Exploring the meaning of life from the perspective of patients with depression: A phenomenological study

This study explored the perceptions of meaning of life for patients with depression. A qualitative phenomenology approach was used. Patients with depression (n = 20) were recruited until data saturation occurred. Findings revealed four themes all related to their value of: (1) accepting depression; (2) appreciating work (paid and non-paid); (3) embodying love and taking on responsibilities; (4) receiving spiritual comfort. Healthcare professionals could facilitate patients with depression to explore their meaning of life while enduring and transforming the emotional pain that accompanies depression, hence, perhaps, decreasing their suicidal ideations.     

Care for residents with dementia in an assisted living facility

The purpose of this prospective, ethnographic study was to describe and analyze the care of residents with dementia in an assisted living facility (ALF) providing dementia care. Participant observation and interviews with 20 employees were used to obtain data. Data were collected and analyzed over a period of 6 months. Four major themes emerged from the data: (a) Caregivers' Level of Knowledge of Dementia, (b) Caregivers' Lack of Knowledge in Preventing or Assessing Acute Illnesses, (c) Limitations in Monitoring and Reporting Resident Changes, and (d) Inappropriate Medication Administration. Forty percent of the residents (N = 35) were admitted to the hospital over 6 months. The problems in providing quality care in this facility demonstrate the need for gerontological nurses in ALFs, who would improve care by assessing and monitoring the residents and by supervising and educating the caregivers.     

Implementation of personalized music listening for assisted living residents with dementia

Personalized music listening (PML) has been touted as a safe and inexpensive means of improving the quality of life, mood, and behavior of persons with dementia. A PML program was implemented in an assisted living facility and evaluated across the five dimensions of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. The first 17 residents invited to participate were enrolled and followed over eight months. Effectiveness was evident in staff-reported mood improvement in 62% of encounters. Adoption was evident in qualitative feedback collected from medication technicians. Implementation was facilitated by low costs, engagement of external volunteers, highlighting outcomes that are relevant to staff, and attention to playlists over time. Maintenance required continued engagement of volunteers, ongoing fundraising, attention to facility staff engagement, and iterative adjustments to the program framework as staffing changes occurred. PML was found to be a meaningful intervention that is possible at a reasonable cost.     

Family perceptions of mouth care for assisted living residents with dementia: Implications for care

Mouth care is an important component of care for persons with dementia in assisted living (AL). However, there is little information about family member knowledge, beliefs, and experiences with resident oral health. Family perceptions and involvement in care may impact oral and systemic health for AL residents. Therefore, semi-structured interviews to assess these domains were conducted with 23 adult family members of AL residents with dementia, from 9 AL communities. Thematic analysis found that families identified (1) the centrality of oral health to well-being; (2) organizational influences on mouth care; (3) mouth care in the context of dementia; and (4) collaboration to facilitate mouth care. Family perspectives can provide useful guidance for collaborative interventions that support oral health and mouth care in AL.     

The feasibility of an intervention combining self-efficacy theory and Wii Fit exergames in assisted living residents: A pilot study

The purpose of this study was to examine the feasibility of a self-efficacy based intervention using Wii exergames in assisted living residents. The study was a single-group pre- and post-test design. Seven older adults (aged 80–94 years) were instructed to engage in exergames twice a week for 8 weeks. Physical function (balance, mobility, and walking distance), fear of falling, self-efficacy for exercise, and outcome expectations for exercise were evaluated. All participants had enjoyable experiences and no serious adverse events were reported. Participants had significant improvement on balance. Although not significant, there were trends indicating that participants improved mobility, walking endurance, and decreased fear of falling. The use of Wii exergames was an acceptable, safe, and potentially effective approach to promote physical activity in older adults. Findings provide support for the applications of integrating self-efficacy theory into exergames as a mechanism to encourage older adults to engage in exercise.     

Quality of life for patients with diabetes in Korea--I: the meaning of health-related quality of life

This study describes the impact of diabetes and the meaning of health-related quality of life (HRQOL) for 22 male and female patients in Korea. Open-ended interviews yielded six HRQOL themes: health, overall well-being, harmonious relationships and family responsibilities, a rewarding life, spiritual life, and material support. The physical impact of diabetes included decreased energy, limitations, and physical suffering; while its psychological/spiritual impact extended to general stress, helplessness, fear, depression, anger, and relationship with God. Like Americans, Koreans valued health, psychological well-being and interpersonal support. In addition, the Koreans valued smooth, harmonious interpersonal relationships, overall well-being pertaining to living a comfortable and honorable life.     

