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PubMed2000

Agitated behavior in elderly nursing home residents with dementia in Japan.

This study is the first investigation of the frequency of agitated behaviors in elderly dementia patients in Japanese nursing homes using the Cohen-Mansfield Agitation Inventory (J. Cohen-Mansfield, 1991). Despite major differences between Japanese and American cultures, findings were highly consistent with those of previous U.S. studies. Physically aggressive behavior, although evidenced by only 10-20% of the sample, comprised the strongest factor. A separate factor for verbal agitation also emerged. The behaviors declined during the evening and night shifts. In both the Japanese and U.S. samples, wandering, general restlessness, verbal agitation such as repetitious questioning, cursing, and complaining occurred most frequently. Another 4-point scale was used to code the degree to which agitated behavior occurred during eating, dressing, bathing, and toileting for each resident. The majority of aggressive behavior occurred in relation to personal caregiving, especially in regard to bathing. Despite major cultural differences, Japanese findings paralleled previous U.S. results.

Aged↗
PubMed1981

The alcoholic family at home. Patterns of interaction in dry, wet, and transitional stages of alcoholism.

Thirty-one alcoholic families were observed in their homes on nine separate occasions over a six-month period. During each occasion, behavioral observers made systematic recordings of interactional behavior using the Home Observation Assessment Method, a method that concentrates on the family's style of regulating its home environment. Three distinct patterns of home behavior could be identified using univariate and multivariate statistical analyses. Each pattern was associated dry, or transitional phase. This suggests that these families manifest characteristic family-level patterns of behavior in their homes at different stages in the course of chronic alcoholism. The critical issue was the relative rigidity vs flexibility of behavior. Families in either stable wet and transitional phases proved to have rigid patterns of behavior; those in the stable dry phase had flexible patterns. The findings provide an initial insight into how families manage a chronic disease process in their home environment.

Adult↗
PubMedDate not supplied

Perceptions of the most helpful nursing behaviors in a home-care hospice setting: caregivers and nurses.

The purpose of this study was to determine those nursing behaviors perceived as most helpful and least helpful by primary caregivers and by hospice nurses in a home-care hospice setting. A Q-sort of 60 nursing behaviors ranked from most to least helpful was completed by 20 caregivers, during the bereavement period and by five hospice nurses, who were currently employed by the hospice. These nursing behaviors were categorized as: Nursing behaviors related to the patient's physical needs; nursing behaviors related to the patient's psychosocial needs; and nursing behaviors related to the psychosocial needs of the caregivers.

Adult↗
PubMed1999

Chronic pain-associated behaviors in the nursing home: resident versus caregiver perceptions.

Pain assessment in nursing home residents poses challenges since many of these individuals are too cognitively impaired to respond to traditional self-report instruments. Assessment of pain behavior in this population offers a logical alternative. The purpose of this study was to compare perceptions of behaviors identified as being pain-related in 42 nursing home residents with chronic pain, as reported by residents themselves, their nursing home caregivers and their family caregivers. Our specific research agenda was to identify the most salient behaviors that signal pain in nursing home residents; to determine the test-retest agreement of residents' self-perceived pain behaviors; to learn of the confidence that caregivers feel regarding assessment of residents' pain behavior; and to examine the agreement between caregivers and residents about pain behaviors in particular residents. We also wanted to compare residents' and caregivers' ratings of the residents' pain intensity. Finally, we explored the beliefs of nursing home staff about the influence of dementia on pain and pain assessment. Twenty-two of 26 pain-related behaviors identified by residents showed fair to perfect test-retest agreement (kappas 0.40-1). For the vast majority of pain-related behavior items, kappas for resident-caregiver agreement were <0.30. Agreement with regard to pain intensity was similarly poor (r = -0.19-0.34). Confidence in pain rating was high for both nurse (on average, 7.2 on a scale of 0-10) and family (on average, 6.7) caregivers. Seventy-one percent of nurses felt that pain assessment is more difficult in demented individuals, but that cognitive function does not influence pain prevalence. While nursing home residents with chronic pain and their caregivers have different perceptions regarding which behaviors are pain-related, additional studies are required to determine the underpinnings of these differing perceptions and to determine the extent to which formal pain behavior observation protocols will be useful for evaluating nursing home residents with chronic pain.

Adult↗
PubMed2001

Relationship between aggressive behaviors and depression among nursing home residents with dementia.

BACKGROUND: Verbal and physical aggression are common behavior problems among nursing home residents with dementia. Depression among nursing home residents is also a common but underdiagnosed disorder. METHOD: Data collected on 1101 residents with dementia, newly admitted to a sample of 59 nursing homes across Maryland, were analyzed to determine if there was a relationship between depression and physical and verbal aggression. RESULTS: Residents with dementia who manifested physical or verbal aggression had a higher prevalence of depression than those without such behaviors (p<0.05). CONCLUSIONS: Our findings suggest that nursing home residents with aggressive behaviors should be screened for depression and treated.

Aged↗
PubMed2006

Home uroflowmetry biofeedback in behavioral training for dysfunctional voiding in school-age children: a randomized controlled study.

PURPOSE: We studied the added value of home uroflowmetry for biofeedback training compared to added attention and standard therapy in a multicomponent behavioral training program for voiding disorders in school-age children. Little is known about the role of biofeedback by home uroflowmetry for dysfunctional voiding due to NNBSD in children. MATERIALS AND METHODS: A randomized controlled study was conducted at an outpatient pediatric incontinence university clinic from January 2000 to June 2003. A total of 192 children 6 to 16 years old who were suffering from recurrent urinary tract infections with or without urge incontinence were screened for NNBSD. Of 143 eligible patients 44 were randomly allocated to receive 8 weeks of standard therapy (outpatient behavioral therapy), 46 to receive 8 weeks of home video instructions together with standard therapy and 53 to receive 8 weeks of home uroflowmetry biofeedback together with standard therapy. After 8 weeks all treatment groups proceeded with standard therapy for 16 weeks, after which prophylaxis with antibiotics was stopped and patients were followed for another 6 months. Main outcome measurement was total relief of complaints, namely urinary tract infections and, if present, incontinence, at 12 months after randomization. RESULTS: At baseline there was no reason to predict major incomparabilities between the groups. In an intent to treat analysis there was no difference in total relief between standard treatment (44%) and added video instruction (42%, RR 0.96, 95% CI 0.59 to 1.56). Total relief in the added home uroflowmetry group (55%) was higher than with standard therapy (RR 1.24, 95% CI 0.80 to 1.93), although the difference was not statistically significant. A per protocol analysis suggested that the groups with added home uroflowmetry showed better total relief than the pooled groups with standard therapy and those with added video (RR 1.40, 95% CI 0.98 to 2.00). CONCLUSIONS: Home uroflowmetry appears to be a useful adjunctive treatment for the reduction of complaints in children with dysfunctional voiding due to nonneurogenic bladder-sphincter dyssynergia.

Behavior Therapy↗
PubMed1990

A descriptive analysis of nursing staff behaviors in a teaching nursing home: differences among NAs, LPNs, and RNs.

Various staff behaviors in a nursing home were sampled seven times a day, 5 days a week over 37 months and were coded separately for LPNs, RNs, and NAs. The behavior most frequently observed was patient care, which occurred during 56.9% of the samples. We observed staff interacting with patients during 10.7% and with other staff during 19.5% of the samples. The LPNs displayed significantly more patient care behaviors and NAs significantly more nonwork behaviors than other nursing staff. RNs displayed the least nonwork behavior. We conclude that nursing staff devote most of their time to patient needs and relatively little time to nonproductive activities.

Behavior↗