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1
Giesbers, Markus. "Aus der Not geboren oder sinnvolle Substitution? Chancen und Grenzen des Einsatzes von „Pflegerobotern“ in der stationären Altenpflege aus ethischer Sicht." Journal for Markets and Ethics 8, no. 1 (June 1, 2020): 1–12. http://dx.doi.org/10.2478/jome-2020-0001.
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Abstract This article deals with a differentiated examination of robotics and its evaluation in inpatient geriatric care. It examines the extent to which nursing robots fit into person-centered nursing work and possibly change it significantly. The advantages and new possibilities are shown, but also the dangers and problems from the point of view of different area ethics are pointed out. In the centre of the considerations are residents and employees as a benchmark for the ethical evaluation of robots in geriatric care.
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Juujärvi, Soile, Kirsi Ronkainen, and Piia Silvennoinen. "The ethics of care and justice in primary nursing of older patients." Clinical Ethics 14, no. 4 (September 19, 2019): 187–94. http://dx.doi.org/10.1177/1477750919876250.
Повний текст джерелаАнотація:
While the ethic of care has generally been regarded as an appropriate attitude for nurses, it has not received equal attention as a mode of ethical problem solving. The primary nursing model is expected to be aligned with the ethic of care because it emphases the nurse–patient relationship and enables more independent role for nurses in decision-making. The aim of this study was to examine nurses’ ethical decision-making in the context of primary nursing. Participants were seven nurses, and one physiotherapist from a geriatric rehabilitation unit of a public hospital in Finland. Data were collected through focus group interviews and qualitatively analyzed through Lyons’ coding scheme for moral orientations. The results showed that primary nurses employ empathic understanding and particularistic thinking when building relationships with patients and their families, and when assessing their needs for coping at home after discharge. Most ethical conflicts were related to discharge and were solved through balancing the ethics of care and justice considerations. It is concluded that care and justice are integrated in nurses’ everyday ethical decision-making. The ethic of care nurtures good patient–nurse relationships, while the ethic of justice is needed to address the fair delivery of care in the context of an aging population and diminishing public resources. Both ethics should be acknowledged in clinical practices and included in ethics education.
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Spielman, Bethany J. "Rethinking paradigms in geriatric ethics." Journal of Religion & Health 25, no. 2 (June 1986): 142–48. http://dx.doi.org/10.1007/bf01533244.
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Gerber, Lois. "ETHICS AND CARING: Cornerstones of Nursing Geriatric Case Management." Journal of Gerontological Nursing 21, no. 12 (December 1, 1995): 15–19. http://dx.doi.org/10.3928/0098-9134-19951201-05.
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Skinner, Elise, Jean Daniel Jacob, Brandi Vanderspank-Wright, and David Kenneth Wright. "Ethics of Finitude: Nursing and the Palliative Approach in Geriatric and Forensic Psychiatry." Global Qualitative Nursing Research 7 (January 2020): 233339362091326. http://dx.doi.org/10.1177/2333393620913269.
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There is a called-for shift to an upstream provision of palliative care as an overall care approach within a health equity perspective. Our research explored how nurses in psychiatry engage with aging patients and mortality to discern enactment of ethical dimensions of care. Drawing from tenets of interpretative phenomenological analysis, forensic and geriatric psychiatry registered nurses working at a mental health facility in eastern Ontario completed interviews for analysis. Nurses engaged with mortality through a process of recognition and through the affirmation of their values. The affirmed values are aligned with the palliative care approach and within an ethics of finitude lens in that their enactment is partly premised on the recognition of patients’ accumulated losses related to human facticities (social, temporal, mortal). This research underscores preliminary insights on a process identifying care practices aligned with the palliative approach and possibilities for expanding upon an ethics of finitude lens.
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Kim, Moonok, Younjae Oh, and Byunghye Kong. "Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”." International Journal of Environmental Research and Public Health 17, no. 12 (June 20, 2020): 4442. http://dx.doi.org/10.3390/ijerph17124442.
Повний текст джерелаАнотація:
Ethical conflicts among nurses can undermine nurses’ psychological comfort and compromise the quality of patient care. In the last decade, several empirical studies on the phenomena related to ethical conflicts, such as ethical dilemmas, issues, problems, difficulties, or challenges, have been reported; however, they have not always deeply explored the meaning of ethical conflicts experienced by nurses in geriatric care. This study aims to understand the lived experiences of ethical conflict of nurses in geriatric hospitals in South Korea. A phenomenological study was conducted. In-depth, face-to-face interviews were performed with nine registered nurses who cared for elderly patients in geriatric hospitals in South Korea between August 2015 and January 2016. Three main themes emerged from the analysis: (1) confusing values for good nursing, (2) distress resulting from not taking required action despite knowing about a problem, and (3) avoiding ethical conflicts as a last resort. It was found that for geriatric nurses to cope with ethical conflicts successfully, clear ethical guidance, continuing ethics education to improve ethical knowledge and moral behaviors, and a supportive system or program to resolve ethical conflicts involving nurses should be established.
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Teófilo, Tiago José Silveira, Rafaella Felix Serafim Veras, Valkênia Alves Silva, Nilza Maria Cunha, Jacira dos Santos Oliveira, and Selene Cordeiro Vasconcelos. "Empathy in the nurse–patient relationship in geriatric care: An integrative review." Nursing Ethics 26, no. 6 (August 3, 2018): 1585–600. http://dx.doi.org/10.1177/0969733018787228.
Повний текст джерелаАнотація:
Introduction: Empathy is a complex human experience that involves the subjective intersection of different individuals. In the context of nursing care in the geriatric setting, the benefits of empathetic relationships are directly related to the quality of the practice of nursing. Objective: Analyze scientific production on the benefits of empathy in the nurse–patient relationship in the geriatric care setting. Methods: An integrative review of the literature was performed using the PubMed, Cochrane, CINAHL, Scopus, PsycINFO, and Web of Science databases. The articles retrieved were organized, evaluated, and classified based on the level of scientific evidence. Results: Relationships of empathy between nurses and older people were analyzed in quasi-experimental studies using different assessment tools, the majority of which had moderate levels of validity and reliability. Studies with a qualitative approach discussed the meaning of empathy in terms of the quality of care offered, compassion, and vulnerability. Discussion: Levels of empathy increase when activities are developed with the aim of teaching, sensitization, and training for relational care between nursing staff and older people. The analysis of empathetic relationships is important to the evaluation of the quality of care provided to older people. Conclusion: Empathy in the nurse–patient relationship in the geriatric care setting is an important ethical aspect that contributes to the quality of the practice of nursing. The present findings indicate the need for more robust assessment tools with adequate psychometric properties and the descriptive analysis of empathy.
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Dierckx de Casterlé, Bernadette, Evelyne Mertens, Jessica Steenacker, and Yvonne Denier. "Nurses’ experiences of working under time pressure in care for older persons." Nursing Ethics 27, no. 4 (January 24, 2020): 979–90. http://dx.doi.org/10.1177/0969733019895797.
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Background The international health workforce crisis had led to an increasing shortage of nurses, which has substantial implications for the quality of patient care. This shortage potentially results in nurse-perceived time pressure, which can be particularly challenging for nurses who provide care for older persons. Objective This study aimed to show how geriatric nurses experience working under time pressure, perceive its impact on care and deal with time pressure in daily care. Research design A qualitative descriptive interview design was used. Participants and research context Purposive sampling led to the inclusion of 11 nurses from three geriatric nursing wards in two general hospitals in Flanders (Belgium). Data were collected using semi-structured in-depth interviews and analysed using the QUAGOL (Qualitative Analysis Guide of Leuven). Ethical considerations The study protocol was approved by the Ethics Committee of the University Hospitals Leuven (Ethics committee of the University Hospitals Leuven). Findings In all interviews, time pressure was described as ubiquitous in the daily care of older persons. A sense of failure in providing care was the common thread in many interviews. Nurses felt compelled to ‘reduce’ good-quality care to basic care by focusing on the physical and visible aspects of care. Nevertheless, personal experiences with time pressure and strategies to cope with it differed among the interviewees. These variations were related to the working environment and the nurses themselves. They underscored the importance of nurses’ perspectives for a good understanding of the phenomenon of time pressure. Discussion and conclusion Working under time pressure in the care of older persons leads to various important challenges for nursing ethics. The findings show that providing care that promotes the human dignity of older persons in busy working environments in which care is rationed is an important ethical challenge. As such, our study offers a baseline for further research and discussion on how to support nurses working under time pressure.
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Mahieu, Lieslot, and Chris Gastmans. "Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature." International Psychogeriatrics 24, no. 3 (August 24, 2011): 346–57. http://dx.doi.org/10.1017/s1041610211001542.