Three nursing home residents speak about meaning at the end of life

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18-24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize.     

Beyond the rhythm and routine: adjusting to life in assisted living

In Western countries, demographic trends indicate an increase in the aging population well into the next century. Because of declining health, many older adults will benefit from residence in assisted living (AL). The purpose of this qualitative study was to explore the experience and contextual influences in everyday decision-making of four older adults in AL using a case study method. Several themes emerged as significant in older adult satisfaction with everyday decision-making (i.e., trigger event, level of physical functioning, inside and outside support systems, past patterns of decision-making). Strategies for assessing and strengthening these contextually relevant factors are discussed.     

The assisted living project: a process evaluation of implementation of sensor technology in community assisted living. A feasibility study

Abstract

Introduction: The ageing population has been described as a grand societal challenge worldwide, and access to technology is one important strategy for meeting this challenge. The Assisted Living Project has a responsible research and innovation approach and includes older adults in evaluating sensor-based functions in assisted living facilities. The purpose of involving users in research is to enhance a wider dialogue about the values, methods, and purposes of the research project.

Methods: We carried out a feasibility study in order to inform the development and conduct of a pilot project with eight residents. The purposes were to evaluate the process of technology installation, the feasibility of the technology, and methods for user involvement. One resident, Hilda, gave her informed consent to take part in this feasibility study. Her sensor system consisted of two magnetic sensors, six pyroelectric infrared motion sensors, one power sensor, one push button by the entrance door, and one loudspeaker. The sensors were wirelessly connected to a controller, which registered and transmitted all data to a secure server.

Results: The feasibility study suggested important modifications for the pilot project, which concerned pre-configuration of the sensors, securing efficiently, rapid installation, number of visitors during the installation, preparation necessitating a site acceptance test for the wireless network and environmental prerequisites for mounting the sensors. Furthermore, this study recommends that the signals that are transmitted from the sensors to the secure server need verification.

Conclusion: A feasibility study provides an opportunity to inform develop and conduct of a main trial. The MRC framework was useful for doing a process evaluation to assess feasbility and quality of implementation, clarify causal mechanisms and identify contextual factors associated with variations in outcome.

• Implications for rehabilitation

• The feasibility study was useful in order to develop sustainable technological solutions by

• evaluating the robustness of the technology

• consider challenges regarding the architectural features/requirements for mounting sensors etc.

• decide user needs for individual tailoring to reach a ‘person-fit’ technology

• User participation in a feasibility study is vital to learn about the end user’s needs and expectations regarding information, technical support, for support in daily use and follow-up.

• Transdisciplinary collaboration in the feasibility study is necessary to inform the main technology implementation project.

     

OLA - Optimizing quality of life of elderly people. Development of quality measurement tools for nursing homes and assisted living organizations

There are no systematically used quality measurement instruments for nursing homes in Switzerland. That is why a private organization developed its own quality measurement tools. This article describes the development of a questionnaire for satisfaction of family members of nursing home residents. The aim was to construct a valid and reliable instrument. Background for the construction of the items were problem-based interviews with relatives, knowledge from literature as well as know-how from management and a master's prepared nurse. Factor analyses of 145 questionnaires showed the following themes: "your relationship to the staff", "relationship of staff members to residents", "everyday life in the institution", "the institution as home for your family member" and "know-how of staff". These themes are consistent with the literature. Cronbach's alpha of these factors was between 0.78 and 0.91. The instrument meets the requirements of both science and practice.     

Validation of the quality of life scale: living with HIV

A grounded theory of Salvaging Quality of Life provided the conceptual framework for the development of the Living with HIV scale which was validated in this study. The HIV+ convenience sample ( n =187) was 66% male, with a mean age of 40·6 years, 69% African-American, and with an average CD4 count of 229  mm³. A principal components factor analysis with varimax rotation was conducted on the final 32-item scale and nine factors with Eigenvalues >1 explained 60% of the variance. A second order factor analysis of these nine factors resulted in a two factor solution (HIV Struggles and HIV Reverence) which explained 49·4% of the variance. Cronbach alpha reliability coefficient for the total scale was 0·84. Differences between gender, ethnicity, education and presence of an AIDS diagnosis, and quality of life, were explored. Females had higher total scores which suggested they had a more positive quality of life than males. The Living with HIV scale can be used as a method of obtaining input from patients for care planning and for evaluating the effectiveness of nursing care intervention using quality of life as an outcome of care.     

