Caregiving experiences of family members of persons with dementia in south India.

This study reports on the first phase of an investigation aimed at adapting The Savvy Caregiver program, a successful family caregiving curriculum developed in the United States, for application in South India. Thirty family members caring for a person with dementia were interviewed regarding their experiences as caregivers (CGs). Qualitative interviews were conducted with the family member at a geriatric clinic, while other diagnostic procedures were being carried out with the person with dementia. Findings from the study revealed that although family members understood the term CG, none could identify a word for CG in his or her language. There was little understanding of dementia as an illness. Family CGs reported feeling distressed, overwhelmed, and frustrated with caregiving. Caregivers were interested in an educational program, but many had unrealistic expectations for what they wanted to learn. The findings provide directions for adapting The Savvy Caregiver curriculum for Indian family CGs.

Advanced practice nurse psychiatric bridging intervention.

Depression is a prevalent and treatable condition; however, extensive waiting periods for treatment are associated with high failure to attend initial psychiatric evaluation (IPE) appointments. This article describes the development, implementation, and pilot evaluation of the Advanced Practice Nurse (APN) Psychiatric Bridging Intervention. The project was grounded in Peplau's theory of interpersonal relations and designed to provide supportive psychoeducational counseling and initiation of psychotropic medication for clients with depressive symptoms during the time between intake and IPE. Project development was guided by Roger's Diffusion of Innovations framework used for adopting an evidence-based innovation into an organization. A two-group design allowed comparison of preintervention clients (38 clients who received standard care) and intervention clients (19 clients who participated in the bridging intervention). The difference in IPE appointment attendance rates between the two groups approached statistical significance (p = 0.08). An unanticipated finding was that APN Psychiatric Bridging Intervention clients required only 30-minute IPE appointments compared to the typical 60-minute appointment.

Decision analysis as a tool to support an analytical pattern-of-reasoning.

Decision analysis is offered as a tool to aid nurses' decision-making in complex and troublesome situations where there are mutually exclusive actions and time is available for deliberation. Decision analysis can be formal or informal. Formal decision analysis provides a structure for representing the decision situation and a mathematical procedure for prescribing the alternative action that is most consistent with what is known and what one values. Informal decision analysis uses the concepts and sometimes the structure of decision analysis, but usually does not include the mathematical calculations. In the present paper, the authors illustrate how formal and informal decision analysis might be used by nurses to: (i) enhance their own decision-making; (ii) assist patients or family caregivers with decision-making and; (iii) promote informed health care policy development. Finally, the advantages and limitations of decision analysis are discussed.