Impact of Mediterranean Dietary Education on Symptoms for Adults at Risk for Nonalcoholic Fatty Liver Disease.

This 2-month quasi-experimental study focused on the impact of education regarding the Mediterranean diet on symptoms for adults who are at risk for nonalcoholic fatty liver disease (NAFLD). The study was conducted on a sample of 28 adults who presented to Pinnacle clinical research for NAFLD screening via a fibroscan. These individuals who are at risk for NAFLD received a single 15-minute one-on-one in person education regarding the Mediterranean diet. The diet encourages fruits, vegetables, whole grains, legumes, nuts, seeds, fish, and olive oil. The results of the study showed that the Mediterranean diet education was associated with significant improvement of abdominal symptoms ( t = 3.34, p = .03), improvement of fatigue symptoms ( t = 5.88, p < .001), and decrease in hepatic steatosis ( t = 5.77, p < .001). Our study suggests that the education on the Mediterranean diet may be associated with improvement of self-reported abdominal symptoms, fatigue, and steatosis score.

Familism and Health Care Provision to Hispanic Older Adults.

The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described.

The influence of aquariums on weight in individuals with dementia.

This study assessed whether individuals with dementia who observe aquariums increase the amount of food they consume and maintain body weight. The sample included 70 residents in dementia units within 3 extended care facilities in 2 states. The intervention included the introduction of an aquarium into each common dining area. A total increase of 196.9 g of daily food intake (25.0%) was noted from baseline to the end of the 10-week study. Resident body weight increased an average of 2.2 pounds during the study. Eight of 70 residents experienced a weight loss ((Equation is included in full-text article.)=1.89 lbs). People with advanced dementia responded to aquariums in their environment documenting that attraction to the natural environment is so innate that it survives dementia.

Perceived patient safety culture in a critical care transport program.

BACKGROUND: The purpose of this study was to examine the association among selected safety culture dimensions and safety outcomes in the context of a critical care transport (CCT) program. METHODS: A descriptive cross-sectional correlational design used the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture to validate perceived safety culture among personnel (n = 76) in a large Midwestern CCT program. RESULTS: Findings revealed significant associations between 1) teamwork and frequency of error reporting (r = .428, P < .001), overall perception of safety (r = .745, P < .001), and perceived patient safety grade (r = -.681, P < .001); 2) between perception of manager actions promoting safety and frequency of error reporting (r = .521, P < .001), overall perception of safety (r = .779, P < .001), and perceived patient safety grade (r = -.756, P < .001); and 3) between communication openness and frequency of error reporting (r = .575, P < .001), overall perception of safety (r = .588, P < .001), and perceived patient safety grade (r = -.627, P < .001). CONCLUSION: The study supports other literature showing significant associations among safety culture dimensions and safety outcomes and provides a framework for future research on safety culture in CCT programs.

Association of SGLT-2 Inhibitors With Treatment Satisfaction and Diabetes-Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes.

Background It is unknown if initiation of a sodium-glucose cotransporter-2 inhibitor (SGLT-2i) is associated with changes in patient-reported health status outside of clinical trials. Methods and Results Using a prospective observational study design, adults with type 2 diabetes and cardiovascular disease were recruited from 14 US hospitals between November 2019 and December 2021 if they were new users of noninsulin antidiabetic medications. The primary outcome was change in 6-month diabetes treatment satisfaction. Secondary outcomes included diabetes-related symptom distress, diabetes-specific quality of life, and general health status for all patients and based on cardiovascular disease type. Inverse probability of treatment weight using propensity score was performed to compare outcome changes based on medication use. Of 887 patients (SGLT-2i: n=242) included in the inverse probability of treatment weight analyses, there was no difference in changes in treatment satisfaction in SGLT-2i users compared with other diabetes medication users (0.99 [95% CI, -0.14 to 2.13] versus 1.54 [1.08 to 2.00], P=0.38). Initiating an SGLT-2i versus other diabetes medications was associated with a greater reduction in ophthalmological symptoms (-3.09 [95% CI, -4.99 to -1.18] versus -0.38 [-1.54 to 0.77], P=0.018) but less improvement in hyperglycemia (1.08 [-2.63 to 4.79] versus -3.60 [-5.34 to -1.86], P=0.026). In subgroup analyses by cardiovascular disease type, SGLT-2i use was associated with a greater reduction in total diabetes symptom burden and neurological sensory symptoms in patients with heart failure. Conclusions Among patients with type 2 diabetes and cardiovascular disease, initiating an SGLT-2i was not associated with changes in diabetes treatment satisfaction, total diabetes symptoms, diabetes-specific quality of life, or general health status.

Animal-Assisted Intervention and Dementia: A Systematic Review.

This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.

Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study.

PURPOSE: The use of animals in various healthcare settings dates as far back as the 19th century, and is still a widely practiced intervention even today. The use of animals in the acute rehabilitation setting is a common practice that benefits both the patient's therapy progression and allows the opportunity for financial reimbursement for the facility. As acute rehabilitation facilities continue to cope with ever changing rules and guidelines, the use of alternate modalities can help the facility overcome difficult challenges while focusing on the needs of the patients. The use of animal assisted therapy is illustrated with a stroke patient at an acute rehabilitation facility who benefited from implementing a pet therapy regimen when regular therapy modalities were not helping. CLINICAL RELEVANCE: Incorporating animal assisted therapy in acute rehabilitation settings is described to obtain greater satisfaction for patients and staff and to facilitate reimbursement for rehabilitation settings.

