Pain and psychological well-being of older persons living in nursing homes: an exploratory study in planning patient-centred intervention.

Authors:
Tse, Mimi; Leung, Rincy; Ho, Suki

Affiliation:
Mimi Tse PhD RN Assistant Professor School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
Rincy Leung BSN RN Registered Nurse Department of Health, Hong Kong
Suki Ho BSN RN Clinical Instructor School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong

Source:
Journal of Advanced Nursing (J ADV NURS), 2012 Feb; 68 (2): 312-21. (47 ref)

Publication Type:
journal article – pictorial, research, tables/charts

Language:
English

Major Subjects:
Gerontologic Care
Long Term Care
Nursing Home Patients — Psychosocial Factors — In Old Age
Pain — Therapy — In Old Age
Patient Centered Care
Psychological Well-Being — In Old Age

Minor Subjects:
Activities of Daily Living; Aged; Aged, 80 and Over; Analgesics — Therapeutic Use; Clinical Assessment Tools; Coefficient Alpha; Convenience Sample; Cross Sectional Studies; Data Analysis Software; Depression; Descriptive Statistics; Educational Status; Female; Funding Source; Geriatric Assessment; Geriatric Depression Scale; Happiness; Health Status; Hong Kong; Human; Inpatients; Internal Consistency; Interviews; Loneliness; Male; Mann-Whitney U Test; Marital Status; Middle Age; Nursing Homes; P-Value; Pain Measurement; Personal Satisfaction; Psychological Tests; Quantitative Studies; Revised UCLA Loneliness Scale; Scales; Spearman’s Rank Correlation Coefficient; Summated Rating Scaling; Test-Retest Reliability

Abstract:
tse m., leung r. & ho s. (2012) Pain and psychological well-being of older persons living in nursing homes: an exploratory study in planning patient-centred intervention. Journal of Advanced Nursing 68(2), 312-321. Abstract Aim. This article is a report on a study to examine the pain situation, the use of oral analgesics and non-pharmacological strategies and the psychological well-being of older patients living in nursing homes; the relationships between pain and psychological well-being were also explored. Background. Pain is common among older adults world-wide, and tends to be under-treated. Indeed, the high prevalence of pain may further hinder the fulfilment of psychological needs in a Maslow hierarchy of needs model. Method. It was a quantitative cross-sectional study; older adults from six nursing homes were invited to join the study in 2007-2009, with a response rate of 100%. Pain was measured using the Geriatric Pain Assessment, happiness using the Subjective Happiness Scale, life satisfaction using the Life Satisfaction Index – A Form, loneliness using the Revised UCLA Loneliness Scale and depression was measured using the Geriatric Depression Scale. Results. A convenience sample of 302 older patients (213 females and 89 males aged from 60 to 101, mean age of 84·99) joined the study. The majority of them had experienced pain in the previous 3 months, with a pain intensity of 4·51 on a 10-point scale. Pain sites were mainly the knee, back, shoulder and musculoskeletal areas. Only 50% of them took oral analgesics, and 70% used non-pharmacological measures for pain relief. The pain group reported significantly more loneliness and depression when compared with their no-pain counterparts. Conclusions. As the number of older patients increases, so does the need for alternative accommodation; thus, pain management education is urgently needed for staff and nursing home residents.

Journal Subset:
Core Nursing; Europe; Nursing; Peer Reviewed; UK & Ireland

Special Interest:
Advanced Nursing Practice; Gerontologic Care; Pain and Pain Management; Psychiatry/Psychology

Instrumentation:
Geriatric Depression Scale (GDS) [Chinese]
Subjective Happiness Scale
Geriatric Pain Assessment
Life Satisfaction Index ¿ A Form [Chinese]
Revised UCLA Loneliness Scale [Chinese]

ISSN:
0309-2402

MEDLINE Info:
PMID: 21679226 NLM UID: 7609811

Grant Information:
CADENZA: A Jockey Club Initiative for Seniors, The Hong Kong Jockey Club Charities Trust.

Entry Date:
20120127

Revision Date:
20150605

DOI:
http://dx.doi.org/10.1111/j.1365-2648.2011.05738.x

Law and Ethics in Nursing

Discuss the moral and ethical principles, nursing and midwifery competencies and standards and codes and legals issues and health charter of Australia for each of the three persons in the case study. Please set it out like this. Introduction, summarise the facts, but please do not waste words repeating the facts of the case study in detail. Outline what you are going to use as references in the introduction and how you intend to set out the essay, must outline the essay content. for the body of the paper set out into sections in line with the three people in the case study and discuss each in turn. Each issue for each individual person needs to be referenced to the three ethical schools of thinking being Deontology, teleology and virtue ethics. The five ethical principles being veracity, autonomous, beneficence, non maleficence and justice. Also relate to the Australian charter of healthcare rights being safety, access, communication, respect, participation, comment and privacy. Also in relation to the two codes of conduct. The conclusion needs to relate and tie in the three people and summarise the key points of the essay. No new information added in the conclusion. Also include a word count and with the references they need to be credible references and dated between 2009-2015. Please remember this essay needs to be about the Australian laws and ethics etc not American. Please see the attached case study that the essay is based on its the same as the last one you did.

