Teaching Philosophy and Methods of Restorative Care to Assisted Living Owners and Staff

To implement restorative care in assisted living facilities, staff need to understand the philosophy and learn methods to help residents maintain optimal function. In this study, the researchers developed a multimedia training program designed to teach staff how to encourage residents to increase their participation in dressing themselves. Researchers conducted a pilot test to measure the short-term effects of the training on 40 staff from two states. Program effects were measured by completing a survey developed by the researchers. Pretest scores were significantly related to gender (women as a group had higher scores than men). Results indicated significant gains in knowledge at posttest. In addition, 93% of participants described positive changes related to restorative care that they planned to make at their facility as a result of the training.     

EVALUATION OF A GERIATRICS ROTATION FOR POSTGRADUATE RESIDENTS IN LEBANON

As we enter the 21st century, increasing numbers of older adults will reside, either temporarily or permanently, in nursing homes. Training in nursing home care must become an integral part of the curriculum for internal and family medicine residency programs. The changing demographics of the Lebanese population have created an imperative for medical schools to increase their emphasis on the education and training of residents in the care of the elderly. A four-week block rotation was started for residents in the family medicine department in Hotel Dieu (The French Medical School). The rotation is taking place at the comprehensive Geriatric Program at Ain Wazein Community Hospital. The goal of the rotation is to provide formal training in nursing home care to family practice residents as a component of the geriatrics curriculum. The organization and the curriculum content of the rotation are presented. The initial evaluation of the rotation by the residents showed that the residents became more comfortable with elderly issues by the end of the rotation. Residents responded on a scale of one to six regarding four constructs. The rotation was positively evaluated by residents and staff. Consequently, the rotation has been incorporated into the curriculum of family medicine residents in Hotel Dieu.     

Activity Engagement: Perspectives from Nursing Home Residents with Dementia

Engagement in social and leisure activities is an indicator of quality of life and well-being in nursing homes. There are few studies in which nursing home residents with dementia self-reported their experiences in activity engagement. This qualitative study describes types of current activity involvement and barriers to activities as perceived by nursing home residents with dementia. Thirty-one residents participated in short, open-ended interviews and six in in-depth interviews. Thematic content analysis showed that participants primarily depended on activities organized by their nursing homes. Few participants engaged in self-directed activities such as walking, visiting other residents and family members, and attending church services. Many residents felt they had limited opportunities and motivation for activities. They missed past hobbies greatly but could not continue them due to lack of accommodation and limitation in physical function. Environmental factors, along with a fixed activity schedule, further prevented them from engaging in activities. Residents with dementia should be invited to participate in activity planning and have necessary assistance and accommodation in order to engage in activities that matter to them. Based on the findings, a checklist for individualizing and evaluating activities for persons with dementia is detailed.     

Singing Along the Way to Becoming Baby-Friendly

In this column, two assistant nurse managers describe an innovative and fun strategy they developed and implemented at NYU Langone Medical Center in New York to assist the nursing staff in preparing for their Baby-Friendly auditors’ visit.     

STAFF PERCEPTIONS OF BEHAVIORAL PROBLEMS IN NURSING HOME RESIDENTS WITH DEMENTIA: THE ROLE OF TRAINING

Residents of nursing homes with a dementing illness constitute a challenge for direct practitioners because of the presence of behavioral problems often accompanying the illness. A before‐after evaluation design was used to assess characteristics of patients and their staff caregivers at baseline and 1 year after the educational intervention. Overall, resident cognition and functioning declined at posttest, as would be expected due to the nature of the illness. Thirty‐six behaviors were assessed to identify staff perceptions of the frequency and difficulty of managing these behaviors. The most frequently reported behavioral symptoms at baseline were poor personal hygiene and bladder and bowel incontinence; however, after the intervention there were no reports of frequently occurring disruptive behavioral symptoms. Overall, staff perceptions of the frequency and difficulty in managing behavioral symptoms declined by 47% at the post‐test. Although managing difficult behaviors of dementia patients is a challenge for staff in long‐term care facilities, results of this study suggest that through training staff may perceive behavioral symptoms as less problematic and thus be enabled to respond more effectively to specific behavioral problems of the residents.     

Empowering Staff in Dementia Long-Term Care: Towards a More Supportive Approach to Interventions

This pilot-study aimed to assess a psychoeducational program for staff in care homes. The program was designed to increase knowledge regarding dementia care, promote skills to integrate motor and multisensory stimulation in daily care, and develop coping strategies to manage emotional work-related demands. Six staff members received eight psychoeducational sessions held fortnightly and individualized assistance during the provision of morning care to six residents with dementia. An audio-recorded focus group interview with staff and video recordings of residents' behavior during morning care were made and used to assess the program. Staff reported several benefits: acquisition of new knowledge; demystification of preexisting beliefs related to dementia; group cohesion; self-worth feelings; and positive coping. A trend towards improvements at residents' levels of interaction was found. The findings suggest the need of interventions to go beyond the objectives exclusively centered on staff education and the promotion of residents' well-being. This should be achieved by also allowing workers to feel supported and empowered.     

