International Survey of Nursing Home Research Priorities

doi:10.1016/j.jamda.2014.03.003

Journal of the American Medical Directors Association

Volume 15, Issue 5, May 2014, Pages 309-312

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https://doi.org/10.1016/j.jamda.2014.03.003 Get rights and content

Abstract

This article reports the findings of a policy survey designed to establish research priorities to inform future research strategy and advance nursing home practice. The survey was administered in 2 rounds during 2013, and involved a combination of open questions and ranking exercises to move toward consensus on the research priorities. A key finding was the prioritization of research to underpin the care of people with cognitive impairment/dementia and of the management of the behavioral and psychological symptoms of dementia within the nursing home. Other important areas were end-of-life care, nutrition, polypharmacy, and developing new approaches to putting evidence-based practices into routine practice in nursing homes. It explores possible innovative educational approaches, reasons why best practices are difficult to implement, and challenges faced in developing high-quality nursing home research.

Section snippets

Methods

Integrating knowledge and expertise across a range of stakeholders and disciplines is an essential component of reaching consensus on policy directions and is applicable to the identification of research priorities.⁹ Methods for achieving consensus are often framed around Delphi approaches with expert panels and a range of analytical group processes. In this study, we took a pragmatic approach and limited our survey to 2 rounds, with consensus development through simple ranking techniques.

Results

The top 15 research priorities are listed in Table 1. Caring for persons with cognitive impairment and behavioral symptoms of dementia were ranked first and second, respectively. Three of the top priorities focused on end-of-life care (effect of palliative [end-of-life] care; advance-care planning, and aggressive treatment withdrawal). Other research questions listed by the nursing home experts but not ranked as highest priority included educational delivery, international survey of nursing

Discussion

International nursing home experts clearly identified the 2 most important areas for research to be a focus on the needs of cognitively impaired residents, including the management of challenging behaviors and the need to focus on palliative and end-of-life care. Approaches to improving care for the cognitively impaired10, 11, 12, 13, 14, 15, 16 and issues related to palliative and end-of-life care17, 18, 19 have been highlighted previously in the Journal.

