Tesi sul tema "Long Term Care – psychology"

An exploratory study was conducted to examine the effectiveness of a group gratitude intervention with 29 permanent residents at a long term care/ skilled nursing facility in improving elder mood, behavior, and well- being over a 3 week time period. The sample included individuals diagnosed with dementia, other cognitive impairment, major depressive disorder, insomnia, and generalized anxiety disorder. The gratitude intervention consisted of asking elders to share what they are thankful for at the dinner table each day. Measures included the Elder Well Being Scale and The Dinner Rating Scale. On both measures, higher scores indicated better functioning. To test the hypothesis that post treatment elder well-being will be significantly higher than pretreatment elder well-being ratings, a one-way ANOVA was conducted. Post-hoc tests revealed a statistically significant increase in Elder Well Being Scale scores. An ANOVA of comparing Dinner Ratings demonstrated a nonsignificant increase over the 3 week experiment. Implications are discussed.

Ainsworth and Bowlby’s Attachment Theory suggest that young children experience lasting effects of disconnection if separated from their primary caretaker. Foster children are legally removed from their primary caretakers, yet the effects of foster care on later social relationships of foster children is unknown.

The purpose of this exploratory study was to investigate the perceptions of adult foster children, ages 18 years and over, who were placed into foster care under 5 years of age. The major challenge was to obtain qualifying participants, first, because this is an invisible population in the American culture and, secondly, these individuals are hesitant to share their stories. The initial population included 5 persons from a local shelter and, using the snowball method, the researcher secured an additional 15 adult foster children that met the criteria.

Applying the phenomenological approach, these long interviews included 6 questions that addressed the research question: What do adults who have been in foster care placements prior to age 5 and have experienced more than 5 years in foster care placements from age 0-18 perceive are the long-term effects of foster care on their adult social relationships? The interviews occurred throughout Southern California and were taped and lasted 40 minutes to 2 hours, often filled with tears and high emotion. The participants included 3 with prior jail time, 6 who were homeless, 14 who were employed, 10 with an addiction, and 2 who were married. All had obtained a high school degree. All shared repeated unsuccessful friendship or romantic relationships.

The transcribed interviews were reviewed by 4 trained coders in a doctoral program and produced 8 themes, leading to the 8 conclusions. The primary conclusions are adult foster children express that abandonment is a deep core aspect of their psychological profile (95%); share the mental health issues of low self-esteem, lack of trust, and putting up walls in their social relationships (100%); act out their generational cycles of various addictive behavior relating to abandonment (100%); spirituality helped to stabilize more than half of these adult foster children through challenging times; and those without spiritual connections described the support of mentors in their lives.

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the program have on improving nursing geriatric knowledge, retention, and job satisfaction by project end? Guided by the advancing research and clinical practice through close collaboration (ARCC) model for evidence-based practice (EBP), the learning needs of nurses in the LTC setting were assessed. The 6-week education program was designed to provide education on the basics of geriatric care, pharmacology and aging, symptom evaluation, dementia care, and geriatric physical assessment. Project participants consisted of 8 nurses who volunteered to take part in the program. The program was evaluated using a pre-test and post-test method to examine nurse’s knowledge before and after the education program. Using a paired t test, the results indicated a significant increase (p < .05) between the mean pre-test (3.75) and mean post-test (4.25) scores of nurse knowledge of geriatric care. The education program improved participant knowledge of geriatric care. Positive social change will be achieved with this scholarly project as nurses with greater knowledge gain confidence, strengthen decision making and clinical skills, and improve patient outcomes in the LTC setting.

The purpose of this study was to examine the phenomena of burnout and self-care as experienced by long-term anti-war activists. The current investigation of burnout and self-care was carried out using a qualitative transcendental phenomenological approach developed by Clark Moustakas. Interviews were conducted with eight adult men and women who had been active in the anti-war movement for at least ten years. The data collection consisted of in-depth interviews with open-ended questions regarding participants' experience of self-care and burnout in the process of anti-war activism.

Findings reveal that participants experienced burnout and self-care in much the same way as other professions. Participants experienced burnout within the following themes: stress, frustration and exhaustion; inner and outer pressure and responsibility; body shut-down; betrayal and isolation; and depression and grief. These activists experienced self-care within the following themes: enrichment of soul; satisfaction and celebration; great love and healing; awareness and keeping balance; deep understanding; and belief, enthusiasm and inspiration. In addition, the research uncovered the irony that while anti-war activism causes burnout at times, this same activism plays a critical role in self-care for the activist. Furthermore, findings lend support to previous studies of the experience of anti-war activists. Future research on this topic is suggested in several areas.

