using movement observation and standardized assessment tools to evaluate walking. When selecting methods to evaluate walking, physical therapists described being influenced by a hierarchy of factors. Factors included characteristics of the assessment tool, the therapist, the workplace, and patients, as well as influential individuals or organizations. Familiarity exerted the primary influence on adoption of a tool into a therapist's assessment repertoire, whereas patient factors commonly determined daily use. Participants reported using the results from walking assessments to communicate progress to the patient and health care professionals. Conclusions Multilevel factors influence physical therapists' adoption and daily administration of standardized tools to assess walking. Findings will inform knowledge translation efforts aimed at increasing the standardized assessment of walking poststroke.

Food First: Nutrition as the Foundation for Health

2015 ◽  
Vol 21 (4) ◽  
pp. 213-221 ◽  
Author(s):  
Laura Sandquist
Keyword(s):  
Health Care Professionals ◽  
Well Being ◽  
The Body ◽  
Biological Functions ◽  
Gastrointestinal Dysfunction ◽  
Physiological Processes ◽  
Novel Approach ◽  
Whole Person ◽  
Whole Systems ◽  
Health And Well Being

The principles of integrative nursing advocate that food be considered as a primary intervention for health promotion, risk reduction, and generally improved well-being. Food provides information to the body, signaling basic biological functions and normalizing physiological processes. Health care professionals should query patients about their nutritional intake, recognizing that adjustments in the types of foods consumed can often address long-standing symptoms that create distress, including pain, fatigue, anxiety, and gastrointestinal dysfunction. A Food First approach to care offers a novel approach that champions whole person/whole systems emergent health and well-being.

Adoption of a Pain Assessment Tool in Older Homebound Patients With Dementia in a Housecall Practice: A Dissemination Study

2012 ◽  
Vol 5 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Jean-Claude K. Provost
Keyword(s):  
Older Adults ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Selection Process ◽  
Pain Scale ◽  
Assessment Tools ◽  
Advanced Dementia ◽  
Pain Diagnosis

This article describes the steps of a pilot dissemination study toward adopting a pain assessment tool for older homebound adults with dementia. The chosen practice site had not previously used adequate pain assessment tools for older adults with dementia. After the selection process by a pain assessment tool committee, providers (N = 20) were asked to choose between three tools: pain assessment in advanced dementia (PAINAD), the Abbey Pain Scale, and DOLOPLUS-2/ DOLOSHORT. Providers voted to use the PAINAD (54%) for the following 2 weeks. A preintervention audit showed that without the use of a pain assessment tool, 97.7% of the charts did not have any documentation of a pain diagnosis nor an intervention. Postintervention using PAINAD, 91.3% of the charts had both (χ2[1] = 18.645, p < .001). The feedback obtained from providers (n = 10) after 2 weeks of testing the tool was unanimously positive. Many providers reported increased confidence in identifying pain and some changed their practice by placing pain assessment in the forefront of their encounter with their older clients with dementia. PAINAD was adopted as the pain assessment tool for this practice.

scholarly journals A Descriptive Research Study on Factors that Impact Upon the Quality of Life of Elderly Women with Comorbid Chronic Illnesses; Three Women's Perspectives

2021 ◽  
Author(s):  
◽  
Pauline Lowe
Keyword(s):  
Quality Of Life ◽  
Chronic Illness ◽  
Older Women ◽  
Health Care Professionals ◽  
Research Study ◽  
Elderly Women ◽  
Chronic Illnesses ◽  
Positive Outlook ◽  
The Impact

<p>Background: Women live longer than men and are more likely to live alone; this makes dealing with chronic illnesses more of a challenge for older women. Therefore, an understanding of what living with chronic illness is like for these women is essential in ensuring health professionals can meet their health needs. Aim of Research: The aim of this research study is to explore factors that older women living with comorbid chronic illnesses identify as key to maintaining or improving their quality of life. Design: This study uses a qualitative approach, with a descriptive methodology. Face-to-face: interviews were conducted with three women over the age of 80 who had been diagnosed with more than one chronic illness. These interviews were audiotaped, and the data analysed using thematic analysis. Findings: What emerged from this analysis of older women was the need for them to create meaning in their life, which is further explicated through three main themes: (1) coping with changing health, (2) the impact of family, and (3) attitude. Attitude to life and having a positive outlook were all factors these participants expressed as being essential to maintaining their quality of life. Conclusion: The quality of life of these participants is enhanced by the ability of these women to create meaning in their life. They do this by integrating their wealth of past experience into their present, reflecting back on their lives, but still gaining enjoyment from the here and now. Understanding of how chronic illness impacts, and is managed, by these women leads health care professionals to a greater understanding of being older and living with comorbid chronic illness. The findings of this research may assist nurses working alongside older people to focus on the making of meaning,which may facilitate these people to retain a sense of autonomy and control over their life.</p>

scholarly journals An educational strategy for the implementation of a delirium assessment tool

