The effects of the Positive Environment Program (PEP) on the behaviors of adults with profound cognitive and physical disabilities

Realon, Rodney E.; Bligen, Richard A.; Force, Anne La; Helsel, William J.; Goldman, Vinston J.

doi:10.1002/bin.102

Cited by 20 publications

(32 citation statements)

References 14 publications

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“…An experienced children’s nurse and nurse educationalist (TM) helped to develop the nurse-led package of care. SN was a chartered psychologist who had obtained a research PhD supervised by PG and DT, examining new methods of care for night-time wetting [11]. She joined the expert group and undertook the initial audit of GP referrals.…”

Section: Methodsmentioning

confidence: 99%

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Development of an early nurse led intervention to treat children referred to secondary paediatric care with constipation with or without soiling

et al. 2013

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BackgroundConstipation is a common chronic childhood condition referred to secondary care. Effective treatment requires early intervention, prolonged medication to soften stools and behavioural support to achieve a regular habit of sitting on the toilet to pass a stool. The purpose of this audit and service development was to assess routine consultant paediatrician-led care against minimum standards and if appropriate to develop a nurse-led intervention. The new care package could then be tried out within general paediatric clinics in Glasgow as a service evaluation. NICE guideline (CG99) has a research recommendation to compare nurse-led care with routine consultant-led care.MethodsDesign was an audit then development of a nurse-led intervention followed by a service evaluation. Participants were children (age 0–13 years), referred by their General Practitioner (GP) to the Royal Hospital for Sick Children Glasgow, with constipation the main problem in the GP letter. The audit covered appointment waiting times, intervention provided, initial follow-up and parental satisfaction with routine consultant-led practice. The nurse-led intervention focused on self-help psychology practice with NICE guideline medical support. This was compared with routine consultant paediatrician care in a service evaluation.ResultsThe audit found consultant-led care had long waiting times, delayed initial follow-up and variable intervention. The new nurse-led intervention is described in detail. The nurse-led intervention performed well compared with consultant-led care. Less ‘nurse-led’ children, 3/45 (7%), were still constipated passing less than 3 stools per week compared with 8/58 (14%) receiving consultant-led care. Less ‘nurse-led’ parents, 10/45 (22%), reported their child having pain passing stools in the previous week compared with consultant-led care, 26/58 (45%). The proportion of children, over 4 years, free from soiling accidents was similar, 15/23 (65%) in the nurse-led group and 18/29 (62%) with consultant-led care. Parental satisfaction was slightly better in the nurse-led group.ConclusionIt is difficult to achieve minimum standards using routine consultant-led care for children referred by their GP with constipation. Nurse-led early intervention is feasible and has produced promising results in a service evaluation. An exploratory trial is planned to develop a teaching module, robust outcomes including costs and benefits, and methodology for a definitive trial recommended by NICE.

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Section: Methodsmentioning

confidence: 99%

“…SN is a chartered psychologist who gained a PhD by research working on new intervention strategies for children who have night-time wetting [11]. …”

Section: Authors’ Informationmentioning

confidence: 99%

Development of an early nurse led intervention to treat children referred to secondary paediatric care with constipation with or without soiling

et al. 2013

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“…2002, 2005). Seemingly, the students involved in this study had a relatively overt display of their enjoyment in relation to programme conditions (Carver 2000; Helm 2000; Realon et al. 2002).…”

Section: Discussionmentioning

confidence: 99%

Assessing the effects of stimulation versus microswitch‐based programmes on indices of happiness of students with multiple disabilities

Lancioni

Singh²,

O’Reilly

et al. 2006

J intellect Disabil Res

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“…The quality of the interaction (i.e., therapeutic and rapport-building content) is rarely investigated. A recent investigation performed in a residential setting examined quality staff interactions on 19 adults with profound mental retardation whom were nonambulatory and lacked functional communication skills (Realon et al, 2002). As staff interactions with the residents increased, so did the engagement and alertness among residents.…”

Section: Abstract Observer Effect Interaction Style Happiness Indicesmentioning

confidence: 98%

The Observer Effect and Its Impact on Staff Behavior in an Acquired Brain Injury Neurobehavioral Treatment Setting

Guercio¹,

Dixon²

2011

Journal of Organizational Behavior Management

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Staff in three neurobehavioral residential settings (5 in each residence for a total of 15 staff) were trained on specific positive interaction behaviors in a multiple baseline design. Staff in each of the residences were provided with recommended behaviors for interacting with residents through an observational procedure where they observed and completed checklists on video models of the targeted staff interaction behavior. In addition to staff interaction behaviors, subsequent levels of adaptive resident behaviors were also examined, such as active engagement and indices of happiness. Targeted interactions increased from an average of 7.2% of intervals during baseline to 80% during the intervention. Productive involvement engaged in by residents increased from 17.9% in baseline to 73.9% during the intervention, and the happiness indices of residents increased from 6.1% in baseline to 67.5% during the intervention. KEYWORDS observer effect, interaction style, happiness indicesFunctional work performance of direct care staff in acquired brain injury (ABI) rehabilitation settings is a crucial factor in facilitating the successful recovery of the individual receiving services (Guercio et al., 2002;Guercio et al., 2005). When an individual sustains an ABI, time is of the essence and rehabilitation should allow the patient to experience quality care from direct

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The effects of the Positive Environment Program (PEP) on the behaviors of adults with profound cognitive and physical disabilities

Cited by 20 publications

References 14 publications

Development of an early nurse led intervention to treat children referred to secondary paediatric care with constipation with or without soiling

Development of an early nurse led intervention to treat children referred to secondary paediatric care with constipation with or without soiling

Assessing the effects of stimulation versus microswitch‐based programmes on indices of happiness of students with multiple disabilities

The Observer Effect and Its Impact on Staff Behavior in an Acquired Brain Injury Neurobehavioral Treatment Setting

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