Research studies show that work engagement is credited with having a positive effect on business outcomes. As health care leaders and administrators continue to make efforts to improve work engagement, the global nursing shortage has become a major problem that can affect registered nurses (RNs') work engagement and turnover intentions. RNs are important to the nation's well-being as everyone's health care needs involve the role of a nurse, but RNs currently in practice experience higher demands in an environment already constrained. This qualitative case study explored the perceptions of eight RNs in a long-term health care facility located in a Northeastern region of the United States utilizing semi-structured open-ended interviews. The study illustrated how RNs' work engagement could be improved and strengthened, turnover intentions minimized to make nurses' practice environment more attractive to motivate and retain nurses in long-term care setting. Study results suggest that nurses are highly engaged in their work though they encounter several issues including understaffing that creates work overload leading to burnout and job-related stress that challenge and undermine their engagement. Results also indicate that in order to improve RNs' practice environment and minimize turnover intentions and turnover, concerns regarding understaffing, job role stress, and nurse-management conflicts need to be addressed. Study results imply that to be effective as a nurse one has to be dedicated and committed to his or her work and the profession. Additionally, organizational leaders should make concerted effort to identify and address nurses' issues to create practice environments that attract and retain nurses.

The primary purpose of this clinical scholarly research project is to determine whether there are undiagnosed symptoms of depression among the residents in a small population Long Term Care facility (LTC). Caregivers at the LTC receive specific knowledge regarding older adult late-life depression and then apply said knowledge by surveying the LTC residents (LTCR’s) using the Geriatric Depression Scale instrument (GDS-15). The secondary purpose is to determine whether the LTC caregivers perceive this training as beneficial. Using two-sample t-test statistical analysis, the results of this study indicate a positive correlation with the alternative hypothesis; the number of LTCRs with previously undetected depressive symptoms increased. H_a: μ LTCR with depression or delirium ≠ μ LTCR with depression or delirium. In this study, the number of LTCRs with symptoms of depression or delirium increased by 60.4 percent. The P (T<=t) two-tail value is less than 0.001. In the literature, this difference is extremely statistically significant. The mean of the medical records examined minus the mean of the number of medical records with an indication of depression or delirium is 0.60. For a 95% confidence interval, this difference must fall between the ranges of 0.45 to 0.76. These data confirm the alternative hypothesis.

Additionally, the caregiver participant’s satisfaction outcome survey results reported the training was substantially beneficial.

This research examines the physical operations of a health care sector called long term care facilities. Long term care refers to organizations that provide onsite nursing care for people with long-term illnesses, elderly people who need continuous medical supervision, or for those in long-term rehabilitation programs. Most specifically, this research looks at the performance of the physical buildings (i.e. facilities) and how this performance impacts the external environment. Using secondary data from the organization Practice Greenhealth, this study addresses the following two research questions.

1. What is the combined current state of environmental performance at the long term care facilities that have applied for a Practice Greenhealth award?

2. What are the proposed environmental key performance indicators for the long term care sector?

Based on this research, a model is suggested for future researchers interested in the environmental performance of long term care facilities. The model suggests six drivers for improving environmental performance in long term care; (1) maintain compliance with environmental regulations, (2) reduce costs, (3) meet expectations of parent organization, (4) increase market competitiveness, (5) engage stakeholders, and (6) improve patient outcomes. Four environmental improvement categories are then established; (1) waste, (2) energy, (3) water, and (4) engagement initiatives, along with each categories’ associated indicators. Finally, this study develops a concise environmental performance survey that could be used by any long term care facility looking to make improvements to its environmental performance over time.

This research used a Delphi methodology to solicit challenges that significantly impact the operational success of pediatric long-term care facilities. Further, this study sought to understand the ability of pediatrics administrators to impact, affect, overcome, or resolve these challenges. Round 1 accomplished the desired goal of eliciting a substantial amount of new qualitative information regarding administrative challenges in pediatric long-term care, which previously had been extant in the literature. In Round 2, data were distilled into categories and unique exemplars which in turn were validated by participants. In Round 3, administrators ranked and rated categories and individual challenges in terms of significance and impact.

Findings revealed that the most important challenges for administrators are those of working with an inadequate model that is designed for a geriatric population, inadequate Medicaid funding, and the lack of clinical and administrative indicators in pediatric long-term care. The most important challenges that could be affected by the administrators are related to inadequate model, clinical practice, and the need for diversification. Administrators believe they can strongly impact the rules, regulations, and protocols that are currently geriatric focused, develop pediatric long-term care indicators and evidence-based research, and impact their financial security by diversification.

The Delphi research accomplishes the desired goal of eliciting a substantial amount of new information regarding administrative challenges in pediatric long- term care and contributes to the broader body of knowledge in health services administration. The significant research findings suggest the need for changes in the regulatory and financial models in pediatric long-term care and the need for enhanced clinical practice though evidence-based practice and outcomes.