A pilot study: Resistive behavior in the context of informal caregiver-assisted activities of daily living.

Providing care for people with dementia is difficult when resistive behaviors displayed by people impede caregiving efforts. PURPOSE: To examined the frequency of resistive behaviors during informal caregiver-assisted activities of daily living and the impact of these occurrences. DESIGN: A cross sectional design was used to recruit 17 caregivers from Alzheimer's support group meetings in 2010. METHOD: Self-report surveys were used to obtain participants' report of resistive behaviors. FINDINGS: A positive correlation was found between caregivers reported frequency of bathing behaviors and their reported upset with dressing behaviors. Gender differences emerged in caregiver reported frequencies of the resistive behaviors. Caregivers reported behaviors occurring between two and six times per week but rated the not frequent behaviors as somewhat to very upsetting when they occurred. CONCLUSIONS: When informal caregivers provide assisted care, resistive behaviors occur. Future research is needed to identify interventions to help caregivers manage their upset when resistiveness occurs.

Resistiveness to Care as Experienced by Family Caregivers Providing Care for Someone With Dementia.

PURPOSE: This research explored family caregivers' lived experiences of resistiveness to care when they provided care for people with dementia. The goal was to identify a general meaning of family caregivers' lived experiences to target potential areas for future nursing interventions to help family caregivers manage their caregiving role and provide a base for future research surrounding resistiveness to care. DESIGN: Descriptive phenomenology was used to provide descriptions of eight family caregivers who provided care for someone with dementia and experienced resistiveness to care. Family caregivers were recruited from Alzheimer's support groups from June to November 2014. METHOD: Caregiver interviews were transcribed verbatim and analyzed using scientific phenomenology to identify essential constituents of the experience. FINDINGS: The identified general meaning structure contained five essential constituents. These included self-questioning of abilities; signal for increased future caregiver responsibilities; changed perception of personal self; unexpected emotional responses; and seeing a changed person, not the disease. CONCLUSIONS: Study findings represent family caregivers' lived perceptions of resistiveness to care, which are different from current research findings regarding nurses' perceptions of resistiveness to care. The identified meaning structure indicates focus areas for future research and for nursing interventions to help family caregivers manage their distress when experiencing resistiveness to care. CLINICAL RELEVANCE: Identification of the meaning caregivers ascribe to their lived experience of resistiveness to care (five essential constituents) provides nurses with opportunities to help family caregivers (coproviders of care) holistically. Supporting caregivers in their caregiving role can decrease caregiver distress when resistiveness to care occurs.

Disaster Preparedness in K-12 Schools: An Integrative Review.

BACKGROUND: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents. METHODS: An integrative review using Whittemore and Knafl's model was conducted to explore peer-reviewed publications about K-12 schools and natural disasters and pandemic preparedness and planning. RESULTS: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level. CONCLUSIONS: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters.

Mindfulness Self-Compassion: Helping Family Caregivers Cope with Cognitive Behaviors of Dementia.

Purpose: To test the feasibility of recruiting dementia family caregivers to participate in the holistic intervention of mindfulness self-compassion (MSC) to decrease perceived distress. There are few studies focused on MSC for dementia caregivers. Design: An interdisciplinary approach (nursing and psychology) and uncontrolled experimental design tested a holistic intervention Mindfulness Self Compassion (MSC) as a coping strategy using the Stress Process framework. Findings: Twenty-four caregivers participated. Dementia caregivers' use of positive reappraisal increased with a mean difference of 2.53 (t = 2.10; SD = 5.23) (p = .049) indicating that family caregivers may have increased their use of positive reappraisal. MSC sessions impacted the caregivers ways of coping with increases in accepting responsibility [model: F(4, 13) 3.18, p-value 0.0499, R-sq = 49.5%, estimate: B = 1.11, t = 2.64, p-value = 0.02)] and impacted caregivers' ways of coping using distancing [model: F(4, 13) 1.47, p-value 0.2682, R-sq = 31.1%, estimate: B = 1.63, t = 2.19, p-value = 0.05)]. Conclusion: Satisfaction with MSC was high among caregivers. At the study's conclusion, caregivers appraised their caregiving non-judgmentally and reduced their negative thoughts of difficult situations. MSC as a holistic practice has the potential to shift caregivers' focus to positive appraisals and promote caregiver wellbeing.

