Anna S. BeeberMatthias HobenJennifer LeemanStephanie Palmertree...
11页
查看更多>>摘要：Abstract Assisted living (AL) communities are experiencing rising levels of resident acuity, challenging efforts to balance person‐centered care—which prioritizes personhood, autonomy, and relationship‐based care practices—with efforts to keep residents safe. Safety is a broad‐scale problem in AL that encompasses care concerns (e.g., abuse/neglect, medication errors, inadequate staffing, and infection management) as well as resident issues (e.g., falls, elopement, and medical emergencies). Person and family engagement (PFE) is one approach to achieving a balance between person‐centered care and safety. In other settings, PFE interventions have improved patient care processes, outcomes, and experiences. In this paper, we describe the protocol for a multiple methods AHRQ‐funded study (Engage) to develop a toolkit for increasing resident and family engagement in AL safety. The study aims are to engage AL residents and family caregivers, AL staff, and other AL stakeholders to (1) identify common AL safety problems; (2) prioritize safety problems and identify and evaluate existing PFE interventions with the potential to address safety problems in the AL setting; and (3) develop a testable toolkit to improve PFE in AL safety. We discuss our methods, including qualitative interviews, a scoping review of existing PFE interventions, and stakeholder panel meetings that involved a Delphi priority‐setting exercise. In addition to describing the protocol, we detail how we modified the protocol to address the unique challenges of the COVID‐19 pandemic. Study findings will result in a toolkit to improve resident and family engagement in the safety of AL that will be tested in future research.
查看更多>>摘要：Abstract Workplace bullying is a severe problem that affects individuals, organizations, and society. Although there is a growing research interest in bystanders of workplace bullying, the rationale underlying bystanders' behavior in healthcare settings requires further investigation. The aim of the current study is?to explore factors that influence the behavior of bystanders to workplace bullying in the healthcare sector. Qualitative semistructured interviews were conducted with 32 staff members in the healthcare sector in Sweden. Data were collected between March 2019 and September 2020 and were analyzed with thematic analysis. The participants experienced that bystanders of bullying, both colleagues and managers, were in many situations acting in a passive way. Organizational factors?such as dysfunctional organizational culture and deficiencies in management affected how actively the bystanders could intervene. Additionally, a fear of negative consequences, lack of awareness of what was going on, bullying behavior being excused, and the bystander not being a member of the dominant group were social factors contributing to bystanders' passive behavior. For bystander intervention to be successful, the organization must consider bullying as a serious issue, take action, and show support for both the target and the bystander.
Joan Blanco‐BlancoLaura Albornos‐Mu?ozMaria àngels Costa‐MenenEster García‐Martínez...
13页
查看更多>>摘要：Abstract Falls have a considerable impact on the functional prognosis of older adults. The main focus of this multicenter, retrospective, observational study was to examine the prevalence of falls in Spanish people aged 65?80 years still living at home. The secondary aims included examining the overall sociodemographic and clinical variables associated with a history of falls and then stratifying these findings by sex. We also aimed to determine the differences between sexes with regard to the history and consequences of falls and to evaluate associations between fall history and functional performance tests. The 747 older adults had all participated in the otago exercise program, which is a progressive home program of strength, balance, and endurance exercises. They were recruited by nurses in 21 primary care centers in 10 Spanish provinces between September 2017 to December 2018. The participants' mean age was 72.2 (SD: 4.3) years, and 67% were women. We recorded sociodemographic and clinical variables, functional performance test results, and any falls and/or injuries in the last 12 months. We found that 32% had fallen, 36% of those had fallen more than once, and 48% had sustained injuries when they fell. The bivariate analysis showed that women had more than twice the odds of falling than men and that living alone and being obese or overweight increased the odds of a fall, although living alone was not associated with falls in the multivariable analysis. Our results could guide the development of risk‐specific fall prevention programs to prevent disabilities in older people.
