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 1 or more falls in 6 months (n = 597). MEASUREMENTS:Fall-prevention process measures in 4 categories derived from Assessing Care of Vulnerable Elders quality indicators were measured in 2 ways: (1) chart abstraction; and (2) staff responses to clinical vignettes of hypothetical residents at risk for falls. Recurrent fall rates (falls/resident/year) were measured. The proportion of the total variation in falls rates explained by the scores for each method (chart abstraction or vignette) was calculated using multilevel adjusted models. RESULTS:Chart and vignette measures of comorbidity management were moderately correlated (Pearson correlation coefficient 0.43), whereas other process measure categories had low or negative correlation between the 2 methods (psychoactive medication reduction 0.13, environmental modification -0.42, and exercise/rehabilitation -0.08). Measures of environmental modification and comorbidity management explained a moderate amount of the total variation in recurrent fall fates, vignettes (7%-10% variation explained) were superior to chart abstraction (2%-6% variation explained). Vignette responses from unlicensed staff (nurse aides and rehabilitation aides) explained more variance than registered nurses, licensed practical nurses, or other licensed staff in these categories. Process measures for psychoactive medication reduction and exercise/rehabilitation did not explain any of the variation in fall outcomes. Overall, vignette process measures explained 3.9% and chart abstraction measures explained 0% of the variation in fall outcomes. CONCLUSIONS:Clinical vignettes completed by nursing home staff had greater association with resident recurrent fall rates than traditional chart abstraction process measures.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Colón-Emeric CS,Corazzini KN,McConnell ES,Pan W,Toles MP,Hall R,Batchelor-Murphy M,Yap TL,Anderson AL,Burd A,Amarasekara S,Anderson RAdoi
10.1016/j.jamda.2017.10.018subject
Has Abstractpub_date
2018-05-01 00:00:00pages
405-410issue
5eissn
1525-8610issn
1538-9375pii
S1525-8610(17)30600-Xjournal_volume
19pub_type
杂志文章abstract:OBJECTIVE:To cross-culturally adapt and test the FRAIL scale in Chinese community-dwelling older adults. DESIGN:Cross-sectional study. METHODS:The Chinese FRAIL scale was generated by translation and back-translation. An urban sample of 1235 Chinese community-dwelling older adults was enrolled to test its psychometri...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.011
更新日期:2018-01-01 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:BACKGROUND:Unexplained absence of nursing home (NH) residents is one of the most challenging issues related to the care of older people. The aim of this review was to examine the death and injury outcomes of unexplained absence of NH residents. METHOD:We searched MEDLINE, CINAHL, EMBASE, PsycINFO, AgeLine, and Cochran...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2017.01.007
更新日期:2017-04-01 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: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: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:The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory trai...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamda.2014.10.021
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Protein supplementation has been proposed as an effective dietary strategy to increase skeletal muscle mass and improve physical performance in frail elderly people. Our objective was to assess the impact of 24 weeks of dietary protein supplementation on muscle mass, strength, and physical performance in fra...
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.2012.07.005
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Cognitive impairment is common in people living with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); however, accurate estimates of prevalence are lacking. To date, there are no meta-analyses that have specifically investigated prevalence of mild cognitive impairment (MCI) in th...
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.2017.01.014
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:Long-term care facilities have lagged heavily behind other health providers in adopting health information technology (IT). This article examines the facility characteristics that are associated with health IT adoption. DESIGN AND METHODS:This study is a secondary data analysis of information gathered between ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.028
更新日期:2016-05-01 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:To explore determinants of behavior change maintenance of a physically active lifestyle in patients with chronic obstructive pulmonary disease (COPD) 8-11 months after completion of a 4-month outpatient pulmonary rehabilitation program. DESIGN:A qualitative descriptive study of semistructured interviews. S...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.003
更新日期:2014-09-01 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: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::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:BACKGROUND:Exercise tolerance is an important clinical aspect of chronic obstructive pulmonary disease that can be easily and reliably measured with the 6-minute walking test (6MWT). To improve the utility of the 6MWT for patient and health care system management, the interpretation of the functional status measure in ...
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.2011.06.009
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:The Geriatric Level of Dysfunction Scale (GLDS) was developed to assess the intensity, frequency, and duration of 19 behavioral disturbance categories that can potentially interfere with long-term care. DESIGN:Secondary analysis of data collected from residents in long-term care facilities. PARTICIPANTS:Par...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.04.006
更新日期:2005-09-01 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: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: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::Throughout the millennia, the cannabis plant has been utilized as a recognized therapy for pain relief and symptom management. Following the Prohibition-era stigmatization and criminalization of all forms of cannabis of the early 20th century, there has been a recent nationwide and worldwide resurgence in interest and...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.013
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:New guidelines recommend a target glycated hemoglobin (HbA1c) of 7.5% to 8.0% in elderly persons with type 2 diabetes mellitus (T2DM), but real-world data regarding outcomes associated with different HbA1c levels in the elderly are limited. This study assessed outcomes and their association with defined HbA1c...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.06.007
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To determine if a facility-wide oral care educational program will improve the quality of routine oral care provided to nursing home residents. DESIGN:Single-blind, pre-post observational study of direct caregivers providing routine oral care to residents in 2 nursing homes. INTERVENTION:A 30-minute oral ca...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.09.001
更新日期:2009-11-01 00:00:00
abstract::Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's indivi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2017.08.001
更新日期:2017-11-01 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:OBJECTIVE:Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and i...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.04.021
更新日期:2019-10-01 00:00:00
abstract::More than 6 million adults in the United States are homebound or semi-homebound and would benefit from home-based medical care (HBMC). There is currently no nationally recognized quality of care framework for home-based medical care. We sought to capture diverse stakeholder perspectives on the essential aspects of qua...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.020
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:Psychotropic drugs are usually prescribed to deal with behavioral and psychological symptoms of dementia, especially when nonpharmacologic approaches are not available or have limited efficacy. Poor outcomes and serious adverse events of the drugs used must be addressed, and risk-benefit ratios need to be co...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.02.003
更新日期:2014-07-01 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:PURPOSE:Urinary incontinence (UI) is common but inadequately assessed and treated in nursing facility (NF) residents. The purpose of this study is two-fold: (1) to determine perceptions about the importance of UI and its management in the NF setting compared with other geriatric syndromes and (2) to compare barriers to...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.08.003
更新日期:2008-01-01 00:00:00