Background Neuropsychiatric symptoms (NPS) occur in people with dementia throughout disease course and across etiologies. NPS are associated with significant morbidities and hastened disease processes. Nevertheless, people with dementia are not systematically assessed for NPS in clinical settings. We review existing NPS measures for clinical and/or research purposes, and identify measurement gaps. Methods We conducted a computerized search of peer-reviewed published studies of measures (January 1, 1980–December 1, 2013) using multiple search terms. Measures selected for review were in English, had adequate psychometric properties, and were developed for or used with people with dementia. Papers describing measures were evaluated by three coders along seven characteristics: behavioral domains, number of items, method of administration, response categories, targeted population, setting, and psychometric properties. Results Overall, 2,233 papers were identified through search terms, and 36 papers from manual searches of references. From 2,269 papers, 85 measures were identified of which 45 (52.9%) had adequate psychometric properties and were developed or used with dementia populations. Of these, 16 (35.6%) were general measures that included a wide range of behaviors; 29 (64.4%) targeted specific behaviors (e.g. agitation). Measures differed widely as to behaviors assessed and measurement properties. Conclusions A robust set of diverse measures exists for assessing NPS in different settings. No measures identify risk factors for behaviors or enable an evaluation of the context in which behaviors occur. To improve clinical efforts, research is needed to evaluate concordance of behavioral ratings between formal and informal caregivers, and to develop and test measures that can identify known risks for behaviors and the circumstances under which behaviors occur.
ARTICLEHOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE Instructions 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certifi cate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must:1. Read the article, "Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia" found on pages 26-34, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certifi cate will be automatically generated.This activity is valid for continuing education credit until November 30, 2016. Contact HoursThis activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Activity Objectives1. Discuss the learning needs of staff on a dementia care unit.2. Describe challenging behaviors that occur in patients with dementia. Disclosure StatementNeither the planners nor the authors have any confl icts of interest to disclose. of Gerontological Nursing, 40(12),[26][27][28][29][30][31][32][33][34] 26Copyright © SLACK Incorporated cne ARTICLE iors, physiological instability, and safety concerns result in increased risk of hospitalizations (Callahan et al., 2012;Toot, Devine, Akporobaro, & Orrell, 2013). In the hospital, staff often confront behavioral challenges, for which little formal training is provided. Common behavioral challenges include medication refusal, rejection of needed assistance, fearfulness of medical procedures, heightened confusion, agitation, and verbal/ physical aggression toward staff (Galvin et al., 2010).Managing behaviors is associated with low job satisfaction and burnout (Brodaty, Draper, & Low, 2003;Miyamoto, Tachimori, & Ito, 2010 Dementia, 2014;Sadowsky & Galvin, 2012). Although nonpharmacological approaches to managing behaviors are endorsed by medical organizations a...
Aims and Objectives To explore the interventions aimed at increasing human papillomavirus (HPV) vaccination rates among adolescents in family practice settings. Background HPV is the most common sexually transmitted disease in the United States, and the cause of thousands of anogenital and oropharyngeal cancers annually. Although HPV infection can be prevented with recommended vaccination during adolescence, national HPV vaccine rates remain low. Design Systematic review. Methods Four databases (MEDLINE, CINAHL, EMBASE and the Cochrane Library) were searched. The search was guided by PRISMA and by the question, ‘What are targeted interventions that improve HPV vaccination rates among adolescents in family practice settings?’ Articles were reviewed for study characteristics and appraised for quality using the revised Cochrane risk of bias tools. Results Eleven studies met inclusion and exclusion criteria. Individual study size samples ranged from 749–147,294, with a combined total from all included studies of 276,205; the largest sample reviewed to date from family practice settings. Interventions used to increase HPV vaccination rates included reminder systems; provider and staff education; sensory incentives such as hitting a gong or petting a puppy; and iPad tailored messaging programmes. Studies that employed interventions pre‐, during and postvisit were most effective in increasing HPV vaccination rates. Conclusions This review provides the largest data supporting multimodal strategies to increase HPV vaccination rates among adolescent populations. It provides strong evidence to suggest that vaccination rates can be improved using measures at varying times of the patient visit. Relevance to Clinical Practice Adolescents seek health care in various settings. Many studies have examined interventions to increase HPV vaccination in paediatric settings, but few have examined interventions in family practice settings. This review suggests that family practices should implement multimodal measures before, during and after visits to increase HPV vaccination among adolescent patients.
Various factors have compelled nurse educators to address the lack of substance use-related content in nursing curriculum. Initiatives to add this content are often met with resistance because of an already crowded curriculum. This article describes a 4-phase process that guided the integration of this specialty content into a prelicensure nursing curriculum and a master's level advanced practice nursing curriculum. Lessons learned and recommendations from those experiences are provided to guide nurse educators undertaking similar efforts.
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