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- Title
- USE OF A MUSIC AND MEMORY PROGRAM BY CAREGIVERS OF PERSONS WITH DEMENTIA.
- Creator
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Mendez Campos, Barbara, Gammonley, Denise, University of Central Florida
- Abstract / Description
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Although use of personal music devices by persons with dementia and their caregivers is now widespread, there is limited literature concerning music and memory's effects on caregivers for persons with dementia. Caregivers were provided an iPod by two respite agencies and were encouraged to use it with their care recipient. A mailed survey of 50 caregivers who received an IPod explored: (a) associations between use of an iPod and caregiver self-efficacy, burden, and care recipient functional...
Show moreAlthough use of personal music devices by persons with dementia and their caregivers is now widespread, there is limited literature concerning music and memory's effects on caregivers for persons with dementia. Caregivers were provided an iPod by two respite agencies and were encouraged to use it with their care recipient. A mailed survey of 50 caregivers who received an IPod explored: (a) associations between use of an iPod and caregiver self-efficacy, burden, and care recipient functional abilities, and; (b) if the method of presenting the music playlist was associated with use of the iPod. Associations were examined for 10 complete surveys returned by caregiver respondents using non-parametric methods. There was no relationship between self-efficacy, burden, functional abilities and use of the iPod. A content analysis was conducted of caregiver open-ended responses to questions about factors associated with use of the device. Mean caregiver age in this study was 75 years of age, care recipient mean was 79 years of age. On average caregivers used the IPods 2-3 times per month. Scores on caregiver burden measured by the 12-item Zarit Burden Interview had a mean of 12.5 which suggests a moderate level of burden. Emergent themes from caregiver open-ended responses about using the device revealed care recipients as primary users, use mostly in the evening, and in response to caregiving tasks or difficult care recipient behaviors. Keywords: Music and memory, dementia caregiver burden, self-efficacy
Show less - Date Issued
- 2017
- Identifier
- CFH2000181, ucf:46046
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000181
- Title
- FAMILY SUPPORT AND MENTAL HEALTH CARE QUALITY IN NURSING HOMES SERVING RESIDENTS WITH A MENTAL HEALTH HISTORY.
- Creator
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Frahm, Kathryn, Gammonley, Denise, University of Central Florida
- Abstract / Description
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The prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with...
Show moreThe prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with a mental health history and to determine if family support influences the quality of their mental health care accounting for other facility resident and facility organizational characteristics. The study utilized a retrospective, cross-sectional design with 2003 national Online Survey Certification and Reporting (OSCAR) facility data merged with the resident-level Minimum Data Set (MDS) resulting in N=2,499 nursing homes. Guided by the convoy model of social support and socioemotional selectivity theory, descriptive statistics and exploratory factor analysis were used to create a profile of facility level data of nursing home residents with a mental health history, explore the role of family support, and determine if items within the OSCAR and MDS databases could respectively be used to measure mental health care quality and family support. Overall, it was found that families have a positive relationship with their relatives and are involved in their lives. Additionally, items within the OSCAR and MDS databases could be used to measure mental health care quality and family support. Finally, facility organizational characteristics explained more variation in the quality of mental health care than did facility resident, family support, or market characteristics. In sum, to enhance the quality of mental health care in nursing homes, partnering with families may be an important tool to meet resident needs.
Show less - Date Issued
- 2009
- Identifier
- CFE0002529, ucf:47670
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002529
- Title
- LGBT AFFIRMING ENVIRONMENTS IN HOSPICE CARE SETTINGS.
- Creator
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Gore, Maria, Gammonley , Denise, University of Central Florida
- Abstract / Description
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Abstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of...
Show moreAbstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of LGBT affirming environments in hospice care settings. Utilizing a formal PICO questioning method, a search strategy was devised and studies were identified based on established criteria. The results suggest that there is a paucity of data in relation to the implementation of LGBT affirming environments in hospice care settings. In an effort to assist in identifying existing interventions that have not been studied this project also includes a recommended survey tool to measure the active efforts of hospice organizations to implement LGBT affirming environments.
