Biomedical subjects

Jay Magaziner

Publications and source records attributed to Jay Magaziner.

61 records · Page 4Linked to original sources

PubMedDate not supplied

Health-related quality of life: is it a good indicator of function post THR?

The purpose of this study was to explore the impact of health-related quality of life (HRQOL) measured with the Short Form Health Survey (SF-36) on Functional Recovery Status (physical and psychosocial recovery status) at base-line, 2 months, 6 months, and 12 months following total hip replacement (THR). A secondary analysis was performed using data gathered from a sample of 271 older adults post THR. Four empirically based hypothesized models were tested. None of the models fit the data, with each having significant chi2 values and chi2 /df ratios greater than 3. Different dimensions of HRQOL at baseline, 2, 6, and 12 months were related to physical recovery status, and none of the 8 dimensions of the SF-36 was significantly related to psychosocial recovery status. Overall, the results of this study do not support the hypothesis that HRQOL, as measured by the SF-36, comprehensively explains functional recovery status following THR. Clinically, these findings may be applicable to individuals at risk for poor recovery. They also may prompt practitioners to consider alternative factors that influence psychosocial recovery.

Age Distribution↗

PubMedDate not supplied

Making a difference: nursing assistants' perspectives of restorative care nursing.

This article explores the experiences of nursing assistants who participated in the Res-Care Pilot Intervention. A qualitative study used a focus group methodology. An interview guide was used and data from focus groups were audiotaped and transcribed verbatim. A purposive sample of 13 nursing assistants participated in the focus groups. A total of 35 different codes were identified, and these were reduced to the following four themes: resident barriers to restorative care, facility or system barriers to restorative care, nursing assistant strategies, and system facilitators of restorative care. The study supports and adds to previous work that suggests that in order to successfully implement changes in care in nursing home settings the following issues should be addressed: real or perceived workload issues, poor communication with nursing, insufficient knowledge or education, lack of appropriate supplies, and insufficient administrative support. The findings may be used to revise the Res-Care Pilot Intervention and direct future implementation of programs in nursing home settings.

Attitude of Health Personnel↗

PubMedDate not supplied

Testing of the Res-Care Pilot Intervention: Impact on nursing assistants.

The purpose of this study was to test the feasibility and effectiveness of a two-tiered motivational intervention--the Res-Care Pilot Intervention--on willingness of nursing assistants to participate in the Res-Care Intervention, the impact of the intervention on nursing assistants' self-efficacy, and outcome expectations related to restorative care, knowledge of restorative care, restorative care behaviors, and job satisfaction. A sample of 13 nursing assistants with an average age of 47.3 +/- 8.9 (range 29-56) years, the majority of whom were women (93%) and African American (77%), consented to participate in the study. There was a statistically significant increase in outcome expectations related to restorative care activities (F = 8.9, P <.05), a nonsignificant trend toward increased knowledge of restorative care (F = 1.4, P > .05) and documented time doing restorative care activities (F = -.56, P > .05), and no difference in self-efficacy expectations (F = .58, P > .05) or job satisfaction (F = .48, P > .05). The findings provide useful information for future research in restorative care.

Activities of Daily Living↗

PubMedDate not supplied

Measuring the frequency of contact between nursing home residents and their family and friends.

BACKGROUND: The involvement of family and friends in nursing home care represents an important resource for an overburdened long-term care system. However, little guidance exists for researchers interested in measuring family involvement. OBJECTIVES: This methodological report provides an overview of approaches to measuring family involvement in nursing home care and examines agreement between family and staff on the frequency of visits and telephone calls to a resident by family and friends. Agreement is also assessed for subgroups of the sample based on characteristics of the family, staff, facility, and resident. METHODS: From a large and representative sample of nursing home residents, 823 pairs of significant others and staff were interviewed. Primary variables were reports of visitation and telephone contact received by the resident in the preceding 2 weeks according to the significant other and staff person. RESULTS: Significant other reports of visitation and telephone contact were significantly higher than staff reports (p <.001 and p <.01). Agreement (via intraclass correlation) between significant others and staff was moderate for reports of visit and telephone call frequency. With one exception, no significant differences in agreement were found between subgroups defined by characteristics of the family, staff, facility, or resident. For visits, agreement between nurse's aides and significant others was lower than between other staff persons (e.g., LPNs and RNs) and significant others (p <.05). DISCUSSION: Due to the complexity of nursing home settings as well as of the social support system of residents, researchers need to carefully consider their approach to the measurement of the involvement of family and friends in the nursing home.

