In nursing homes, antipsychotic prescribing decisions (APDs) for managing behavioral and psychological symptoms of dementia (BPSD) depend on the nursing staff’s feedback. Inappropriate APDs can result in the lack of ...In nursing homes, antipsychotic prescribing decisions (APDs) for managing behavioral and psychological symptoms of dementia (BPSD) depend on the nursing staff’s feedback. Inappropriate APDs can result in the lack of timeliness, objectivity and important clinical information when nursing staff’s feedback on residents’ behavior and pharmacotherapy outcomes. Currently, there are no reported interventions for improving psychiatrists’ APDs through nursing staff’s monitoring and feedback processes. This one-group pre-and-post pilot study aimed to evaluate the feasibility and impact of implementing a newly-developed Psychotropic Use Monitoring (PUM) program for improving the appropriateness of APDs in a 50-bed dementia ward of a nursing home. The PUM intervention involved 16 pharmacist-trained nursing staff, who monitored and reported residents’ BPSD changes and psychotropic side effects for 24 weeks, while carrying out their routine care duties. A face-to-face interview was then administered to determine the nursing staff’s perceptions of PUM. Data of 51 residents were collected from hardcopy individual patient records to evaluate the changes in APDs and the number of resident falls before and after implementing PUM. The nursing staff reported increases in their knowledge, awareness, confidence, and actual frequency of monitoring for side effects, as well as their ability in differentiating and managing BPSD (p < 0.05). After PUM, there was a significant increase in the number of APDs due to side effect-related reasons (4 versus 16) (p < 0.031). Although not significant, the number of APDs with no documented reasons (5 versus 9) and the number of resident falls (7 versus 15) appeared to be lesser after PUM. This study demonstrated the nursing staff’s positive participation in PUM intervention, specifically in monitoring and feedback of side effects. Furthermore, a potential exists for PUM to encourage more judicious APDs, which may be useful in settings with heavy patient load, limited human resources and dependence on foreign nursing staff from differing cultural backgrounds.展开更多
目的构建老年脑卒中患者跌倒恐惧(fear of falling,FoF)干预方案,以降低老年脑卒中患者FoF程度,提高患者活动水平。方法系统检索国内外文献,以理论域的行为改变技术为指导,构建老年脑卒中患者FoF干预方案初稿。通过德尔菲法进行2轮专家...目的构建老年脑卒中患者跌倒恐惧(fear of falling,FoF)干预方案,以降低老年脑卒中患者FoF程度,提高患者活动水平。方法系统检索国内外文献,以理论域的行为改变技术为指导,构建老年脑卒中患者FoF干预方案初稿。通过德尔菲法进行2轮专家函询,征询专家意见并修订,形成方案终稿。结果经过2轮函询后15名专家意见趋于一致,专家权威系数为0.923,肯德尔和谐系数为0.204(P<0.001),条目变异系数为0.000~0.198,最终形成的干预方案涉及到7个理论领域,分为基础内容和巩固提升2个阶段。结论构建的老年脑卒中患者FoF干预方案具有科学性,能为降低老年脑卒中患者FoF提供指导。展开更多
目的调查结直肠患者化疗间歇期静态行为现状,并分析其影响因素,为提高患者体力活动水平提供参考。方法采取便利抽样方法抽取200例住院结直肠化疗间歇期患者,采用一般资料问卷、静态行为问卷、国际跌倒效能感量表、运动障碍量表和家庭关...目的调查结直肠患者化疗间歇期静态行为现状,并分析其影响因素,为提高患者体力活动水平提供参考。方法采取便利抽样方法抽取200例住院结直肠化疗间歇期患者,采用一般资料问卷、静态行为问卷、国际跌倒效能感量表、运动障碍量表和家庭关怀度量表进行调查。结果结直肠癌患者化疗间歇期静态行为时间为7.6(5.5,8.6)h,静态行为≥6 h 136例(68.00%)。年龄、化疗周期、疼痛、跌倒效能感水平、家庭关怀度是结直肠癌患者化疗间歇期静态行为的影响因素(均P<0.05)。结论结直肠癌患者化疗间歇期静态行为时间较长,医护人员需根据危险因素采取针对性的措施积极干预,改善患者的静态行为。展开更多
文摘In nursing homes, antipsychotic prescribing decisions (APDs) for managing behavioral and psychological symptoms of dementia (BPSD) depend on the nursing staff’s feedback. Inappropriate APDs can result in the lack of timeliness, objectivity and important clinical information when nursing staff’s feedback on residents’ behavior and pharmacotherapy outcomes. Currently, there are no reported interventions for improving psychiatrists’ APDs through nursing staff’s monitoring and feedback processes. This one-group pre-and-post pilot study aimed to evaluate the feasibility and impact of implementing a newly-developed Psychotropic Use Monitoring (PUM) program for improving the appropriateness of APDs in a 50-bed dementia ward of a nursing home. The PUM intervention involved 16 pharmacist-trained nursing staff, who monitored and reported residents’ BPSD changes and psychotropic side effects for 24 weeks, while carrying out their routine care duties. A face-to-face interview was then administered to determine the nursing staff’s perceptions of PUM. Data of 51 residents were collected from hardcopy individual patient records to evaluate the changes in APDs and the number of resident falls before and after implementing PUM. The nursing staff reported increases in their knowledge, awareness, confidence, and actual frequency of monitoring for side effects, as well as their ability in differentiating and managing BPSD (p < 0.05). After PUM, there was a significant increase in the number of APDs due to side effect-related reasons (4 versus 16) (p < 0.031). Although not significant, the number of APDs with no documented reasons (5 versus 9) and the number of resident falls (7 versus 15) appeared to be lesser after PUM. This study demonstrated the nursing staff’s positive participation in PUM intervention, specifically in monitoring and feedback of side effects. Furthermore, a potential exists for PUM to encourage more judicious APDs, which may be useful in settings with heavy patient load, limited human resources and dependence on foreign nursing staff from differing cultural backgrounds.
文摘目的构建老年脑卒中患者跌倒恐惧(fear of falling,FoF)干预方案,以降低老年脑卒中患者FoF程度,提高患者活动水平。方法系统检索国内外文献,以理论域的行为改变技术为指导,构建老年脑卒中患者FoF干预方案初稿。通过德尔菲法进行2轮专家函询,征询专家意见并修订,形成方案终稿。结果经过2轮函询后15名专家意见趋于一致,专家权威系数为0.923,肯德尔和谐系数为0.204(P<0.001),条目变异系数为0.000~0.198,最终形成的干预方案涉及到7个理论领域,分为基础内容和巩固提升2个阶段。结论构建的老年脑卒中患者FoF干预方案具有科学性,能为降低老年脑卒中患者FoF提供指导。
文摘目的调查结直肠患者化疗间歇期静态行为现状,并分析其影响因素,为提高患者体力活动水平提供参考。方法采取便利抽样方法抽取200例住院结直肠化疗间歇期患者,采用一般资料问卷、静态行为问卷、国际跌倒效能感量表、运动障碍量表和家庭关怀度量表进行调查。结果结直肠癌患者化疗间歇期静态行为时间为7.6(5.5,8.6)h,静态行为≥6 h 136例(68.00%)。年龄、化疗周期、疼痛、跌倒效能感水平、家庭关怀度是结直肠癌患者化疗间歇期静态行为的影响因素(均P<0.05)。结论结直肠癌患者化疗间歇期静态行为时间较长,医护人员需根据危险因素采取针对性的措施积极干预,改善患者的静态行为。
