Matching Items (21)

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Being Proactive in Geriatric Advance Care Planning

Description

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care setting. The Medicare Incentive Program is the platform for this initiative. This quantitative project used a valid and reliable pre and posttest design that consisted of 27 items on a Likert-scale. A 3.5-month chart audit (n=91) was conducted to assess the completion rate. Descriptive statistics was used to describe the demographic data.

The results of the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -2.37, p = .018. There was a significant increase in the post-readiness to change average scores. A Mann Whitney test was used to analyze the statistically significant difference between the averages in two ACP types and electronic health record documentation (EHR). Staff did not always code (Mdn = 0.00) but they documented in the EHR (Mdn =1.00; 512.00, p = 0.003). ACP discussion was performed 63% of the time during Annual Wellness Visits (AWV), and there was a 49% increase in the EHR documentation. Trained staff are key stakeholders in guiding ACP conversations. They understand the barriers, impact, and consequences related to the lack of advance directives.

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Created

Date Created
  • 2020-04-30

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Transitional Care of Adults with Chronic Diseases Post-Discharge from Acute Settings

Description

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually,

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

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Created

Date Created
  • 2020-05-05

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The Impact of Cochlear Implants on the Quality of Life and Personhood of Cochlear Implant Users as Expressed In Patient Narratives

Description

Cochlear implants are electronic medical devices that create hearing capabilities in those with inner ear damage that results in total or partial hearing loss. The decision to get a cochlear

Cochlear implants are electronic medical devices that create hearing capabilities in those with inner ear damage that results in total or partial hearing loss. The decision to get a cochlear implant can be difficult and controversial. Cochlear implants have many physical and social impacts on cochlear implant users. The aim of this study was to evaluate how patient narratives written by people with cochlear implants (or their caregivers) express issues of quality of life and personhood related to the use of this medical device. The methodology used to answer this question was a content analysis of patient narratives. The content analysis was done using grounded theory and the constant comparative method. Two sensitizing concepts, quality of life and personhood, were used and became the large umbrella themes found in the narratives. Under the major theme of quality of life, the sub-themes that emerged were improved hearing, improved communication skills, and assimilation into the hearing world. Under the major theme of personhood, the sub-themes that emerged were confidence, self-image, and technology and the body. Another major theme, importance of education, also emerged. In general, cochlear implant users and their caregivers expressed in their narratives that cochlear implants have positive effects on the quality of life of cochlear implant users. This is because almost all of the narrative writers reported improved hearing, improved communication skills, and better assimilation into the hearing world. In addition, it was found that cochlear implants do not have a significant affect on the actual personal identity of cochlear implant users, though they do make them more confident. The majority of cochlear implant users expressed that they view the cochlear implant device as an assistive tool they use as opposed to a part of themselves. Lastly, there is a need for more awareness of or access to education and therapy for cochlear implant users.

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Created

Date Created
  • 2016-05

The Effects of Modifiable Risk Factor Video Education on Self-Efficacy in Adults with Atrial Fibrillation

Description

Atrial fibrillation, also known as Afib or AF, is the most common irregular heart rhythm among the United States adult population. Atrial fibrillation is characterized by an abnormal fibrillation of

Atrial fibrillation, also known as Afib or AF, is the most common irregular heart rhythm among the United States adult population. Atrial fibrillation is characterized by an abnormal fibrillation of the upper chambers of the heart, known as the atria. When left chronically untreated, this condition may lead to insufficient systemic blood flow or the formation of blood clots. Atrial fibrillation has many modifiable risk factors, meaning contributing habits and practices within the patient's control that may worsen the condition. Communication of these modifiable risk factors to patients with atrial fibrillation is important in improving patient quality of life and for reduction of disease symptoms. The motivation for this study was to convey the potential of improved disease process by lifestyle modification to patients with atrial fibrillation.

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Created

Date Created
  • 2017-12

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Quality of Life and Health Metrics in Young Children at Genetic Risk for Speech and Language Disorder and their Parents: Broad and longitudinal effects of a proactive intervention, the Babble Boot Camp

Description

The objective of this study was to examine the quality of life health metrics of parents whose children were diagnosed with Classic Galactosemia and underwent a proactive treatment program. The

