Matching Items (3)
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- All Subjects: Gerontology
- All Subjects: Context Aware Computing
- Creators: Shearer, Nelma
Description
Greater than half of older adults who are admitted to an acute care setting experience delirium with an estimated cost between four to twenty billion dollars annually in the United States. As a strategy to address the gap between research and practice, this feasibility study used the Roy Adaptation Model to provide a theoretical perspective for intervention design and evaluation, with a focus on modifying contextual stimuli in a Trauma Intensive Care and a Trauma Orthopedic Unit setting. The study sample included older hospitalized patients in a Trauma Intensive Care and a Trauma Orthopedic setting where there is a greater incidence for delirium. Study participants included two groups, with one group assigned to receive either a music intervention or usual care. The music intervention included pre-recorded music, delivered using an iPod player with soft headsets, with music self-selected from a collection of music compositions with musical elements of slow tempo and simple repetitive rhythm that influence delirium prevention. For the proposed study a music intervention dose included intervention delivery for 60 minutes, twice a day, over a three day period following admission. Physiologic variables measured included systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate, which were electronically monitored every four hours for the study. The Confusion Assessment Method was used as a screening tool to identify delirium in the admitted patients. Specific aims of this feasibility study were to (a) examine the feasibility of a music intervention designed to prevent delirium among older adults, and (b) evaluate the effects of a music intervention designed to prevent delirium among older adults. Findings indicate there was a significant music group by time interaction effect which suggests that change over time was different for the music and usual care group.
ContributorsJohnson, Kari Elizabeth (Author) / Fleury, Julie (Thesis advisor) / Shearer, Nelma (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2015
Description
As people age, the desire to grow old independently and in place becomes larger and takes greater importance in their lives. Successful aging involves the physical, mental and social well-being of an individual. To enable successful aging of older adults, it is necessary for them to perform both activities of daily living (ADL) and instrumental activities of daily living (IADL). Embedded assessment has made it possible to assess an individual's functional ability in-place, however the success of any technology depends largely on the user than the technology itself. Previous researches in in-situ functional assessment systems have heavily focused on the technology rather than on the user. This dissertation takes a user-centric approach to this problem by trying to identify the design and technical challenges of deploying and using a functional assessment system in the real world.
To investigate this line of research, a case study was conducted with 4 older adults in their homes, interviews were conducted with 8 caregivers and a controlled lab experiment was conducted with 8 young healthy adults at ASU, to test the sensors. This methodology provides a significant opportunity to advance the scientific field by expanding the present focus on IADL task performance to an integrated assessment of ADL and IADL task performance. Doing so would not only be more effective in identifying functional decline but could also provide a more comprehensive assessment of individuals' functional abilities with independence and also providing the caregivers with much needed respite.
The controlled lab study tested the sensors embedded into daily objects and found them to be reliable, and efficient. Short term exploratory case studies with healthy older adults revealed the challenges associated with design and technical aspects of the current system, while inductive analysis performed on interviews with caregivers helped to generate central themes on which future functional assessment systems need to be designed and built. The key central themes were a) focus on design / user experience, b) consider user's characteristics, personality, behavior and functional ability, c) provide support for independence, and d) adapt to individual user's needs.
To investigate this line of research, a case study was conducted with 4 older adults in their homes, interviews were conducted with 8 caregivers and a controlled lab experiment was conducted with 8 young healthy adults at ASU, to test the sensors. This methodology provides a significant opportunity to advance the scientific field by expanding the present focus on IADL task performance to an integrated assessment of ADL and IADL task performance. Doing so would not only be more effective in identifying functional decline but could also provide a more comprehensive assessment of individuals' functional abilities with independence and also providing the caregivers with much needed respite.
The controlled lab study tested the sensors embedded into daily objects and found them to be reliable, and efficient. Short term exploratory case studies with healthy older adults revealed the challenges associated with design and technical aspects of the current system, while inductive analysis performed on interviews with caregivers helped to generate central themes on which future functional assessment systems need to be designed and built. The key central themes were a) focus on design / user experience, b) consider user's characteristics, personality, behavior and functional ability, c) provide support for independence, and d) adapt to individual user's needs.