查看更多>>摘要：Abstract Early in the pandemic when hospitals reached capacity, Home Health Care (HHC) became a critical source of care for COVID‐19 patients and continues to be an important source of care for recovering COVID‐19 patients. Little is known about the COVID‐19 patient population treated in HHC. This retrospective observational cohort follows 1614 HHC patients with a COVID‐19 diagnosis and compares an “Early Cohort” between March 31 and May 31, 2020 to a “Late Cohort” between June 1 and December 31, 2020 for differences in: (1) sociodemographic and clinical characteristics (2) health care utilization, and (3) outcomes. Early patients were younger, more likely to be a minority, referred from hospitals or directly from emergency departments, started their care with greater independence in functional abilities, and had fewer comorbidities. Early patients were more likely to have COVID‐19 as their primary diagnosis (88.5% vs. 79.4%, p?<?0.001), and were assessed as having more severe COVID‐19 symptoms. Early and Late Cohorts were assessed similarly for dyspnea at the start of care. COVID‐19 patients in the Early Cohort were more likely to have their vital signs monitored remotely (7.3% vs. 1.4%; p?<?0.001), have received oxygen in their home (27.8% vs. 15.3%; p?<?0.001), and received more virtual care than patients in the Late Cohort (2.04 visits vs. 0.86 visits; p?<?0.001), although they had approximately two fewer total visits (12.48 vs. 14.45; p?<?0.001). Patients in both cohorts had substantial improvement in dyspnea and functional ability during the course of HHC.
查看更多>>摘要：Abstract The understanding of stigma resistance and its prevalence is limited due to the limitation of existing measures. This study aims to modify the Stigma Resistance Scale (SRS) and assess the psychometric properties of Chinese patients with mental illness. Seven experts were invited to assess the content validity of the Chinese version of the SRS (C‐SRS), which has been translated and adapted into Chinese. Convenience samples were included from two psychiatric hospitals and three community healthcare centers in Beijing, China. A total of 484 patients completed the survey from November 2020 to July 2021. Samples were randomized into two parts exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA (n?=?242) yielded three factors with Cronbach's α of 0.932 for the total scale, and 0.835, 0.877, and 0.858 for the subscales. CFA (n?=?242) revealed good model fit (χ2/df?=?2.190, RMSEA?=?0.070). The domain‐total correlation scores were 0.834–0.939. The correlation coefficient of test‐retest ranged from 0.726 to 0.887. The correlation coefficient between the C‐SRS and Stigma Resistance subscale of the Internalized Stigma of Mental Illness scale was 0.399. This study found that the C‐SRS has evidence of excellent reliability and validity for assessing stigma resistance. It could be used in Chinese people with mental illness to identify and address stigma resistance.
Karen A. MonsenRobin R. AustinMichelle A. Mathiason
11页
查看更多>>摘要：Abstract Data visualization techniques are useful for examining large multidimensional data sets. In this exploratory data analysis (EDA) study, we applied a visualization pattern detection and testing process to deidentified data to discover patterns in whole‐person health for adults 65 and older. Whole‐person health examines a person's environmental, psychosocial, and physical health, as well as their health‐related behaviors; and assesses their strengths, challenges, and needs. Strengths are defined as assets and capabilities in the face of short‐or long‐term stressors. We collected data using a mobile application that delivers a comprehensive whole‐person assessment using a simplified version of a standardized instrument, the Omaha System. The visualization pattern detection process is iterative, includes various techniques, and requires visualization literacy. The data visualization techniques applied in this analysis included bubble charts, parallel coordinates line graphs, box plots, and alluvial flow diagrams. We discovered six patterns within the visualizations. We formulated and tested six hypotheses based on these six patterns, and all six hypotheses were supported. Adults 65 and older had more strengths than challenges and more challenges than needs (p?<?0.001). Strengths and challenges were negatively correlated (p?<?0.001). Unexpectedly, a subset of adults 65 and older who had many, but not all, strengths had significantly more needs (p?=?0.04). The use of standardized terminology with its inherent data interrelationships was key to discovering patterns in whole‐person health. This methodology may be used in future EDA research using new data sets.
NSTL
Wiley