Evidence-based health promotion in nursing homes: A pilot intervention to improve oral health

ABSTRACT

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts’ nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an intervention targeting Certified Nurses’ Aides (CNAs) was developed and tested. We hypothesized that following the training, CNAs would have increased knowledge and self-efficacy toward providing oral health care to the residents in their charge.

This pilot study used a one-group pretest-posttest design to test the effectiveness of a psycho-educational training intervention. Utilizing the constructs of knowledge and self-efficacy from the Theory of Planned Behavior and the Social Cognitive Theory, we framed the content of a training intervention and administered a 21-item instrument. The survey was distributed to the CNA staff of a single midsize nursing home immediately prior to and after the intervention. The 1-hour training intervention was empirically supported by formative data and delivered by dental faculty researchers.

Findings indicate increases in two areas of oral health knowledge: toothbrush position and frequency of brushing. Self-efficacy, however, did not significantly change. Although the results marginally supported our hypothesis, this pilot study demonstrates the feasibility of delivering interventions to CNAs who have direct responsibility for promoting the oral health of long-term care facility residents.     

Challenges and management frameworks of residential schools for students with severe emotional and behavioural difficulties in Hong Kong

This study by Stella Suk‐Ching Chong, an assistant professor, and Ka‐wai Leung, a teaching fellow, both at the Hong Kong Institute of Education, focuses on the perspectives of hostel staff from six residential schools for students with severe emotional and behavioural difficulties. Individual or focus group interviews were conducted to explore the range of challenges perceived by staff and the strategies they employed to address the needs of the students. The software N‐Vivo was used to analyse both qualitative and quantitative data. This study finds that staff met a multiplicity of challenges, of which 67.9% were management‐related rather than student‐related (32.1%). In relation to effective strategies for staff, co‐ordinated and concerted efforts are frequently used between different stakeholders, such as intra‐hostel‐staff‐student collaboration (84%), inter‐hostel‐community collaboration (8.6%), inter‐hostel‐home collaboration (5.1%), and finally inter‐hostel‐school collaboration (2.2). In summing up the findings of various approaches deemed favourable by different residential staff, a residential school management framework is conceptualised and presented in this article. Implications and future research directions are also highlighted.     

PREDICTORS OF CYBERBULLYING INTERVENTION AMONG ELEMENTARY SCHOOL STAFF: THE MODERATING EFFECT OF STAFF STATUS

Cyberbullying behavior among youth has become a growing concern among parents, educators, and policymakers due to emerging evidence documenting its harmful consequences on youths’ development. As such, schools are increasingly required to address to this form of bullying. Thus, effective responses by school staff are needed. However, no study to date has examined the likelihood of cyberbullying intervention among certified and noncertified school personnel. To that end, the present study assessed whether perceptions, attitudes, and self‐efficacy beliefs predicted the likelihood of cyberbullying intervention and examined whether these relationships were moderated by staff status (e.g., certified and noncertified). Results revealed that attitudes toward victims and self‐efficacy beliefs to intervene were significant predictors of the likelihood of cyberbullying intervention among staff; however, the prevalence of bullying and staff attitudes toward bullies were not significant predictors of intervention likelihood. Implications for in‐service staff training efforts are discussed.     

ORAL HISTORY AND THE MOTIVATION TO LEARN: AN EXPLORATORY STUDY

Previous research has indicated that (1) older adults are predisposed to reflect on the meaning and integrity of their lives, (2) few legitimate opportunities to reminisce are available to the elderly, and (3) oral history has been used successfully as a teaching method with young students who worked with the elderly. The oral histories of 13 residents of a Veterans Administration Hospital nursing home care unit were collected by 11 members of the staff. The histories were reviewed by teachers and were used to establish the content of two experimental courses that were open only to residents who had been interviewed. At the conclusion of the classes, data were collected from attendance records and from the teachers, members of the staff, and friends and relatives of the residents. The data were used to assess the impact of the project on the residents and on the staff. The implications of the study for teachers and administrators and for educational researchers are discussed.     

Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global assessments of job-satisfaction, psychological stress, and perceived pressures that may affect provision of care. There were also items dealing with the perceived benefit of prospective in-service training programs. Content analyses indicated interactions with residents as the most frequent source of stress and ethical challenges encountered by nursing staff. Further, results of correlational analyses suggested psychological stress to be associated with job satisfaction and pressure to take shortcuts in the provision of care. Continuing education via in-service training that addresses workplace stress and ethical challenges in nursing care is discussed.     

Writers develop skills through collaboration: an action research approach

Collaborative approaches designed to increase writing productivity (amount written) as well as writing quality were implemented over a period of six months with a small group of 12 six‐year‐olds in a Primary School in Newcastle, NSW, Australia. The study demonstrated the positive nature of peer interactions with an increase in quality and productivity of writing products. The classroom teacher employed action research approaches where observations informed action, which in turn was reflected upon. Some central themes emerged from this study. It was found that collaboration often meant that students shared strengths and expertise, provided encouragement and assistance, as well as provided opportunities for peer tutoring.     

