Abstract:
OBJECTIVE:This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides. SETTING AND PARTICIPANTS:A total of 1262 care aides in 25 nursing homes in the 3 Canadian prairie provinces. Care aides are unregulated workers who provide 80% of direct care to residents in Canadian nursing homes. METHOD:We used hierarchical linear modeling to (1) assess the amount of variance in use of best practices, as reported by care aides, that could be attributed to individual or organizational factors, and (2) identify predictors of best practices use by care aides. RESULTS:At the individual level, statistically significant predictors of instrumental use of best practices included sex, age, shift worked, job efficacy, and belief suspension. At the unit level, significant predictors were social capital, organizational slack (staffing and time), number of informal interactions, and unit type. At the facility level, ownership model and province were significant. Significant predictors of conceptual use of best practices at the individual level included English as a first language, job efficacy, belief suspension, intent to use research, adequate knowledge, and number of information sources used. At the unit level, significant predictors were evaluation (feedback mechanisms), structural resources, and organizational slack (time). At the facility level, province was significant. The R(2) was 18.3% for instrumental use of best practices and 43.4% for conceptual use. Unit level factors added a substantial amount of explained variance whereas facility level factors added relatively little explained variance. CONCLUSIONS:Our study suggests that context plays an important role in care aides' use of best practices in nursing homes. Individual characteristics played a more prominent role than contextual factors in predicting conceptual use of best practices.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Estabrooks CA,Squires JE,Hayduk L,Morgan D,Cummings GG,Ginsburg L,Stewart N,McGilton K,Kang SH,Norton PGdoi
10.1016/j.jamda.2015.03.009subject
Has Abstractpub_date
2015-06-01 00:00:00pages
537.e1-10issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(15)00223-6journal_volume
16pub_type
杂志文章abstract::Loneliness is a common problem in long-term care facilities (LTCF) and previous work has shown that animal-assisted therapy (AAT) can to some degree reverse loneliness. Here, we compared the ability of a living dog (Dog) and a robotic dog (AIBO) to treat loneliness in elderly patients living in LTCF. In comparison wit...
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.2007.11.007
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:Clinical implications of asymptomatic cases of the novel coronavirus disease 2019 (COVID-19) in nursing homes remain poorly understood. We assessed the association of symptom status and medical comorbidities on mortality and hospitalization risk associated with COVID-19 in residents across 15 nursing homes in...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.011
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD). METHODS:Queries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription cl...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.01.010
更新日期:2014-06-01 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:Dysphagia is a major healthcare problem as it increases the risk of malnutrition, dehydration, aspiration pneumonia, and death. The aims of this analysis of data from nursing homes (NHs) worldwide were to examine prevalence rates of dysphagia, to identify characteristics of residents with dysphagia, and to d...
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.2017.08.015
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents. SETTINGS AND PARTICIPANTS:Members of the telemedicine workgroup of AMDA-The Society for Post-Acute Long-Term Medic...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2018.11.022
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To report on the process and effect of a quality improvement project on end-of-life (EOL) care in a state veterans' home. DESIGN:The design uses survey data from representatives of the deceased, continuous quality improvement (QI) techniques, and interdisciplinary team activities. Representatives of the dece...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.12.020
更新日期:2006-03-01 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:OBJECTIVES:To assess the 30-day mortality predictive markers in the oldest patients with Clostridioides difficile infection (CDI) and to analyze the accuracy of the European severity risk markers in this population. DESIGN:Observational prospective multicenter cohort study conducted by the French Infectious Diseases S...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.002
更新日期:2020-01-01 00:00:00
abstract::The aging population in China is growing rapidly and by the middle of this century will peak. In addition, in 2000, elderly people aged 80 and older accounted for 18% of the world's population of oldest old. We identify here ways to begin addressing China's unique aging population needs. Through improving geriatric an...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.06.007
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:Current guidelines recommend antithrombotic prophylaxis for venous thromboembolism (VTE) using risk assessment, factoring contraindications. This report represents a summary of current practice patterns to prevent VTE in long term care as Phase 1 of a 3-phase educational intervention study. PHASE 1 PARTIC...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2011.04.016
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Studies show that in nursing homes (NHs), the prevalence of moderate-to-severe obesity has doubled in the last decade and continues to increase. Obese residents are often complex and costly, and this increase in prevalence has come at a time when NHs struggle to decrease hospitalizations, particul...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.03.009
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:Paratonia, a form of hypertonia typically seen in dementia, is often associated with difficulties in positioning and daily care. No evidence-based therapy or clinical guideline for management is available. In this study, the short-term effect of harmonic techniques (HT) and supporting cushions (SC) on parato...