Dependability of Leadership and Management in Nursing

Order Description

TOPIC OF PAPER: ( Dependability of Leadership and Management in Nursing )

Comprehensive FINAL (Conceptual) PAPER
To demonstrate writing skills and mastery of the course content, the student will write a comprehensive leadership concept analysis paper. Emphasis of the paper will be on a demonstration of new knowledge, learning through documentation and research, and the student’s ability to use writing as a process for developing critical thinking. Concepts for this exercise must pertain to Leadership and Management in the profession of nursing.

Total Possible Points: 100

Grading Criteria

I. Introduction (20 points) _______
a. Thesis statement
b. Definition of concept and Background information on concept.

II. Literature Review (20 points) ________
a. Current Research on the topic (at least two journal articles must be
cited, Articles MUST BE WITHIN THE LAST 5 YEARS)
b. Theory/theories addressing the concept (with citations)
c. Journals and books addressing the concept (with citations)

III. Analysis and Application (30 points) _______
a. Analysis of concept as it pertains to leading and managing
b. Implications (good and bad) for inclusion of concept within
leadership environment
c. Evaluation of known outcomes when concept applied to leading
and managing in nursing.

V. Conclusion (20 points) _______
a. Concise summation of the main and supporting ideas of the paper.
b. No introduction of new material
c. Final summary statement (addresses the thesis statement)

VI. APA format; composition/word use; spelling/punctuation/grammar/paragraph length (10 points) ________
a. Appropriate headings, in-text citations, reference page citations

Nursing and Health Care Informatics Ethics and the Law

Order Description

Nursing and Health Care Informatics Ethics and the Law

“Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.”
—Confidentiality excerpt from the Hippocratic Oath (as cited in Croll, 2010)

Traditional schools of medicine have a ritual of reciting oath excerpts such as the one above during their graduation ceremonies. Such excerpts usually revolve around a professional’s promise to uphold the ideals of patient safety and confidentiality to the best of his or her ability.

With the continued integration of HIT, and advances in technology such as hand-held computers, new ethical considerations have evolved within health care settings. For example, wireless capabilities can provide easier access to information from unauthorized outside parties. While technological advances have led to improvements in health care, they have also created new vulnerabilities. DNP-prepared nurses need to be aware of ethical issues surrounding the use of patient information, technology, and the respective liabilities.

Reference:
Croll, P. (2010). Privacy, security and access with sensitive health information. Studies in Health Technology and Informatics, 151, 167–175.

To prepare:

Reflect on this week’s Learning Resources, focusing on the ethical and legal issues associated with usage of data and health information.

For this Discussion, identify an ethical issue related to data collection or information management at your organization or one with which you are familiar.

Determine the potential liabilities that this ethical issue presents by reviewing the AMIA Code of Ethics.

Consider the legal aspects of your ethical issue and the steps that could be taken to avoid or minimize risk.
By Day 3 post a cohesive response that addresses the following:

Describe your selected ethical issue.

Analyze the potential liabilities that this issue poses to the organization by referencing the AMIA Code of Ethics.

Formulate strategies that the organization could implement to address the ethical issue

INTERGRARED NURSING CONCEPTS

Order Description

Integrated Nursing Concepts
Assessment 2 2015

Case Study: (part one 400words)
This case study involves an exploration of the impact and associated challenges of chronic illness on a particular patient and their family in the Australian context. An evaluation of the provision and adequacy of care, the efficacy of management and support, and importantly the emerging role for nurses in chronic disease management will be of particular interest throughout this assessment.

ANMC Competency: 1, 2, 4, 5, 6, 7, 8

Student conclusion: 400-500 words

This assessment task will assist students to understand theories and concepts related to the prevention and non-acute management of chronic and complex illness and the role of nursing in this increasingly important arena of care.

In small groups students will prepare a presentation based on an identifiable chronic and complex illness group from the list below in an attempt to capture the lived experience of a person and their family who are on a particular illness journey. The case study chosen must be authentic, that is, it must be based on a real but unidentified person known to a student in the group, or be based on a sufficiently detailed real case described in the academic literature or other media.

Students are also required to submit an individual written conclusion to this assessment task that connects learning from the case presentation to the present and emerging role of registered nurses in chronic disease management.