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ABSTRACTBackground: Admission to a nursing home might challenge the way in which individuals experience their own sexuality, but it does not automatically diminish their need and desire for sexual fulfillment. Despite the fact that sexuality proves to be an intrinsic part of human existence, the sexual expression of geriatric residents remains a sensitive subject for many caregivers and family members. It evokes a variety of ethical issues and concerns, especially when dementia patients are involved. The overall objective of this review was to examine the ethical arguments and concepts about the debate on sexuality within a nursing home environment.Methods: We conducted a systematic search for argument-based ethics literature focusing on sexuality in institutionalized elderly people. Twenty-five appropriate studies were identified.Results: A thematic analysis of the included literature led us to distinguish two major groups of ethical arguments: (i) principles and (ii) care. Ethics arguments on sexuality in institutionalized elderly are particularly guided by the principle of respect for autonomy and the concomitant notion of informed consent. Arguments related to care were also apparent within the research literature although they received considerably less attention than the arguments related to the principles of respect for autonomy, beneficence, nonmaleficence and justice.Conclusions: The lack of clarity in the conceptualization of the arguments referred to in the research literature indicates that there is a pressing need for a better defined, more fundamental philosophical-ethical analysis of the values at stake.
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de Casterlé, Bernadette Dierckx, Sabine Goethals, and Chris Gastmans. "Contextual influences on nurses’ decision-making in cases of physical restraint." Nursing Ethics 22, no. 6 (August 6, 2014): 642–51. http://dx.doi.org/10.1177/0969733014543215.
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Background: In order to fully understand nurses’ ethical decision-making in cases of physical restraint in acute older people care, contextual influences on the process of decision-making should be clarified. Research questions: What is the influence of context on nurses’ decision-making process in cases of physical restraint, and what is the impact of context on the prioritizing of ethical values when making a decision on physical restraint? Research design: A qualitative descriptive study inspired by the Grounded Theory approach was carried out. Participants and research context: In total, 21 in-depth interviews were carried out with nurses working on acute geriatric wards in Flanders, Belgium. Ethical considerations: The research protocol was approved by the Ethics Committee of the Faculty of Medicine, Leuven. Findings: Relationships with nursing colleagues and the patient’s family form an inter-personal network. Nurses also point to the importance of the procedural–legal context as expressed in an institutional ethics policy and procedures, or through legal requirements concerning physical restraint. Furthermore, the architectural structure of a ward, the availability of materials and alternatives for restraint use can be decisive in nurses’ decision-making. All interviewed nurses highlighted the unquestionable role of the practical context of care. Context can have a guiding, supportive, or decisive role in decision-making concerning the application of physical restraint. Discussion: The discussion focuses on the role of the inter-personal network of nurses on the process of decision-making. Conclusion: An institutional ethics policy and a value-supportive care environment can support nurses in their challenge to take ethically sound decisions.
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O'Shaughnessy, Íde, Katie Robinson, Margaret O'Connor, Mairéad Conneely, Fiona Steed, Damien Ryan, Leonora Carey, et al. "Comprehensive geriatric assessment in the emergency department: A protocol for a prospective cohort study." HRB Open Research 5 (September 14, 2022): 26. http://dx.doi.org/10.12688/hrbopenres.13504.2.
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Background: Comprehensive geriatric assessment (CGA) has been shown to improve outcomes in hospitalised older adults; however, there is currently no compelling evidence to support CGA interventions within the Emergency Department (ED). The aim of this study is to explore the clinical and process outcomes of older adults who receive ED-CGA over a period of six months after their initial ED attendance. Design: Prospective cohort study. Methods: The STrengthening the Reporting of the OBservational studies in Epidemiology (STROBE) standardised reporting guidelines will be adhered to. Older adults aged ≥65 years who score ≥2 on the Identification of Seniors at Risk (ISAR) tool and present to the ED with a medical complaint during the operational hours of the dedicated interdisciplinary team, will be considered eligible for recruitment. Demographic and health assessment information will be obtained at the ED index attendance followed by completion of an interdisciplinary CGA. A dedicated research nurse will complete follow-up telephone interviews with participants at 30 days and six months. The primary outcome will be incidence of hospital admission from the ED index attendance. Secondary outcomes will include functional decline, patient satisfaction with the ED index attendance, unscheduled ED reattendance(s), unscheduled hospital (re)admission(s), nursing home admission(s), healthcare utilisation, and death. Descriptive statistics will be used to profile the characteristics of the study participants and multivariate logistic and linear regression analysis will be used to analyse risk of adverse outcomes. Ethics and dissemination: Ethical approval was granted by the University of Limerick Hospital Group Research Ethics Committee (107/2021). The authors will disseminate study findings through publication in a peer-reviewed journal and presentation at national and international conferences. Patient and public involvement will be sought from a panel of older adults at the Ageing Research Centre in the University of Limerick. Clinicaltrials.gov Identifier: NCT05252182.
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O'Shaughnessy, Íde, Katie Robinson, Margaret O'Connor, Mairéad Conneely, Fiona Steed, Damien Ryan, Leonora Carey, et al. "Comprehensive geriatric assessment in the emergency department: A protocol for a prospective cohort study." HRB Open Research 5 (April 1, 2022): 26. http://dx.doi.org/10.12688/hrbopenres.13504.1.
Повний текст джерелаАнотація:
Background: Comprehensive geriatric assessment (CGA) has been shown to improve outcomes in hospitalised older adults; however, there is currently no compelling evidence to support CGA interventions within the Emergency Department (ED). The aim of this study is to explore the clinical and process outcomes of older adults who receive ED-CGA over a period of six months after their initial ED attendance. Design: Prospective cohort study. Methods: The STrengthening the Reporting of the OBservational studies in Epidemiology (STROBE) standardised reporting guidelines will be adhered to. Older adults aged ≥65 years who score ≥2 on the Identification of Seniors at Risk (ISAR) tool and present to the ED with a medical complaint during the operational hours of the dedicated interdisciplinary team, will be considered eligible for recruitment. Demographic and health assessment information will be obtained at the ED index attendance followed by completion of an interdisciplinary CGA. A dedicated research nurse will complete follow-up telephone interviews with participants at 30 days and six months. The primary outcome will be incidence of hospital admission from the ED index attendance. Secondary outcomes will include functional decline, patient satisfaction with the ED index attendance, unscheduled ED reattendance(s), unscheduled hospital (re)admission(s), nursing home admission(s), healthcare utilisation, and death. Descriptive statistics will be used to profile the characteristics of the study participants and multivariate logistic and linear regression analysis will be used to analyse risk of adverse outcomes. Ethics and dissemination: Ethical approval was granted by the University of Limerick Hospital Group Hospital Research Ethics Committee (107/2021). The authors will disseminate study findings through publication in a peer-reviewed journal and presentation at national and international conferences. Patient and public involvement will be sought from a panel of older adults at the Ageing Research Centre in the University of Limerick. Clinicaltrials.gov Identifier: NCT05252182.
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Nordström, Karin, and Tenzin Wangmo. "Caring for elder patients: Mutual vulnerabilities in professional ethics." Nursing Ethics 25, no. 8 (January 4, 2017): 1004–16. http://dx.doi.org/10.1177/0969733016684548.
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Background: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. Objectives: The goal was to understand caregivers’ concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional ethics within the care setting. Research design: A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. Participants and research context: A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. Ethical considerations: Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland] (2014-015). Findings: Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. Discussion: Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. Conclusion: Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities.
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Randers, Ingrid, and Anne-Cathrine Mattiasson. "The Experiences of Elderly People in Geriatric Care with Special Reference to Integrity." Nursing Ethics 7, no. 6 (November 2000): 503–19. http://dx.doi.org/10.1177/096973300000700606.
Повний текст джерелаАнотація:
The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers’ integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people’s integrity relating to their corporal self were the least violated. On the other hand, their psycological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people’s social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions.
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Rodin, Miriam. "Practicing Medicine and Practicing Anthropology Can be Complementary: A Physician-Anthropologist in Academic Geriatric Practice." Practicing Anthropology 20, no. 2 (April 1, 1998): 21–25. http://dx.doi.org/10.17730/praa.20.2.m64402j2618wl65w.
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First I was an urban anthropologist, then I was a medical anthropologist on the faculty of a university medical center. Then I went to medical school, completing undergraduate, graduate and fellowship training in internal medicine and geriatrics. At first I thought of myself as an anthropologist in medical school, a privileged participant-observer of the making of doctors in the United States. Ten years out of medical training I think of myself as a physician. I am responsible for the outpatient and inpatient care of elderly patients. I am also the medical director of a nursing home. I am teaching faculty for medical students and medical residents at Northwestern University Medical School in Chicago where I give both lecture and bedside instruction in the finer points of geriatric differential diagnosis and medical management. Occasionally I volunteer for teaching duties in ethics and humanities. Yet my funded research is more recognizably applied anthropology. With funding from the Illinois Department of Public Health and from the United States Army Breast Cancer Research Fund, I direct a research and intervention project to increase use of early cancer detection among older immigrant women in Chicago. In this article I will describe the research, but my principal focus will be on the role of anthropology in my practice as an academic geriatrician.
