Demographic and Socioenvironmental Characteristics of Black and White Community-Dwelling Caregivers and Care Recipients' Behavioral and Psychological Symptoms of Dementia.

The purpose of the current study was to compare the association between caregiver background characteristics and care recipients' behavioral and psychological symptoms of dementia (BPSD) in Black and White community-dwelling family caregivers. Using logistic regression models, caregiver/care recipient dyad data from the Aging Demographics and Memory Study were used to describe associations between caregiver background characteristics (i.e.

Nursing opinion leadership: a preliminary model derived from philosophic theories of rational belief.

Opinion leaders are informal leaders who have the ability to influence others' decisions about adopting new products, practices or ideas. In the healthcare setting, the importance of translating new research evidence into practice has led to interest in understanding how opinion leaders could be used to speed this process. Despite continued interest, gaps in understanding opinion leadership remain.

Measurement of aggressive behaviors in dementia: comparison of the physical aggression subscales of the Cohen-Mansfield Agitation Inventory and the Ryden Aggression Scale.

One of the central issues in the development of research-based interventions for aggressive behavior (AB) in late-stage dementia is the provision of precise measurement of the major dependent variable, in this case, AB levels. To advance the nursing goal of evidence-based practice, this article presents the characteristics of two research instruments: the Cohen-Mansfield Agitation Inventory (CMAI) aggressive behavior subscale (CMAI-ABS) and the Ryden Aggression Scale (RAS) physically aggressive behavior subscale (RAS-PABS). A total of 282 shower bath events (which are most associated with AB) were observed for 107 nursing home residents with dementia in nine randomly selected nursing homes.

Nonlinear indices of circadian changes in individuals with dementia and aggression.

Nonlinear analyses of actigraphy data were utilized to investigate circadian rest-activity system motor control in nursing-home residents with dementia and with/without aggressive behavior (AB). Significant differences observed between groups in measures of approximate entropy (ApEn) and fractal dimension (FD). ApEn and FD are sensitive to detecting and characterizing discrete changes in central motoric control and temporality of behaviors in dementia.

Factors associated with problematic vocalizations in nursing home residents with dementia.

Purpose Of The Study: Problematic vocalizations (PVs) are the most frequent and persistent disruptive behaviors exhibited by nursing home residents with dementia. Understanding factors associated with these behaviors are important to prevent or reduce them. We used the Need-Driven Dementia-Compromised Behavior model to identify the characteristics of persons with dementia who are likely to display nonaggressive and aggressive PVs and the conditions under which these behaviors are likely to occur and persist.

A philosophical analysis of agent-based modelling: a new tool for theory development in nursing.

Aim: In this paper we present a discussion of the nature of agent-based modelling from nursing's philosophical perspectives and truth criteria as a means of evaluating this methodological tool's disciplinary fit.

Background: Agent-based modelling is a new methodological tool used to study complex systems. Researchers from a multitude of disciplines are using agent-based models to enhance understanding of problems that transcend disciplinary and geographical boundaries.

Contributing factors associated with impulsivity-related falls in hospitalized, older adults.

Impulsivity-related falls (IRFs) sustained by hospitalized, older adults can lead to critical adverse events. The purpose of this study was to determine whether 7 common fall risk factors contributed to the occurrence of IRF in hospitalized, older adults. This study found that 31% of falls were classified as IRF.

Evaluating the relationship between inattention and impulsivity-related falls in hospitalized older adults.

Impulsivity in older adults is poorly understood and there is limited literature on the relationship between impulsivity and falls. This retrospective study evaluated the relationship between of inattention and impulsivity related falls (IRF) in hospitalized older adults. The sample (N = 192) included patients 65 years and older with a documented in-patient fall in 2007.

Factors associated with aggressive behavior among nursing home residents with dementia.

Purpose: In an attempt to more thoroughly describe aggressive behavior in nursing home residents with dementia, we examined background and proximal factors as guided by the Need-Driven Dementia-Compromised Behavior model.

Design And Methods: We used a multivariate cross-sectional survey with repeated measures; participants resided in nine randomly selected nursing homes within four midwestern counties. The Minimum Data Set (with verification by caregivers) identified participants.

Preserved implicit memory in dementia: a potential model for care.