Show less - Date Issued
- 2013
- Identifier
- CFH0004353, ucf:44986
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004353
- Title
- Tobacco Prevention and Cessation Policies and Youth Tobacco Use in Florida Public Schools.
- Creator
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Terry, Amanda, Zhang, Ning, Martin, Lawrence, Gammonley, Denise, Delnevo, Cristine, University of Central Florida
- Abstract / Description
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Tobacco use is the leading cause of preventable disease and premature death in the United States. In 2014, an estimated 16.8% of adults were current cigarette smokers, and 9.2% of high school students smoked cigarettes. Nearly 90% of smokers developed their habit as teenagers, and students' tobacco use in high school influences their behaviors later in adulthood. Smoking behaviors appear to be inseparable from the social environment, physical environment, small social groups, and cognitive...
Show moreTobacco use is the leading cause of preventable disease and premature death in the United States. In 2014, an estimated 16.8% of adults were current cigarette smokers, and 9.2% of high school students smoked cigarettes. Nearly 90% of smokers developed their habit as teenagers, and students' tobacco use in high school influences their behaviors later in adulthood. Smoking behaviors appear to be inseparable from the social environment, physical environment, small social groups, and cognitive and affective processes. Preventive strategies, such as advertising bans, clean indoor air laws, education programs, increased taxes, labeling limitations, mass-media campaigns, and youth access regulations, have been commonly used to prevent and reduce youth tobacco use nationwide. In Florida, local public school districts were authorized to develop new tobacco-free school policies through an amendment to the Florida Clean Indoor Air Act in June 2011. The purpose of this study was to determine the impact of the recently implemented smoking cessation policies, as well as individual-level factors and interpersonal-level factors, on youth tobacco use in Florida public schools. This study employed a pooled cross-sectional design with data for high school students from the Florida Youth Tobacco Survey (FYTS) in 2010 (n=37,797) and 2014 (n=32,930). It was guided by a theoretical framework based on the reasoned action approach and the social ecological model. Hierarchical logistic regression was used to analyze the data. The four models were binary logistic regression for cigarette use, multinomial logistic regression for cigarette use, binary logistic regression for cigar use, and multinomial logistic regression for cigar use. The results of this study support the importance of the individual-level constructs of background factors, behavioral beliefs, and control beliefs, the interpersonal-level construct of normative beliefs, and the policy-level construct of actual behavioral control when applied to youth tobacco use. These findings led to a better understanding of which policies, environments, and cognitions contribute to preventing and reducing teenage tobacco use, which is imperative in controlling the risks related to smoking and improving youth health. Now that the individual-level factors, interpersonal-level factors, and policy-level factors that contribute to youth tobacco use were recognized, preventative and therapeutic programs and interventions can be suggested and improved. This study provided evidence-based knowledge for improving public policies and interventional strategies towards smoking prevention and cessation for youth.
Show less - Date Issued
- 2016
- Identifier
- CFE0006188, ucf:51128
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006188
- Title
- Early and Intermediate Hospital-to-Home Transition Outcomes of Older Adults Diagnosed with Diabetes.
- Creator
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Lamanna, Jacqueline, Bushy, Angeline, Norris, Anne, Wink, Diane, Gammonley, Denise, University of Central Florida
- Abstract / Description
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Over 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by...