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Palviainen, Piia, Minna Hietala, Pirkko Routasalo, Tarja Suominen, and Maija Hupli. "Do Nurses Exercise Power in Basic Care Situations?" Nursing Ethics 10, no. 3 (May 2003): 269–80. http://dx.doi.org/10.1191/0969733003ne605oa.
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Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses’ opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in activities that take into account the patient’s characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses’ own opinion, negative power is exercised only in certain situations and in the patient’s best interest, when for instance there are concerns that something may happen to the patient.
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Schönstein, A., H. W. Wahl, H. A. Katus, and A. Bahrmann. "SPMSQ for risk stratification of older patients in the emergency department." Zeitschrift für Gerontologie und Geriatrie 52, S4 (October 16, 2019): 222–28. http://dx.doi.org/10.1007/s00391-019-01626-z.
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Abstract Background Risk stratification of older patients in the emergency department (ED) is seen as a promising and efficient solution for handling the increase in demand for geriatric emergency medicine. Previously, the predictive validity of commonly used tools for risk stratification, such as the identification of seniors at risk (ISAR), have found only limited evidence in German geriatric patient samples. Given that the adverse outcomes in question, such as rehospitalization, nursing home admission and mortality, are substantially associated with cognitive impairment, the potential of the short portable mental status questionnaire (SPMSQ) as a tool for risk stratification of older ED patients was investigated. Objective To estimate the predictive validity of the SPMSQ for a composite endpoint of adverse events (e.g. rehospitalization, nursing home admission and mortality). Method This was a prospective cohort study with 260 patients aged 70 years and above, recruited in a cardiology ED. Patients with a likely life-expectancy below 24 h were excluded. Follow-up examinations were conducted at 1, 3, 6 and 12 month(s) after recruitment. Results The SPMSQ was found to be a significant predictor of adverse outcomes not at 1 month (area under the curve, AUC 0.55, 95% confidence interval, CI 0.46–0.63) but at 3 months (AUC 0.61, 95% CI 0.54–0.68), 6 months (AUC 0.63, 95% CI 0.56–0.70) and 12 months (AUC 0.63, 95% CI 0.56–0.70) after initial contact. Conclusion For longer periods of observation the SPMSQ can be a predictor of a composite endpoint of adverse outcomes even when controlled for a range of confounders. Its characteristics, specifically the low sensitivity, make it unsuitable as an accurate risk stratification tool on its own.
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El Genedy-Kalyoncu, Monira, Alexandra Fastner, Bettina Völzer, Kathrin Raeder, Konrad Neumann, Nils Axel Lahmann, and Jan Kottner. "Comparison of two skin protection regimes for the Prevention of Incontinence-associated Dermatitis in geriatric care (PID): a study protocol for an exploratory randomised controlled pragmatic trial." BMJ Open 12, no. 9 (September 2022): e065909. http://dx.doi.org/10.1136/bmjopen-2022-065909.
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IntroductionThe majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant contact dermatitis caused by repeated and prolonged direct contact of the skin with urine and stool. The prevalence of IAD in these settings is high. Preventive measures include mild skin cleansing and the application of skin protecting leave-on products. Available evidence is weak regarding the comparative performance of different skin protection strategies and products due to a lack of confirmatory trials using relevant comparators and endpoints. Therefore, the overall aim of this exploratory trial is to compare the effects of three skin protection strategies to estimate effect sizes of the recently published core outcomes in IAD research.Methods and analysisA pragmatic three-arm, assessor-blinded, randomised controlled, exploratory trial with parallel group design will be performed, comparing film-forming and lipophilic skin protecting leave-on products for IAD prevention with standard incontinence care alone. The trial will be conducted in geriatric nursing homes and geriatric acute care settings in the federal state of Berlin, Germany. A total of n=210 participants being incontinent of urine and stool will be included. Outcomes include IAD incidence, erythema, erosion, maceration, IAD-related pain, patient satisfaction, safety, feasibility and compliance. IAD incidence of the control and intervention groups will be compared to estimate effect sizes, and the procedural feasibility of the intervention will be tested to plan a possible subsequent confirmatory randomised controlled trial.Ethics and disseminationThe study received the approval of the ethics committee of Charité–Universitätsmedizin Berlin (EA4/043/22). Results will be disseminated through peer-reviewed open-access journals and international conferences.Trial registration numberClinicalTrials.gov (NCT05403762) and German Clinical Trials Register (Deutsches Register Klinischer Studien, or DRKS) (DRKS00028954).
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Naudé, Bérangère, Anne-Sophie Rigaud, Laila Kamali, and Maribel Pino. "Barriers and Enablers for the Use of Digital Interactive Television in Nursing Home Settings: An Interview Case Study with Older Adults and Professionals." International Journal of Environmental Research and Public Health 20, no. 3 (January 18, 2023): 1813. http://dx.doi.org/10.3390/ijerph20031813.
Повний текст джерелаАнотація:
Increasingly, public health programs are recommending the use of information and communication technologies to address the psychosocial needs of Older Adults (OAs). Recently, several applications that allow access to communication and stimulation functionalities using digital interactive television (DiTV) have been developed. The use of the television interface to access digital services seems to help meet several accessibility and usability needs of OAs. However, its use entails other challenges related to different dimensions (organizational, technological, ethical, etc.). This study aims to identify the factors that enable or hinder the use of DiTV by OAs living in geriatric institutions. A qualitative interview case study was conducted in three French geriatric facilities. A total of 25 semi-structured interviews were carried out with residents and care professionals, between February and April 2022, to identify enablers and barriers to DiTV use. Data were processed using a thematic deductive analysis inspired by a multidimensional Health Technology Assessment model. The analysis showed that DiTV use may be limited by organizational (e.g., workload), technological (e.g., ergonomic issues), human (e.g., health issues), ethical (e.g., privacy), and safety factors (e.g., frustration due to technical problems). A summary of these factors and five recommendations for DiTV implementation in geriatric settings are presented in this paper.
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Chichin, Eileen R. "Everything You Need to Know About Ethics in the Nursing Home." Journal of the American Geriatrics Society 52, no. 10 (October 2004): 1766–67. http://dx.doi.org/10.1111/j.1532-5415.2004.52475.x.
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Thompson, Sanja, Kiloran Metcalfe, Katy Boncey, Clair Merriman, Lorna Catherine Flynn, Gaggandeep Singh Alg, Harriet Bothwell, et al. "Interprofessional education in geriatric medicine: towards best practice. A controlled before–after study of medical and nursing students." BMJ Open 10, no. 1 (January 2020): e018041. http://dx.doi.org/10.1136/bmjopen-2017-018041.
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ObjectivesTo investigate nursing and medical students’ readiness for interprofessional learning before and after implementing geriatric interprofessional education (IPE), based on problem-based learning (PBL) case scenarios. To define the optimal number of geriatric IPE sessions, the size and the ratio of participants from each profession in the learner groups, the outcomes related to the Kirkpatrick four-level typology of learning evaluation, students’ concerns about joint learning and impact of geriatric IPE on these concerns. The study looked at the perception of roles and expertise of the ‘other’ profession in interprofessional teams, and students’ choice of topics for future sessions. Students’ expectations, experience, learning points and the influence on the understanding of IP collaboration, as well as their readiness to participate in such education again were investigated.DesignA controlled before–after study (2014/2015, 2015/2016) with data collected immediately before and after the intervention period. Study includes additional comparison of the results from the intervention with a control group of students. Outcomes were determined with a validated ‘Readiness for Interprofessional Learning’ questionnaire, to which we added questions with free comments, combining quantitative and qualitative research methods. The teaching sessions were facilitated by experienced practitioners/educators, so each group had both, a clinician (either geratology consultant or registrar) and a senior nurse.Participants300 medical, 150 nursing students.SettingTertiary care university teaching hospital.ResultsAnalysis of the returned forms in the intervention group had shown that nursing students scored higher on teamwork and collaboration post-IPE (M=40.78, SD=4.05) than pre-IPE (M=34.59, SD=10.36)—statistically significant. On negative professional identity, they scored lower post-IPE (M=7.21, SD=4.2) than pre-IPE (M=8.46, SD=4.1)—statistically significant. The higher score on positive professional identity post-IPE (M=16.43, SD=2.76) than pre-IPE (M=14.32, SD=4.59) was also statistically significant. Likewise, the lower score on roles and responsibilities post-IPE (M=5.41, SD=1.63) than pre-IPE (M=6.84, SD=2.75).Medical students scored higher on teamwork and collaboration post-IPE (M=36.66, SD=5.1) than pre-IPE (M=32.68, SD=7.4)—statistically significant. Higher positive professional identity post-IPE (M=14.3, SD=3.2) than pre-IPE (M=13.1, SD=4.31)—statistically significant. The lower negative professional identity post-IPE (M=7.6, SD=3.17) than pre-IPE (M=8.36, SD=2.91) was not statistically significant. Nor was the post-IPE difference over roles and responsibilities (M=7.4, SD=1.85), pre-IPE (M=7.85, SD=2.1).In the control group, medical students scored higher for teamwork and collaboration post-IPE (M=36.07, SD=3.8) than pre-IPE (M=33.95, SD=3.37)—statistically significant, same for positive professional identity post-IPE (M=13.74, SD=2.64), pre-IPE (M=12.8, SD=2.29), while negative professional identity post-IPE (M=8.48, SD=2.52), pre-IPE (M=9, SD=2.07), and roles and responsibilities post-IPE (M=7.89, SD=1.69), pre-IPE (M=7.91, SD=1.51) shown no statistically significant differences. Student concerns, enhanced understanding of collaboration and readiness for future joint work were addressed, but not understanding of roles.ConclusionsEducators with nursing and medical backgrounds delivered geriatric IPE through case-based PBL. The optimal learner group size was determined. The equal numbers of participants from each profession for successful IPE are not necessary. The IPE delivered by clinicians and senior nurses had an overall positive impact on all participants, but more markedly on nursing students. Surprisingly, it had the same impact on medical students regardless if it was delivered to the mixed groups with nursing students, or to medical students alone. Teaching successfully addressed students’ concerns about joint learning and communication and ethics were most commonly suggested topics for the future.