美国州政府对义务教育阶段私立学校的资助：原则、内容及特点

美国州政府遵从“政教分离”和“儿童受益”原则,对义务教育阶段私立学校进行资助。其内容包括以提供交通服务、教科书为主的服务性资助和以减税、发放教育券为主的鼓励教育选择的资助。政府资助私立学校以服务性资助为主,但鼓励教育选择的资助逐渐增加;实行分类资助,但主要资助非营利性私立学校;在资助的同时加强对私立学校的管理。     

Enhancing nursing home care for seniors: impact of a living classroom on nursing assistant’s education

ABSTRACT

Nursing Assistants (NAs) are the largest workforce in nursing homes, but often lack adequate preparation for their role. The Living Classroom (LC) is an integrated learning approach, whereby a NA program is delivered in a nursing home (NH) in collaboration with a community college. This paper describes the implementation and evaluation of the LC. Mixed methods were used to gather data from 48 NA students, 5 faculty, and 42 NH staff over 30 weeks. Students, faculty, and nursing home staff described the LC as a positive learning experience. Students’ gerontological knowledge increased over time (p = .0012). Students reported very positive relationships with program mentors and NH residents. The LC provides a unique approach to prepare NAs to work in nursing homes. This model could expand to other educational programs with a gerontology focus.     

Attitudes about death in the nursing home: a research note

An increasing percentage of the U.S. population dies in nursing homes. Despite the increased attention given to the topic of death, most nursing homes practice a covert approach. A total of 86 residents and staff members from 2 nursing homes support this finding; yet many expressed an interest in modifying the policy. A majority believed that others should be told about the death of a resident. Respondents reported the interview process to be satisfying.     

Personal Digital Assistants as Point-of-Care Tools in Long-Term Care Facilities: A Pilot Study

This study used both survey and interview questionnaires. It was designed to assess the feasibility, usability, and utility of two point-of-care tools especially prepared with information relevant for dementia care by staff nurses in a small, a medium-sized, and a large nursing home in Florida. Twenty-five LPN or RN nurses were recruited for the study of their use of one of the tools—either a set of pocket cards (used by the control group) or a pocket PC (used by the experimental group). The findings of our study indicate that personal digital assistants (PDAs) can potentially improve long-term care clinicians' effectiveness and efficiency at work, resulting in better patient care for nursing home residents.     

Enhancing care for older people living in nursing homes in rural Australia using action learning as a catalyst for change

The implementation of action learning workshops in three nursing homes in rural Victoria, Australia has been critical in the re-visioning of how care can be enhanced for residents. The workshops were designed with the intent of improving quality of care for residents by providing health care staff with opportunities to learn together and effect cultural change. Valuing what was accomplished well in these nursing homes was the starting point. The project was funded by a Commonwealth Government Rural Education Grant and was based on ‘My Home Life’ a popular programme that promotes quality of life and delivers positive change in care homes for older people across the United Kingdom. This paper provides an account of the project including key components of the action learning workshops and subsequent evaluation of the programme conducted in Australia. The lessons learnt throughout this project have provided the impetus to continue using appreciative inquiry and action learning to involve participants in reflecting on their practice, valuing what they do well while identifying areas that require change. Working together in a safe and respectful space provides participants with opportunity to harness their own collective wisdom and as the health professionals in this project experienced, also learn valuable skills that support progressive action that makes a difference to older people’s lives.     

旅游高等教育师资队伍建设的研究

高等院校的旅游专业是近几年快速崛起的新兴专业,抓好旅游高等教育师资队伍建设是刻不容缓的一件事.目前,旅游专业师资队伍总量上供需失衡,人员流动性大,人才流失严重,入职门槛过低,业务水平低下,缺乏实践经验,教学科研成果少,必须采取相应的对策以促进旅游高等教育更好的发展.     

Workshops in caring: a first module

Workshops in Caring were designed to expose attitudes, biases, and concerns of a nursing home staff toward aging, illness, and death. This paper touches on techniques and materials (more literary and humanistic than clinical) for encouraging participants to focus on and share their feelings. What inhibits or facilitates a caring relationship between elderly, often terminally ill, residents and staff members was the prime focus of both sessions: "Will You Still Need Me, Will You Still Feed Me?" and "Who Owns One's Life?"     

Selection and Induction of New Staff to Posts in Initial Teacher Training in Scotland

An account is provided of how one teacher training institution in Scotland appoints and inducts lecturing staff. The first part of the account describes institutional policy and is based on an interview with a senior administrator. The second part reflects institutional practice and is based on an interview with a member of staff on a short‐term contract six months after his appointment. While the actual process of selection corresponds with the formal there is a recognised need for development of induction arrangements.