The objective of this study was to examine the quality of life health metrics of parents whose children were diagnosed with Classic Galactosemia and underwent a proactive treatment program. The data analyzed in this study came from the Babble Boot Camp©, which included one control family and nine treatment families. The Babble Boot Camp© is an innovative intervention program that is implemented via parent training. Child progress and parent quality of life are closely monitored in regular intervals. The purpose of this study was to evaluate if the intervention was successful in terms of child language growth, how the child’s progress affected the parent’s quality of life, and if there were differences in the psychological and physical health of the mothers and fathers. We utilized a variety of questionnaires, specifically the Ages and Stages Questionnaires- 3 (ASQ3) (Squires & Bricker, 2009), Pediatric Quality of Life (PedsQL) Questionnaire (Varni, 1998), Parental Stress Index (PSI-4) (Abidin 2012) and the MacArthur CDI Questionnaire (MBCDI2) (Fenson et al., 2007). The three main findings of this study are: the BBC© treatment protocol showed beneficial gain to the children, the development of the child did affect the parent’s quality of life, and the mother’s physical health was significantly worse than the father’s in terms of health metrics. The significance of this study is to identify preliminary trends in quality of life data of the parents. Clinical implications for the future include investigation of various possible factors driving the improvement of the parent’s quality of life.

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Created

Date Created
  • 2020-05

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Correlation between Perceived Quality of Life and Perceived Accessibility in Metropolitan Phoenix Area

Description

The research presented here aims to explore the perceived Quality of Life (QoL) and perceived accessibility among varying demographic and socioeconomic groups in the Phoenix Metropolitan Area. A relationship between

The research presented here aims to explore the perceived Quality of Life (QoL) and perceived accessibility among varying demographic and socioeconomic groups in the Phoenix Metropolitan Area. A relationship between perceived QoL and perceived accessibility was further investigated. The data was collected through the Phoenix Area Social Survey (PASS), which sent randomized surveys to 496 people in the Phoenix region. The survey’s response rate varied, from a low of 22.2% in one of the lowest-income neighborhoods and a high of 55.6% for a middle-income neighborhood. Results were obtained through statistical analyses, such as correlations, chi-squared tests, and t-tests. Results for income, gender and ethnicity indicated similar and comparable perceived QoL and perceived accessibility in the Phoenix area. The data did not reveal a relationship between perceived QoL and perceived accessibility; however, accessibility did increase with increasing income. A striking finding revolved around disparities in access to walkability and transit across all income, genders and ethnicities. This presents implications for built environment and resource allocation planning in order to enhance the lives of residents in the Valley. Future research and investigation into the objective indicators of QoL and impacts of culture on QoL should be pursued.

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Created

Date Created
  • 2021-05

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Discrimination & Psychological Health of Minority Nursing Staff amidst COVID-19

Description

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is little research regarding the effects of COVID-19 and related and/or concurring discrimination upon minority nursing staff, despite their importance in supporting the diverse American patient population with culturally competent, tireless care amid the pandemic. This cross-sectional survey study aimed to examine 1) the relationships between discrimination, social support, resilience, and quality of life among minority nursing staff in the US during COVID-19, and 2) the differences of discrimination, social support resilience, and quality of life among minority nursing staff between different racial/ethnic groups during COVID-19. The sample (n = 514) included Black/African American (n = 161, 31.4%), Latinx/Hispanic (n = 131, 25.5%), Asian (n = 87, 17%), Native American/Alaskan Native (n = 69, 13.5%), and Pacific Islander (n = 65, 12.7%) nursing staff from 47 US states. The multiple regression results showed that witnessing discrimination was associated with a lower quality of life score, while higher social support and resilience scores were associated with higher quality of life scores across all racial groups. Furthermore, while participants from all racial groups witnessed and experienced discrimination, Hispanic/Latinx nursing staff experienced discrimination most commonly, alongside having lowest quality of life and highest resilience scores. Native American/Alaskan Native nursing staff had similarly high discrimination and low quality of life, although low resilience scores. Our findings suggest that minority nursing staff who have higher COVID-19 morbidity and mortality rates (Hispanic/Latinx, Native American/Alaskan Native) were left more vulnerable to negative effects from discrimination. Hispanic/Latinx nursing staff reported a relatively higher resilience score than all other groups, potentially attributed to the positive effects of biculturality in the workplace, however, the low average quality of life score suggests a simultaneous erosion of well-being. Compared to all other groups, Native American and Alaskan Native nursing staff’s low resilience and quality of life scores suggest a potential compounding effect of historical trauma affecting their well-being, especially in contrast to Hispanic/Latinx nursing staff. This study has broader implications for research on the lasting effects of COVID-19 on minority healthcare workers’ and communities’ well-being, especially regarding Hispanic/Latinx and Native American/Alaskan Native nursing staff.

