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1.
BMC Geriatr ; 23(1): 497, 2023 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-37596549

RESUMEN

BACKGROUND: Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings. METHODS: This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively. RESULTS: Linear mixed model (LMM) showed that MBEC participants' mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group. CONCLUSIONS: MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines. TRIAL REGISTRATION: This study was registered with Clinical Trial Registry (ClinicalTrials.gov - U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.


Asunto(s)
Ansiedad , Depresión , Personas con Discapacidad , Atención Plena , Anciano , Humanos , Ansiedad/terapia , Trastornos de Ansiedad , Depresión/terapia , Atención Plena/métodos , Estados Unidos , Instituciones Residenciales , Salud Mental , Religión y Medicina
2.
J Cross Cult Gerontol ; 38(3): 263-283, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37466844

RESUMEN

Drawing on Mason Durie's (1985) New Zealand Whare Tapa Wha model of health (spiritual, emotional, physical, and family domains), the goal was to link a model of well-being with the lived reality for long-term care residents and bereaved family members during COVID-19. Interviews were conducted with five residents and six family members of previous residents of one long-term care in one urban centre between July and September 2020. The increased demands imposed by the pandemic highlighted the gaps in well-being for residents and families. In particular, the inability to connect with family during COVID-19 restrictions reduced perceptions of well-being for residents. Study findings indicate that the provision of well-being for older adults and families in long-term care extends beyond the narrow bounds of the biomedical model. The Whare Tapa Wha model provides a valuable framework describing the holistic balance needed between the four health domains.


Asunto(s)
COVID-19 , Cuidados a Largo Plazo , Humanos , Anciano , Nueva Zelanda/epidemiología , Familia
3.
Bull Menninger Clin ; 87(1): 83-103, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36856474

RESUMEN

It is well documented how adverse childhood experiences can inhibit child development and mentalizing ability and lead to high risk of developmental psychopathology. Mentalization-based treatment (MBT) has been established as an effective approach to treatment for a long range of psychopathologies with both in- and outpatient treatment, yet the evidence base for effective clinical interventions that can help guide professionals working in residential care on how to support the development of neglected and traumatized children is underdeveloped. This article demonstrates a mentalization-based approach to understanding and working with children in residential care, and offers practical models and tools as well as considerations on implementation that are beneficial and easy to apply, demonstrated through cases. The STORM model and "Obtaining Skills" screening tool may be helpful models for professionals addressing mentalization in children while working in challenging environments such as with traumatized and neglected children.


Asunto(s)
Experiencias Adversas de la Infancia , Mentalización , Humanos , Niño , Atención Ambulatoria , Desarrollo Infantil
4.
BMC Geriatr ; 22(1): 457, 2022 05 27.
Artículo en Inglés | MEDLINE | ID: mdl-35624435

RESUMEN

BACKGROUND: Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of implementing pet robots for dementia care in nursing homes, from the perspectives of healthcare professionals and organisational leaders. METHODS: A descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), was conducted. We conducted semi-structured interviews with healthcare professionals and organisational leaders from nursing homes. Data was transcribed and analysed using Framework Analysis, based on the CFIR as an a priori framework. RESULTS: A total of 22 participants from eight nursing homes were included. Determinants were mapped to constructs from all five CFIR domains. Determinants relating to the characteristics of pet robots include their design, realisticness and interactivity, affordability, cleanability, perceived evidence strength and comparative advantages to live pets. Determinants relating to external influences (outer setting) include national regulatory guidelines, funding and networks with other organisations. With regards to characteristics of nursing homes (inner setting), determinants include the relevance of pet robots in relation to the needs of residents with dementia, alignment with care processes, infection control mandates and their relative priority. In the domain 'characteristics of individuals', determinants were associated with individuals' beliefs on the role of technology, desires to enhance residents' quality of life, and differential attitudes on the use of robots. Finally, in the domain 'implementation process', assessments and care planning were identified as determinants. CONCLUSIONS: Overall, while sentiments around determinants within CFIR domains of pet robots' characteristics, outer setting and implementation process were similar, participants' opinions on the determinants within the 'inner setting' and 'characteristics of individuals' were more varied. This could be due to different organisational structures, disciplinary differences and personal experiences of using pet robots. Many determinants in different domains were interrelated. Findings provide a springboard for identifying and designing implementation strategies to guide the translation of pet robots from research into real-world practice.


