Falling is a serious hazard for older veterans that may lead to severe injury, loss of independence, and death. While the American Geriatric Society (AGS) provides guidelines to screen individuals at-risk for falls, the guidelines may be less successful with specific subgroups of patients. In a veteran sample, we examined whether the Timed Up and Go (TUG) test, including a modified version, the TUG-cognition, effectively detected potential fallers whose risk was associated with cognitive deficits. Specifically, we sought to determine whether TUG tasks and AGS criteria were differentially associated with executive dysfunction, whether the TUG tasks identified potential fallers outside of those recognized by AGS criteria, and whether these tasks distinguished groups of fallers. Participants included 120 mostly male patients referred to the Memory Assessment Clinic due to cognitive impairment. TUG-cognition scores were strongly associated with executive dysfunction and differed systematically between fallers grouped by number of falls. These findings suggest that the TUG-cognition shows promise in identifying fallers whose risk is related to, or compounded by cognitive impairment. Future research should study the predictive validity of these measures by following patients prospectively.
Previous studies revealed that an alarming number of family therapists exclude children from family therapy, largely because they lacked comfort with children and perceived that their training, especially in play therapy, was inadequate. Implementing findings from one earlier study, a child-focused course was designed to address these issues. This current study examined students' perceptions of the efficacy of this course in developing their knowledge and skills to treat children individually and in family sessions. Following institutional review board approval, 43 out of the 44 students enrolled in the child course over five semesters agreed to participate. A qualitative content analysis was utilized to explore participants' written responses to openended questions on a questionnaire administered in the last class. Four overall themes emerged from the data: (1) training, (2) skills, (3) impact of training, and (4) knowledge. Frequency counts revealed the three subthemes/topics with the most comments: (1) the benefits of hands-on training, (2) students plan to continue child-focused training, and (3) general comments about the training in play interventions. Many reported increased comfort with children, and that they were more likely to work with children. Students' comments reflect a significant increase in their perceived ability to work effectively with children and families. The findings indicate that many students experienced personal growth and significant development of their childrelated knowledge, skills, and use of play therapy techniques. Included are a description of the course, recommendations, and limitations of the study.
Abstract-Falling is a serious hazard for older veterans that may lead to severe injury, loss of independence, and death. While the American Geriatrics Society (AGS) provides guidelines to screen individuals at risk for falls, the guidelines may be less successful with specific subgroups of patients. In a veteran sample, we examined whether the Timed Up and Go (TUG) test, including a modified version, the TUG-Cognition, effectively detected potential fallers whose risk was associated with cognitive deficits. Specifically, we sought to determine whether TUG tasks and AGS criteria were differentially associated with executive dysfunction, whether the TUG tasks identified potential fallers outside of those recognized by AGS criteria, and whether these tasks distinguished groups of fallers. Participants included 120 mostly male patients referred to the Memory Assessment Clinic because of cognitive impairment. TUG-Cognition scores were strongly associated with executive dysfunction and differed systematically between fallers grouped by number of falls. These findings suggest that the TUG-Cognition shows promise in identifying fallers whose risk is related to or compounded by cognitive impairment. Future research should study the predictive validity of these measures by following patients prospectively.
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