Abstract:
OBJECTIVE:The objective of this study was to examine the association between psychoactive medications and sleep quality in a sample of nursing home patients. DESIGN:We studied a baseline data collection for a clinical trial of a nonpharmacologic sleep intervention program. SETTING:This study was conducted at six community nursing homes. PARTICIPANTS:We studied 168 nursing home patients. METHODS:Sleep was recorded by wrist actigraphy for three to five nights under usual care conditions. Demographic and clinical data were collected by medical record reviews and patient assessments. RESULT:One or more routine psychoactive medications were being taken by 109 (65%) of the patients. Number of minutes of sleep, percent of time in bed asleep, and number of awakenings did not differ between those receiving and not receiving a psychoactive medication. Neither the use of antidepressants nor the use of only psychoactive medications reported to cause sedation was associated with significantly better sleep quality. CONCLUSION:Psychoactive medications as a general class of drugs were not associated with better or worse sleep quality in this very frail nursing home population. The effect of individual classes of psychoactive drugs on sleep quality in this patient population requires further study.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Greco KE,Deaton C,Kutner M,Schnelle JF,Ouslander JGdoi
10.1097/01.JAM.0000131499.71697.9Ekeywords:
subject
Has Abstractpub_date
2004-07-01 00:00:00pages
223-7issue
4eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70126-7journal_volume
5pub_type
临床试验,杂志文章,多中心研究abstract:OBJECTIVE:To compare the effects of care based on comprehensive geriatric assessment (CGA) as a complement to usual care in an outpatient setting with those of usual care alone. The assessment was performed 36 months after study inclusion. DESIGN:Randomized, controlled, assessor-blinded, single-center trial. SETTING:...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2015.12.008
更新日期:2016-03-01 00:00:00
abstract:CONTEXT:Home Hospital is a worldwide phenomenon that provides acute and subacute medical care in the home in an attempt to reduce the need for hospitalization. OBJECTIVE:To evaluate the clinical parameters of a home hospitalization program operating in Jerusalem for 8 years. DESIGN:The Jerusalem Home Hospitalization ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVES:The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents. DESIGN:Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrosp...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.007
更新日期:2011-11-01 00:00:00
abstract::Because long-term care residents often have chronic illnesses and complex care regimens, nutritional issues are common in these populations. Furthermore, management is complicated because some residents are terminally ill and under palliative care treatment plans that allow for dehydration and low oral intake. As a re...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2008.03.005
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.008
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:Long-term care (LTC) is an important setting for goals of care (GoC) discussions. Understanding clinician barriers to GoC discussions could identify opportunities for LTC-specific interventions to improve quantity and quality of GoC discussions in the context of serious illness. DESIGN:A multicenter, cross-...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.08.022
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:The issue of subjects with mild cognitive impairment (MCI) reverting to normal cognition (NC) has to date been taken in limited consideration, and no conclusive data are available on the rate of reversion. We aimed at systematically reviewing available longitudinal studies on MCI and meta-analyzing data with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2016.06.020
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:The Electronic Health Record (EHR) is being advocated as a tool to improve patient care. Nationwide initiatives are under way to determine how to implement EHR. To date, community nursing homes have not been involved in that effort. Many reasons, including multiple providers in a home, physical structure o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2006.09.013
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. DESIGN:Observational study of nurse hand hygiene practices. SETTING:and Participants: Licensed practical...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.031
更新日期:2020-09-15 00:00:00
abstract:BACKGROUND:Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptom...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2015.11.015
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Long-term care (LTC) homes expressed concern that patients had experienced medication incidents after hospital discharge as a result of poor coordination of care. OBJECTIVE:The London Transfer Project aimed to reduce LTC medication incidents by 50% within 48 hours of discharge from general medicine units at...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.09.037
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:Approximately 14% of Medicare beneficiaries are readmitted to a hospital within 30 days of home health care admission. Individuals with dementia account for 30% of all home health care admissions and are at high risk for readmission. Our primary objective was to determine the association between dementia sev...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.09.012
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To identify patient characteristics associated with higher numbers of prescribed drugs or risk of receiving one or more inappropriate medications. DESIGN:A cross-sectional survey using chart reviews. PARTICIPANTS:A total of 414 long-stay residents of 20 nursing homes in three states MEASUREMENTS:Current m...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVES:Nursing home (NH) residents receiving texture-modified diet (TMD) are at risk of inadequate nutritional intake and subsequent malnutrition. It is essential to monitor dietary intake to take corrective actions, if necessary. Plate diagrams (PDs) are widely used to assess dietary intake in institutions but lit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.12.014
更新日期:2020-01-27 00:00:00
