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S M Albert

Publications and source records attributed to S M Albert.

45 records · Page 3Linked to original sources
PubMed1994

Assessing patient dependence in Alzheimer's disease.

BACKGROUND: While cognitive and functional deficits are the hallmark of Alzheimer's disease (AD), loss of social function (and the dependence this implies) is also critical, especially in early stages of disease. Little attention has been directed to this facet of dementing disease. We describe a scale for assessing dependency in AD and present a baseline profile of dependency in a cohort of AD patients. METHODS: In a study of the predictors of the course of AD, 233 patients in early stages of disease (modified MMS > or = 30) were assessed. Psychometric properties of the dependence scale were established. To validate the scale, dependence scores at baseline were correlated with a series of measures assessing cognition and function. The course of dependency over 18 months of follow-up was also analyzed. RESULTS: The scale shows adequate reliability (test-retest, intraclass correlation). Dependence stage was related to other measures of disease severity. Scalogram analysis shows that the dependence scale is consistent with the course of functional loss established for dementing disease. Prospective data indicate sensitivity of the scale to disease progression. CONCLUSION: Dependency is a distinct, measurable component of dementing disease and should be considered an important outcome in studies of AD.

Activities of Daily Living↗
PubMed1994

Exploring the validity of the Affect Balance Scale with a sample of family caregivers.

Open-ended responses of caregiving daughters and daughters-in-law were generated by a modified random probe technique to investigate the construct validity of the two subscales of the Affect Balance Scale (ABS), i.e., the 5-item Positive Affect Scale (PAS) and the 5-item Negative Affect Scale (NAS). A set of criteria were developed to distinguish between responses that did and did not correspond to Bradburn's assumptions concerning affect. While most responses met at least one of the criteria, very few met all. In exploring the nature of affect, we found that positive affect was based to a large extent on personal accomplishments and the recognition of others. The assessment of negative affect was a more interior, or self-focused process. For a significant subset of the sample, a negative response to a closed-ended PAS or NAS item implied disagreement or discontent with the wording or the implications of the item itself, rather than an absence of affect. Not all of the ABS items were equally valid measures of affect.

Affect↗
PubMed1993

Do family caregivers recognize malnutrition in the frail elderly?

OBJECTIVE: To determine if family caregivers are aware of the severely underweight elder's risk of malnutrition and accordingly increase nutritional care efforts. DESIGN: Case-control study. PARTICIPANTS: Familial caregivers to community-dwelling elders. MEASUREMENTS: Risk of malnutrition as defined by body mass index < or = 5th percentile of the national average for elders aged 65-90. RESULTS: Compared with caregivers of elders without risk for malnutrition, caregivers to undernourished elders are significantly more likely to give elders protein supplements, to make foods accessible to elders, and to encourage and pressure the elder to eat. CONCLUSIONS: Caregivers recognize gross signs of malnutrition in elders, increase nutritional care in response, and deserve some measure of support for their claims of health expertise.

Activities of Daily Living↗
PubMed1992

Psychometric investigation of a belief system: caregiving to the chronically ill parent.

This research draws on psychometric theory to assess open-ended items and develop reliable measures for investigation of caregiver ideology. Coding criteria used in a qualitative investigation of caregivers' beliefs about filial obligation and parental dependency were transformed into closed-end items and fielded with a large sample. Factor analysis confirmed the dimensions derived from the qualitative inquiry, but also showed that variability on the filial obligation dimension was greater than anticipated. Assessing familial caregivers' beliefs about filial obligation and parental dependency is useful, for these beliefs predict aspects of caregiver satisfaction and burden. Thus, beliefs about one's commitment to render care are not simply a norm divorced from behavior, but rather a cultural model with motivational force.

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PubMed1991

Caregiving daughters' perceptions of their own and their mothers' personalities.

This research explores differences between caregiving daughters' perceptions of their own and their mothers' personalities. A sample of caregiving daughters (N = 150) rated themselves and their mothers on the same 17 personality attributes. Daughters generally rated their mothers more negatively than themselves. Within this pattern of generally negative evaluations, varying types of impairment function differently. Functional impairment is not related to assessments of mothers' personalities, whereas psychological and cognitive impairments are.

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PubMed1991

Cognition of caregiving tasks: multidimensional scaling of the caregiver task domain.

This research investigates the distinctions caregivers use in thinking about home care tasks. A sample of 52 adult child caregivers sorted 25 cards with caregiving tasks printed on them into different piles based on the similarity of the tasks. Multidimensional scaling of the aggregate proximity matrix for the items showed three dimensions in the caregiver task domain: type of impairment (physical vs. cognitive-emotional), location of caregiving (within home vs. outside home), and response to parental incompetency (autonomy-fostering vs. guardianship). Respondents' statements support the dimensionality of the domain.

Activities of Daily Living↗
PubMedDate not supplied

The quality of life associated with prophylactic treatments for women with BRCA1/2 mutations.

PURPOSE: This study was conducted to obtain and compare the preferences assigned to cancer states and prevention measures by women who had breast cancer, were at high risk for breast cancer, or had neither condition. PATIENTS AND METHODS: We administered a time trade-off questionnaire to 21 breast cancer patients, 28 women with a personal history of multiple breast biopsies or a family history of breast cancer, and 135 women without these conditions (the reference group). We stratified the reference group into two groups aged 20 to 32 years and 33 to 50 years, respectively. RESULTS: All four groups assigned higher preference to breast cancer than to ovarian cancer. Both reference groups preferred using a tamoxifen-like drug to having mastectomy or oophorectomy for cancer prevention; the high-risk and breast cancer groups did not. None of the four groups had a preference between prophylactic mastectomy and breast cancer. All the groups were willing to subtract more years from their life expectancy to protect offspring from genetic risk than to protect themselves. Reference group members in the 33- to 50-year age range had lower mean ratings than the breast cancer group for almost all the health states, and breast cancer patients were less willing than other respondents to trade time for health. Most of these differences were not statistically significant. The high-risk group was similar to the older reference group in time trade-off ratings. DISCUSSION: The time trade-off-based preferences of healthy women may be used to predict the treatment preferences of women with BRCA1/2 mutations. Obtaining healthy women's ratings of treatment outcomes may help health care policy makers envision the consequences of the difficult choices that high-risk women face.

Adult↗
PubMedDate not supplied

Home health care and quality of life of patients with Alzheimer's disease.

BACKGROUND: Little is known about the quality of life (QOL) of people with Alzheimer's disease (AD). The formal home care sector plays an increasingly large role in care for this population, but home care agencies do not routinely collect QOL information or use this information in care planning. METHODS: A series of roundtable discussions with representatives of the home care industry were held to document current practices by home care providers regarding the elicitation, recording, and use of QOL information; to derive indicators of QOL in AD patients; and to develop standardized procedures for using QOL information. Results from this investigation were incorporated into an epidemiological investigation of community-dwelling AD patients, comparing formal sector home attendants to family caregivers regarding efforts to enhance patient QOL. RESULTS: Twenty representatives of the home care industry met over three sessions to discuss these issues. Patient QOL indicators were derived, showing divergence of patient and caregiver perspectives. A survey of 240 AD patients compared family and formal home attendant caregivers and showed that home attendants underutilize opportunities to enhance patient QOL, as referenced by patient participation in activities that require supervision. CONCLUSIONS: Collaboration with home care agencies allowed a better understanding of quality of life for this vulnerable patient population. More research will be required to refine QOL outcomes and develop quality assurance tools for dementia care. Medical Subject Headings (MeSH): Alzheimer's disease, quality of life, home care, paraprofessional care.

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