Show moreOver 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by the continuous interaction of personal, community, and societal-level conditions that facilitate or inhibit the health of a transition. Hospitalization has been described as a series of three successive, interrelated transitions. The aims of this study were to determine whether personal and community transition conditions impacted the early and intermediate post-discharge outcomes in a sample of older adults with diabetes. A simultaneous quantitative/qualitative mixed method design was used to identify factors that impacted the home recovery transition experiences in a sample of 96 older adults with a mean age of 75 years. A supplementary content analysis of free-response data gathered during administration of the Post-Discharge Coping Difficulty Scale (PDCDS) clarified difficulties encountered by elders and caregivers during in the first 30 days following discharge. Four overarching themes emerged: (")the daily stuff is difficult("); (")engineering care at home is difficult("); (")life is stressful(") and (")difficulty managing complex health problems(").Difficulties managing a complex medication regimen, regulating blood glucose, and managing a non-diabetes chronic health problem such as hypertension and chronic lung disease were subthemes that emerged during qualitative data analyses. These subthemes were transposed into discrete nominal level variables and served as additional indicators of post-discharge coping difficulty in the descriptive correlational core component of the research project.Participants in this study who experienced an event of recidivism had lower pre-discharge assessments of readiness on the Readiness for Hospital Discharge Scale (RHDS) (t = 2.274,df = 48, p =.028). Higher PDCDS scores were observed in patients who experienced an event of recidivism within 30 days of discharge (t = -3.363, df=24.7, p = .003) and also in respondents who described difficulties with managing medications, controlling diabetes, and managing a chronic illness. Binary logistic regression was used to identify factors that may predict recidivism risk. No condition-specific predictor variables were identified. A statistically significant three-variable model (X2 = 26.737, df = 3, p (<) .001) revealed that PDCDS scores at 7 days (Wald X2 =3.671, df = 1, p =.050), PDCDS scores at 30 days (Wald X2 = 6.723, df = 1, p =.010), and difficulty managing a chronic health condition (Wald X2 = 8.200, df = 1, p =.004) were predictive of an event of recidivism within 30 days of discharge. Difficulty managing a chronic health problem other than diabetes was particularly predictive of recidivism. The nurse's skill in delivering discharge education was a factor in limiting early post-discharge difficulties. Elders with residual information needs on the day of discharge as measured by scores the Quality of Discharge Teaching Scale (QDTS) reported a lower readiness for discharge (r = -.314, p = .003) and experienced greater difficulties with early post-discharge coping (r =. 288, p = .023). Greater satisfaction with the post-discharge transition was noted in participants with higher QDTS scores (r = .444, p (<).001). Outcomes of the hospital-to-home transition experience were impacted by a variety of personal, hospital, and community factors. Findings of this study suggest that there is a need to better understand the sequential nature of the home recovery transition and the fluid needs of older adults during this high-risk phase of care. The environments in which older adults receive post-discharge care are complex and need to be thoroughly considered when planning the post-discharge transition. Metrics of institutional performance of transitional care practices need to extend beyond events to recidivism and include evaluations of post-discharge coping and transition satisfaction. The nurse as the primary provider of discharge education has the potential to significantly promote positive transition outcomes for older adults and their family care providers.
Show less - Date Issued
- 2013
- Identifier
- CFE0004875, ucf:49652
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004875
- Title
- Patient Violence and Aggression in Non-Institutional Health Care Settings: Predictors of Reporting By Healthcare Providers.
- Creator
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Campbell, Colleen, Burg, Mary Ann, Gammonley, Denise, Steen, Julie, Potter, Roberto, University of Central Florida
- Abstract / Description
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This dissertation is conducted to examine the factors which contribute to the reporting of incidents of violence or aggression perpetrated by patients against health care providers in non-institutional health care settings. With a theoretical foundation grounded in community science, applying stress theory, broken windows theory and the theory of reasoned action, the following cross sectional study examines the contribution of characteristics of the healthcare provider, characteristics of the...
Show moreThis dissertation is conducted to examine the factors which contribute to the reporting of incidents of violence or aggression perpetrated by patients against health care providers in non-institutional health care settings. With a theoretical foundation grounded in community science, applying stress theory, broken windows theory and the theory of reasoned action, the following cross sectional study examines the contribution of characteristics of the healthcare provider, characteristics of the patient perpetrator and the form of violence to the providers' reporting or failing to report incidents. A self-administered survey was disseminated to a sample of non-institutional healthcare providers to test the research hypotheses about variables associated with reporting of incidents. The final sample size included 218 respondents, of which 213 met inclusion criteria for the study. 79.4% (N=169) of respondents had experienced at least one form of patient violence or aggression and were thus eligible for inclusion in the statistical analysis. The collected data was then analyzed through use of logistic regression to determine the contribution of each variable and the relative impact on the dependent variable of incident reporting. Findings indicated that there is a statistically significant contribution of the form of abuse, specifically verbal abuse in comparison to sexual abuse, to incident reporting. Specifically, the odds of reporting abuse are four times higher among individuals experiencing verbal abuse in contrast to providers subjected to patient-perpetrated sexual abuse.