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Hanssen, Ingrid, and Phuong Thai Minh Tran. "The influence of individualistic and collectivistic morality on dementia care choices." Nursing Ethics 26, no. 7-8 (September 10, 2018): 2047–57. http://dx.doi.org/10.1177/0969733018791342.
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Background: If collectivistic-oriented family carers choose professional care for dependents with dementia, they risk being stigmatised as failing their obligation. This may influence dementia care choices. Research question: How may individualistic and collectivistic values influence choices in dementia care? Method: Qualitative design with in-depth interviews with a total of 29 nurses, 13 family members in Norway and the Balkans and 3 Norwegian dementia care coordinators. A hermeneutic content-focused analysis was used. Ethical considerations: Ethical approval was obtained from the Regional Ethics Committee for Research, South-Eastern Norway, and the nursing homes’ leadership. Findings: Family domain reasons why institutionalisation of dependents with dementia was seen as a last resort: obligation towards family members, particularly parents; worry about other family members’ reactions and inability to cope with the care for the person with dementia. Social domain reasons: feelings of shame and stigma regarding dementia, particularly in connection with institutionalisation of family members. Discussion: Children’s obligation towards their parents is an important aspect of the morality of collectivistic societies. Institutionalising parents with dementia may cause feelings of guilt and shame and worry about being stigmatised and ostracised. To avoid blame and rejection, caregiver(s) try to keep the fact that family members have dementia ‘in the family’. The decision to accept professional healthcare for dependents with severe dementia or have them admitted to a geriatric institution was postponed as long as possible. Conclusion: Family care morality may constitute a significant barrier against seeking professional help for persons with dementia, a barrier based on the expectation that the family will care for their old, even when suffering from severe dementia. Hence, stigma and shame may significantly affect the provision of care. Culturally tailored information may encourage family carers to seek professional help before the disruptive influence of the disease makes institutionalisation the only feasible option.
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Powers, Bethel Ann. "Everyday ethics of dementia care in nursing homes: A definition and taxonomy." American Journal of Alzheimer's Disease 15, no. 3 (May 2000): 143–51. http://dx.doi.org/10.1177/153331750001500308.
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Dahlstrom, Elijah Blue, Jin Ho Han, Heather Healy, Maura Kennedy, Glenn Arendts, Jacques Lee, Chris Carpenter, and Sangil Lee. "Delirium prevention and treatment in the emergency department (ED): a systematic review protocol." BMJ Open 10, no. 10 (October 2020): e037915. http://dx.doi.org/10.1136/bmjopen-2020-037915.
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IntroductionDelirium is a dangerous syndrome of acute brain dysfunction that is common in the emergency department (ED), especially among the geriatric population. Most systematic reviews of interventions for delirium prevention and treatment have focused on inpatient settings. Best practices of effective delirium care in ED settings have not been established. The primary objective of this study is to identify pharmacologic and non-pharmacologic interventions as applied by physicians, nursing staff, pharmacists and other ED personnel to prevent incident delirium and to shorten the severity and duration of prevalent delirium in a geriatric population within the ED.Methods and analysisSearches using subject headings and keywords will be conducted from database inception through June 2020 in MEDLINE, EMBASE, Web of Science, PsychINFO, CINAHL, ProQuest Dissertations and Theses Global and Cochrane CENTRAL as well as grey literature. Database searches will not be limited by date or language. Two reviewers will identify studies describing any interventions for delirium prevention and/or treatment in the ED. Disagreements will be settled by a third reviewer. Pooled data analysis will be performed where possible using Review Manager. Risk ratios and weighted difference of means will be used for incidence of delirium and other binary outcomes related to delirium, delirium severity or duration of symptoms, along with 95% CIs. Heterogeneity will be measured by calculating I2, and a forest plot will be created. If significant heterogeneity is identified, metaregression is planned using OpenMeta to identify possible sources of heterogeneity.Ethics and disseminationThis is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. This review will be prepared as a manuscript and submitted for publication to a peer-reviewed journal, and the results will be presented at conferences.PROSPERO trial registration numberCRD42020169654.
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Fernandez, PharmD, BCPS, CGP, Julianna, James Douglas Thornton, PhD, PharmD, BCPS, Sanika Rege, MS, Benjamin Lewing, MS, Shweta Bapat, BPharm, Qingqing Xu, MS, and Marc L. Fleming, PhD, MPH, RPH. "Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study." Journal of Opioid Management 14, no. 5 (September 1, 2018): 317–26. http://dx.doi.org/10.5055/jom.2018.0464.
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Objective: To qualitatively assess prescribers’ perceptions regarding the consequences associated with hydrocodone rescheduling among geriatric patients being discharged from inpatient settings.Design: This was a cross-sectional study.Setting: Two focus groups were conducted by a trained facilitator in a metropolitan academic medical center in January 2016.Participants: Prescribers who manage noncancer pain for geriatric patients were recruited. Focus groups were recorded, transcribed, and then analyzed using ATLAS.ti Qualitative Data Analysis software. Codes were derived from six primary research questions and results were summarized into key themes regarding the impact of rescheduling.Main outcome measures: Prescribers’ perceptions regarding hydrocodone rescheduling.Results: Prescribers mentioned that they review the prescription monitoring program (PMP) more often before prescribing opioids after rescheduling. They expressed concern regarding the required special serialized prescription forms needed to issue schedule II prescriptions. This led to substituting hydrocodone with potentially less effective pain medications, the inability to issue refills on hydrocodone prescriptions, and an ethical concern over prescribing hydrocodone to patients not under their direct care. Additionally, rescheduling has affected the coordination of care upon discharge, as patients moving to long-term care or skilled nursing facilities may not have adequate pain management when transferred.Conclusions: The majority of physicians felt rescheduling negatively impacted both practical and ethical aspects of patient care related to pain management after discharge. Rescheduling has changed physicians’ hydrocodone prescribing patterns, leading to more caution when prescribing hydrocodone and greater use of the PMP. Future studies should assess geriatric patients’ satisfaction and quality of life regarding pain management since hydrocodone was rescheduled.
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Melnick, Vijaya L. "Special Considerations in Geriatric Research: Ethical and Legal Issues." Drug Information Journal 19, no. 4 (October 1985): 475–82. http://dx.doi.org/10.1177/009286158501900412.
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Skinner, Elise, David Kenneth Wright, Jean Daniel Jacob, Brandi Vanderspank-Wright, and Thomas Foth. "Ethical Dimensions of Nursing and the Palliative Approach in Geriatric and Forensic Psychiatry: A Qualitative Study." Journal of Pain and Symptom Management 56, no. 6 (December 2018): e122. http://dx.doi.org/10.1016/j.jpainsymman.2018.10.395.
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Carrero-Planells, Alba, Ana Urrutia-Beaskoa, and Cristina Moreno-Mulet. "The Use of Physical Restraints on Geriatric Patients: Culture and Attitudes among Healthcare Professionals at Intermediate Care Hospitals in Majorca. A Qualitative Study Protocol." International Journal of Environmental Research and Public Health 18, no. 14 (July 14, 2021): 7509. http://dx.doi.org/10.3390/ijerph18147509.
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The use of physical restraints is a common practice in the care of hospitalised and institutionalised elderly people. This use is determined by factors related to the patients, their families, the healthcare professionals, the institution, and prevailing social values. Today, however, this practice is often questioned because of its physical, psychological, moral, ethical, and legal repercussions. The present study explores attitudes among healthcare professionals towards the physical restraint of geriatric patients in intermediate care hospitals in Majorca. This study is based on a qualitative design, combining an ethnomethodological approach with critical discourse analysis. The theoretical framework is drawn from Foucault’s work in this field and from Haslam’s theory of mechanisation. Individual interviews will be conducted with physicians, nurses, and nursing assistants at intermediate care hospitals in Majorca. The analysis will focus on these professionals’ knowledge, attitudes, and practices regarding the use of such measures, seeking to identify the factors, especially institutional factors, that determine the use of restraints. It is essential to determine the prevailing culture among healthcare professionals regarding the use of physical restraints on geriatric patients in order to design and propose a more dignified health care model in which such restraints are eliminated.
