Abstract：
OBJECTIVES:Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship between a culture change initiative and nursing home elders' behavioral symptoms. DESIGN:Seven long term care communities (nursing units in 3 skilled nursing facilities) participated in a culture change intervention designed to transform the nursing home experience from a traditional hospital-model of care to one that is person-centered. Six comparison communities were matched to the intervention communities and continued to function along the typical nursing home organizational structure. Data were collected at baseline and 2 years later. METHODS:Subjects were 101 elders (intervention group n = 50, comparison group n = 51). Each elder's primary day certified nursing assistant completed the Cohen-Mansfield Agitation Inventory, examining frequency of behavioral symptoms, including verbal and physical agitation as well as more forceful behaviors (eg, hitting, kicking) at both data collection periods. RESULTS:After controlling for functional status and race, a significant condition by time interaction was found for physical agitation and forceful behaviors with the person-centered group maintaining levels of behavioral symptoms as compared with a significant increase over time among the comparison group. A trend with the same pattern was found for verbal agitation. CONCLUSIONS:Person-centered care demonstrated potential as a nonpharmacological intervention for distressing behavioral symptoms. The positive impact of culture change appears to extend to elders with cognitive impairment who are less obvious beneficiaries of this model, featuring the central principals of autonomy and person-centered care.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Burack OR,Weiner AS,Reinhardt JPdoi
10.1016/j.jamda.2012.02.006subject
Has Abstractpub_date
2012-07-01 00:00:00pages
522-8issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(12)00081-3journal_volume
13pub_type
杂志文章abstract：OBJECTIVE:The aim of this study was to identify the clinical efficacy of acupuncture in combination with RehaCom cognitive training in poststroke patients with cognitive dysfunction. METHODS/DESIGN:This study was a 2 × 2 factorial design randomized controlled trial comparing acupuncture, computer-assisted cognitive re...
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.2016.07.021
更新日期：2016-12-01 00:00:00
abstract：OBJECTIVES:Our study examined the proportion of skilled nursing facility (SNF) post-acute care residents who did not receive timely primary care provider (PCP) services following discharge, factors associated with lack of timely PCP services, and factors associated with perfect 30-day home time among those who did not ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.09.016
更新日期：2020-10-26 00:00:00
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 comm...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1097/01.JAM.0000131499.71697.9E
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVES:The primary objective of this study was to identify proton pump inhibitor (PPI) prescribing patterns in a population of older adults admitted to 22 Midwestern skilled long term care facilities (LTCF) with medical coverage provided by the US Medicare Part A program. The relationship between PPI prescribing pa...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.01.021
更新日期：2013-06-01 00:00:00
abstract：:Unintentional weight loss is a common problem among nursing home residents and one that can lead to adverse and costly clinical outcomes. Observational studies have shown that residents often receive inadequate and poor-quality feeding assistance during meals, and residents consume few calories between meals from oral...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2006.12.003
更新日期：2007-03-01 00:00:00
abstract：OBJECTIVES:Examine the association between completion of an outpatient visit with a physician or advanced practice provider (PCP) within 7 days of discharge from a short skilled nursing facility (SNF) stay and 30-day readmission and determine if functional status at discharge moderates visit effectiveness. DESIGN:Retr...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.05.023
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVES:In the United States, home health agencies (HHAs) provide essential services for patients recovering from post-acute care and older adults who are aging in place. During the COVID-19 pandemic, HHAs may face additional challenges caring for these vulnerable patients. Our objective was to explore COVID-19 prep...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2020.06.002
更新日期：2020-07-01 00:00:00
abstract：:Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2013.01.022
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:To describe current practices of incontinence care in nursing homes (NHs) provided by certified nurse assistants (CNAs), and to evaluate the feasibility and acceptability of an integrated incontinence care product, the One Step Incontinence System (OSIS) in the NH setting. While the ultimate purpose of OSIS ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jamda.2006.10.001
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVES:The purpose of this review was to describe the characteristics of late-life obesity, including prevalence, pathophysiology, and influences on morbidity and mortality. A second objective was to systematically review the empiric evidence on the effects of intentional weight loss interventions in older individu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2008.01.006
更新日期：2008-06-01 00:00:00
abstract：OBJECTIVE:To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. DESIGN:Systematic literature review. SETTING:PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.12.099