Show less - Date Issued
- 2016
- Identifier
- CFE0006082, ucf:50953
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006082
- Title
- Prehabilitation (Prehab): Prevention in Motion.
- Creator
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Russell, Billie, Sole, Mary Lou, Chase, Susan, Damato-Kubiet, Leslee, Gammonley, Denise, University of Central Florida
- Abstract / Description
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ABSTRACTCardiovascular disease is the leading cause of death for U.S. adults. It adds greater than $100 billion to U.S. health care costs annually. Rates of morbidity, mortality, and economic burden of the disease could be dramatically reduced with improvements in sedentary behaviors among adults with coronary artery disease (CAD). A regular commitment to moderate physical activity can reduce ischemic heart events up to 50%. Although the benefits of physical activity are well-known for...
Show moreABSTRACTCardiovascular disease is the leading cause of death for U.S. adults. It adds greater than $100 billion to U.S. health care costs annually. Rates of morbidity, mortality, and economic burden of the disease could be dramatically reduced with improvements in sedentary behaviors among adults with coronary artery disease (CAD). A regular commitment to moderate physical activity can reduce ischemic heart events up to 50%. Although the benefits of physical activity are well-known for individuals with coronary artery disease, an estimated 70% of this population remains relatively sedentary. Hospital-based cardiac rehabilitation programs are the single secondary prevention option offered to improve physical activity habits in persons with CAD. Although effective, cardiac rehabilitation is inaccessible for the majority of CAD sufferers and is offered only after an acute cardiac event. Different from rehabilitation, prehabilitation (prehab) programs use physical activity as a means to deter a worsening condition or prevent injury before an acute event occurs. These programs have proved successful in other areas of medicine but there are currently no such secondary prevention programs available for stable persons with CAD in the U.S. A home-based prehab program could help adults with CAD establish improved physical activity habits and circumvent many of the barriers associated with admission and attendance of a hospital-based cardiac rehabilitation program. Researchers have indicated that self-efficacy is key to initiation and sustentation of a regular physical activity habit, regardless of the physical activity program that one attends. These habits are more likely to last when participants receive self-efficacy based support for an average of 66 days. The purpose of this study was to determine if a nurse-practitioner-led, home-based, prehab program could assist adults with CAD to improve and maintain increased physical activity habits and levels of self-efficacy for physical activity. The five primary facilitators of self-efficacy were used to devise a 10-week prehab program. A convenience sample of 54 adults with diagnosed CAD was recruited from cardiology practices in St. Johns County, Florida. The research population was 68.5% (n=37) male, 88.9% (n=48) Caucasian, and 74% (n=40) married with a mean age of 68.57 years. Participants attended a 90-minute prehab class which offered health education and group discussion of barriers and goals for regular physical activity. Following the class, participants were contacted weekly for 10-weeks to discuss goal progress, assist in circumventing barriers, and revise physical activity goals as needed. After the 10-week call period, participants were contacted 30-days later to assess for physical activity habit maintenance and any sustained benefit in self-efficacy for physical activity. Self-efficacy for exercise was measured before the prehab class, after the prehab class, and after the 10-week intervention period using the Short Self-Efficacy Expectations scale (SSEE), Multidimensional Outcomes Expectations for Exercise Scale (MOEES), and the Barriers Self-Efficacy Scale (BARSE). All baseline measures of self-efficacy (MOEES, BARSE, SSEE) improved significantly immediately following the prehab class. Baseline physical outcome expectations of the MOEES (m=21.87, sd=4.67), self-evaluative outcome expectations of the MOEES (m=16.70, sd=4.15) and SSEE (m=12.75, sd=4.02) remained significantly improved after the 10-week intervention period (p(<).05). At the 10-week assessment, mean significant self-efficacy scores were 24.39 (sd=1.26, p(<).01) for physical outcome expectations, 18.39 (sd=2.27, p(<).02) for self-evaluative outcome expectations, and 15.06, (sd=3.25, p(<).001) for SSEE. The SSEE was reassessed 30-days after the study and remained significantly improved compared to baseline (m=15.65, sd=3.42, p(<).01). Qualitative data collection coincided with the quantitative self-efficacy findings. Participants