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Richter, D., S. Lowens, and A. Liekenbrock. "Psychosocial nursing requirements in a psychogeriatric nursing home." Zeitschrift für Gerontologie und Geriatrie 33, no. 1 (February 2000): 17–23. http://dx.doi.org/10.1007/s003910050003.
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Jonasson, Lise-Lotte, Per-Erik Liss, Björn Westerlind, and Carina Berterö. "Ethical values in caring encounters on a geriatric ward from the next of kin's perspective: An interview study." International Journal of Nursing Practice 16, no. 1 (February 2010): 20–26. http://dx.doi.org/10.1111/j.1440-172x.2009.01805.x.
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Lemonidou, Chryssoula, Anastasios Merkouris, Helena Leino-Kilpi, Maritta Välimäki, Theo Dassen, Maria Gasull, P. Anne Scott, Elizabeth Papathanassoglou, and Marianne Arndt. "Nurses' and elderly patients’ perceptions regarding autonomy, privacy and informed consent in nursing interventions in Greece." Reviews in Clinical Gerontology 12, no. 3 (August 2002): 191–204. http://dx.doi.org/10.1017/s0959259802012327.
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Ethics increasingly becomes a forefront issue in health care decision-making, as health care becomes more technologically and organizationally complex. Hence, a great number of new laws on the status and rights of patients and professional codes have been adopted in Europe. However, research suggests that violation of patients’ rights of autonomy, informed consent and privacy may still be common, especially in elderly care.
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Nitchingham, Anita, Andrew Milne, Barbara Toson, Bernard Tuch, Meera Agar, Jacqueline Close, and Gideon Caplan. "Intranasal insulin for treatment of delirium in older hospitalised patients: study protocol for a randomised controlled trial." BMJ Open 11, no. 10 (October 2021): e050765. http://dx.doi.org/10.1136/bmjopen-2021-050765.
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IntroductionDelirium is one of the most common conditions diagnosed in hospitalised older people and is associated with numerous adverse outcomes, yet there are no proven pharmacological treatments. Recent research has identified cerebral glucose hypometabolism as a pathophysiological mechanism offering a therapeutic target in delirium. Insulin, delivered via the intranasal route, acts directly on the central nervous system and has been shown to enhance cerebral metabolism and improve cognition in patients with mild cognitive impairment and dementia. This trial will determine whether intranasal insulin can reduce the duration of delirium in older hospitalised patients.Methods and analysisThis is a prospective randomised, placebo-controlled, double-blind study with 6 months follow-up. One hundred patients aged 65 years or older presenting to hospital with delirium admitted under geriatric medicine will be recruited. Participants will be randomised to intranasal insulin detemir or placebo administered twice daily until delirium resolves, defined as Confusion Assessment Method (CAM) negative for 2 days, or discharge from hospital. The primary outcome measure will be duration of delirium using the CAM. Secondary outcome measures will include length of hospital stay, severity of delirium, adherence to treatment, hospital complications, new admission to nursing home, mortality, use of antipsychotic medications during hospital stay and cognitive and physical function at 6 months postdischarge.Ethics and disseminationThis trial has been approved by the South Eastern Sydney Human Research and Ethics Committee. Dissemination plans include submission to a peer-reviewed journal for publication and presentation at scientific conferences.Trial registration numberACTRN12618000318280.
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Kilaberia, Tina. "Organizational Commitment Among Residential Senior Care Workers." Innovation in Aging 4, Supplement_1 (December 1, 2020): 21. http://dx.doi.org/10.1093/geroni/igaa057.068.
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Abstract Despite growing evidence of the increase in the aging population nationally, there continues to be a shortage of health and social care professionals who work with older adults. Some studies examine this phenomenon by looking at motivations that underlie commitment to geriatric careers. Others study commitment among those who are already geriatric professionals. Both the volume and diversity of the aging population challenge organizations to provide care. Drawing on 44 interviews, observations of 62 meetings, and a 5-year immersion, this organizational ethnography looks at commitment factors at a large, urban, faith-based residential senior care organization. Commitment factors are examined on three levels: daily tensions and rewards; value tensions and rewards; and deal breakers and clinchers. Findings show that intrinsic identity-based factors such as affective bonds with older persons and sharing in faith values sustain commitment on the person level. Interprofessional tensions may detract from commitment. Implications pertain to the role of leadership in equity-related and ethical tensions as well as the improved uptake of allied health professional expertises such as social work and chaplaincy. This study extends the extant knowledge by incorporating perspectives of social workers, chaplains, rehabilitation, recreational, diet and environmental services workers in addition to the more commonly examined groups such as nurses and certified nursing assistants, and in a setting that includes Assisted Living in addition to long-term care.
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Benzinger, Petra, Jürgen Martin Bauer, Michael Schwenk, Stefan Grund, and Sabine Goisser. "Treatment of sarcopenia in nursing home residents: a scoping review protocol." BMJ Open 10, no. 8 (August 2020): e037531. http://dx.doi.org/10.1136/bmjopen-2020-037531.
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IntroductionSarcopenia has been recognised as a disease that is consistently associated with a range of geriatric syndromes and negative health consequences. The prevalence of sarcopenia is high among nursing home residents. Several systematic reviews have assessed the efficacy of a range of treatment strategies against sarcopenia. However, no systematic review discussing specifically the treatment options for sarcopenic nursing home residents has been conducted so far. The objective of this scoping review, therefore, is to identify and map existing studies that assessed the feasibility and effectiveness of interventions that were conducted with the aim to treat sarcopenic nursing home residents.Methods and analysisThe protocol was developed using an established scoping review methodological framework. A systematic search of relevant literature databases will be conducted. We will also conduct a search of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform Search Portal for ongoing and recently completed trials, and will search for grey literature. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. A data extraction sheet will be developed including key study characteristics that will be relevant for collating, summarising and reporting the results of the scoping review.Ethics and disseminationThe proposed scoping review will undertake a secondary analysis of publicly available data, and therefore does not require ethical approval. The results will be disseminated to researchers in the field by submitting the review to a peer-reviewed international journal and by presenting our findings at relevant conferences. We expect that the results of the final review will help to guide future research in the field of sarcopenia treatment for nursing home residents.
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Ingravallo, Francesca, Emma Gilmore, Luca Vignatelli, Ada Dormi, Grazia Carosielli, Luigia Lanni, and Patrizia Taddia. "Factors associated with nurses’ opinions and practices regarding information and consent." Nursing Ethics 21, no. 3 (September 12, 2013): 299–313. http://dx.doi.org/10.1177/0969733013495225.
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This cross-sectional survey aimed to investigate nurses’ opinions and practices regarding information and consent in the context of a large Italian teaching hospital and to explore potential influences of gender, age, university education, length of professional experience, and care setting. A questionnaire was administered to 282 nurses from six different care settings (Emergency Room, Emergency Medicine, Surgery, Hematology–Oncology, Geriatrics, and Internal Medicine). Overall, 84% (n = 237) of nurses returned the questionnaire (men: 24%; mean age: 36.2 ± 8 years; university degree: 35%; mean length of professional experience: 12 ± 8.2 years). Most respondents regularly informed patients about medications and nursing procedures and asked for consent prior to invasive procedures, but some provided information to relatives instead of patients. Lack of time or opportunity was the main difficulty in informing patients. The work setting was the foremost factor significantly associated with participants’ opinions and practices. Further investigations are needed to confirm these findings in similar and other care settings.
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Khagi, Bina Rana, Shanti Awale Maharjan, Shobha Laxmi Bajracharya, Radhika Upadhyay, and Kabita Bade Shrestha. "Attitude of Nurses towards Care of Elderly People in Teaching Hospitals of Kathmandu Valley." Birat Journal of Health Sciences 5, no. 2 (September 30, 2020): 1022–26. http://dx.doi.org/10.3126/bjhs.v5i2.31375.
Повний текст джерелаАнотація:
Introduction: Globally, the numbers of elderly population are increasing which is one of the challenges for nurses in health care setting. Nurses' attitude towards elderly people is associated to quality of care they provide.
Objective To identify attitude of nurses towards care of elderly people in teaching hospitals of Kathmandu valley.
Methodology A cross sectional research design was used to identify attitude of nurses towards care of elderly people. Proportionate stratified random sampling technique was used to select 450 nurses. Ethical approval was taken from Institutional Review Board of Nepal Health Research Council. Data collection was done from 17 April 2017 to 16 April 2018 by using self-administrative questionnaire on socio-demographic characteristics and Multi-factorial Attitude Questionnaires (MAQ) to measure attitude. Data analysis was done using descriptive and inferential statistics.