abstract:OBJECTIVE:To investigate the efficacy and cost effectiveness of an herbal tea, Smooth Move, in nursing home residents with chronic constipation. DESIGN:Double-blind, placebo-controlled, 2-armed, parallel-group clinical trial. SETTING:A 483-bed nursing home in Allentown, Pennsylvania, operated by Lehigh County Governm...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2006.06.001
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:There is a paucity of data for the assessment of frailty in acutely ill hospitalized older adults. We aim to (1) compare the performance of frailty measures [5-item scale of fatigue, resistance, ambulation, illnesses, and loss of weight) (FRAIL), Tilburg Frailty Indicator (TFI), and Clinical Frailty Scale (C...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.04.011
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:Advance care planning in young-onset dementia largely remains a blind spot within current literature. This study aimed to explore the engagement in and the conceptualization of advance care planning from the perspective of family caregivers of persons with young-onset dementia and to identify potential simil...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.007
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:This study presents the design of an integrated, proactive palliative care pathway covering the full care cycle and evaluates its effects using 3 types of outcomes: (1) physician-reported outcomes, (2) outcomes reported by family, and (3) (utilization of) health care outcomes. DESIGN:A clustered, partially ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.025
更新日期:2020-11-19 00:00:00
abstract:OBJECTIVES:Telomere length is associated with aging-related pathologies. Although the association between telomere length and frailty has been studied previously, only a few studies assessing longitudinal changes in telomere length and frailty exist. DESIGN:Longitudinal cohort study. SETTING AND PARTICIPANTS:A subpop...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.011
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:There is an increased demand for nursing homes (NHs) in middle-income countries such as Brazil. To monitor the quality of NHs, there is a need for reliable instruments to assess the extent to which the care provided meets the expectations and rights of residents and their families. PURPOSE:To evaluate the r...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.04.007
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:Validated process measures that correlate with patient outcomes are needed for research and quality improvement. DESIGN:Cross-sectional analysis within a cluster-randomized fall prevention study. SETTING:Nursing homes in North Carolina (n = 16). PARTICIPANTS:Nursing home staff (n = 541) and residents with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.10.018
更新日期:2018-05-01 00:00:00
abstract::The purpose of this literature review was to assess the current state of affairs in end-of-life care for persons with dementia, to identify barriers to the provision of high-quality care, and to describe exemplary programs that have discovered ways to overcome these barriers. The literature reviewed included English-l...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVES:Although the biological rationale for the association between folate, vitamin B12, and homocysteine with cognitive function seems plausible, conflicting results have been reported. This study aimed to determine the associations between 1-carbon (1-C) metabolism biomarkers (folate, vitamin B12, and homocystei...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.05.008
更新日期:2017-09-01 00:00:00
abstract::Chronic indwelling catheters are used to manage urinary retention, especially in the presence of urethral obstruction, and to facilitate healing of incontinence-related skin breakdown. These indwelling foreign bodies become coated and sometimes obstructed by biofilm laden with bacteria and struvite crystals. Bacteria ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2006.01.020
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:Age-related changes mean that the older population can encounter barriers toward taking medication orally. Further work is needed to identify the characteristics of oral solid dosage forms that will improve patient acceptance and adherence. The aim of this systematic review was to identify if and how formula...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.01.108
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to evaluate the impact of a well-developed theory-based function-focused care for cognitively impaired (FFC-CI) intervention on eating performance among long-term care (LTC) residents with moderate-to-severe cognitive impairment. DESIGN:A secondary analysis of longitudinal da...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.06.023
更新日期:2015-12-01 00:00:00
abstract:RATIONALE:Malnutrition screening among nursing home residents is often performed with tools developed for use among older subjects, and sometimes with tools designed for an adult population. Only a few tools have been designed specifically for the nursing home setting. This systematic review assesses the criterion and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.10.006
更新日期:2014-03-01 00:00:00
abstract::New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ing...
journal_title:Journal of the American Medical Directors Association
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/j.jamda.2013.05.021
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:Pulmonary infections are common in children with quadriplegic cerebral palsy. High frequency chest wall oscillation with the vest therapy (VT) is used to promote pulmonary clearance and to prevent pneumonias in cystic fibrosis patients. The purpose of this study was to ascertain the effectiveness of VT in pa...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000028225.84012.3B
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:Many older adults in long-term care (LTC) experience acute health crises but are at high risk of transfer distress and in-hospital morbidity and mortality. Residents often complete advance directives (ADs) regarding future care wishes, including directives for hospital transfers. This study aims to estimate ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.03.034
更新日期:2019-11-01 00:00:00