2021 ◽  
Vol 6 (1) ◽  
pp. 015-020
Author(s):  
Bonaga Beatriz ◽  
Taravilla Elena Ruiz-Escribano ◽  
Carrilero-López Carmen ◽  
Castillo-Lag María Dolores ◽  
Boehm Leanne M ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Daily Practice ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Assessment Tools ◽  
Critically Ill Patient ◽  
Daily Routine

Background: Delirium is an acute syndrome of organ dysfunction with long-term consequences which commonly occurs in the Intensive Care Unit (ICU). The incidence of delirium ranges from 30% - 50% in low severity ICU patients and up to 80% in mechanically ventilated patients. This condition is frequently under-recognized and daily routine screening is a key strategy to early intervention. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) are the most recommended assessment tools for detecting delirium in the critical ill patient. Objective: The main objective of this study is to educate ICU staff about delirium. In addition, nurses were trained to use the CAM-ICU as a standard screening tool. The intervention was evaluated through a survey aimed at ICU staff. Methods: An educational intervention was started in 2014 in our ICU. An educational package for ICU staff consisted of a didactic brochure and explanatory videos. One-on-one teaching, case based scenarios and didactic teaching were strategies used in the implementation process. The entire intervention was evaluated by means of a survey directed to the professionals. Results: The structure of the didactic brochure was simple in order to have an easy understanding of the CAM-ICU tool. We also created 10-minute videos. According to the results of the satisfaction survey (N=62), disorganized thinking was the most difficult feature of CAM-ICU to interpret. When in doubt, consultation between co-workers was the primary resource selected by unit staff. Conclusion: This initiative achieved the objective of training health care professionals in the application of the CAM-ICU tool with a good level of satisfaction from them. Therefore, ICU staff consider delirium management in the broader picture of critically ill patient care as a major activity of daily practice.

scholarly journals Perception of Chronic Illnesses in the Context of Psychological Well-being of Older Adults

2017 ◽  
Vol 45 (4) ◽  
pp. 231-240
Author(s):  
Neala Ambrosi-Randic ◽  
◽  
Marina Nekic ◽  
Ivana Tucak Junakovic ◽  
◽  
...  
Keyword(s):  
Older Adults ◽  
Well Being ◽  
Chronic Illnesses ◽  
Psychological Well Being

scholarly journals Evaluation of the Usability and Acceptability of the InnoWell Platform as Rated by Older Adults: Survey Study

JMIR Aging ◽  
10.2196/25928 ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. e25928
Author(s):  
Haley M LaMonica ◽  
Anna E Roberts ◽  
Tracey A Davenport ◽  
Ian B Hickie
Keyword(s):  
Older Adults ◽  
Social Engagement ◽  
Later Life ◽  
Well Being ◽  
Assessment Tools ◽  
Self Report ◽  
Digital Tool ◽  
System Usability Scale ◽  
Mental Well Being ◽  
Health And Well Being

Background As the global population ages, there is increased interest in developing strategies to promote health and well-being in later life, thus enabling continued productivity, social engagement, and independence. As older adults use technologies with greater frequency, proficiency, and confidence, health information technologies (HITs) now hold considerable potential as a means to enable broader access to tools and services for the purposes of screening, treatment, monitoring, and ongoing maintenance of health for this group. The InnoWell Platform is a digital tool co-designed with lived experience to facilitate better outcomes by enabling access to a comprehensive multidimensional assessment, the results of which are provided in real time to enable consumers to make informed decisions about clinical and nonclinical care options independently or in collaboration with a health professional. Objective This study aims to evaluate the usability and acceptability of a prototype of the InnoWell Platform, co-designed and configured with and for older adults, using self-report surveys. Methods Participants were adults 50 years and older who were invited to engage with the InnoWell Platform naturalistically (ie, at their own discretion) for a period of 90 days. In addition, they completed short web-based surveys at baseline regarding their background, health, and mental well-being. After 90 days, participants were asked to complete the System Usability Scale to evaluate the usability and acceptability of the prototyped InnoWell Platform, with the aim of informing the iterative redesign and development of this digital tool before implementation within a health service setting. Results A total of 19 participants consented to participate in the study; however, only the data from the 16 participants (mean age 62.8 years, SD 7.5; range 50-72) who completed at least part of the survey at 90 days were included in the analyses. Participants generally reported low levels of psychological distress and good mental well-being. In relation to the InnoWell Platform, the usability scores were suboptimal. Although the InnoWell Platform was noted to be easy to use, participants had difficulty identifying the relevance of the tool for their personal circumstances. Ease of use, the comprehensive nature of the assessment tools, and the ability to track progress over time were favored features of the InnoWell Platform, whereas the need for greater personalization and improved mobile functionality were cited as areas for improvement. Conclusions HITs such as the InnoWell Platform have tremendous potential to improve access to cost-effective and low-intensity interventions at scale to improve and maintain mental health and well-being in later life. However, to promote adoption of and continued engagement with such tools, it is essential that these HITs are personalized and relevant for older adult end users, accounting for differences in background, clinical profiles, and levels of need.

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