Abstract：
OBJECTIVES:To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. DESIGN:Single-blind cluster randomized controlled trial. SETTING:A total of 35 Sydney nursing homes. PARTICIPANTS:All eligible residents within geographically defined areas within each nursing home were invited to participate. INTERVENTION:Professional "ElderClowns" provided 9 to 12 weekly humor therapy sessions, augmented by resident engagement by trained staff "LaughterBosses." Controls received usual care. MEASUREMENTS:The Behavior Engagement Affect Measure (BEAM) touchpad observational tool was used to capture real-time behavioral data. The tool assesses the duration in seconds of agitation, positive behavior toward others, engagement, and affect (angry, anxious, happy, neutral, sad). RESULTS:Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Over 26 weeks, in comparison with controls, the humor therapy group decreased in duration of high agitation (effect size = 0.168 and 0.129 at 13 and 26 weeks, respectively) and increased in duration of happiness (effect size = 0.4 and 0.236 at 13 and 26 weeks, respectively). CONCLUSION:We confirmed that humor therapy decreases agitation and also showed that it increases happiness. Researchers may consider evaluating impacts of nonpharmaceutical interventions on positive outcomes. Computer-assisted observational measures should be considered, particularly for residents with dementia and when the reliability of staff is uncertain.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Low LF,Goodenough B,Fletcher J,Xu K,Casey AN,Chenoweth L,Fleming R,Spitzer P,Bell JP,Brodaty Hdoi
10.1016/j.jamda.2014.03.017subject
Has Abstractpub_date
2014-08-01 00:00:00pages
564-9issue
8eissn
1525-8610issn
1538-9375pii
S1525-8610(14)00190-Xjournal_volume
15pub_type
杂志文章,随机对照试验abstract：OBJECTIVE:To analyze the burden of institutionalizations after femoral fracture and compare it with other "catastrophic" disease entities like stroke, myocardial infarction, or pneumonia. DESIGN/SETTING/PARTICIPANTS:Routine data of 414,000 hospitalized German patients aged 66 years and older were used to calculate ins...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.05.013
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVES:To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI). DESIGN:Medicaid cost savings are estimated using a semi-Markov model and simulation approach. SETTING AND PARTICIPANTS:RTCI is a statewide program that assists private paying ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.07.016
更新日期：2020-08-28 00:00:00
abstract：OBJECTIVES:The objectives of this study were to identify the barriers to osteoporosis clinical practice guideline use perceived by Medical Directors (MED DIR) and Directors of Nursing (DON) in skilled nursing facilities; and to describe differences in the perceptions of MED DIRs and DONs. DESIGN:The authors conducted ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.03.024
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people. DESIGN:The design was a population-based retrospective cohort study. SETTING:Taiwan's National Health Insurance claims data. PARTICIPANTS:Participants were 5063 ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.12.003
更新日期：2014-04-01 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:To quantify and characterize the chronic conditions of older Americans who live in nursing homes (NHs) but have minimal disability and might be able to live in less restrictive and less expensive settings. DESIGN:Secondary analysis of the 1999 National Nursing Home Survey. PARTICIPANTS:NH staff members fam...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2007.03.001
更新日期：2007-07-01 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：PURPOSE:To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss. DESIGN AND METHODS:Supervisory ALF staf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.12.012
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:Incident reports guide fall prevention efforts in long-term care (LTC) facilities, often based on descriptions of how falls occurred. The validity of these reports is poorly understood. We examined agreement on fall characteristics between fall incident reports and analysis of video footage of real-life falls...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.12.003
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:To investigate whether polypharmacy is associated with a higher incidence of frailty in a large cohort of North Americans during 8 years of follow-up. DESIGN:Longitudinal study, follow-up of 8 years. PARTICIPANTS:A total of 4402 individuals at high risk or having knee osteoarthritis free from frailty at bas...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.02.009
更新日期：2017-07-01 00:00:00
abstract：:In long-term care facilities, 5 to 15% of residents have chronic urinary catheters in place. Catheters are commonly used for urinary retention, incontinence control, wound management, and patient comfort. The appropriate use and management of these devices continues to be studied and debated. Transurethral catheters a...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
abstract：OBJECTIVES:Assisted living (AL) is an expanding site of end-of-life (EOL) care in the United States. Understanding determinants of quality of life (QoL) for AL residents near EOL is vital to optimize care for this growing population, most of whom have some degree of cognitive impairment (CI). This analysis aimed to ide...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.10.012
更新日期：2020-05-01 00:00:00