A growing body of evidence supports the presence of a preserved implicit memory (PIM) system for persons with Alzheimer's disease (AD). This article describes a new approach to dementia care, the PIM model, which translates evidence from implicit memory research into a practice model of dementia care. The PIM model predicts that function can be sustained longer for persons with AD through interventions and environments that activate an individual's PIM.

Initial psychometrics of the ambiance scale: a tool to study person-environment interaction in dementia.

Our purpose was to evaluate the psychometric properties of the Ambiance Scale (AS), a new instrument that assesses the capacity of long-term care environments for generating affective and behavioural responses in people with dementia. Within the context of three parent studies of dementia-related behaviour in long-term care settings, we conducted a cross-sectional correlational study by creating two separate samples of ratings from among all those available. Factor analysis revealed a two-factor structure (engaging, soothing) for the AS.

Factors associated with psychotropic drug usage among nursing home residents with dementia.

Background: Although federal regulations hold nursing homes responsible for monitoring psychotropic drug (PD) usage, there is a high prevalence of PD usage and significant variation in use across nursing homes.

Objectives: The aims of study were to (a) describe current PD usage in nursing homes and (b) examine resident and nursing home factors associated with PD usage in nursing home residents with dementia.

Methods: A multivariate, multisite, cross-sectional descriptive study was used on data from 107 dementia patients residing in nine randomly selected nursing homes in southeastern Michigan.

Expert nurses' use of implicit memory in the care of patients with Alzheimer's disease.

Aim: This paper reports a study exploring expert nurses' use of implicit memory in the care of people with Alzheimer's disease.

Background: Although research has shown the benefits of preserving and using implicit memory in patients with Alzheimer's disease, the literature shows little evidence of how nurses, in particular expert ones, make use of implicit memory with this client group in clinical practice.

Method: Semi-structured interviews were carried out with a purposive sample of eight nurses (four from Michigan, United States of America and four from Northern Ireland) in 2004.

Teaching interdisciplinary geriatrics ambulatory care: a case study.

Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary care to learners from internal medicine, social work, pharmacy, and nursing in a geriatrics clinic at a major academic institution in the United States.

An ontological view of advanced practice nursing.

Identifying, developing, and incorporating nursing's unique ontological and epistemological perspective into advanced practice nursing practice places priority on delivering care based on research-derived knowledge. Without a clear distinction of our metatheoretical space, we risk blindly adopting the practice values of other disciplines, which may not necessarily reflect those of nursing. A lack of focus may lead current advanced practice nursing curricula and emerging doctorate of nursing practice programs to mirror the logical positivist paradigm and perspective of medicine.

Getting lost: directed attention and executive functions in early Alzheimer's disease patients.

This study explores the link between directed attention (DA) and getting lost behavior (GLB) in early Alzheimer's disease (AD) using a cross-sectional design with 3 groups. Based on their dementia levels, 116 community-dwelling participants were recruited from a teaching hospital in Taiwan and classified as the non-demented control, questionably demented, and mild AD groups. Statistical analyses include Pearson correlations, one-way ANOVA, and multiple regressions.

Deriving interventions from the NDB model. Using natural environment and implicit memory theories.

By drawing on theoretical propositions developed outside nursing, and by modifying and synthesizing these with nursing experiential data, useful statements for practice may be developed for further examination. Because practice theory for the care of patients with dementia is not well-developed or well-examined yet, the process described here to develop meaningful interventions for practice should be further explored and evaluated.

Implicit memory and familiarity among elders with dementia.

Purpose: To propose a framework for familiar environment as a cue for maintaining or maximizing functional abilities in elders with dementia.

Organizing Construct: The organizing construct is the sense of familiarity. Although a feeling of familiarity can be processed in both explicit and implicit memory in normal populations, it is retrieved more frequently and efficiently in the implicit memory system than through explicit memory in elders with dementia.

The unrecognized paradigm shift in nursing: implications, problems, and possibilities.

An important paradigm (or worldview) shift is occurring in science that affects the nature of nursing education, practice, and research. The shift from positivism to postmodernism and now to neomodernism has received little attention in US nursing and as such may forestall many opportunities related to such change. The nature of this paradigm shift and its effects on selected aspects of nursing education, practice, and research are described, and related implications, problems, and possibilities are explored.