Asunto(s)
Demencia , Robótica , Demencia/terapia , Personal de Salud , Humanos , Casas de Salud , Calidad de Vida
5.
Int J Older People Nurs ; 17(2): e12428, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34601784

RESUMEN

BACKGROUND: Nurses play a crucial role in enabling older people's autonomy in residential care. However, there is a lack of synthesised knowledge about how nurses can support older people. OBJECTIVE: The aim of this study was to identify and synthesise nursing support for older people's autonomy in residential care. METHODS: An integrative review was carried out by searching the CINAHL, Philosopher's index, PubMed, SocINDEX, Scopus and Web of Science databases, supplemented by manual searches. The searches focused on peer-reviewed scientific empirical research papers published in English, without date limitations. The constant comparison method was used for the analysis. RESULTS: The review identified 24 papers, and these showed that older people's autonomy was based on dignity. Nurses protected older people's autonomy in eight different ways. They protected their right to make their own decisions, acted as advocates, respected their wishes, provided opportunities for autonomy, fostered independence, gave information to residents and relatives, provided individualised care practices and protected older people's safety. However, there were also barriers that needed to be overcome. CONCLUSIONS: Nurses used multiple, individually tailored activities to support older people's autonomy, but they also had different reasons for supporting or hindering it. Work and leadership structures are needed to ensure that older people's autonomy is driven by ethical practices. IMPLICATIONS FOR PRACTICE: The results of this review can help nurses who provide residential care for older people to recognise the different nursing activities that can be used to support older people's autonomy and to develop strategies to apply them in different daily care situations. However, further research is needed to determine how these activities can be realised in daily care and how they cover different aspects of older people's lives in residential care.


Asunto(s)
Liderazgo , Anciano , Humanos
6.
Clin Gerontol ; 45(5): 1087-1102, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34233601

RESUMEN

OBJECTIVES: To synthesize literature about lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults in long-term care (LTC) facilities and provide recommendations for best practice guideline development to inform practice, research, and policy. METHODS: Four electronic databases were searched in June 2019 for studies conducted between 2000- 2019 related to caring for LGBTQ older adults in LTC settings. An integrative literature review was conducted on the twenty eligible studies. RESULTS: LGBTQ participants fear discrimination in LTC settings leading to the invisibility of their identities. They recognize a need for increased staff training and the importance of community networks and facility preferences. LTC staff have mixed experiences with inclusive practices and complex views of LGBTQ older adults. LTC staff experience training deficits and require more expansive modalities. CONCLUSIONS: LGBTQ participants and LTC staff both advise that LTC facilities revise forms and policies to ensure all sexual orientations and gender identities are affirmed and protected in addition to providing widespread training. CLINICAL IMPLICATIONS: This review calls to attention the need for LTC settings to uniformly follow best-practices. Clinical recommendations to promote equitable healthcare include: staff training at all levels and communication that does not assume heterosexuality or cisgender identity.


Asunto(s)
Minorías Sexuales y de Género , Personas Transgénero , Anciano , Femenino , Identidad de Género , Humanos , Cuidados a Largo Plazo , Conducta Sexual
7.
Ageing Res Rev ; 70: 101401, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34237434