abstract：:Urinary tract infection (UTI) is arguably the most common infection in the long term care (LTC) setting. Making the diagnosis of UTI and deciding when to initiate treatment with antimicrobial therapy is a challenge to all LTC providers. Widespread prevalence of asymptomatic bacteriuria, lack of an accepted clinical or...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.11.009
更新日期：2014-02-01 00:00:00
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 be...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.02.006
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVE:Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. DESIGN:Meta-analysis. SETTING AND PARTICIPANTS:PubMed and E...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.05.059
更新日期：2020-07-15 00:00:00
abstract：:Long term care facilities are important sites of care for elderly adults. Despite a growing need and interest in medical direction in nursing homes, there have been limited educational opportunities in this area for geriatric medicine fellows. This article describes a novel medical director's curriculum for first-year...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.10.008
更新日期：2013-03-01 00:00:00
abstract：:Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting,...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.08.002
更新日期：2020-02-01 00:00:00
abstract：OBJECTIVES:This study aimed to examine the incidence of, and factors associated with, hospital presentation for self-harm among older Canadians in long-term care (LTC). DESIGN:Retrospective cohort study. SETTING AND PARTICIPANTS:The LTC data were collected using Resident Assessment Instrument-Minimum Data Set (RAI-MD...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.12.022
更新日期：2021-01-15 00:00:00
abstract：BACKGROUND:Both anemia and blood transfusion could be precipitating factors for delirium; hence in postoperative patients with anemia at high risk for delirium, it is controversial whether transfusion is the best option. The aim of this study is to investigate the association of anemia and delirium and the role of bloo...
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.2016.04.008
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:Older people who are admitted to inpatient rehabilitation settings often experience sleep disturbance or disorders. Both intrinsic and environmental factors may contribute to reduced sleep quality. Poor sleep quality has been reported to be associated with poorer rehabilitation outcomes. The aim of this revi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2020.03.002
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVES:To examine costs and effects of care based on comprehensive geriatric assessment (CGA) provided by an ambulatory geriatric care unit (AGU) in addition to usual care. DESIGN:Assessor-blinded, single-center randomized controlled trial. SETTING:AGU in an acute hospital in southeastern Sweden. PARTICIPANTS:Co...
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.2015.01.074
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:More than one-half of nursing home residents experience a complex mix of pain. Despite this, assessment and treatment of pain remain inadequate. METHODS:Using techniques of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we assessed effi...
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.2016.09.016
更新日期：2016-12-01 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：OBJECTIVE:Delirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/PARTICIPANTS:Older hospitalized adults with dementia were prospectively enrolled from medical a...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.05.011
更新日期：2019-11-01 00:00:00
abstract：:Medication errors remain an important cause of patient morbidity and mortality. Although all medications have the potential to induce unwanted adverse effects, data on the actual incidence and overall severity of preventable adverse drug reactions remains unknown. An Institute of Medicine report (Institute of Medicine...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2007.07.004
更新日期：2007-10-01 00:00:00
abstract：OBJECTIVE:To characterize Medicare skilled nursing facility (SNF) residents who become acutely ill with heart failure (HF) and assess the association between the outcomes of rehospitalization and mortality, and severity of the acute exacerbation, comorbidity, and processes of care. DESIGN:SNF medical record review of ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000073964.19754.C0
更新日期：2003-07-01 00:00:00
abstract：INTRODUCTION:According to the World Health Organization (WHO) and FDI World Dental Federation (FDI), malnutrition and bad oral health are of great concern to global health, especially among the older population. This study aimed to assess the associations between oral health problems ([artificial] teeth problems, chewi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.05.022
更新日期：2017-11-01 00:00:00
abstract：OBJECTIVES:To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN:Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after b...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.10.009
更新日期：2010-06-01 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
abstract：OBJECTIVES:Little is known about the relationship between how medical care is organized and delivered in nursing homes. Taking a lead from the acute care arena, we hypothesize that nursing home medical staff organization (NHMSO) is an important predictor of clinical outcomes in the nursing home. METHODS:A total of 202...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.06.004
更新日期：2011-11-01 00:00:00
