Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.     

The “Our Homes,Not Nursing Homes” Project

ABSTRACT

The voices of non-elderly adults with disabilities who currently-or used to-reside in nursing homes are rarely heard. A grassroots disability advocacy organization conducts participatory action research in the form of a writing workshop in collaboration with a local community-college. Participants with disabilities describe their lives and their experiences in nursing homes with the help of volunteer scribes. The information provided in their accounts will help strengthen community-organizing efforts of the disability advocacy organization. And participants have been empowered by the realization that their life stories are helping others to leave nursing homes and join community settings.     

人口老龄化背景下机构养老国内外研究比较

当前学界对机构养老的讨论日趋热烈,但遍观国内现有文献,对国外机构养老研究进展普遍关注不足。本研究通过从机构养老的概念界定、养老机构、入住老年人群、机构养老服务质量这四个维度对国内外机构养老研究成果进行归类梳理,发现国内机构养老研究在功能界定、管理与运营、服务质量监管等方面差距较大,而对于入住老年人群的需求和入住意愿分析方面则与西方差距较小。同时,我国机构养老的理论对于实践的指导作用并不显著,我国理论界相对于养老实践有滞后之虞。基于以上分析,本文提出以下建议：探索机构养老发展的新模式,完善养老机构管理与运营结构以及发展第三方服务监管体系。     

护理专业课程设置改革的探索

对护理专业的课程设置和调整势在必行。应加强人文学科、护理保健等课程 ,拓宽新世纪护理专门人才知识结构 ,在护理专业课程设置改革中要有创新性、超前性。     

Criteria families use to select nursing homes

The study is conducted to determine families' rankings of characteristics they consider most important when selecting a nursing home. Friedman's two-way analysis of variance is used to test for differences in the rankings. In response to a mailed survey, 231 families rank the characteristics in the following order: quality of care, appearance, atmosphere, location, reputation, building safety, quality of food, cost, and activities. Relationships are also found between the rankings and the demographic characteristics: gender, marital status, education, income, number of homes available, patient/respondent relationship, and distance respondent lived from the chosen home.     

The Invisible (Inaudible) Woman: Nursing in the English Academy

Nursing is numerically a far larger academic discipline than medicine, and is situated in many more higher education institutions in England (over 50), whereas there are 21 medical schools. Like the rest of ‘non medical education and training’ it is purchased through a quasi‐market. Despite the size of this market, however, nursing education has until recently been largely invisible in policy documents and the ambitions of nursing academics to develop their subject are seen as inappropriate. This article explores this invisibility and inaudibility, with particular reference to the 1997 Richards Report, Clinical Academic Careers and the 2001 Nuffield Trust report, A New Framework for NHS/University Relations. It draws on the work of Davies on the ‘professional predicament’ of nursing, to argue that, although the move of nursing education into higher education had the aim of improving its status, nursing has difficulty finding its voice within academia. As a result, issues which are salient for nursing (as for many of the health professions), such as a poor (or relatively poor) showing in the Research Assessment Exercise and the complexities of balancing research, teaching and maintaining clinical competence, are raised as high‐profile issues only in medicine.     

舟山独生子女家庭养老的策略选择

独生子女家庭养老备受社会关注。舟山作为计划生育政策执行好的城市,独子家庭比例较高。家庭规模缩小,传统家庭赡养功能被削弱,加之社会养老准备不足,"空巢"现象突出、养老产业滞后、医疗护理服务缺失等,造成影响经济社会发展的系列问题。为此,必须弘扬传统敬老美德,保障老人正当权益;改变传统养老的陋习,创新养老模式;大力发展中介机构,全面推进"银发工程";强化政府责任和投入,完善独生子女家庭养老政策;制定鼓励政策和措施,开发并利用老人发挥余热。     

论中医护理理论的形成与特色

中医护理学的历史十分久远 ,它起源于个别零星病案的诊疗体会 ,经历了许多朝代 ,汇积了历史上各个医家的临床护理经验 ,直至形成了当今比较系统的辨证施护理论。中医护理具有整体性、客观性、实用性的特点 ,对现代护理理论的形成起着不可估量的作用     

跨文化背景下儿向语的普遍性特征

儿向语是成人对儿童的一种简易化的特殊语言。最早是由西方中产阶级提出并运用的。对这种语言现象,目前有两种看法,一种观点认为这是一种语言句法的学习形式,另一种则认为是一种交流形式。西方心理语言学家认为儿向语在不同的语言和文化群体中有不同的表现。不同的文化背景下会形成不同的看护儿童的理念,也决定了儿向语在该文化背景下的特点。     

试论护理管理者的考核与提高

护理管理者在医院管理队伍中占很大比重。护理管理者只有具备很好的综合素质和管理能力,才能顺利完成各项护理工作并推动护理事业不断发展。通过对护理管理队伍现状的分析,提出对护理管理者进行动态考核的内容。