RESUMEN

Malnutrition, in particular protein-energy malnutrition, is a highly prevalent condition in older adults, and is associated with low muscle mass and function, and increased prevalence of physical frailty. Malnutrition is often exacerbated in the residential care setting due to factors including lack of dentition and appetite, and increased prevalence of dementia and dysphagia. This review aims to provide an overview of the available literature in older adults in the residential care setting regarding the following: links between sarcopenia, frailty, and malnutrition (in particular, protein-energy malnutrition (PEM)), recognition and diagnosis of malnutrition, factors contributing to PEM, and the effectiveness of different forms of protein supplementation (in particular, oral nutritional supplementation (ONS) and protein-fortified foods (PFF)) to target PEM. This review found a lack of consensus on effective malnutrition diagnostic tools and lack of universal requirement for malnutrition screening in the residential care setting, making identifying and treating malnutrition in this population a challenge. When assessing the use of protein supplementation in the residential care setting, the two primary forms of supplementation were ONS and PFF. There is evidence that ONS and PFF increase protein and energy intakes in residential care setting, yet compliance with supplementation and their impact on functional status is unclear and conflicting. Further research comparing the use of ONS and PFF is needed to fully determine feasibility and efficacy of protein supplementation in the residential care setting.


Asunto(s)
Fragilidad , Desnutrición , Desnutrición Proteico-Calórica , Sarcopenia , Anciano , Suplementos Dietéticos , Ingestión de Energía , Humanos , Desnutrición/diagnóstico , Desnutrición/epidemiología , Desnutrición/terapia , Estado Nutricional , Desnutrición Proteico-Calórica/diagnóstico , Desnutrición Proteico-Calórica/epidemiología , Desnutrición Proteico-Calórica/terapia , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Sarcopenia/terapia
8.
Nurs Ethics ; 28(3): 414-434, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33000683

RESUMEN

Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people's perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher's Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people's individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples' autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people's choices. Professionals' characteristics, such as education and attitudes, and the older people's living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people's perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.


Asunto(s)
Atención a la Salud , Calidad de Vida , Anciano , Humanos
9.
J Aging Phys Act ; 29(1): 142-161, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32723928

RESUMEN

The objective of this study was to explore and synthesize evidence on the effectiveness and implementation of recreational therapy programs to enhance mobility outcomes (e.g., balance, functional performance, fall incidence) for older adults in long-term care. The authors conducted a scoping review of 66 studies following the PRISMA guidelines. Two independent reviewers evaluated each article, and a third reviewer resolved discrepancies. Randomized controlled studies provided strong to moderate evidence that tai chi programs, walking, dancing, and ball games improve flexibility, functional mobility, and balance. Studies assessing program implementation highlighted that program delivery was facilitated by clear instruction, encouragement, attendance documentation, and minimal equipment. This review elucidated the benefit of recreational therapy programs on mobility. It also identified the need for customized programs based on individuals' interests and their physical and mental abilities. These findings and recommendations will assist practitioners in designing effective and feasible recreational therapy programs for long-term care.


Asunto(s)
Accidentes por Caídas/prevención & control , Promoción de la Salud/métodos , Terapia Recreativa , Taichi Chuan , Anciano , Humanos , Cuidados a Largo Plazo , Caminata
10.
Gerontologist ; 61(3): e61-e74, 2021 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-31773131

RESUMEN

BACKGROUND AND OBJECTIVES: When workload demands are greater than available time and resources, staff members must prioritize care by degree of importance and urgency. Care tasks assigned a lower priority may be missed, rationed, or delayed; collectively referred to as "unfinished care." Residential aged care facilities (RACFs) are susceptible to unfinished care due to consumers' complex needs, workforce composition, and constraints placed on resource availability. The objectives of this integrative review were to investigate the current state of knowledge of unfinished care in RACFs and to identify knowledge gaps. RESEARCH DESIGN AND METHODS: We conducted a search of academic databases and included English-language, peer-reviewed, empirical journal articles that discussed unfinished care in RACFs. Data were synthesized using mind mapping techniques and frequency counts, resulting in two categorization frameworks. RESULTS: We identified 17 core studies and 27 informing studies (n = 44). Across core studies, 32 types of unfinished care were organized under five categories: personal care, mobility, person-centeredness, medical and health care, and general care processes. We classified 50 factors associated with unfinished care under seven categories: staff member characteristics, staff member well-being, resident characteristics, interactions, resources, the work environment, and delivery of care activities. DISCUSSION AND IMPLICATIONS: This review signifies that unfinished care in RACFs is a diverse concept in terms of types of unfinished care, associated factors, and terminology. Our findings suggest that policymakers and providers could reduce unfinished care by focusing on modifiable factors such as staffing levels. Four key knowledge gaps were identified to direct future research.