亲属活体肾移植供体术后生活质量及心理状况随访研究

目的探讨亲属活体肾移植供肾切取术对供体生活质量的影响。方法随访调查我科2013年1月-2015年6月行亲属活体肾移植供肾切取术74例供者,随访时间为6~36个月。使用SF-36健康调查简表调查供体术后生活质量;同时使用焦虑、抑郁自评量表(SAS、SDS)调查供体术后心理状况。结果亲属活体肾移植供体术后6个月比术后3个月生活质量得分高,各维度比较P0.05;部分供体术后3个月存在焦虑心理状态,供体术后3个月SAS、SDS评分比术后6个月评分高(P0.05),术后3个月SF-36各维度与焦虑、抑郁得分呈负相关(P0.05),术后6个月焦虑得分与生理机能、情感职能、精神健康维度呈负相关(P0.05),抑郁得分与生理机能、情感职能呈负相关(P0.05)。结论亲属活体肾移植供体术后生活质量与其焦虑抑郁心理状况呈负相关,促进供体术后快速康复,给予有效的心理支持和人文关怀,是提高其生活质量的关键。     

Assessing the effectiveness of a walking program on physical function of residents living in an assisted living facility

The purpose of this study was to assess the effectiveness of a resident-led walking program at an assisted living facility (ALF). Seventeen women (mean age 80, range 62-99) agreed to participate in a "walking club." Pre and post measurements included the Tinetti Performance-Oriented Assessment of Mobility Problems in Elderly Patients, the Functional Reach Test, and the Barthel Index to measure independence in activities of daily living (ADLs). Participants set their own goals for walking distance and frequency, with the assistance of the lead researcher if requested. Distances ranged from 75 ft to over 1 mile. At the end of the 9-week intervention, there was a significant increase in all of the pre-test measurements. In addition, post-test assessment included individual interviews with participants about their experiences with the physical activity program. Four positive themes about the walking program emerged: (a) as a pleasurable activity, (b) as a way to manage current health problems, (c) as a way to continue life-long activity, and (d) because of perceived physical and psychological benefits from the activity. The participants planned to continue the walking program. The results of this pilot study suggest that a walking program can be instituted in an assisted living facility with minimal staff effort and significant benefit to residents.     

Fire safety knowledge and practices among residents of an assisted living facility

INTRODUCTION: Assisted living facilities (ALFs) pose unique fire risks to the elderly that may be linked to specific fire safety (FS) practices. OBJECTIVE: To evaluate self-reported FS practices among ALF residents. METHODS: All residents of a small ALF were surveyed regarding actual and hypothetical FS behaviors, self-perceived fire risk, and FS preparedness. RESULTS: Fifty-eight ALF residents completed the survey. Thirty-three (58%) individuals reported one or more disabilities. Seven (12%) residents ignored the fire alarm and 21 (35%) could not hear it clearly. Sixteen (28%) residents would attempt to locate the source of a fire rather than escape from the building. Only 24 (42%) residents were familiar with the building fire plan. Twenty-three (40%) people surveyed believed that they were not at risk of fire in the study facility. CONCLUSION: Residents of an ALF may be at increased fire injury risk due to their FS practices and disabilities.     

Exploring the meaning of critical incident stress experienced by undergraduate nursing students: A hermeneutic study

AimTo better understand the meaning of clinical related critical incident stress experienced by undergraduate nursing students.BackgroundUndergraduate nursing students who engage in learning in the clinical practice setting may experience critical incidents.DesignGadamer’s philosophical hermeneutics (1960/2013) was used to explore the meaning of clinical related critical incident stress experienced by undergraduate nursing students.MethodsA purposive sample was used to recruit 11 students who were enrolled in a Canadian university baccalaureate nursing program. Data collection involved conducting semi-structured interviews over 10 months in 2020–2021. The interviews were recorded and transcribed verbatim and the data were analyzed using the interpretive method of hermeneutics.ResultsFindings from this research revealed that the student-teacher relationship was influenced by students’ experiences of critical incident stress. Students’ navigating uncertainty and the need to maintain the optic of perfection had a potential impact on the response to critical incidents.ConclusionThis study highlighted that critical incident stress may lead to distress associated with students’ altered perception of nursing as a discipline and profession as well as created opportunity for new insights and possibilities.