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:10.1016/j.jamda.2019.04.031
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To determine the association between hypertension at age 90 years, treatment, and 5-year mortality. DESIGN:A prospective observational study of a representative community-dwelling birth cohort (born 1920-1921) by the Jerusalem Longitudinal Study (1990-2015). SETTING:Home-assessment. PARTICIPANTS:480 subjec...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.12.076
更新日期:2017-03-01 00:00:00
abstract::The role of nutrition in modulating Alzheimer disease (AD) remains uncertain. Persons ingesting a Mediterranean-type diet appear to be less likely to develop AD. Epidemiologically, food combinations rich in antioxidant vitamins reduced the risk of AD. Combination formulas (eg, Souvenaid) appear to have small effects o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.01.014
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Coronavirus disease 2019 (COVID-19) has caused many nursing homes to prohibit resident visits to prevent viral spread. Although visiting restrictions are instituted to prolong the life of nursing home residents, they may detrimentally affect their quality of life. The aim of this study was to capture perspec...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.09.031
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:With advancing age, the prevalence of vitamin D deficiency and musculoskeletal pain increases. However, published data on the effectiveness of vitamin D supplementation in reducing chronic pain are inconclusive. The purpose of this study was to test the effect of 3 different monthly doses of vitamin D on chro...
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.2018.09.004
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN:This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumo...
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.2017.01.021
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:In cognitively normal adults, nutritional parameters are related to cognitive decline and incidence of dementia. Studies on the role of nutrition in predementia stages subjective cognitive decline and mild cognitive impairment, and mild stages of Alzheimer's disease (AD) dementia in a clinical setting are lac...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.020
更新日期:2020-11-15 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:To establish the mortality risk and adverse events associated with the use of atypical antipsychotic medications in people with Parkinson disease psychosis (PDP) in a clinically defined trial cohort. DESIGN:Post hoc analysis of data from a multicenter, open-label extension study of pimavanserin comparing pe...
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.2015.06.021
更新日期:2015-10-01 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:OBJECTIVES:To define the prevalence of dysphagia and its associated factors and to investigate the influence of dysphagia and nutritional therapies performed in dysphagic subjects on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality. DESIGN:A prospective observational stu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.023
更新日期:2019-02-01 00:00:00
abstract::Sexuality is a basic human need that begins at birth and continues throughout life. The sexual needs of the elderly are similar to those of the young, but with variations in frequency, intensity, and mode of expression. Regardless of age, every individual has a need for love, intimacy, and companionship. Unfortunately...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1097/10.1097/01.JAM.0000061465.00838.57
更新日期:2004-03-01 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:The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of p...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.009
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:This study examined the extent to which program site-based and Veteran characteristics were associated with potentially avoidable hospitalizations or other hospitalization of Veterans enrolled in the Veterans Affairs (VA) Home Based Primary Care (HBPC). DESIGN:Retrospective claims-based study. SETTING AND ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.033
更新日期:2021-01-29 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::Singapore faces a rapidly aging population. By 2030, 19% of her population will be aged 65 years and above. Other Asian countries face similar problems, with South Korea having the fastest aging population worldwide, followed by China and Thailand. With Singapore possessing an advanced aging population, its policy pro...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.12.082
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2017.09.003
更新日期:2017-12-01 00:00:00