Select from the following chronic and complex illness groups:

The person with heart failure

Presentations are to focus on the following aspects of the illness journey:

• Models of care (highlighting self-management expectations) and recent innovations in care

Process:
1. Select an illness group (The person with heart failure)
2. Groups are required to cover each of the aspects of chronic illness mentioned above however one aspect is to be covered in greater depth. Please note the presentation is about the patient journey and you are trying to understand what this experience is like for the patient/family and convey that to your tutor and audience. Basing the presentation on an authentic patient will enhance the relevance of the presentation
3. References are to be identified throughout the presentation
4. Groups will also present their concept map of chronic illness that has been developed across the semester and discuss how their concept of chronic and complex illness has been informed by researching their chosen topic
5. Bring energy and enthusiasm to your presentation. As a group you want the audience to be engaged and learn something useful for their practise
6. Presentation techniques (can take many forms) and work allocation can be decided by each group (one person could present for example), however, at least 90% of the presentation in whatever form it takes, must be original. A 15 minute video of a patient speaking about their experience for example, would not be acceptable, but some shorter grabs would be fine

Student conclusion:(part two 400 words)
The final aspect of this assessment task is to write a short individual conclusion (400 words) to this learning experience that connects the understanding gained with present and emerging roles for registered nurses in chronic disease prevention and management. To be clear the question to be answered is: Is there an emerging role for registered nurses in chronic disease prevention and management in Australia? Relate this discussion to the general literature in this area and your case study learning.

This question is to be answered in the same way as the short answers in assessment 1. Students will be provided with all references required apart from one which students must locate either individually or as a group.

The following marking criteria will be used to grade the presentation:
Criteria and weighting Fail:
Below expected level Pass:
At expected level Credit:
Above expected level
Distinction and High Distinction: Exceptional

Development of topic: research, understanding and knowledge demonstrated (15%)
Limited understanding of topic shown. Some links and connections made between ideas but largely superficial. Points are usually developed with minimum detail. Information is at times irrelevant and lacks analysis and critique Good understanding of topic shown. Links and connections between ideas made clear. Information was relevant and expressed in own words. Points were developed with sufficient and appropriate detail. Some evidence of critique and analysis A very good understanding of the topic shown. Links and connections between ideas made clear. Information was relevant and well expressed in own words. Points were well-organised and developed with sufficient and appropriate details. Aspects of critique and analysis noted An exceptional understanding of the topic shown. Links and connections between ideas have clarity, ideas were integrated, synthesised and critically delivered. Information was relevant and well expressed in own words. Points were well-organised and developed with sufficient and appropriate details
Ability to engage and involve audience (5%) Topic not introduced with any clarity
Some eye contact was made.
Techniques used to engage audience were minimal and mainly ineffective
Choice of case study is poor for purpose
Topic introduced clearly, and purpose of presentation was made clear
An interesting approach taken to topic. Some eye contact was made. Presentation used techniques such as visual aids and props, anecdote, surprising facts, direct audience participation

Case study is authentic, appropriate and of interest. The case study is connected to discussion Topic introduced clearly and in an interesting way. Purpose of talk was made clear. Outline of focus was provided
Speakers monitored audience and adapted presentation accordingly. An interesting or original approach taken to the topic. Speaker used techniques such as visual aids and props, anecdote, humour, surprising facts, direct audience participation

Engaging, authentic and well utilised case study
Introduction was particularly engaging. Purpose of talk was made clear. Outline of focus was provided
Outstanding creativity was demonstrated.
Class engagement was maintained throughout the presentation. Speakers monitored audience and adapted presentation accordingly. An interesting or original approach taken to the topic. Speaker used techniques such as visual aids and props, anecdote, humour, surprising facts, direct audience participation

Engaging, authentic and well utilised case study

Use of visual aids (5%) No visual aids were used; OR
Visual aids were inappropriate or poorly related to the spoken message Visual aids were often appropriate and related to the spoken message Visual aids supported the presentation effectively. They clarified and reinforced the spoken message Visual aids were carefully prepared and supported the presentation effectively. They clarified and reinforced the spoken message. The aids added impact and interest to the presentation
Conclusion of topic and presentation of concept map (5%) A poor attempt was made to conclude the presentation.
Concept map demonstrated a poor understanding of chronic and complex illness and was not informed by this assessment An attempt was made to conclude the presentation.
Concept map was informative and contained sufficient detail. Group could express some connection between the map and this assessment The presentation was summed up clearly.
Concept map was informative and detailed. Group conveyed a sense of understanding how this assessment informed their understanding and the development of the concept map The presentation was summed up clearly and effectively, with key points emphasised.
Concept map was informative and detailed. Group conveyed at a high level how this assessment informed their understanding of chronic and complex illness