Impact of social phone programs on loneliness and mood in older adults: a mixed methods systematic review protocol.

OBJECTIVE: The objective of this mixed methods review is to examine the effectiveness and experience of social phone programs on loneliness and/or mood in community-dwelling older adults. INTRODUCTION: There is a large and growing older adult population that is burdened with loneliness. Loneliness affects both physical and mental health, and it is, therefore, imperative to examine ways of mitigating experiences of loneliness. Social phone programs are being offered through multiple organizations as a way of increasing socialization and decreasing loneliness in older adults. There is a need to examine existing data on social phone programs to determine their effectiveness and optimize their implementation. INCLUSION CRITERIA: Included studies will be original qualitative, quantitative, or mixed methods research, along with gray literature, examining the use of social phone programs to address loneliness and/or mood in older adults. METHODS: A convergent segregated mixed methods approach will be used, in line with the JBI methodology for mixed methods reviews. Articles will be searched in selected databases, sources of clinical trials, and gray literature. No limits have been set for language or date of publication. Two team members will select studies through title and abstract screening and then full-text screening. Critical appraisal will be performed in accordance with the standard JBI critical assessment tools, although no articles will be excluded based on this appraisal. Quantitative articles will be synthesized using meta-analysis, while a process of meta-aggregation will be used for qualitative articles. The findings will be integrated into a final report. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022335119.

Pain assessment as intervention: a study of older adults with severe dementia.

OBJECTIVES: The communication impairments that characterize severe dementia make pain assessment challenging. As such, pain problems often go undetected. Our goal was to determine whether systematic pain assessment leads to improved pain management practices and decreases nursing stress in comparison with a control condition. METHODS: We adopted a 3-month comparative longitudinal design. Nursing staff regularly assessed dementia patients' pain through the use of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). A second group of nurses completed an attention-control measure for a control group of patients. In addition, nursing staff regularly completed measures of work stress to investigate the effects of the workload associated with systematic pain assessment on nurse stress. RESULTS: Regular use of the PACSLAC improved pain management practices over time as reflected in increased usage of analgesic medications (prescribed on "as needed" basis) in comparison with the control group. As pain interventions increased, a corresponding decrease in observable pain behaviors (as reflected on the PACSLAC assessments that were completed by the nurses) was observed. In addition, nurses who used the PACSLAC reported decreased distress and burnout over time. DISCUSSION: This investigation provides strong support for both the importance of systematic pain assessment in long-term care and for the clinical utility of the PACSLAC in improving pain management practices and decreasing caregiver distress.

[Validity 'and Utilities' clinic of a grid observation (PACSLAC-F) to evaluate the pain in seniors with dementia's living in the Long-Term Care ]. / Validité et utilité clinique d'une grille d'observation (PACSLAC-F) pour évaluer la douleur chez des aînés atteints de démence vivant en milieu de soins de longue durée.

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations. The test-retest and inter-observer reliability, the internal consistency, and the discriminent validity were found to be satisfactory. To evaluate the convergent validity with the DOLOPLUS-2 and the clinical relevance of the PACSLAC, it was also completed by nurses during their work shift, with 26 additional patients, for three days per week during a period of four weeks. These results encourage us to test the PACSLAC in a comprehensive program of pain management targeting this population.

Identical elements model of arithmetic memory: extension to addition and subtraction.

The identical elements (IE) model of arithmetic fact representation (Rickard, 2005; Rickard & Bourne, 1996) was developed and tested with multiplication and division. In Experiment 1, we demonstrated that the model also applies to addition and subtraction by examining transfer of response time (RT) savings between prime and probe problems tested in the same block of trials. As is predicted by the IE model, there were equivalent probe RT savings for addition with identical repetition (prime 6 + 9 --> probe 6 + 9) or an order change (9 + 6 --> 6 + 9), but much greater savings for subtraction with identical repetition (15 - 6 --> 15 - 6) than with an order change (15 - 9 --> 15 - 6), and no savings with an operation change (15 - 9 --> 6 + 9 or 6 + 9 --> 4 15 - 6). In Experiment 2, we examined transfer in simple multiplication and division and demonstrated symmetrical transfer between operations. Cross-operation RT savings were eliminated, however, when the RT analysis included only trials on which both the prime and the probe problems were reportedly solved by direct retrieval. An IE model extended to accommodate savings associated with procedural strategies provides a coherent account of facilitative transfer effects in simple arithmetic.

Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC).

The purpose of this study, conducted in three phases, was to develop a clinically useful observational tool (i.e., the Pain Assessment Checklist for Seniors With Limited Ability to Communicate [PACSLAC]) to assess pain in seniors with severe dementia. In Phase 1, professional caregivers of seniors with severe dementia were interviewed in order to generate a list of pain-related behaviors that are characteristic of care recipients living in long-term-care facilities. Based on a systematic examination of interview transcripts by experienced researchers and an independent coder, a behavioral checklist (i.e., the initial version of the PACSLAC) was developed. The checklist items were organized into conceptually based subscales (e.g., facial expressions, activity/body movement). Phase 2 focused on an assessment of the internal consistency of the checklist (alpha =.92). Following an item analysis, the subscales of the PACSLAC (Social/Personality/Mood Indicators, Facial Expressions, Activity/Body Movement, and Physiological Indicators/Eating/Sleeping Changes/Vocal Behaviors) were found to be internally consistent. Phase 3 focused on a preliminary validation of the PACSLAC. Analyses suggest that the PACSLAC discriminated among pain events (during which there was a clear and recognizable cause for the patients' pain), events during which patients were experiencing nonpainful distress, and situations during which patients were calm.

Comparing two observational systems in the assessment of knee pain.

OBJECTIVE: Research has demonstrated the utility of the Pain Behavior Measurement (PBM) system as a pain index. PBM involves the recording of sighing, rubbing, grimacing, guarding and bracing. A modification of this system has been proposed, focusing on the occurrence of joint flexing, rubbing, unloading the joint, guarding and rigidity, specifically for patients with knee pain. The aim of the present study was to compare the original PBM to the modified version in a sample of knee replacement patients to assess the utility of the more specialized approach. It was expected that the more discomforting physiotherapy activities (knee bending and quadriceps exercises) would result in more pain behaviours than intermediate activities (walking and standing), which, in turn, would result in more pain behaviours than reclining. The extent to which each system reflected this expected pattern was examined. METHODS: Ninety-three seniors were observed while completing a series of structured post-knee surgery physiotherapy activities (knee bending, standing, walking, reclining and a quadriceps exercise). RESULTS: Analyses of self-reported levels of pain were consistent with the expected pattern of pain levels in relation to the physiotherapy activities. Specific pain behaviours within each system (eg, grimacing, rigidity) occurred in a manner consistent with the expected pattern, while other behaviours (e.g., rubbing the affected area) did not. CONCLUSIONS: Although there was no clear advantage for the modified system over the PBM, an optimal approach may involve combining specific behaviours from each system.

The ethical ideologies of psychologists and physicians: a preliminary comparison.

The ethical ideologies of psychologists (who provide health services) and physicians were compared using the Ethics Position Questionnaire. The findings reveal that psychologists tend to be less relativistic than physicians. Further, we explored the degree to which physicians and psychologists report being influenced by a variety of factors (e.g., family views) in their ethical decision making. Psychologists were more influenced by their code of ethics and less influenced by family views, religious background, and peer attitudes than were physicians. We argue that these differences reflect the varied professional cultures in which practitioners are trained and socialized.