Asunto(s)
Instituciones de Vida Asistida , Anciano , Atención a la Salud , Humanos
11.
Gerontologist ; 60(6): 1115-1125, 2020 08 14.
Artículo en Inglés | MEDLINE | ID: mdl-31812993

RESUMEN

BACKGROUND AND OBJECTIVES: Research has indicated the benefit of music interventions on biological, psychological, and cognitive aspects of dementias, yet there is limited research focusing on music's role in communication. This study developed a conceptual understanding of how people with late-stage dementia may express themselves nonverbally and interact with others during a live music group over time. RESEARCH DESIGN AND METHODS: Eight people with advanced dementias in residential care (aged 82-97 years), four care staff, and three musicians participated in 8-hr-long weekly live Music for Life sessions and listened to 1-hr-long recorded music session. Visual grounded theory was used to analyze video data collected nonintrusively via the Fly 360-degree camera. RESULTS: The live music group facilitated a multisensory communicative environment allowing for verbal and nonverbal communicative actions, social interactional components and agency to develop over time. These aspects were influenced by three factors: time, one-to-one interaction within a group setting and the characteristics of the music. DISCUSSION AND IMPLICATIONS: Nonverbal communication in later-stage dementia may be overlooked or underestimated by busy care staff and families. Using music as an interactive way to communicate can help develop mirroring and turn-taking which has been shown to improve quality of life for people with communication impairment, increase their nonverbal communication and allow for a connection to be built between people. Although further research is recommended, individuals responsible for residential care should feel confident that the development of ongoing music groups for this population is warranted as part of ongoing care.


Asunto(s)
Demencia , Musicoterapia , Música , Anciano de 80 o más Años , Comunicación , Humanos , Calidad de Vida
12.
Gerontologist ; 60(3): e184-e199, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-30884495

RESUMEN

BACKGROUND AND OBJECTIVES: Having contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. We conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings. RESEARCH DESIGN AND METHODS: Search terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). We also pursued grey literature, global clinical trials registries, and a range of supplementary methods. RESULTS: Of 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction. DISCUSSION AND IMPLICATIONS: There is inconsistent evidence that indoor nature exposures are beneficial for older care residents. We expect that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.


Asunto(s)
Jardinería/métodos , Terapia por Relajación/métodos , Instituciones Residenciales , Anciano , Anciano de 80 o más Años , Ambiente , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad
13.
Int J Older People Nurs ; 14(4): e12269, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31469240

RESUMEN

PURPOSE: The increase in agitated or aggressive behaviour amongst nursing home residents with dementia is a challenging problem. Such behaviour causes stress for both resident and caregiver. Many non-pharmacological interventions have been studied, but these interventions disregard the resident's unfulfilled needs and are executed by a single, designated caregiver. This study tests a non-pharmacological intervention, applied by the entire team and based on the resident's underlying needs. DESIGN: A pretest and post-test interventional study design was used, in which 65 residents with dementia who expressed agitated or aggressive behaviour. Data were collected from December 2016 until March 2017. METHODS: The ABC method and the Senses Framework were used to assign residents to either therapeutic touch, group music sessions or a meaningful individual activity. All staff members applied the interventions. Data were collected by use of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) and the Cohen-Mansfield Agitation Inventory (CMAI). RESULTS: The frequency of aggression, loss of decorum, depression and the severity of aggression decreased for all three interventions. However, the overall severity of fear also increased. The overall prevalence of agitated of residents decreased for the therapeutic touch, group music sessions and individual activities. CONCLUSIONS: This study shows the possibilities of designing individualised interventions on the Senses Framework and the ABC method for addressing agitated and aggressive behaviour amongst nursing home residents with dementia. The framework presented in this study should be further explored. IMPLICATIONS FOR PRACTICE: A team-based approach is effective to reduce agitated or aggressive behaviour amongst nursing home residents.