Results The study revealed that 55.3% of respondents had negative attitude and 44.7% had positive attitude towards care of elderly people. There was significant association between age, marital status, studied geriatric nursing and work experiences in nursing with attitudes of nurses. However, there is no association found of ethnicity, religion, type of family, living with elderly, education and currently working with elderly with attitudes of nurses.
Conclusion From these findings, it is concluded that about more than half of the nurses had negative attitude towards care of elderly. Gerontological nursing course plays significant role in the attitude of nurses. Therefore, it should be given continuity in all level of nursing education for providing quality care of elderly people.
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Cruz, Isabel Cristina Fonseca da. "OBJN index 2004." Online Brazilian Journal of Nursing 3, no. 3 (December 20, 2004): 86–87. http://dx.doi.org/10.17665/1676-4285.20044944.
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EDITORIAL A scientific evidence: the OBJN has more quantitative and qualitative links. (text in English) Aurora de Afonso Costa School of Nursing - from 1944 to 2004: 60 years preparing nurses to care people´s responses to health and illness and to leader the health system. (text in English) The OBJN upgrade: now it is the official journal of the Professional Master in Nursing Program at the Fluminense Federal University Nursing School. (text in English)ORIGINAL ARTICLESClowns doctors: the child talk. (text in Portuguese) Interfaces of geriatric nursing and dental care.(text in Portuguese)Mortality for Accidents of Traffic in Rio Branco – Acre - Brazil, 2001 to 2003.(text in Portuguese)Nursing diagnosis of patients with myocardial infarction, according to the conceptual model of Florence Nightingale. (text in Portuguese)Nursing process: application to the professional practice. (text in Portuguese)Participation of nursing students in the network for the prevention of occupational accidents - REPAT. (text in Portuguese)The american tegumentary leishmaniasis in the perspective of who lives it. (text in Portuguese)The nurse’s leadership: challenges of the practice. (text in Portuguese)Understanding functional health literacy in experiences with prostate cancer: older men as consumers of health information. (text in English)Vancomycin administration in an universitary hospital at general surgical units inpatients (text in Portuguese)We have needs, too: parental needs during a child’s hospitalisation.(text in English)Work accidents with needles and other sharp medical devices in the nursing team at public hospitals - Rio Branco, Acre - Brazil.(text in Portuguese)REVIEW ARTICL ESGender, health and nursing: The male inclusion in the nursing care. (text in Portuguese)Influence of psychosociais needs in the mental health of the children.(text in Portuguese)Literature review on ineffective thermoregulation – OBNJ Club Journal.(text in Portuguese)Literature review on Neonatal Pain – OBJN Club Journal. (text in Portuguese)Literature review on newbons care – OBJN Club Journal.(text in Portuguese)Literature review on risk for impaired parenting – OBJN Club Journal. (text in Portuguese)Literature review on risk of infection in intravenous catheter related to the dialysis treatment – OBJN Club Journal. (text in Portuguese)Public policies regarding family, institutional requirement from the politics philosophy of Hegel and Marx.(text in Portuguese)Review of research about parish nursing practice (text in English)The civil responsibility of nurse as a public agent. (text in Portuguese)The contribution of philosophy, ethics, and bioethics in the Ribeirão Preto School of Nursing – USP(text in Portuguese)The importance of the insert of the thematic " violence against the woman " in the curriculum of nursing. (text in Portuguese)Work of nursing in the family health program of and its relation with the non-institucionalization.(text in Portuguese)ABSTRACTSConstruction and validation of an instrument of collection of data of the aged one in the Program of Health of the Family.Construction and validation of data collection instrument for children from 0 - 5 years.Interaction among teachers and students in the construction of the nurses professional identityKnowledge and practice of beginner and veteran (men and women) nurses in the hospital scenarioNursing in field from training: “ Natural Lab” a professional learningPsycossocial Necessities of the Client at the Unit of Chest Pain: issues for caring in the Emergency Room.The social representation of family: expectation and meaning of cardiac surgery.(text in English)PROFESSIONAL ISSUES2004 Brazilian Women Year: Visual reflections related to the female sexuality in a feminine (sexy) Brazil focusing the female nurse.(pps in Portuguese) 5th European Conference of ACENDIO: Association for Common European Nursing Diagnoses, Interventions and Outcomes (text in English)NURSES: Working with the Poor; Against Poverty. Message from ICN (text in English)OBJN 2004 thanks to the Editorial and Peer-Review Board (text in English)The Professional Master in Nursing Website (EEAAC/UFF): linking knowledge to nursing practice (text in Portuguese)Thirteen National Brazilian Nursing Research Congress (SENPE) June 2005, São Luiz, Maranhão.World Health Organization: Forum 8 + World Summit on Health Research Mexico City, November 6-10, 2004 (text in English)
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Miller, Rachael Lucia, Jonathan David Barnes, Ronelle Mouton, Philip Braude, and Robert Hinchliffe. "Comprehensive geriatric assessment in perioperative care: a protocol for a systematic review and qualitative synthesis." BMJ Open 11, no. 12 (December 2021): e049875. http://dx.doi.org/10.1136/bmjopen-2021-049875.
Повний текст джерелаАнотація:
IntroductionComprehensive geriatric assessment (CGA) is an intervention that has been deployed in the perioperative setting with the aim to improve outcomes for older patients admitted to hospital. Older patients undergoing surgery are more likely to have postoperative complications, a longer hospital stay and be discharged to a care facility. Despite the increasing application of this intervention within surgical services, the evidence for CGA remains limited in this group. The aim of this systematic review is to describe CGA as in intervention applied to surgical populations in randomised controlled trials (RCTs) as well as the outcomes assessed.Methods and analysisA systematic search of RCTs of CGA in surgery will be run in Embase, Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Cochrane library. Further articles will be identified from reference lists in relevant studies found in the search. A narrative synthesis will be undertaken outlining specialties included, detailed descriptions of the intervention and outcomes.Ethics and disseminationNo ethical approval is required. The results of this review will be published and used as the basis of work to optimise this intervention for future trials in surgical populations.PROSPERO registration numberThis review is registered with PROSPERO CRD42020221797.
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Zhao, Yuanyuan, Fakhrul Zaman Rokhani, Sazlina Shariff Ghazali, and Boon How Chew. "Defining the concepts of a smart nursing home and its potential technology utilities that integrate medical services and are acceptable to stakeholders: a scoping review protocol." BMJ Open 11, no. 2 (February 2021): e041452. http://dx.doi.org/10.1136/bmjopen-2020-041452.
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IntroductionSmart technologies, digital health and eHealth have been shown to enhance institutional elderly care. Because of the rapidly ageing societies, information technologies in geriatric healthcare are urgently needed. A lot of innovation in smart healthcare has occurred in the past decade, and its use in nursing care assessment, daily living activities and service management is yet to be defined. More fundamentally, the concepts, definitions and scopes of a smart nursing home are still vague. Thus, this scoping review aims to examine the extent, range (variety) and nature (characteristics) of evidence on the existing smart concepts and feasible healthcare technologies, types of medical services in nursing home settings and acceptability of a smart nursing home by the elderly people ≥60 years old, their caregivers, nursing home operators and government agencies.Methods and analysisThis scoping review will be guided by the smart technology adoption behaviours of elder consumers theoretical model (Elderadopt) by Golant and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. First, we will conduct an internet search for nursing homes and websites and databases related to the stakeholders to retrieve the definitions, concepts and criteria of a smart nursing home (phase 1). Second, we will conduct an additional systematic electronic database search for published articles on any measures of technological feasibility and integration of medical services in nursing home settings and their acceptability by nursing home residents and caregivers (phase 2). The electronic database search will be carried out from 1999 to 30 September 2020 and limited to works published in English and Chinese languages. For phase 2, the selection of literature is further limited to residents of nursing homes aged ≥60 years old with or without medical needs but are not terminally ill or bed-bound. Qualitative data analysis will follow the Framework Methods and thematic analysis using combined inductive and deductive approaches, conducted by at least two reviewers.Ethics and disseminationThis protocol is registered on osf.io (URL: https://osf.io/qtwz2/). Ethical approval is not necessary as the scoping review is not a primary study, and the information is collected from selected articles that are publicly available sources. All findings will be disseminated at conferences and published in peer-reviewed journals.
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Stein, Sorah, and Karola Dillenburger. "Ethics in sexual behavior assessment and support for people with intellectual disability." International Journal on Disability and Human Development 16, no. 1 (February 1, 2017): 11–17. http://dx.doi.org/10.1515/ijdhd-2016-0023.