Surprisingly, transitions of care,

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Unplanned Hospital Visits and Poor Oral Health With Undernutrition in Nursing Home Residents
2023, Journal of the American Medical Directors Association
In 2021, the Japanese government began operating a long-term care (LTC) database called the Long-Term Care Information System for Evidence (LIFE). However, its utility has not been verified. Regarding unplanned hospital visits of nursing home residents, one of the challenges in LTC is that poor oral health with undernutrition could indicate high-risk residents. Therefore, this study examined the association between poor oral health with undernutrition assessed using the LIFE data and unplanned hospital visits of nursing home residents.
Retrospective cohort study.
The participants were 237 residents aged ≥65 years in 4 nursing homes in Japan. The analyses included 1041 LIFE data entries repeatedly measured for the participants every month and unplanned hospital visit data during the observation period.
The participants' LIFE and unplanned hospital visit data were obtained from the nursing home providers. Poor oral health was defined using oral items included in the LIFE data and body mass index. Using the LIFE data, the association between poor oral health and unplanned hospital visits within 1 month after LIFE assessment entries was analyzed. The odds ratios (ORs) and 95% CIs were calculated using a generalized linear mixed model.
In total, 59 of 1041 LIFE data (5.7%) entries were unplanned hospital visits within 1 month after LIFE assessment. Among patient characteristics, significant differences were noted in dementia diagnosis [OR (95% CI): 2.66 (1.26-5.63)], although no significant differences were observed in other characteristics. Multivariate analysis using participant identification as a random effect confirmed that poor oral health was associated with unplanned hospital visits within 1 month [adjusted OR (95% CI): 2.63 (1.05-6.61)].
Poor oral health assessed using the LIFE data could be used as an indicator to identify nursing home residents at high risk for unplanned hospital visits.
Nurses’ and midwives’ participation and utilization of health-related research in Kenya: Implications for evidence-based practice
2023, International Journal of Nursing Sciences
To assess the level of participation of nurses and midwives in health-related research, determine the status of utilization of research to inform nursing and midwifery practice in Kenya, and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya.
Data were extracted from online survey responses of 156 nurse and midwife educators, practitioners, and managers/administrators. SPSS version 26 was used to analyze quantitative data; qualitative data were analyzed using Excel to organize data into categories.
Over one-third of participants reported ever publishing research (37.2%, 58/156). Participants reported using knowledge gained in nursing school to guide practice most frequently (n = 148). Utilization of research findings to guide practice was reported by 80.3% (110/137) of participants. Strategies to enhance participation in the research included research training, research forums, policy reforms, and emphasis on research in curricula.
There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.
The use of herbs and spices in sodium-reduced meals enhances saltiness and is highly accepted by the elderly
2023, Food Quality and Preference
Dietary intake of sodium by the elderly population in nursing homes should be monitored due to the greater sensitivity of elderly people to sodium. This study aimed to explore any associations between sodium intake and salt taste perception in an institutionalized elderly population and to research the potential of sodium reduction by the use of herbs and spices. The study included 123 senior citizens in nursing home who were on average 80.7 (±5.8) years old. The nutritionist collected data on sodium intake by using 24-hour recall on two non-consecutive days, and taste perception was assessed by salty taste detection and recognition thresholds. An intervention study of sodium reduction was tested on three categories of dishes, potentially high sources of sodium. The participants were divided into three intervention groups, the control group, the 30 % sodium reduction group, and the 30 % sodium reduction with an added blend of herbs and spices. The elderly's average sodium intake exceeded the recommendation by 70 %. The study determined a significant positive correlation between sodium intake and a higher salt taste threshold (r = 0.17; p < 0.05). The saltiness of sodium-reduced foods was significantly lower than the control, but herbs and spices enhanced the saltiness, and the intensity was the same as the control. The liking for sodium-reduced meals was the same as for the control. A declining salty taste is an important determinant of elderly nursing home residents' adherence to the dietary recommendation for sodium intake. Reducing sodium content in meals through the careful addition of spices and herbs aids elderly people in maintaining healthy dietary habits.
Optimizing mealtime care for people with dementia from the perspective of formal caregivers: A systematic review of qualitative research
2021, International Journal of Nursing Studies
As dementia progresses, people with dementia experience many problems during mealtimes that seriously affect their physical, psychological, and social health and quality of life. Formal caregivers play an important role in optimizing mealtime care.
To systematically review and synthesise relevant qualitative studies exploring the experience and perceptions of formal caregivers regarding optimizing mealtime care for people with dementia.
A systematic review of qualitative research.
The PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang and Vip databases were systematically searched.
Two reviewers independently screened the titles and abstracts, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis.
A total of 10 studies were included. The formal caregivers included nursing assistants, nurses, speech and language therapists, nursing students, dietitians, a social worker, a professional educator, physiotherapists, health care aides, kitchen staff, diversional therapy assistants and other unidentified care staff. The findings were synthesised into the following 3 analytical themes: (1) tailored rather than standardized; (2) emotional nurturance; and (3) beyond the individual level.
Mealtimes involve complex physiological and psychological processes. Formal caregivers should develop tailored care practices based on individual patients’ preferences and needs. Emotional connection plays a key role and has a positive impact on the mealtime experience. Further research is needed to explore the specific effects of emotional connections on optimizing mealtime care.
Improvement of quality of life and postural balance of institutionalized elderly people undergoing to a treadmill walking training
2021, Journal of Bodywork and Movement Therapies
Institutionalized older adults have fewer opportunities to participate in daily living activities and tasks in an independent manner, with greater deleterious effects on the physiological losses inherent to aging and with increased gait and balance impairment compared to community-dwelling older adults. The use of a treadmill for rehabilitation, with or without partial weight support, has been studied in different groups, but not on institutionalized older adults.
To assess the effects of a treadmill walking program on the postural balance and quality of life of institutionalized older adults.
Thirty-seven institutionalized older adults: intervention group (n = 23, 75.7 ± 7.8 years) and control group (n = 14, 78.9 ± 10.2 years). A total of 10 weeks of treadmill walking, twice a week (intervention group) vs. no training (control group). Postural balance was assessed by the Tinetti test, 6-min walk test (6MWT), and 10-m walk test and Quality of life with the WHOQOL-Bref questionnaire.
Significant improvement was observed in balance parameters (6MWT distance: p < 0.001; gait speed 6MWT: p < 0.001; gait speed 10MWT: p < 0.001; Tinetti scale: p = 0.001), and in the physical (p = 0.01), psychological (p = 0.002), self-assessed quality of life (p = 0.01) and overall quality of life domains (p = 0.002).
Treadmill walking program had positive effects on the postural balance and quality of life of institutionalized older adults.
Staff Training Interventions to Improve End-of-Life Care of Nursing Home Residents: A Systematic Review
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The aim was to review evidence from all randomized controlled trials (RCTs) using palliative care education or staff training as an intervention to improve nursing home residents' quality of life (QOL) or quality of dying (QOD) or to reduce burdensome hospitalizations.
A systematic review with a narrative summary.
Residents in nursing homes and other long-term care facilities.
We searched MEDLINE, CINAHL, PsycINFO, the Cochrane Library, Scopus, and Google Scholar, references of known articles, previous reviews, and recent volumes of key journals. RCTs were included in the review. Methodologic quality was assessed.
The search yielded 932 articles after removing the duplicates. Of them, 16 cluster RCTs fulfilled inclusion criteria for analysis. There was a great variety in the interventions with respect to learning methods, intensity, complexity, and length of staff training. Most interventions featured other elements besides staff training. In the 6 high-quality trials, only 1 showed a reduction in hospitalizations, whereas among 6 moderate-quality trials 2 suggested a reduction in hospitalizations. None of the high-quality trials showed effects on residents' QOL or QOD. Staff reported an improved QOD in 1 moderate-quality trial.
Irrespective of the means of staff training, there were surprisingly few effects of education on residents' QOL, QOD, or burdensome hospitalizations. Further studies are needed to explore the reasons behind these findings.

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: The authors declare no conflicts of interest.

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Special ArticleInternational Survey of Nursing Home Research Priorities

Abstract

Section snippets

Methods

Results

Discussion

J Nutr Health Aging

J Nutr Health Aging

J Am Med Dir Assoc

J Nutr Health Aging

Med Clin North Am

J Am Med Dir Assoc

J Am Med Dir Assoc

Int J Forecast

J Am Med Dir Assoc

J Am Med Dir Assoc

J Am Med Dir Assoc

J Am Med Dir Assoc

J Am Med Dir Assoc

J Nutr Health Aging

J Nutr Health Aging

J Am Med Dir Assoc

Special Article
International Survey of Nursing Home Research Priorities