Simulation: An active learning pedagogy for an undergraduate nursing leadership course.

BACKGROUND: Interpretive pedagogy with simulation encourages students to consider multiple perspectives contextually leading students to think deeper in a shared learning environment. PROBLEM: Clinical sites were lacking in a senior nursing leadership and management course and necessitated the adaptation of traditional clinical teaching methodologies. APPROACH: Low-fidelity simulation was used as an active learning strategy to fulfill clinical hours. OUTCOMES: Comparing student groups' pretest mean scores were not significant (p = .610; 95% confidence interval [CI] [-0.95, 0.12]). Comparatively, the student groups' posttest scores ranging between 87% and 90%, respectively, were also not statistical significance (p = .136, 95% CI [-0.95, 0.12]). CONCLUSION: Students were positive about their experience. They appreciated the opportunity to practice what they learned in the classroom in a safe environment. As a result, simulation in a senior nursing leadership course can be successfully used as an alternative to traditional clinical experiences and fulfill clinical hour requirements.

A Concept Analysis of Resistiveness to Care.

People with cognitive impairment often require assistance with activities of daily living. It is when providing assistance with these activities that many caregivers experience behaviors that have been categorized as disruptive or problematic and called resistiveness to care. These behaviors are considered to be a source of burden and job burnout for caregivers. Nurses wanting to help caregivers, who manage these trying situations, need to understand the concept of resistiveness to care and communicate this knowledge clearly with health care providers. Therefore, a literature search was conducted in 2012 within the databases CINAHL, Medline (PubMed), ProQuest, and PsychINFO. This produced 40 relevant articles. Because no concept analysis existed for resistiveness to care, a principle-based concept analysis was performed. The analysis helped construct a theoretically defined concept. Further analysis highlighted that more research is needed to advance the concept of resistiveness to care to enhance professional communication surrounding this phenomenon.

Educating Post-Partum Women: Interventions to Improve Engagement.

Women giving birth in in-patient maternity units are required to complete certain education. The aim of this study was to investigate the effects of prompting on post-partum women's education engagement (time from assignment to completion) while testing the feasibility of staff nurses assisting in research. A quasi-experimental design was used with 141 women allocated by admission date to one of three groups (usual care and two intervention) between September 2014 and December 2015. Intervention group I women were quickest to engage in their education and had the shortest length of stay. Significance was found for academic attainment (df = 1, F = 6.218, p = .014), partial eta squared = 0.053 and R2 = 0.124. Women who had attended college engaged more quickly in all groups than those who had not. This statistically significant finding indicates how nurses can identify patients needing more assistance. Nurses reported no adverse effects on care.

Mouth care in nursing homes: knowledge, beliefs, and practices of nursing assistants.

UNLABELLED: The purpose of this study was to examine the knowledge, beliefs, and practices of nursing assistants (NAs) providing oral hygiene care to frail elders in nursing homes, with the intent of developing an educational program for NAs. METHODS: The study occurred in two economically and geographically diverse nursing homes. From a sample size of 202 NAs, 106 returned the 19-item Oral Care Survey. RESULTS: The NAs reported satisfactory knowledge regarding the tasks associated with providing mouth care. The NAs believed that tooth loss was a natural consequence of aging. They reported that they provided mouth care less frequently than is optimal but cited challenges such as caring for persons exhibiting care-resistive behaviors, fear of causing pain, and lack of supplies. CONCLUSION: Nurses are in a powerful position to support NAs in providing mouth care by ensuring that they have adequate supplies and knowledge to respond to resistive behaviors.