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Abstract Sexuality is an issue of equality, rights, and ethics, especially when it comes to the sexuality of people with intellectual and developmental disabilities (IDD). This paper offers a discussion of ethics related to the assessment and intervention supports of sexual behavior in people with IDD. A brief history of sexuality and disability is presented. Issues of sexual abuse of people with IDD and the laws related to sterilization, pornography, sexual rights, and consent are explored. Finally, specific ethical concerns related to intervention by behavior analysts in the realm of sexual behavior are examined.
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Santos, Silvana Sidney Costa. "The teaching of gerontogeriatric nursing in Brazil from 1991 to 200 seen under the complexity of Edgar Morin." Online Brazilian Journal of Nursing 4, no. 2 (April 17, 2005): 60–61. http://dx.doi.org/10.17665/1676-4285.20054863.
Повний текст джерелаАнотація:
The present study had the following objectives: to identify the characteristics of gerontogeriatric nursing such as exhibited on Brazilian Nursing Journals; and to draw a reflection on the teaching of gerontogeriatric nursing in undergraduation courses, based on identified characteristics as seen under the Complexity of Edgar Morin. A qualitative research, it had as a data-source 9 proceedings volumes of Brazilian Nursing Congresses (281 abstracts, of which 260 are on gerontogeriatrics and 21 on the teaching of gerontogeriatric nursing), plus 7 national nursing publications: “Revista Texto e Contexto em Enfermagem”, “Revista da Escola de Enfermagem da USP”, “Revista Gaúcha de Enfermagem”, “Revista Enfermagem da UERJ”, “Revista da RENE”, REBEN, “Revista Latino-Americana de Enfermagem” (186 Journal issues of which 88 articles on gerontogeriatrics and 9 covering the teaching of gerontogeriatric nursing) for the 1991-2000 period. The main body of this article comprised 16 scientific articles on the teaching of gerontogeriatric nursing, where software was used for a qualitative analysis – QRS- NUD*IST4. Results made possible to perceive teaching during the research period conducted as: the mandatory subject, the introduction of specific contents in various subjects, the participation on extension work, and extra-curriculum training stages. Contents were presented through the themes: the aged; growing old; old age; gerontology and geriatrics; gerontogeriatric nursing turned to conceptual aspects; work process, nursing process, care to the elder – in houses for the aged, dependent and undergoing surgery, family care, care given to family carers, and care given at home. Such findings strongly support the thesis that Brazilian nursing already understands the gerontogeriatric field as a void still to be filled, requiring roads for an autonomous and/or multidisciplinary team work professional action, and interdisciplinary and/or transdisciplinary work. To think of the teaching of gerontogeriatric nursing or any other subject matter, in Nursing, using the Principles of Edgar Morin’s Complexity is tantamount to perceiving educative teaching as trying to convey a culture enabling the future worker to: understand the human condition; think in a contextualized, open, globalized, ethics, dialogic, recursive and hologrammatic form; and, to direct this worker towards: acquiring qualifications, learning how to do research, to develop practical classes and/or training stages, and other activities turned to the care of the elderly, reconnecting the various knowledges with other disciplines, having as the main target of this educational teaching the human, professional, and ecological care.
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Pouw, Maaike A., Agneta H. Calf, Barbara C. van Munster, Jan C. ter Maaten, Nynke Smidt, and Sophia E. de Rooij. "Hospital at Home care for older patients with cognitive impairment: a protocol for a randomised controlled feasibility trial." BMJ Open 8, no. 3 (March 2018): e020332. http://dx.doi.org/10.1136/bmjopen-2017-020332.
Повний текст джерелаАнотація:
IntroductionAn acute hospital admission is a stressful life event for older people, particularly for those with cognitive impairment. The hospitalisation is often complicated by hospital-associated geriatric syndromes, including delirium and functional loss, leading to functional decline and nursing home admission. Hospital at Home care aims to avoid hospitalisation-associated adverse outcomes in older patients with cognitive impairment by providing hospital care in the patient’s own environment.Methods and analysisThis randomised, non-blinded feasibility trial aims to assess the feasibility of conducting a randomised controlled trial in terms of the recruitment, use and acceptability of Hospital at Home care for older patients with cognitive impairment. The quality of care will be evaluated and the advantages and disadvantages of the Hospital at Home care programme compared with usual hospital care. Eligible patients will be randomised either to Hospital at Home care in their own environment or usual hospital care. The intervention consists of hospital level care provided at patients’ homes, including visits from healthcare professionals, diagnostics (laboratory tests, blood cultures) and treatment. The control group will receive usual hospital care. Measurements will be conducted at baseline, during admission, at discharge and at 3 and 6 months after the baseline assessment.Ethics and disseminationInstitutional ethics approval has been granted. The findings will be disseminated through public lectures, professional and scientific conferences, as well as peer-reviewed journal articles. The study findings will contribute to knowledge on the implementation of Hospital at Home care for older patients with cognitive disorders. The results will be used to inform and support strategies to deliver eligible care to older patients with cognitive impairment.Trial registration numberNTR6581; Pre-results.
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Valente, Geilsa Soraia Cavalcanti, Carla Reis Manso, Anna Flávia Cavalcanti Barbosa Maia, Ana Barbara Cerff Ornellas, Selma Petra De Sá, and Mirian Da Costa Lindolpho. "The experience of nursing students in home visits to elderly people living with dementia." Revista de Enfermagem UFPE on line 4, no. 3 (June 30, 2010): 1410. http://dx.doi.org/10.5205/reuol.999-8502-1-le.0403201010.
Повний текст джерелаАнотація:
ABSTRACTObjectives: to identify the main needs of healthcare for the elderly with dementia by home visits and discuss the importance of household visits by scholars, aiming to promote the health of their clients. Method: this is a descriptive study of a kind experience report with a qualitative approach, in which seven were carried out home visits to elderly dementia participating in the Program of Geriatrics and Gerontology in Niterói - RJ, Brazil, September 1 November 24, 2009. The research received approval under No. 062/09 of the Ethics Committee of University Hospital Antonio Pedro - HUAP. Results: the visits, an evaluation of the home as their physical structure and health conditions besides providing guidance to caregivers and family members about changes in the environment and care that meet the specific needs of each client. Conclusion: the activity was very important for the students, allowing the understanding of aspects related to caring for the elderly with dementia at home by means of the holistic approach, taking into account the promotion, prevention and recovery in health. Descriptors: students nursing; home visits; health of the elderly; dementia; Alzheimer disease.RESUMOObjetivos: identificar as principais necessidades de atenção à saúde do idoso com demência através da visita domiciliar e Discutir a importância da realização de Visitas Domiciliares pelos acadêmicos, visando à promoção da saúde destes clientes. Método: trata-se de um estudo descritivo, do tipo relato de experiência com abordagem qualitativa, no qual foram realizadas sete visitas domiciliares aos idosos demenciados que participam do Programa de Geriatria e Gerontologia no município de Niterói - RJ, no período de 1 de setembro a 24 de novembro de 2009. A pesquisa recebeu a aprovação sob nº 062/09 do Comitê de Ética do Hospital Universitário Antonio Pedro – HUAP. Resultados: as visitas permitiram uma avaliação do domicílio quanto a sua estrutura física e condições sanitárias além de possibilitar a orientação aos cuidadores e/ou familiares sobre as mudanças no ambiente e os cuidados que atendem as necessidades específicas de cada cliente. Conclusão: a atividade foi de suma importância para os acadêmicos, possibilitando a compreensão dos aspectos relacionados ao cuidar do idoso com demência no domicilio por meio da abordagem holística, levando em consideração a promoção, prevenção e recuperação em saúde. Descritores: estudantes de enfermagem; visita domiciliar; saúde do idoso; demência; doença de Alzheimer. RESUMENObjetivos: Identificar las principales necesidades de asistencia sanitaria para los ancianos con demencia mediante visitas domiciliarias y discutir la importancia de las visitas domiciliarias por los estudiosos, con el objetivo de promover la salud de sus clientes. Método: estudio descriptivo de un informe experiencia única con un enfoque cualitativo, de los cuales siete se llevaron a cabo visitas domiciliarias a demencia senil que participan en el Programa de Geriatria y Gerontología en Niterói - RJ, Brasil, 1 de septiembre 24 de noviembre 2009. La investigación recibió la aprobación en virtud N º 062/09 de la Comisión de Ética del HUAP. Resultados: las visitas han permitido la evaluación de la vivienda como su estructura física y las condiciones de salud además de proporcionar orientación a los cuidadores y familiares acerca de los cambios en el medio ambiente y la atención que satisfagan las necesidades específicas de cada cliente. Conclusión: la actividad fue muy importante para los estudiantes, permitiendo la comprensión de los aspectos relacionados con el cuidado de los ancianos con demencia en el hogar por medio de un enfoque holístico, teniendo en cuenta la promoción, prevención y recuperación de la salud. Descriptores: estudiantes de enfermería; visita domiciliaria; salud del anciano; demencia; enfermedad de Alzheimer.
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Dookhy, Joshi, and Louise Daly. "14 Identifying and Addressing Challenges Experienced by Nurses when Caring for Persons with Dementia Experiencing Responsive Behaviours in Acute Hospitals." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.08.