Asunto(s)
Agresión , Demencia/psicología , Atención Dirigida al Paciente , Agitación Psicomotora , Anciano , Anciano de 80 o más Años , Bélgica , Demencia/enfermería , Femenino , Enfermería Geriátrica , Servicios de Salud para Ancianos , Humanos , Masculino , Persona de Mediana Edad , Modelos de Enfermería , Casas de Salud , Sensación
14.
Can J Aging ; 38(2): 143-154, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31025619

RESUMEN

ABSTRACTThis qualitative study explores the experiences of older adults participating in a creative visual arts program at a residential care facility in Victoria, British Columbia. A narrative inquiry approach was used to conduct face-to-face interviews with 10 residents and three program staff in addition to the systematic observations of program activities and an arts exhibit. The findings reveal the program fostered a sense of community among participants and enhanced their sense of self-worth as artists. A public art exhibition at a community centre underlined the value of residents' artwork and gave meaning and purpose to their involvement in the program. Findings show the importance of arts programs in fostering creativity in later life and illustrate how people living in institutions can experience multiple dimensions of the self through artistic forms of expression. This study highlights the need to increase access to arts programs for individuals living in residential care.


Asunto(s)
Arteterapia , Instituciones de Vida Asistida , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Participación de la Comunidad , Femenino , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Masculino , Persona de Mediana Edad
15.
J Clin Nurs ; 28(7-8): 1070-1084, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30431682

RESUMEN

AIM: To systematically review the literature regarding the experience of older people, families and staff using life-story work in residential care facilities for older people. BACKGROUND: Life-story work has been promoted as an approach to enhance care provided and involves collecting memories and moments that are important to the person assisting them to regain their sense of self. DESIGN: An integrative review utilising the PRISMA reporting guidelines where seven databases, Scopus, EMBASE, CINAHL, MEDLINE, PsychInfo, PsychARTICLES, and Cochrane, were searched within the timeframe; 1 January 2006 to 14 March 2016. Data were reviewed using Whittemore and Knalf's (Journal of Advanced Nursing, 2005, 52:546) methodological approach for integrative reviews. Analysis was conducted utilising Braun and Clarke's (Qualitative Research in Psychology, 2006, 3:77) six phases to identify, analyse and record themes within the data. RESULTS: Thirteen articles were reviewed, and the review found that life-story work has been introduced using a range of different approaches, with no common approach. Thematic analysis identified two: maintaining identity and building and maintaining relationships. CONCLUSION: The review extends the current evidence on the experience of using life-story work in long-term aged care facilities for older people. Life-story work has the potential to enhance person-centred care in long-term care. However, improving the process of implementation of life-story work will require education, time and resources and a commitment from service providers and managers. RELEVANCE TO CLINICAL PRACTICE: Staff who undertake life-story work with residents need to be equipped with the skills to recognise and manage the challenges and issues that may potentially arise. Further research into the successful implementation of life-story work and how it can be resourced is required.


Asunto(s)
Autobiografías como Asunto , Hogares para Ancianos/organización & administración , Cuidados a Largo Plazo/métodos , Relaciones Enfermero-Paciente , Atención Dirigida al Paciente/métodos , Instituciones de Cuidados Especializados de Enfermería/organización & administración , Anciano , Ego , Humanos , Relaciones Profesional-Familia , Investigación Cualitativa
17.
Trials ; 19(1): 650, 2018 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-30477548

