Search

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 = 0.0012). 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.

Reflecting on sustained calls for patient-centredness and culture change in long-term care, we evaluated the relative importance of personal and organisational predictors of palliative care, hypothesising the former as weaker predictors than the latter. Health-care employees (N = 184) from four Canadian long-term care homes completed a survey of person-centred care, self-efficacy, employee wellbeing and occupational characteristics. Using backward stepwise regression models, we examined the relative contributions of these variables to person-centred palliative care. Specifically, blocks of variables representing personal, organisational and occupational characteristics; palliative care self-efficacy; and employee wellbeing were simultaneously regressed on variables representing aspects of person-centred care. The change in R 2 associated with the removal of each block was examined to determine each block's overall contribution to the model. We found that occupational characteristics (involvement in care planning), employee wellbeing (compassion satisfaction) and self-efficacy were reliably associated with person-centred palliative care (p < 0.05). Facility size was not associated, and facility profit status was less consistently associated. Demographic characteristics (gender, work experience, education level) and some aspects of employee wellbeing (burnout, secondary trauma) were also not reliably associated. Overall, these results raise the possibility that humanistic care is less related to intrinsic characteristics of employees, and more related to workplace factors, or to personal qualities that can be cultivated in the workplace, including meaningful role engagement, compassion and self-efficacy. [ABSTRACT FROM AUTHOR]

Objective: To obtain preliminary evidence of the feasibility and effectiveness of adjunctive family psychoeducation in adolescent major depressive disorder. Method: Participants were from outpatient clinics in Hamilton and London, Ontario. Over 24 months, 41 adolescents ages 13 through 18 years meeting major depressive disorder criteria were recruited (31 in Hamilton, 10 in London). Participants were randomized to usual treatment or usual treatment plus family psychoeducation. Outcome measures were readministered at 2 weeks, mid-treatment, posttreatment, and 3-month follow-up. Intent-to-treat analyses used [chi square] and t tests and growth curve analysis. Standardized effects based on growth curve estimates were calculated for continuous outcomes. Results: The London site was withdrawn because of poor participant retention. In Hamilton, no participant missed more than one assessment and there was good family psychoeducation adherence. Compared to controls, participants in the experimental group showed greater improvement in social functioning and adolescent-parent relationships (with medium standardized effect size greater than 0.5), and parents reported greater satisfaction with treatment. Conclusions: There were positive treatment effects on family and social functioning processes postulated to mediate the clinical course of major depressive disorder. The study provides support for further evaluation of family psychoeducation in this clinical population. (Contains 4 tables.)

Responses from 178 of 528 pediatric nurses showed that higher education levels or courses in research design and use were associated with positive attitudes toward research. Higher education levels were associated with self-reported research use; completing research-related courses was not independently associated with higher research use. (Contains 33 references.) (SK)

Evaluates a parent skills training and education group for parents with ADHD adolescents. The program provides information about ADHD and training in problem solving and parent skills. The evaluation showed there was a statistically significant decrease in frequency and intensity of self-reported parent-adolescent conflict and in parent-reported problem behavior after participation in the program. (Author/MKA)

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1744-6155.2007.00121.x Byline: Jacqueline A. Ellis (1), Lynn McCleary (2), Renee Blouin (3), Karen Dube (3), Betty Rowley (3), Mary MacNeil (3), Carol Cooke (3) Keywords: Best practice pain management; Ottawa Model of Research Use; pain management; pediatrics; program evaluation; program implementation Abstract: PURPOSE. This study aims to evaluate the implementation of a comprehensive program to improve pain management practices in a pediatric hospital. METHODS. The pretest posttest design used questionnaires, patient record audits, and postimplementation focus groups with 366 nurses and 8 physicians. RESULTS. Positive changes occurred in the use of pain scales and in valuing good pain management. The program was less effective in improving procedural pain management and pain documentation. PRACTICE IMPLICATIONS. Important program strengths were the 'local champions' (Pain Resource Nurses) and the ongoing support and expertise of the pain committee. Systematic evaluation was important to document successes as well as areas requiring further focus. Author Affiliation: (1)School of Nursing, University of Ottawa, Ottawa, ON (2)Department of Nursing at Brock University, St. Catharines, ON (3)Children's Hospital of Eastern Ontario, Ottawa, ON Article History: First received January 11, 2007; Revision received June 20, 2007; Accepted for publication June 23, 2007. Article note: Author contact: jellis@uottawa.ca, with a copy to the Editor: roxie.foster@uchsc.edu

Introduction: Advance care planning can improve the quality of life for residents in long-term care homes and reduce stress for families. However, care home staff and families often lack knowledge about advance care planning, making it especially difficult for residents with dementia to communicate their care plan wishes. A Conversation Starter Kit may increase advance care planning awareness among staff and families. Objectives: This study evaluated an advance care planning intervention, the Conversation Starter Kit booklet, for use in long term care homes. Methods: Data were collected at three long-term care homes in southern Ontario. We collected data from 55 residents who were able to make decisions on their own paired with 11 family members of these residents. We also collected data from 24 family members of residents who were unable to make decisions on their own. This study used a quasi-experimental, one group pre/post design. Quantitative surveys were administered before and after a three-month advance care planning intervention. An additional structured interview was completed at the end of the intervention period, which included both closed and open-ended questions to assess perceptions about the booklet's use or non-use. Results: Residents reported more engagement in advance care planning after completing the Conversation Starter Kit booklet, particularly related to asking questions to health care providers about health care decisions. Family members reported feeling very certain that they would be able to make decisions on behalf of the resident but felt less certain after completing the booklet, implying the booklet raised their awareness of the types of decisions they might need to make, hopefully prompting them to be more prepared for decisions in the future. Conclusions: An advance care planning intervention – The Conversation Starter Kit booklet - appears acceptable and easy to use for residents and family members/friends in long-term care and can improve resident engagement in advance care planning. Although using the booklet may decrease efficacy for decision making among family members of long-term care residents, it may highlight the importance of more actionable engagement in advance care planning among residents, their families/friends, and staff. [ABSTRACT FROM AUTHOR]