reported satisfaction with physical activity goal attainment and increased confidence to continue with a regular physical activity plan. The Godin Leisure-Time Exercise Questionnaire (GLTEQ) was used to assess activity levels at baseline, during each weekly phone call, at the end of 10-weeks, and 30-days after the study. Repeated-measures ANOVA (F (2,90) = 21.86, p(<).001) revealed that participant's baseline physical activity volume measured by GLTEQ (m=18.39, sd= 16.93) improved significantly after 10 weeks in the prehab study (m=41.10, sd=24.11, p(<).001) and remained significantly improved when re-measured 30-days after the study (m=39.02, sd=21.87, p(<).001). Qualitative data concurred with quantitative data with participants reporting physical activity habit formation and maintenance of self-regulatory skills. Qualitative data also demonstrated that participants in prehab experienced very similar facilitators and barriers compared to other adults with CAD attempting an exercise program. In summary, the prehab study findings coincided with other research findings in this area. Self-efficacy based support can assist individuals with CAD to improve and maintain physical activity habits. The ease of the intervention likely contributed to lower cost and attrition rates (7%) compared to hospital-based cardiac rehabilitation programs. Although more research is needed, study findings suggest that a nurse-practitioner-led, home-based program could be a viable secondary prevention strategy for stable adults with CAD. This should be considered for the future given that even modest improvements in physical activity can substantially reduce all-cause mortality in this population.
Show less - Date Issued
- 2016
- Identifier
- CFE0006384, ucf:51530
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006384
- Title
- Family Care Giver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults with Cancer.
- Creator
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Geddie, Patricia, Loerzel, Victoria, Sole, Mary Lou, Gammonley, Denise, Norris, Anne, University of Central Florida
- Abstract / Description
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Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated...
Show moreUnplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. The purpose of this study was to explore the factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions of older adults with cancer. A convenience sample of 129 dyads of older adults with cancer and their family caregivers were approached and enrolled in the adult oncology outpatient infusion centers and inpatient units within a community cancer center in central Florida. Patient demographic and clinical data were obtained through a retrospective medical record review. Family caregiver demographic and side effect knowledge data was collected prospectively during interviews with family caregivers using a newly developed tool, Nurse Assessment of Family Caregiver Knowledge and Action Tool (NAFCKAT). The NAFCKAT contains 11 items to determine baseline knowledge about side effects and plan for managing side effects. A fever subsection consists of 4 knowledge and 2 action questions and a dehydration subsection consists of 2 knowledge and 2 action questions. Preliminary research was conducted to determine reliability and validity of the NAFCKAT. Excellent inter-reliability was found for the tool and preliminary support for validity was determined for the fever subscale. Descriptive statistics and logistic regression analyses were used to evaluate data collected from patient medical records and NAFCKAT scores. Study findings revealed that unplanned hospital admissions were more likely to occur when older adults had the presence of impaired function prior to treatment initiation and/or experienced side effects of infection /fever and vomiting/diarrhea during treatment. The presence of impaired function and family caregiver support (knowledge and availability) did not moderate the relationship between side effects and unplanned hospital admissions. Findings suggest that the presence of impaired function and side effects of infection and fever, and vomiting and diarrhea, predict unplanned hospital admissions in older adults during the active cancer treatment phase. Nurses should advocate for and conduct targeted assessments to identify the presence of functional impairments prior to cancer treatment initiation. In addition, nurses should actively monitor for the presence of cancer treatment-related side effects during the treatment phase of the cancer trajectory. Information gained from these assessments will assist nurses to provide practical and tailored strategies to support older adults and their family caregivers during cancer treatment and reduce the risk for unplanned hospital admissions.
Show less - Date Issued
- 2015
- Identifier
- CFE0005618, ucf:50214
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005618
