Biomedical subjects

Marcia Finlayson

Publications and source records attributed to Marcia Finlayson.

12 recordsLinked to original sources

PubMed2005

Activities of daily living (ADL) and instrumental activities of daily living (IADL) items were stable over time in a longitudinal study on aging.

OBJECTIVE: The purpose of this analysis was to examine the stability over time of the activities of daily living (ADL) and instrumental activities of daily living (IADL) items in the Aging in Manitoba (AIM) Longitudinal Study and to evaluate the existence of differential item functioning across settings (home, nursing home). STUDY DESIGN AND SETTING: The study used data from 607 participants of the AIM Longitudinal Study who were more than 85 years of age in 1996 and who had complete data from 1983, 1990, and 1996 for all ADL and IADL items. Rasch analysis was used to examine how the rating scale of the ADL and IADL items was used by participants, and to determine if the ordering of items remained stable across three time periods (1983, 1990, 1996) and the two different settings (home, nursing home). RESULTS: The rating scale worked best when dichotomized into "received no assistance" and "receives assistance." Except for four items (making tea, making meals, doing nursing care, and going outside in any weather), the items were stable across administration periods, and across settings. CONCLUSION: The AIM can be used to evaluate changes in disability over time and may have the potential to identify those at risk for transitions in care.

Activities of Daily Living↗

PubMed2005

Psychometric evaluation of the Energy Conservation Strategies Survey.

OBJECTIVE: To examine the internal consistency and test-retest reliability of the Energy Conservation Strategies Survey (ECSS), a tool that was specifically designed to determine if people with multiple sclerosis who attended the six-week energy conservation course actually implemented the strategies taught to them. DESIGN: The instrument ECSS was administered at six weeks and seven weeks post intervention to evaluate the test-retest reliability, while data from six weeks post intervention were utilized to assess the internal consistency of the ECSS. SETTING: Community locations in Illinois and Minnesota, USA. SUBJECTS: Data from 53 participants with multiple sclerosis living in the community were utilized for the psychometric study. MEASURES: Energy Conservation Strategies Survey. RESULTS: The internal consistency of 0.92 reveals that all the items are consistent with each other and measure a single construct. Inferential analyses using intraclass correlation coefficient indicates good test-retest reliability (intraclass correlation coefficient (ICC) = 0.79). CONCLUSION: Findings of the study suggest that the ECSS exhibits high internal consistency and good test-retest reliability. The study implies that the ECSS could be valuable in measuring changes in behaviour over time among people with multiple sclerosis after the completion of the six-week energy conservation course provided by occupational therapists.

Adult↗

PubMed2005

The outcomes of using self-study modules in energy conservation education for people with multiple sclerosis.

OBJECTIVE: To determine whether there were any differences in the outcomes of individuals with multiple sclerosis who attended all six sessions of an energy conservation education programme compared with people who missed a session and received a self-study module. DESIGN: Secondary analysis of data from two naturally occurring groups emerging from a randomized control trial--compliers who received the intervention as intended (group 1) and noncompliers who received a modified intervention with self-study modules (group 2). SETTING: Community settings in Chicago, Illinois and Minneapolis, Minnesota, USA. PARTICIPANTS: Ninety-two community-dwelling people with multiple sclerosis who were participating in an energy conservation education programme. INTERVENTION: Energy conservation education groups based on the 'Managing Fatigue' programme, which were facilitated by an occupational therapist. Self-study modules were sent to participants who missed a session. OUTCOME MEASURES: Fatigue Impact Scale (FIS), Self-Efficacy for Performing Energy Conservation Strategies Assessment, Energy Conservation Strategies Survey (ECSS), six subscales from the Medical Outcomes Study Short-Form Health Survey (SF-36). RESULTS: When comparing individuals who attended all six sessions with individuals who missed one or more sessions and received a self-study module, no significant differences were found after adjusting for multiple comparisons. CONCLUSIONS: Participants who used the self-study modules because they missed sessions of the Managing Fatigue programme experienced benefits from the course similar to those experienced by participants who fully complied with the intervention as intended. A new prospective study to validate the findings of this secondary analysis is required.