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Created

Date Created
  • 2021-05

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A preliminary assessment looking at perceived quality of life in neighborhoods in the Phoenix metropolitan area focusing on community-oriented design, walkability, and proximity to nature.

Description

As urban areas continue to grow with an increasing amount of population growth and influx, prudent planning for developed and developing cities has never been as important as it is

As urban areas continue to grow with an increasing amount of population growth and influx, prudent planning for developed and developing cities has never been as important as it is today. Currently, about 54% of the world's population lives in urban areas while that number is expected to increase to 66% by 2050 (United Nations 2014). This being said, planners, politicians, and policymakers among others need to be able to anticipate the ideal urban infrastructure needed with the most effective layout and design for creating and maintaining a high quality of life. The purpose of this research is to identify a potential link between neighborhood-scale urban form criteria that are believed to improve quality of life and the perceived quality of life of people who live in neighborhoods that display these specific urban form criteria. This study looked at three neighborhoods that each exhibited differences in neighborhood urban form such as: community-oriented design, high walkability, and close proximity to nature. A non-scientific preliminary survey was conducted in each of these three neighborhoods to identify potential differences in urban form preference targeting different demographics. The scope of this study is a preliminary assessment to gain an idea of which neighborhood-scale urban form factors, if any, are important for improving quality of life from the point of view of the resident. These results may lead to future study that could determine the relationship between availability of infrastructure and residential preference for certain infrastructure. This could also lead to a guide for planners on important criteria to consider for future neighborhood development in an urban setting as well as areas to focus on in the urban retrofitting process.

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Created

Date Created
  • 2016-05

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Is An Enviable Life An Achievable Option for Young Adults with Intellectual and Developmental Disabilities in the United States: A Review of Literature

Description

This literature review investigates the idea of what makes a person’s life ‘enviable’ by defining the term and then by exploring the question of whether or not young adults with

This literature review investigates the idea of what makes a person’s life ‘enviable’ by defining the term and then by exploring the question of whether or not young adults with intellectual and developmental disabilities in the United States can achieve an enviable life as defined. This literature review synthesizes current and historic research through an analysis of various studies on outcomes for individuals with intellectual and developmental disabilities (IDD), their families, and the resources offered within community platforms to help create such a life for young adults with IDD. This review also aims to help change society’s views on young adults with intellectual and developmental disabilities and challenges the community to address this issue further in order to create a more accessible, enviable, and inclusive lifestyle for individuals with intellectual and developmental disabilities.

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Created

Date Created
  • 2016-12

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Sleep Quality and the Effect on Functional Outcomes

Description

Introduction: Sleep disorders can go undiagnosed if a provider is not asking the right questions; they can be characterized by loud snoring with apneic episodes that never fully wake the

Introduction: Sleep disorders can go undiagnosed if a provider is not asking the right questions; they can be characterized by loud snoring with apneic episodes that never fully wake the person, difficulty falling asleep or daytime fatigue. Poor sleep can affect activities of daily living, job performance and personal relationships. Poor sleep can be difficult to detect because some may consider it a symptom because of their lifestyle. The purpose of this study is to assess participants sleep quality and functional outcomes of poor sleep.

Methods: Primary care providers have an opportunity to screen for sleep disorders as part of the intake process during an office visit. The Functional Outcomes of Sleep Questionnaire (FOSQ), has been proposed as guide to determine if a sleep disorder is affecting quality of life. This descriptive study randomly recruited 20 participants from a community health center. A 10-question survey was given to individuals over the age of 18 who can write and speak English and either have a body mass index (BMI) over 30, hypertension (HTN) or diabetes type II (DMII). Demographic information evaluated included age, gender, HTN, DMII, BMI>30, marital status, sleeping alone, employment type, race, type of insurance, how many times do they wake up at night, the average number of hours slept per night and does the person work night shift.

Results: The study used a qualitative approach with a descriptive methodology; statistical analysis consisted of proportions, means and standard deviation to describe the study population. Participant age ranged from 33 to 72 years (M=50.1, SD= 11.32). Sixty percent were both female and married/living with partner. Despite being married/living with partner, 50% slept alone. A Mann-Whitney U test showed that there was a significant difference in four of the questions in the FOSQ-10 in which functional outcomes were not affected by being sleepy or tired.

Conclusion: The FOSQ-10 may serve a role in identifying patients who might benefit from a sleep study. The inclusion of a sleep disorder screening tool may increase the specificity and sensitivity of the intervention and the ability to yield data that will objectively measure disordered sleep.

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Created

Date Created
  • 2019-04-25