Adult↗

PubMedDate not supplied

Recruitment of older women: lessons learned from the Baltimore Hip Studies.

OBJECTIVES: This study used a qualitative approach in which participants were asked to write about their experiences in recruiting older women into either one of two exercise intervention studies that are part of the Baltimore Hip Studies. The sample included 8 researcher nurses all women, White, and 42-53 years of age. BACKGROUND: Older adults, particularly older women, are less likely to participate in research studies when compared to their younger counterparts. The purpose of this study was to explore the techniques successfully used by research nurses in the Baltimore Hip Studies to recruit older women after hip fracture into exercise intervention studies. METHOD: Data analysis was performed using basic content analysis (Crabtree & Miller, 1992; Miles & Huberman, 1984) "in vivo" coding (Dowd, 1991), or "grounded" coding (Glaser & Strauss, 1967), which involves using the informants' own words to capture a particular idea. RESULTS: A total of 16 codes were identified and reduced to nine themes. Seven themes focused on techniques that facilitated recruitment: (a) caring for individuals; (b) emphasizing benefits; (c) eliciting support from others; (d) being an expert; (e) using role models; (f) using good timing; and (g) giving good first impressions. The remaining two themes identified barriers to recruitment: (a) time commitment and (b) lack of support. DISCUSSION: Based on these themes, specific recruitment techniques are recommended. Ongoing research, however, is needed to establish the most effective recruitment procedures with older women.

Adult↗

PubMedDate not supplied

Treatment fidelity in behavior change research: a case example.

BACKGROUND: Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Assuring optimal treatment fidelity also may decrease the costs of a study and help the research team explain findings. APPROACH: The Behavioral Change Consortium developed a comprehensive model of treatment fidelity that incorporates 5 areas: (a) study design, (b) training providers, (c) delivery of treatment, (d) receipt of treatment, and (e) enactment of treatment skills. The definitions of these areas and a case example (Testing the Effectiveness of the Exercise Plus Program) are provided. RESULTS: There was evidence of treatment fidelity related to delivery based on careful monitoring of the study implementation. A comprehensive plan for training of the interventionists was provided, although evidence of treatment fidelity to training was not quantified. There were evidence based on observations of treatment sessions of delivery and receipt of the intervention and evidence of enactments based on evaluation of exercise calendars. DISCUSSION: The development and implementation of a treatment fidelity plan requires a careful conceptualization of what is relevant to treatment fidelity in any given study. Monitoring of treatment fidelity ideally requires direct or indirect observations of sessions, which can be built into the study design so that costs are minimal in terms of time and resources. Monitoring treatment fidelity allows research teams to truly test interventions and to develop and implement interventions that ultimately improve the overall health and well-being of individuals.

Models, Nursing↗

PubMedDate not supplied

Some predictors of psychiatric consultation in nursing home residents.

OBJECTIVE: Despite the high rate of psychiatric disorders in nursing homes, research indicates that psychiatric consultation is requested infrequently. The authors sought to determine the rate of psychiatric consultation in a nursing home population and to assess what factors were related to a consultation request. METHODS: Subjects were recruited from a stratified random sample of 59 nursing homes across Maryland. All new admissions age 65 years and older from September 1992 through March 1995 were eligible for the study. A total of 2,285 subjects were included in the study. Variables examined were factor scores from the Cornell Scale for Depression in Dementia and the Psychogeriatric Dependency Rating Scale (Behavioral Subscale), nursing home characteristics, and whether the resident had a psychiatric consultation within 90 days of admission. RESULTS: Twenty percent of the residents (N=404) had a psychiatric consultation. There was no significant association with demographic variables. Behaviors that triggered a psychiatric consultation included agitation, physical/verbal abuse, wandering, and manic/destructive acts. A psychiatric consultation was also requested when residents displayed anxiety. Surprisingly, depression in retarded and psychotic residents did not trigger a psychiatric consult. CONCLUSION: As expected, behavioral problems and agitation are common reasons for a psychiatric consultation. However, the resident who is depressed, particularly the quiet or retarded depressed resident, may be overlooked. In this context, it is important for the nursing staff to recognize that lethargy and social withdrawal may be signs of depression, and a referral to a psychiatrist may be in order.

Aged↗