Energy Metabolism↗

PubMed2005

Trends in the utilization of specific health care services among older Manitobans: 1985 to 2000.

This paper examines 16-year trends in the utilization of hospital and physician services by Manitobans aged 75 and more, using data from the Manitoba Population Health Research Data Repository. Trends are examined across five measures of hospital services (separations, short-stay days, long-stay days, cataract surgeries, and hip/knee replacements) and two measures of physician care (overall visit rate, and proportion having seven or more visits). Results show changes in the utilization of these services among older adults living in Manitoba over time, with the extent of change varying with the service under consideration, age, and location of residence. Previously large utilization differentials are shown to be shrinking; for example, cataract surgery rates across regions and physician visit rates by age. For other services, such as the rates of hip or knee replacement surgery, the differences across regions are increasing. Findings indicate that global generalizations about the impact of older adults on the health care system are subject to question, as regional differences and differences between age groups (75-84, 85+) can be significant.

Aged↗

PubMed2004

Aging with multiple sclerosis.

Although multiple sclerosis (MS) does not typically reduce life expectancy, there has been relatively little systematic investigation of the experiences and health-related concerns of people aging with this disease. A current search of the database CINAHL produced no articles when the search terms "multiple sclerosis," "nursing" and "aging" were used. To initiate more dialogue about the role of nurses in addressing the issues and concerns of people aging with MS, a cross-sectional descriptive study was conducted using both qualitative interviews and the administration of standardized instruments to elicit information about the health concerns and service needs of 27 people with MS 55 years of age and older. Qualitatively, participants perceived that they had less freedom and required more assistance than same age peers who do not have MS. Scores from standardized instruments support these perceptions. Participants expressed unmet needs in the areas of housework, physical therapy, MS support groups, religious service attendance, information and referral, check-in services, assistive technology use, social activities, personal care, and care coordination. To address these perceptions and needs, neuroscience nurses need to be aware of and sensitive to the challenges of aging with MS. In addition, nurses must be prepared to discuss and provide information, resources, and referrals on a wide range of health, social, and wellness-related services.

Activities of Daily Living↗

PubMed2003

Experiencing the loss of mobility: perspectives of older adults with MS.

PURPOSE: The purpose of this study was to develop an understanding the experience and meaning of mobility loss among older adults with multiple sclerosis (MS). This work is part of a larger study on the health concerns and service needs of older adults with MS. METHODS: Twenty-seven people with MS (mean age = 62 years, range = 55-82) were interviewed using a phenomenological approach. RESULTS: Thematic analysis found that three factors contributed to participants' experience of mobility as a person with MS: reality of having MS, mobility needs, and contextual factors. Participants discussed how the reality of MS meant variability in their ability to get around and the importance of trying to remain in control over their mobility experiences. The experience of mobility lead participants to mourn losses, take action, and contemplate their futures. They expressed concerns about the continual declines in their mobility, losing independence, becoming a burden on caregivers, and the potential for having to move into a nursing home. CONCLUSIONS: Findings provide insight into the experience of mobility loss among older adults with MS, and point to potential strategies that can be used to help people cope with and adapt to these losses.

Activities of Daily Living↗

PubMed2002

Changes predicting long-term care use among the oldest-old.

PURPOSE: The aim of this study was to identify health-related changes occurring between 1983 and 1990 that characterize and differentiate 1996 long-term care outcomes (no services, home care, nursing home) among people aged 85 years and older. DESIGN AND METHODS: Variables capturing health-related changes between 1983 and 1990 in a cohort (N = 616) of Aging in Manitoba Longitudinal Study participants aged 85 years and older were used in a series of logistic regression models to identify factors that best predicted the use of long-term care services in 1996, controlling for age and sex. RESULTS: Factors predicting home care use relative to no services included changes in self-rated health, income adequacy, and railings outside of the house. Factors predicting nursing home use relative to home care included age and changes in general life satisfaction. Factors predicting nursing home use relative to no services included age; previous service use; length of time in the community; and changes in income adequacy, type of housing, and state of mind. IMPLICATIONS: These findings challenge assumptions about the linearity of the continuum of long-term care services, because different factors were shown to predict home care use than were shown to predict nursing home use.

