Evaluating a geriatric rehabilitation continuing education program for nursing home and home health agency nurses.
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Biomedical subjects
Publications and source records attributed to J LeSage.
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This descriptive study investigated the relationship between both demographic characteristics and type of health care setting and elderly people's attributions for control, functional status, mood, type of helplessness, and perception of self-efficacy. Results of the study demonstrate that elderly people in long-term care settings are more vulnerable to experiencing learned helplessness and depression than elderly people in acute or rehabilitation settings. The findings indicate that the critical period for the development of learned helplessness and depression is for subjects with a length of stay of 7 weeks to 6 months. The study supports other research which concludes that depression in elderly people is better explained by the original learned helplessness theory rather than being related to attributions about the cause of loss of control.
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Although research-based information concerning geriatric polypharmacy is lacking, available data suggest possible causes, health risks, and areas for intervention. Nursing home residents are more likely to be recipients of unnecessary and excessive drugs than community-dwelling elderly. Polypharmacy can lead to increased adverse drug reactions, drug interactions, and medication errors. In the future, there will be single drug therapy for conditions now requiring multiple drugs, but improved diagnosis of disease could lead to persons receiving additional, appropriate drugs for these health problems. Informed patients collaborating with knowledgeable prescribers and those dispensing and administering their medications may be able to reduce the number of drugs they are taking. More research is needed to identify methods that promote safe self-medication behavior and better drug use in nursing homes. Health risks associated with polypharmacy and the escalating costs of medications require that nurse participation in ensuring that the elderly receive only necessary and effective drug treatment.
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1. Nurses described learned helplessness solely in terms of residents not performing the daily activities they were capable of. 2. The relatively strong correlation between the learned helplessness subscale of the MDI and the Beck Depression Inventory suggests that learned helplessness can be maladaptive and dysfunctional. 3. Analysis of attributional style found that personal, stable, and global attributions for negative events were closely associated with LH scores and self-reported depressive symptomatology in this sample. 4. Residents, except in the areas of meals and privacy, generally reported satisfaction with the amount of control they had in their treatment setting.
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Color vision deficiencies are a common sign of digoxin intoxication and color vision testing can be used to diagnose digoxin toxicity. We tested two patients, a 79-year-old man and a 61-year-old man, with digoxin toxicity by means of the Farnsworth-Munsell 100-hue test, AOH-R-R plates, and Ishihara plates. Initial testing disclosed both red-green and blue-yellow color vision deficiencies. These improved when digoxin levels diminished. The deficiencies were superimposed on preexisting acquired and congenital deficits. As serum digoxin levels decreased, the color vision deficiencies lessened on all three tests. The Farnsworth-Munsell 100-hue test gave the best quantifiable measure of color vision deficiencies, but proved difficult to use for routine bedside testing.
The ECC tool development and audit experiences indicated that there is promise in developing a process audit tool to monitor quality of care in nursing homes; moreover, the tool selected required only one hour per resident. Focusing on the care process and resident needs provided useful information for care providers at the unit level as well as for administrative personnel. Besides incorporating a more interdisciplinary focus, the revised tool needs to define support services most appropriate for nursing homes, includes items related to discharge planning and increases measurement of significant others' involvement in the care process. Future emphasis at the ECC will focus on developing intervention plans to maintain strengths and correct deficiencies identified in the audits. Various strategies to bring about desired changes in the quality of care will be evaluated through regular, periodic monitoring. Having a valid and reliable measure of quality of care as a tool will be an important step forward for LTC facilities.
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