RESUMEN

BACKGROUND: Older adults in residential aged care facilities have unnecessarily high levels of vision impairment (VI) which are largely treatable or correctable. However, no current comprehensive eye health service model exists in this setting in Australia. We aimed to determine the clinical, person-centered, and economic effectiveness of a novel eye care model, the Residential Ocular Care (ROC). METHODS/DESIGN: This protocol describes a multicentered, prospective, randomized controlled trial. A total of 395 participants with distance vision < 6/12 (0.30 LogMAR) and/or near vision N8 (1.00 M) or worse will be recruited from 38 urban and rural aged care facilities across Victoria, Australia. Aged care facilities will be randomized (1:1) to one of two parallel groups. Participants in the ROC group will receive a comprehensive and tailored eye care pathway that includes, as necessary, refraction and spectacle provision, cataract surgery, low vision rehabilitation, and/or a referral to an ophthalmologist for funded treatment. Usual care participants will be referred for an evaluation to the eye care service associated with the facility or an eye care provider of their choice. The primary outcome will be presenting near and distance vision assessed at the two- and six-month follow-up visits, post baseline. Secondary outcomes will include vision-specific quality of life, mobility, falls, depression, and eye care utilization at two and six months. An incremental cost-effectiveness analysis will also be undertaken. DISCUSSION: The ROC study is the first multicentered, prospective, customized, and cluster randomized controlled trial in Australia to determine the effectiveness of a comprehensive and tailored eye care model for people residing in aged care facilities. Results from this trial will assist health and social care planners in implementing similar innovative models of care for this growing segment of the population in Australia and elsewhere. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12615000587505 . Registered on 4 June 2015 - retrospectively registered.


Asunto(s)
Prestación Integrada de Atención de Salud , Ojo/fisiopatología , Hogares para Ancianos , Casas de Salud , Oftalmología/métodos , Trastornos de la Visión/terapia , Visión Ocular , Factores de Edad , Análisis Costo-Beneficio , Técnicas de Diagnóstico Oftalmológico , Costos de la Atención en Salud , Estado de Salud , Hogares para Ancianos/economía , Humanos , Estudios Multicéntricos como Asunto , Casas de Salud/economía , Oftalmología/economía , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Tiempo , Resultado del Tratamiento , Victoria , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/economía , Trastornos de la Visión/fisiopatología
18.
J Clin Nurs ; 27(23-24): 4390-4399, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29964302

RESUMEN

AIMS AND OBJECTIVES: This qualitative study examined the appropriateness and acceptability of 14-week modified tai chi and yoga programmes in an Australian residential aged care (RAC) setting by exploring experiences and perspectives of frail older residents and staff participants. BACKGROUND: Older persons in RAC have limited opportunities for physical activity. Tai chi and yoga are mindfulness-based exercise interventions that have been used to promote physical and psychological health of older adults in community settings. While research on tai chi and yoga interventions in community settings is promising, there is limited research regarding the interventions' appropriateness and acceptability for frail older residents in residential care settings in Australia. DESIGN: Descriptive and qualitative component of a mixed-methods study. METHODS: All residents who participated in the modified yoga and tai chi interventions and staff who supported them were invited. A total of 19 individuals comprising 16 residents and three staff members participated in three focus group interviews. The interviews were audio-recorded, transcribed and analysed thematically using a qualitative descriptive approach. RESULTS: Nine themes that reflected the uniqueness of the programmes' mind-body approach are presented: (a) novel, new and exciting; (b) smoothness, rhythm and flow; (c) slow and mindful; (d) gentle but rewarding; (e) moving whole body; (f) perceived benefits; (g) worthwhile; (h) feeling alive; and (i) calming and relaxing. CONCLUSIONS: The modified programmes of tai chi and yoga was acceptable, appropriate, enjoyable and helpful. Both tai chi and yoga appear to provide appropriate physical exercise and opportunities for older persons to enhance their quality of life through interaction of physical, emotional and intellectual wellness domains. RELEVANCE TO CLINICAL PRACTICE: The 14-week modified programmes of tai chi and yoga could be applied to frail older RAC population to promote health and active ageing.