Повний текст джерелаАнотація:
Abstract Background Due to the increasing number of persons with dementia being hospitalised (Timmons et al., 2015), nurses working in acute hospitals need to be competent in caring for this patient population. Amongst other dementia-care specific competencies, nurses require competence in caring for those with dementia who experience responsive behaviours, a common phenomenon in acute hospitals. The aims of this study were to explore challenges encountered by nurses in caring for persons with dementia experiencing responsive behaviours in an acute hospital and to explore strategies used by nurses to address the encountered challenges. Methods A qualitative descriptive study, involving semi-structured interviews with nine nurses was conducted. Ethical approval was received from the School of Nursing & Midwifery Research Ethics Committee in the participating University. Data was collected in 2018 and was analysed using a thematic analysis approach. Results An analysis identified three challenging components for nurses, namely: emotional, environmental and organisational challenges. These challenges in turn contributed to barriers to the provision of nursing care and management of responsive behaviours in the setting. To address these challenges, nurses implemented therapeutic interventions, for example reminiscence, and engaged with other healthcare professionals and caregivers. Conclusion This study explored how various emotional, environmental and organisational challenges are experienced and addressed by nurses when managing responsive behaviours in the acute hospital. The increasing number of persons with dementia attending acute hospitals necessitates an urgency for service development to enhance the specific dementia-care competency levels of nurses. Changes at an organisational level, to support competency development in dementia-care in acute hospitals, must also be adopted.
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Cheng, Karis Kin-Fong, Rosalind Chiew-Jiat Siah, Emma Ream, Ravindran Kanesvaran, and Jo Armes. "Protocol for a scoping review of digital health for older adults with cancer and their families." BMJ Open 10, no. 8 (August 2020): e038876. http://dx.doi.org/10.1136/bmjopen-2020-038876.
Повний текст джерелаАнотація:
IntroductionThe potential for digital medicine and healthcare in geriatric oncology settings has received much attention. This scoping review will summarise the nature and extent of the existing literature that describes and examines digital health development, implementation, evaluation, outcome and experience for older adults with cancer, their families and their healthcare providers.Methods and analysisArksey and O'Malley’s six stages of scoping review methodology framework will be used. Searches will be conducted in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase via OvidSP, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus via EBSCO, Scopus and PsycINFO via OvidSP for published articles in peer-reviewed scientific journals from year 2000 onwards. In addition, we will screen databases for all prospectively registered trials. Research articles using quantitative or qualitative study design or reviews will be included if they describe or report the design, development or usability of digital health interventions in the treatment and care of patients 65 years of age or older with cancer and their families before, during and after cancer treatment. Grey literature will not be searched and included. Two investigators will independently perform the literature search, eligibility assessments and study selection. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for the scoping reviews (PRISMA-ScR) will be used to delineate the search decision process. For included articles, the extracted results will be synthesised both quantitatively and qualitatively and reported under key conceptual categories of this scoping review. Research gaps and opportunities will be identified and summarised.Ethics and disseminationSince this review will only include published data, ethics approval will not be sought. The results of the review will be published in peer-reviewed scientific journals. We will also engage with relevant stakeholders within research team’s networks to determine suitable approaches for dissemination.
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Pauly, L., P. Stehle, and D. Volkert. "Nutritional situation of elderly nursing home residents." Zeitschrift für Gerontologie und Geriatrie 40, no. 1 (February 2007): 3–12. http://dx.doi.org/10.1007/s00391-007-0430-x.
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Zygouris, Stelios, Mara Gkioka, Despoina Moraitou, Birgit Teichmann, Thrasyvoulos Tsiatsos, Sotirios Papagianopoulos, and Magda Tsolaki. "Views of nursing staff on computerized dementia screening." Zeitschrift für Gerontologie und Geriatrie 52, S4 (October 22, 2019): 258–63. http://dx.doi.org/10.1007/s00391-019-01633-0.
Повний текст джерелаАнотація:
Abstract Background Cognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed by nonspecialists, such as nurses while featuring automatic scoring and interpretation of results. Objective This study validated a newly developed questionnaire for measuring the attitudes of Greek nurses towards computerized dementia screening. Material and methods The questionnaire was validated in a sample of 212 undergraduate psychology students and subsequently administered to a sample of 19 nurses working in a general hospital. Reliability of the questionnaire was calculated using Cronbach’s alpha (= 0.762). Factor analysis revealed the existence of a single factor (acceptability-feasibility) that accounted for 33.73% of variance with an eigenvalue of 3.036. Results The total score of all the items loading on the single factor (acceptability-feasibility) was calculated. Scores ranged between 10 and 40 with the average score for the validation group being 29.33 (SD = 4.89) and the average score for the nurses’ group being 29.50 (SD = 3.20). Discussion The questionnaire has acceptable reliability. Results indicate that acceptability-feasibility is high in both groups and there were no statistically significant differences between the two groups.
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Thomasma, David C. "Geriatric Ethics." Journal of the American Geriatrics Society 36, no. 10 (October 1988): 959–60. http://dx.doi.org/10.1111/j.1532-5415.1988.tb05791.x.
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Schneider, Julia, Mara Gkioka, Sotirios Papagiannopoulos, Despina Moraitou, Brigitte Metz, Magdalini Tsolaki, Andreas Kruse, and Birgit Teichmann. "Expectations of nursing personnel and physicians on dementia training." Zeitschrift für Gerontologie und Geriatrie 52, S4 (October 15, 2019): 249–57. http://dx.doi.org/10.1007/s00391-019-01625-0.
Повний текст джерелаАнотація:
Abstract Background The number of dementia training programs in hospital settings is steadily increasing. The way training sessions are designed influences the way the learning content is implemented in practice. To develop a successful training it is important to meet the needs of the target group; however, not much is known about staff preferences and expectations relevant to future dementia training programs in hospitals in Germany and Greece. Objective The aim of this survey was to explore staff training needs relevant to the topic of dementia, in general hospitals in Germany and Greece. This study analyzed the interests of staff members, preferences and expectations with respect to dementia training. Material and methods This was a descriptive survey based on a 54-item questionnaire conducted with 61 nursing staff, head nurses and physicians (Germany: n = 25, Greece: n = 36) recruited from 5 hospitals (Germany: n = 3, Greece: n = 2). Parts of the questionnaire explored participants’ previous education regarding dementia and their expectations towards future dementia programs. Results Although staff attendance in educative programs was high in the last 5 years for both countries, participation in dementia training programs was low (Germany 24%, Greece 5.5%). Additionally, the great majority of participants were willing to be trained in future dementia training programs (Germany 96%, Greece 100%). Employees from both countries expect increased clinical skills as a result of participation in such training programs. In Greece, staff members hope for better handling of people with dementia, while in Germany, concrete practical advice is preferred. Conclusion There seems to be a strong willingness to participate in further dementia training programs where not only theoretical knowledge is provided but also practical advice.
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Naughton, C., I. Ezhova, N. Hayes, and J. Fitzpatrick. "77 Developing and Testing An Education-Career Pathway in Healthcare for Older People (ECHO) to Promote Retention in Early-Career Gerontological Nurses." Age and Ageing 49, Supplement_1 (February 2020): i25—i26. http://dx.doi.org/10.1093/ageing/afz191.02.
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Abstract Background The NHS Long Term Plan (2019) sets specific targets for multidisciplinary services for frail older people over the next ten years. Delivery and sustainability is crucially dependant on the capability and capacity of gerontological nursing. High cost cities such as London experience high staff vacancy rates in acute care older adult services. Aim The study took a regional approach, working with NHS Trusts to develop a multicomponent intervention to increase retention and competencies of early career nurses working in gerontological services. The study examined the acceptability and feasibility of the intervention and tested a quasi-experiential evaluation design. Ethical approval was obtained from the University Ethics committee. Methods A co-design approach with stakeholders, early career nurses, educationalists and nurse managers, produced a multicomponent intervention: education module (masters level), gerontological competency booklet, external clinical learning opportunities, career coaching and mentorship delivered over a six-month period. The evaluation involved a mix-methods pre-post survey and focus group interviews. Results Twenty-nine early career nurses were recruited from five Trusts. The multicomponent intervention was well received, but there were difficulties facilitating external learning opportunities and providing career mentors. The primary outcome was intention to remain in gerontological nursing (measured using a point Likert scale). Pre-post the intervention this remained high (mean score 6 IQR 5-7), p=0.78. There was a significant increase in gerontological knowledge: at baseline the median score was 87 (IQR 81-102) compared to 107 (IQR 98-112) post-intervention, p=0.006. In focus groups participants identified three main mechanism of action for ECHO: building gerontological knowledge and skills; professional identity as older adult nurse; and networking to broaden horizons. Conclusions The study has demonstrated the potential of Trusts to work collaboratively with education providers to deliver a model of career-education pathway that may help attract and retain early career nurses to work in gerontology.