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Biomedical subjects

K B Colling

Publications and source records attributed to K B Colling.

10 recordsLinked to original sources
PubMed2004

Caregiver interventions for passive behaviors in dementia: links to the NDB model.

Passive behavior (PB) in persons with Alzheimer's disease (PWAD) has been overlooked despite recognition that it occurs on a daily basis and is often resistant to interventions. The purpose of this study was to describe how the experience of passivity was for the caregiver and the PWAD, factors that precipitated PB, caregiver responses that promoted engagement, and caregiver responses that intensified PB, as well as activities initiated by caregivers over the past month that reduced passivity in the person with dementia (PWD). Fifty caregivers of community-dwelling persons with mild (n = 15), moderate (n = 16), and severe (n = 19) Alzheimer's disease participated in a semi-structured interview. Data were analyzed using Colaizzi's Phenomenological Thematic Extraction and descriptive statistics. Caregivers identified decreased levels of activity, decreased verbalization, withdrawal, less socialization, and decreased interest in activities as examples of PBs. For caregivers, the experience of coping with PBs engendered frustration with their loved ones' cognitive deterioration, difficulty in watching and accepting loss of function, fatigue, sadness, and using coping skills. Paradoxically, both being alone and increased environmental stimuli precipitated PB. Feelings of helplessness and loss of control by the person also caused PB. The most successful interventions to promote engagement were: giving cues and assistance, initiating the task, giving guidance, and providing enjoyable activities. Responses that hindered engagement included: 'correcting' or putting stress on the person, rushing activities, and repeating directions. Faith, humor, patience, and contact with friends and family were identified as positive approaches. Caregiver interventions demonstrated synchrony with selected background and proximal variables in the Need-driven Dementia-compromised Behavior (NDB) model.

Alzheimer Disease↗
PubMed2001

Using measures of agreement to develop a taxonomy of passivity in dementia.

A comprehensive taxonomy categorizing passive behaviors in people with dementia was developed and revised through the use of expert raters. The taxonomy was first derived from the synthesis of 15 empirical studies that addressed this phenomenon, then was rated by an expert panel of six nurse-scientists with expertise in dementia and neuroscience research. This article describes the application of two measures of agreement, multiple rater kappa and proportion of agreement for multiple raters, calculated using Stata and SPSS, to evaluate and revise the taxonomy. The method proved useful for estimating the content validity of the taxonomy and provided evidence of stronger agreement among raters for the revised and final forms of the taxonomy. Nurse researchers will find this methodology to be an efficient, practical approach to applying measures of agreement for a variety of purposes, including taxonomy development.

Dementia↗
PubMed2001

The interaction of age and cognitive representations in predicting blood pressure.

The purpose of this study was to investigate the interaction of age and cognitive representations of hypertension in predicting blood pressure. A model of illness self-regulation was used as the theoretical framework for the study. Secondary analysis of data collected from 224 hypertensive adult outpatients was conducted to assess five constructs of illness. ANOVA results indicated that older adults reported fewer hypertension-related symptoms than younger- and middle-aged adults, and that younger adults reported fewer health behaviors to control hypertension than did middle-aged and older adults. Results of hierarchical multiple regression models indicated that after adjusting for effects of demographic factors, no single cognitive representation construct was a significant predictor of blood pressure. The interactions of age and three cognitive representation constructs were, however, significant predictors of blood pressure. For younger adults, increases in the perceived Consequences, Control, and Timeline for hypertension were predictive of decreases in hypertension, although for older adults increased perceptions of control were associated with increased blood pressure.

Adult↗
PubMed2000

A taxonomy of passive behaviors in people with Alzheimer's disease.

PURPOSE: To construct a taxonomy of passive behaviors for understanding people with Alzheimer's disease. Passive behaviors are those associated with decreased motor movements, decreasing interactions with the environment, and feelings of apathy and listlessness. Little is known about behaviors associated with passivity, and these behaviors have not been categorized. ORGANIZING CONSTRUCT: Taxonomy construction. Passive behaviors in people with Alzheimer's disease were conceptualized as disturbing behaviors, patterns of personality change, and negative symptoms. METHODS: The taxonomy was developed using critical reviews of 15 empirical studies published 1985 through 1998. Procedures included listing behaviors; clustering behaviors into inductively derived groupings; conducting an expert panel-review, making revisions, and conducting a second review; establishing global and category-by-category reliability using Cohen's Kappa. FINDINGS: The nonhierarchic, natural taxonomy indicated five categories of behaviors associated with passivity in Alzheimer's disease: diminutions of cognition, psychomotor activity, emotions, interactions with people, and interactions with the environment. Analysis indicated substantial agreement beyond chance and showed statistically significant agreement among the six nurse-expert rates. Areas of synchrony between the taxonomy and the Need-Driven Dementia Compromised Behavior Model were identified. CONCLUSIONS: This taxonomy of passive behaviors in patients with Alzheimer's disease showed empirical rigor and compatibility with a middle-range theory and can be viewed as a sensitizing analytic scheme to guide future practice, research, and theory development.

Affect↗
PubMed1999

A Nightingale-based model for dementia care and its relevance for Korean nursing.

This article addresses the synchrony between a Western middle-range theory of care for persons with dementia and traditional Korean nursing care. The Western theory is called a need-driven, dementia-compromised behavior model and is heavily influenced by the assessment categories outlined in Nightingale's work. This model is presented as congruent with Nightingale's work and then viewed from the perspective of traditional Korean nursing. Several congruencies and a few incongruencies are found between these Western and Eastern views, and suggestions are made for greater consistency between these views.

Attitude to Health↗
PubMed1998

A theoretical analysis of Carper's ways of knowing using a model of social cognition.

Although Carper's model of the ways of knowing in nursing has played a critical role in delineating the body of knowledge that comprises the discipline, questions remain regarding the defining properties of the knowledge structures, how they relate to each other, and how they function in the process of knowing. In this article, we propose that the cognitive model of social knowledge developed within the field of social psychology can be used to extend our understanding of the form and function of the four types of nursing knowledge. Empirical, personal, esthetic and ethical knowledge are compared with semantic, episodic and procedural knowledge specified in the cognitive model, and the schema construct, which is defined as an organized package of these three types of knowledge, is proposed as an integrative framework for addressing the relationships among the four types of nursing knowledge and their role in the process of knowing. Implications for nursing theory development, education and practice are addressed.

Clinical Competence↗