Animal-assisted therapy and Nutrition in Alzheimer's disease.

This study examined the influence of animal-assisted therapy, specifically fish aquariums, on nutritional intake in individuals with Alzheimer's disease (AD). Sixty-two individuals with AD who lived in specialized units were studied. Baseline nutritional data were obtained followed by a 2-week treatment period when the aquariums were introduced. The treatment data were collected daily for 2 weeks then weekly for 6 weeks. Nutritional intake increased significantly (21.1%; p <.001) when the aquariums were introduced and continued to increase during the 6-week weekly follow-up. Weight increased significantly (1.65 lbs; p < .001) over the 16-week period In addition, participants required less nutritional supplementation, resulting in health care cost savings.

Predictors of burden for caregivers of patients with Parkinson's disease.

Parkinson's disease (PD) is a chronic, progressive neurological disease that affects an estimated 1 million Americans each year. Its progressive nature leads to increased burden for the caregiver. This study explored factors that contribute to the perception of burden in caregivers of individuals with PD using a cross-sectional design. The sample consisted of 41 caregivers who were married to or cohabitating with individuals with PD. Questionnaires were mailed to spousal caregivers and returned via mail. Burden was determined by utilizing the Zarit Burden Inventory. The independent variables that were measured were activities of daily living (ADLs), perceived social support, psychological well-being, and marital satisfaction. All four factors were found to significantly predict perceived burden. Multiple regression analysis showed that ADLs and perceived social support were significant predictors of caregiver burden, accounting for 44.3% of the variance. The implication for healthcare professionals is that they should provide information on PD symptom management, thus promoting independence in performing ADLs, identifying appropriate resources to reduce caregiver burden, and using support groups.

The influence of caregiver burden on patients' management of Parkinson's disease: implications for rehabilitation nursing.

In this study, we examined how the perceived burdens of caregivers influence how people with Parkinson's disease (PD) manage their condition. Burden has previously been defined as the extent to which caregivers perceive that their health, social life, and financial status are being adversely affected because of their care giving. We hypothesized that when caregivers perceive that their burden is increasing, the level of management by PD patients of their disease decreases. A purposive sample of 41 couples in which one spouse or partner had PD was obtained through physician referrals, PD educational programs, and support groups in six Midwestern states. Twenty-eight of the PD patients were men and 13 were women; their spouses or partners included 28 women and 13 men. How patients managed the disease was measured with the Management of Parkinson's Disease Instrument, developed by the first author. The Zarit Perceived Burden Inventory was used to measure the caregivers' perceived burdens. A significant path (p < .02) was noted between the spouse or partner's perceived burden of care and the patient's management of the disease (beta = -.067). A path coefficient of beta = -365 was obtained. The role of the rehabilitation nurse in the relationship of caregiver and care recipient is that of counselor, educator, and supporter.

Influence of aquariums on resident behavior and staff satisfaction in dementia units.

The influence of an aquarium on resident behavior and staff job satisfaction in three dementia units was examined. The sample consisted of 71 individuals with dementia and 71 professional staff. A pretest-posttest design was utilized. Baseline resident behavior and staff satisfaction were obtained, and an aquarium was introduced into the setting. Post-behavioral assessment and job satisfaction surveys were completed. Residents' behaviors improved along four domains: uncooperative, irrational, sleep, and inappropriate behaviors. The overall residents' behavior score was significantly improved after an aquarium was introduced, F = 15.60, p < .001. Their mean disruptive behavior score decreased from 67.2 to 58.2. The staff's satisfaction score significantly improved, F = 35.34, p < .001. Pretest to posttest mean scores improved from 149.4 to 157.9. Aquariums are an innovative way for animal-assisted therapy and nature to be introduced to specialized dementia units in long-term care.

Development and psychometric testing of the Dogs and WalkinG Survey (DAWGS).

PURPOSE: Dog owners represent 40% of the population, a promising audience to increase population levels of physical activity. The purpose of this study was to develop and test the psychometric properties of a new instrument to assess social-cognitive theory constructs related to dog walking. METHOD: Dog owners (N = 431) completed the Dogs and WalkinG Survey (DAWGS). Survey items assessed dog-walking behaviors and self-efficacy, social support, outcome expectations, and outcome expectancies for dog walking. Test-retest reliability was assessed among 252 (58%) survey respondents who completed the survey twice. Factorial validity and factorial invariance by age and walking level were tested using confirmatory factor analysis. RESULTS: DAWGS items demonstrated moderate test-retest reliability (p = .39-.79; k = .41-.89). Acceptable model fit was found for all subscales. All subscales were invariant by age and walking level, except self-efficacy, which showed mixed evidence of invariance. CONCLUSIONS: The DAWGS is a psychometrically sound instrument for examining individual and interpersonal correlates of dog walking.

Textual analysis of retired nurses' oral histories.

This paper considers the use of textual analysis of oral histories as a method for historians of nursing. Fifty-three oral histories of retired nurses in midwestern USA were analyzed for the purpose of historical reconstruction of past education experiences in nursing. Textual analysis was used to determine how nurses made sense of their educational experiences, and it involved gathering data, analyzing the information, and using a different method of interpreting the data. Although the participants responded to specific questions, the oral histories in this study are more than mere answers to the researchers' queries. The participants' memories are narratives that are the joint product of both the historian and the participant. As such, the oral history becomes a text to be stored along with other primary sources for future historians' use. The research also suggests decentering oral histories from an exclusively academic agenda and focusing more on what the participants choose to remember and why they make those choices.