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVES:This study investigates the transitions of community-dwelling patients with a proximal femoral fracture towards recovery of independence using multistate modeling. The prognostic value of factors affecting the short-term rate of recovery of independence in activities of daily living was assessed for the resi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.08.006
更新日期：2020-09-19 00:00:00
abstract：OBJECTIVE:To describe changes in aged care residents' dependency over a 20-year period. DESIGN:All residents in 1988, 1993, 1998, and 2008 were assessed using the same 23-item functional ability survey. SETTING:Residential aged care facilities in Auckland, New Zealand. PARTICIPANTS:In 1988 there were 7516 participan...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2011.01.014
更新日期：2011-09-01 00:00:00
abstract：OBJECTIVE:To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty. DESIGN:Prospective cohort study. Risk algorithms at baseline (1997-1999) were the Framingham Offspring, Cambridge, and Finnish diabetes risk scores. SETTING:Civil service departments in Lond...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.08.016
更新日期：2013-11-01 00:00:00
abstract：:Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2016.03.005
更新日期：2016-06-01 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:Pressure ulcers, like other chronic wounds, fail to proceed through an orderly and timely process to produce anatomical or functional integrity. Treatment of pressure ulcers is directed to improving host factors and providing an optimum wound environment. In addition to providing a moist wound environment, i...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jamda.2004.12.007
更新日期：2005-01-01 00:00:00
abstract：PURPOSE:The culture change (CC) movement aims to transform the traditional nursing home (NH) that is institutional in design with hierarchical management structure into a homelike environment that empowers residents and frontline staff. This study examines differences in adoption of CC practices according to a NH's sel...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.11.002
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVES:Nonagenarian patients are underrepresented in clinical trials that have evaluated oral anticoagulation in patients with atrial fibrillation (AF). The aim of this study was to assess the pronostic impact of oral anticoagulation in patients with AF age ≥90 years. DESIGN:Retrospective multicenter study of nona...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.08.033
更新日期：2020-03-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000066022.74526.CF
更新日期：2003-05-01 00:00:00
abstract：:While federal law establishes guidelines that designated facilities must follow in providing information about a patient's rights regarding self-determination in the health care decision-making process, state law determines the decision-making process and the legal requirements pertaining thereto. A person's capacity ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2006.01.001
更新日期：2006-06-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.06.019
更新日期：2016-11-01 00:00:00
abstract：OBJECTIVES:Elderly persons with low muscle mass (LMM) or sarcopenia are prone to frailty and functional decline. This study aimed to investigate the relationship between serum selenium level and skeletal muscle mass in community-dwelling elderly. DESIGN:Cross-sectional observational study. SETTING AND PARTICIPANTS:A ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.06.014
更新日期：2014-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.01.010
更新日期：2013-05-01 00:00:00
abstract：OBJECTIVE:To identify predictors of adverse outcomes (nursing home placement and hospital length of stay) in a cohort of older hospitalized patients. DESIGN:Prospective cohort study. SETTING:A suburban medical center in the New York City metropolitan area. PARTICIPANTS:Patients aged 65 years and older admitted from ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVES:Older age is associated with higher risk of death during acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Older patients hospitalized for AE-COPD often require post-acute care after acute phase. The aim of this study was to evaluate components of a comprehensive geriatric assessment an...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.01.125
更新日期：2019-07-01 00:00:00
abstract：OBJECTIVES:To assess whether using coronavirus disease 2019 (COVID-19) community activity level can accurately inform strategies for routine testing of facility staff for active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:In total, 59,...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.10.038
更新日期：2021-01-01 00:00:00
abstract：INTRODUCTION:Hospital admissions due to traumatic brain injuries (TBIs) in older persons are increasing. Falls are the leading mechanism of injury in this age group. TBIs are associated with unfavorable outcomes such as mortality and institutionalization. OBJECTIVES:To estimate rates of TBIs in older persons with seve...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.02.032
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVES:To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. DESIGN:This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people livin...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.12.003
更新日期：2020-12-11 00:00:00
abstract：:Skin failure is an emerging concept that clarifies trends in clinical practice. Its recognition provides common nomenclature, opens research directions, and questions assumptions regarding pressure ulcers as a quality measure. Adoption of the term is a step toward uniform terminology in compliance with a value based p...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.03.014
更新日期：2016-07-01 00:00:00