Asunto(s)
Hogares para Ancianos , Casas de Salud , Aceptación de la Atención de Salud , Taichi Chuan , Yoga , Anciano , Australia , Atención a la Salud , Emociones , Ejercicio Físico , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida
19.
Rev. SPAGESP ; 19(1): 35-48, Jan.-Jun. 2018. tab
Artículo en Portugués | LILACS, INDEXPSI | ID: biblio-957389

RESUMEN

Este estudo investigou as imagens sociais atribuídas às instituições de acolhimento através de um questionário aberto. Participaram 202 pessoas, com idades entre 16 e 69 anos (M=32,76, DP=11,67), que indicaram 914 palavras para descrever as instituições. A partir de uma análise de conteúdo, foram identificadas categorias: (1) Acolhimento/Proteção (n=342), (2) Organização/Funcionamento (n=238), (3) Recursos (n=229), (4) Formação/Preparação (n=73), (5) Permanência/Provisoriedade (n=18), (6) Outros (n=14), sendo que em cada uma as palavras ainda foram classificadas em valência positiva ou negativa. Houve predominância da valência positiva em todas as categorias, sugerindo uma imagem social positiva sobre as instituições. Os dados indicam que as funções de acolhimento e organização, bem como a disponibilidade de recursos das instituições são mais reconhecidas pelos participantes.


This study investigated the social images assigned to residential care institutions, through an open questionnaire. The participants were 202 people, aged 16 to 69 years old (M=32.76, SD=11.67), who indicated 914 words to describe the institutions. Through content analysis, the following categories were identified: (1) Care/Protection (n=342), (2) Organization/Operation (n=238), (3) Resources (n=229), (4) Formation/Preparation (n=73), (5) Permanence/Temporariness (n=18), (6) Others (n=14), and each word was classified by its positive or negative valence. There was a predominance of positive valence in all categories, suggesting a positive social image of these institutions. The data indicated that the functions of care and organization, as well as the availability of resources of the institutions are more recognized by the participants.


Este estudio investigó las percepciones sociales sobre las instituciones de acogimiento infantil a través de un cuestionario abierto. Participaron 202 personas, con edades entre 16 y 69 años (M = 32.76, DE = 11.67), las cuales usaron 914 palabras para describir las instituciones. Un análisis de contenido generó categorías: (1) Acogimiento/Protección (n=342), (2) Organización/Operación (n=238), (3) Recursos (n=229), (4) Formación/Preparación (n=73), (5) Permanencia/Temporalidad (n=18), (6) Otros (n=14), y cada palabra aún fue clasificada con valencia positiva o negativa. Hubo un predominio de valencia positiva en todas las categorías, lo que sugiere una imagen social positiva de las instituciones. Los datos indican que las funciones de acogimiento y organización, así como la disponibilidad de recursos son más reconocidas por los participantes.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Imágenes en Psicoterapia , Refugio , Acogimiento
20.
Clin Psychol Psychother ; 24(6): O1485-O1494, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28730756

RESUMEN

The aim of this study was to evaluate the impact of an animal-assisted psychotherapy (AAP) programme on clinical symptoms, personal adjustment, and adaptive skills in a group of adolescents in residential care who had experienced childhood trauma and who presented mental health problems and difficulties adapting to the care home environment. The 87 participants (Mage  = 15.17, SD = 1.53) were divided into two groups: a treatment group (25 girls and 27 boys; Mage  = 15.00, SD = 1.55) and a control group (9 girls and 26 boys; Mage  = 15.42, SD = 1.50). The programme consisted of 34 sessions involving both group (23 sessions) and individual (11 sessions) AAP. The Behaviour Assessment System for Children was used to evaluate clinical and adaptive dimensions of behaviour and personality. The results indicated that, in comparison with controls, the young people who took part in the AAP programme reported a significant improvement on two measures of internalizing symptoms, namely, depression and sense of inadequacy. Although no significant differences were observed in relation to externalizing symptoms, the adolescents who received the AAP programme showed improved social skills in terms of their ability to interact satisfactorily with peers and adults in the care home environment, as well as a more positive attitude towards teachers at school. These results suggest that AAP may be a promising treatment for young people who have experienced childhood trauma and who subsequently find it difficult to adapt to the residential care setting.


Asunto(s)
Terapia Asistida por Animales/métodos , Trastornos de la Conducta Infantil/terapia , Evaluación de Programas y Proyectos de Salud/métodos , Psicoterapia/métodos , Tratamiento Domiciliario/métodos , Adolescente , Trastornos de la Conducta Infantil/psicología , Femenino , Humanos , Masculino , Resultado del Tratamiento
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