ContributorsRavishankar, Vijay Kumar (Author) / Burleson, Winslow (Thesis advisor) / Coon, David (Committee member) / Mahoney, Diane (Committee member) / Walker, Erin (Committee member) / Li, Baoxin (Committee member) / Arizona State University (Publisher)
Created2015
Description
ABSTRACT
The population of older adults in the United States is growing disproportionately, with corresponding medical, social and economic implications. The number of Americans 65 years and older constitutes 13.7% of the U.S. population, and is expected to grow to 21% by 2040. As the adults age, they are at risk for developing chronic illness and disability. According to the Centers for Disease Control and Prevention, 5.7 million Americans have heart failure, and almost 80% of these are 65 years and older. The prevalence of heart failure will increase with the increase in aging population, thus increasing the costs associated with heart failure from 34.7 billion dollars in 2010 to 77.7 billion dollars by 2020. Of all cardiovascular hospitalizations, 28.9% are due to heart failure, and almost 60,000 deaths are accounted for heart failure. Marked disparities in heart failure persist within and between population subgroups. Living with heart failure is challenging for older adults, because being a chronic condition, the responsibility of day to day management of heart failure principally rests with patient. Approaches to improve self-management are targeted at adherence, compliance, and physiologic variables, little attention has been paid to personal and social contextual resources of older adults, crucial for decision making, and purposeful participation in goal attainment, representing a critical area for intervention. Several strategies based on empowerment perspective are focused on outcomes; paying less attention to the process. To address these gaps between research and practice, this feasibility study was guided by a tested theory, the Theory of Health Empowerment, to optimize self-management, functional health and well-being in older adults with heart failure. The study sample included older adults with heart failure attending senior centers. Specific aims of this feasibility study were to: (a) examine the feasibility of the Health Empowerment Intervention in older adults with heart failure, (b) evaluate the effect of the health empowerment intervention on self-management, functional health, and well-being among older adults with heart failure. The Health Empowerment Intervention was delivered focusing on strategies to identify and building upon self-capacity, and supportive social network, informed decision making and goal setting, and purposefully participating in the attainment of personal health goals for well-being. Study was feasible and significantly increased personal growth, and purposeful participation in the attainment of personal health goals.
The population of older adults in the United States is growing disproportionately, with corresponding medical, social and economic implications. The number of Americans 65 years and older constitutes 13.7% of the U.S. population, and is expected to grow to 21% by 2040. As the adults age, they are at risk for developing chronic illness and disability. According to the Centers for Disease Control and Prevention, 5.7 million Americans have heart failure, and almost 80% of these are 65 years and older. The prevalence of heart failure will increase with the increase in aging population, thus increasing the costs associated with heart failure from 34.7 billion dollars in 2010 to 77.7 billion dollars by 2020. Of all cardiovascular hospitalizations, 28.9% are due to heart failure, and almost 60,000 deaths are accounted for heart failure. Marked disparities in heart failure persist within and between population subgroups. Living with heart failure is challenging for older adults, because being a chronic condition, the responsibility of day to day management of heart failure principally rests with patient. Approaches to improve self-management are targeted at adherence, compliance, and physiologic variables, little attention has been paid to personal and social contextual resources of older adults, crucial for decision making, and purposeful participation in goal attainment, representing a critical area for intervention. Several strategies based on empowerment perspective are focused on outcomes; paying less attention to the process. To address these gaps between research and practice, this feasibility study was guided by a tested theory, the Theory of Health Empowerment, to optimize self-management, functional health and well-being in older adults with heart failure. The study sample included older adults with heart failure attending senior centers. Specific aims of this feasibility study were to: (a) examine the feasibility of the Health Empowerment Intervention in older adults with heart failure, (b) evaluate the effect of the health empowerment intervention on self-management, functional health, and well-being among older adults with heart failure. The Health Empowerment Intervention was delivered focusing on strategies to identify and building upon self-capacity, and supportive social network, informed decision making and goal setting, and purposefully participating in the attainment of personal health goals for well-being. Study was feasible and significantly increased personal growth, and purposeful participation in the attainment of personal health goals.
ContributorsThakur, Ramesh Devi (Author) / Fleury, Julie (Thesis advisor) / Shearer, Nelma (Committee member) / Belyea, Michael (Committee member) / Arizona State University (Publisher)
Created2017