Lorna Guse

Use of social commitment robots in the care of elderly people with dementia: A literature review

Globally, the population of elderly people is rising with an increasing number of people living with dementias. This trend is coupled with a prevailing need for compassionate caretakers. A key challenge in dementia care is to assist the person to sustain communication and connection to family, caregivers and the environment. The use of social commitment robots in the care of people with dementia has intriguing possibilities to address some of these care needs. This paper discusses the literature on the use of social commitment robots in the care of elderly people with dementia; the contributions to care that social commitment robots potentially can make and the cautions around their use. Future directions for programs of research are identified to further the development of the evidence-based knowledge in this area.

Quality of life of adults with unhealed and healed diabetic foot ulcers.

Background: Diabetic foot ulcers cause major treatment morbidity and cost of care. This study evaluated quality of life in patients with unhealed and healed diabetic foot ulcers. Methods: This was a cross-sectional study of adult diabetic patients (age 45 years or older) treated in a tertiary care foot clinic who had foot ulcers within the preceding 2 years. Patients with other diabetic complications or conditions that would potentially affect quality of life were excluded. Two patient groups of comparable age, gender distribution, and duration of diabetes were studied: 57 patients with unhealed ulcers (minimum duration, 6 months) and 47 patients with healed ulcers. Telephone interviews were done using the Short Form 12 (SF-12) (both groups) and a Cardiff Wound Impact Scale (CWIS) (unhealed ulcer group). Results: The mean SF-12 Physical Component Summary score was significantly lower for the group with unhealed ulcers (unhealed, 35 ± 8 points; healed, 39 ± 10 points; p = 0.04); these scores for both groups were significantly lower than published Short Form 36 (SF-36) scores for general, diabetic, and hypertensive populations. The mean SF-12 Mental Component Summary scores of the groups did not differ significantly from each other or from published population scores. CWIS responses showed that patients with unhealed ulcers were frustrated with healing and had anxiety about the wounds, resulting in marked negative impact on the average Well-being Component Score (35 ± 6 points). Conclusions: Individuals with diabetic foot ulcers experience profound compromise of physical quality of life, which is worse in those with unhealed ulcers.

A pilot study assessing social support among cancer patients enrolled on clinical trials: a comparison of younger versus older adults

Purpose: This study tested the logistical feasibility of obtaining data on social support systems from cancer patients enrolled on clinical trials and compared the social support of older adults (age ≥65) and younger adults (<50 years of age) with cancer. Methods: Patients had to be eligible for a phase II or phase III oncology clinical trial and enter the study prior to treatment. Patients filled out the Lubben Social Network Scale (LSNS) at baseline. The Symptom Distress Scale (SDS) and single-item overall quality of life (QOL) Uniscale were assessed at baseline and weekly for 4 weeks. Results: There was no significant difference in overall mean Lubben social support levels by age. Older patients had more relatives they felt close to (85% versus 53% with 5 or more relatives, P = 0.02), heard from more friends monthly (84% versus 53% with 3 or more friends, P = 0.02), less overall symptom distress (P = 0.03), less insomnia (P = 0.003), better concentration (P = 0.005), better outlook (P = 0.01), and less depression (P = 0.005) than younger patients. Conclusions: Younger subjects reported worse symptoms, a smaller social support network, and fewer close friends and relatives than older subjects. Having someone to discuss decisions and seeing friends or relatives often was associated with longer survival.

Association of Genetic Factors and Gene–Environment Interactions With Risk of Developing Posttraumatic Stress Disorder in a Case–Control Study

Background: The dopamine receptor D2 (DRD2) and serotonin transporter (5-HTT) genes are associated with posttraumatic stress disorder (PTSD). However, it remains largely unknown whether these genes interact with environmental factors to affect the development of PTSD. Purpose: The purpose of this study was to examine the associations of gene polymorphisms and gene–environment interactions with the risk of developing PTSD among adolescent earthquake survivors. Method: A total of 183 adolescent survivors from an earthquake-stricken area participated in this study. Measures included a questionnaire about demographic characteristics and earthquake exposure, the PTSD Checklist–Civilian Version and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition disorders. Genotypes were analyzed by using the polymerase chain reaction–based restriction fragment length polymorphism. Results: The 5-HTTLPR and 5-HTTVNTR polymorphisms and earthquake exposure had statistically significant positive effects on PTSD. The interaction effects of 5-HTTLPR × Earthquake Exposure and 5-HTTVNTR × Earthquake Exposure were statistically significant. Conclusion: The development of PTSD is the result not only of a genetic effect and environmental factors but also of the interactive effect between gene and environment.

Does restructuring theory and clinical courses better prepare nursing students to manage residents with challenging behaviors in long-term care settings?

ABSTRACT Bachelor of Nursing students (BN) placed in long-term care encounter residents who exhibit challenging behaviors. Students are often inadequately prepared to manage these behaviors, and this is a source of distress for students. This study explored whether enhancing and restructuring theoretical and clinical courses resulted in student nurses feeling better prepared to manage residents’ challenging behaviors and improve their levels of distress. This study was conducted in two phases with 116 BN students (first phase) and 99 students (second phase) where the course on older adults was restructured. The findings of this study indicated that students who felt less prepared experienced greater distress by residents’ behaviors than those who felt better prepared. Scheduling a theoretical course on the care of older adults prior to the clinical course placement, as well as offering an online learning module focused on responsive behaviors, significantly increased students’ feelings of preparedness to manage residents’ complex behaviors.

Undergraduate Placements in Geriatric Care Facilities: Students Gaining Experience With Challenging/Responsive Behaviors

BACKGROUND Undergraduate nursing students may experience challenging behaviors in residents during their clinical placement in geriatric long-term care (GLTC) facilities. METHOD Bachelor of Nursing students participated in an anonymous online questionnaire (n = 116). RESULTS The students witnessed a wide range of challenging behaviors, also referred to as responsive behaviors, in GLTC residents. The most frequent behaviors included agitation/restlessness, repetitive talk, and wandering. Although behaviors such as physical aggression and disinhibited sexual behavior were experienced less frequently, students found these behaviors the most distressing. Students felt ill-prepared to manage these behaviors, which was associated with higher levels of distress. CONCLUSION The students demonstrated good theoretical knowledge about responsive behaviors, but the lack of personal experience in managing such behaviors left the students feeling ill-prepared and distressed. Incorporating the opportunity to experience behaviors in a supported environment, such as in simulation, could reduce student distress and increase their sense of competency. [J Nurs Educ. 2017;56(10):623-627.].