Aged↗

PubMed2002

Predicting the use of occupational therapy services among people with multiple sclerosis in Atlantic Canada.

This secondary analysis examined the factors that predicted the use of occupational therapy services since diagnosis and over the past year among people with multiple sclerosis in Atlantic Canada. Data were gathered through a mail-out survey of members of the Multiple Sclerosis Society of Canada (Atlantic Division) in the winter of 1997/98. The Behavioral Model of Health Services Utilization (Andersen & Newman, 1973) was used to guide the analysis. Seeing greater numbers of health professionals, having a hospitalization in the past year, and having more functional limitations all increased the likelihood of seeing an occupational therapist, both since diagnosis and over the past year. These findings suggest that the organization and structure of the service system play a large role in the likelihood that a person with multiple sclerosis will see an occupational therapist in Atlantic Canada.

Adult↗

PubMedDate not supplied

The process and outcomes of a multimethod needs assessment at a homeless shelter.

Many factors contribute to homelessness, including extreme poverty, extended periods of unemployment, shortages of low-income housing, deinstitutionalization, and substance abuse. As a result, the needs of people who are homeless are broad and complex. This needs assessment used literature reviews, review of local documents and reports, participant observation, locus groups, and reflective journals to guide the development of an occupational performance skills program at one homeless shelter in south Florida. Through these methods, the role of occupational therapy was extended beyond direct service to include program and resource development, staff education, advocacy, and staff-resident mediation. The findings of the needs assessment and the actions taken as a result of this work point to the huge potential for occupational therapists and students to work together with staff and residents of homeless shelters.

Florida↗

PubMedDate not supplied

Documenting outcomes of occupational therapy: the center for outcomes research and education.

This article presents two themes related to the development and implementation of sound outcomes research that emerged from a 3-year dialogue among fellows of the University of Illinois Center for Outcomes Research and Education (CORE). These themes are: that outcomes research needs to be an interrelated multi-method system of investigation, and it should be developed in collaboration with its key stakeholders (consumers and practitioners). Examples from the literature and from a cluster of papers published in this focus issue are used to exemplify the themes.

Evidence-Based Medicine↗

PubMedDate not supplied

Concerns about the future among older adults with multiple sclerosis.

Multiple sclerosis (MS) is a chronic, progressive neurological disease that causes demyelination of the central nervous system. Typically diagnosed in adulthood, it does not significantly reduce life expectancy. The goal of this exploratory study was to describe the health-related concerns and service needs of 27 older adults with MS, ages 55 to 81 years. Through in-depth interviews using a phenomenological approach, fear of the future was found to be a predominant concern among the participants. Within this fear, participants expressed particular concerns about experiencing further losses of mobility and independence, becoming a burden on caregivers, and having to move to a nursing home. The findings raise three major challenges for occupational therapists that include: (1) developing or modifying interventions that can enable older adults with MS to gain a sense of control over their future, (2) working with families affected by MS together with other disciplines such as psychology and social work, and (3) advocating for more and better community support options for persons with MS.

Activities of Daily Living↗

PubMedDate not supplied

Outcomes of a vocational program for persons with AIDS.

Advances in medical treatment combined with changes in the demographics of persons who are becoming infected with autoimmune deficiency syndrome (AIDS) have transformed this illness from a rapidly progressing to a chronically disabling condition in a short period of time. This paper describes the development, implementation, and outcomes of a program of vocational services for persons with AIDS. This program was studied using a single group design, in which participatory action research strategies were used to investigate and improve the program as it unfolded. In addition to examining the overall outcomes of services, the study aimed to discover which components were most helpful to participants and which participants were most likely to benefit from the program. Of 129 participants of who initially enrolled, 39 dropped out before finishing the program. Sixty of the 90 participants who completed the program achieved employment, returned to school, or began a volunteer position or internship. Consequently, the overall success rate was 46.5% and the success rate for program completers was 66.7%. The occupational narrative, which participants told in their initial assessment interview, was closely associated with both program completion and successful outcomes. This association adds support to the importance of narrative for understanding participants and predicting future behavior, as well as for the therapy process.

Acquired Immunodeficiency Syndrome↗