Nancy E. Edwards

Animal-assisted therapy and Nutrition in Alzheimer's disease.

This study examined the influence of animal-assisted therapy, specifically fish aquariums, on nutritional intake in individuals with Alzheimer’s disease (AD). Sixty-two individuals with AD who lived in specialized units were studied. Baseline nutritional data were obtained followed by a 2-week treatment period when the aquariums were introduced. The treatment data were collected daily for 2 weeks then weekly for 6 weeks. Nutritional intake increased significantly (21.1%; p < .001) when the aquariums were introduced and continued to increase during the 6-week weekly follow-up. Weight increased significantly(1.65 lbs; p < .001) over the 16-week period. In addition, participants required less nutritional supplementation, resulting in health care cost savings.

Predictors of burden for caregivers of patients with Parkinson's disease.

&NA; Parkinsons disease (PD) is a chronic, progressive neurological disease that affects an estimated 1 million Americans each year. Its progressive nature leads to increased burden for the caregiver. This study explored factors that contribute to the perception of burden in caregivers of individuals with PD using a cross‐sectional design. The sample consisted of 41 caregivers who were married to or cohabitating with individuals with PD. Questionnaires were mailed to spousal caregivers and returned via mail. Burden was determined by utilizing the Zarit Burden Inventory. The independent variables that were measured were activities of daily living (ADLs), perceived social support, psychological well‐being, and marital satisfaction. All four factors were found to significantly predict perceived burden. Multiple regression analysis showed that ADLs and perceived social support were significant predictors of caregiver burden, accounting for 44.3% of the variance. The implication for healthcare professionals is that they should provide information on PD symptom management, thus promoting independence in performing ADLs, identifying appropriate resources to reduce caregiver burden, and using support groups.

Psychosocial and environmental factors associated with dog-walking

Dog walking is associated with higher levels of physical activity (PA). However, not all dog owners walk their dog(s) at a level sufficient for health benefits. Therefore, identifying correlates of dog-walking may help to inform the design of more effective interventions to promote this specific form of PA. The purpose of this study was to examine psychosocial and environmental correlates of dog-walking and relationships of dog-walking with overall PA. In 2010, 391 dog owners (mean age = 43.6 ± 12.3 years) completed a survey. Multiple logistic regression and structural equation modeling were used to examine psychosocial and environmental correlates of dog-walking status, weekly minutes of dog-walking, and relationships of dog-walking with overall PA. Self-efficacy for dog-walking, dog-related outcome expectancies, family social support, dog social support, and neighborhood walking environment were associated with a 1.3–5.6 greater odds of being a dog walker. Self-efficacy mediated relationships between family support, dog support, and presence of a yard and dog-walking. Neighborhood environment, including the presence of greenery and trails, was also positively associated with duration of dog-walking (β = 0.17; p < 0.05). Every 30-minute increase in dog-walking was associated with a 23% greater odds of meeting PA guidelines by walking. Individual, social, and environmental factors consistent with a social–ecological framework were positively associated with dog-walking. Individuals were more likely to meet PA guidelines if they walked their dog(s) and engaged in dog-walking for longer duration.

The influence of aquariums on weight in individuals with dementia.

This study assessed whether individuals with dementia who observe aquariums increase the amount of food they consume and maintain body weight. The sample included 70 residents in dementia units within 3 extended care facilities in 2 states. The intervention included the introduction of an aquarium into each common dining area. A total increase of 196.9 g of daily food intake (25.0%) was noted from baseline to the end of the 10-week study. Resident body weight increased an average of 2.2 pounds during the study. Eight of 70 residents experienced a weight loss (=1.89 lbs). People with advanced dementia responded to aquariums in their environment documenting that attraction to the natural environment is so innate that it survives dementia.

Quality of health care provided at a pediatric nurse-managed clinic.

Purpose: The purpose of this study is to assimilate evidence regarding quality of care received at nurse‐managed clinics (NMCs), particularly a pediatric NMC that provides health care for the underserved pediatric population. Data sources: A nonexperimental design was used in this study. Quality of care data were collected at Trinity Nursing Center for Child Health (TNCCH), a pediatric NMC. Evidence included whether a pediatric NMC met selected national benchmark pediatric Healthcare Effectiveness and Data Information Set (HEDIS) quality indicators as well as HEDIS targets set by the Office of Medicaid Policy and Planning (OMPP) in Indiana. Conclusions: Findings suggest that TNCCH met or exceeded national HEDIS benchmark standards of care and targets set by OMPP. This study offers further evidence that NMCs provide a high quality of care. Implications for practice: Benefits of addressing the research question in this study include the preservation of the nurse‐managed healthcare safety net, increased access to health care for the medically underserved population resulting in improved health outcomes, and evidence to suggest that NMCs can assist private practice physicians to support this population of patients.

Perceived Patient Safety Culture in a Critical Care Transport Program

BACKGROUND The purpose of this study was to examine the association among selected safety culture dimensions and safety outcomes in the context of a critical care transport (CCT) program. METHODS A descriptive cross-sectional correlational design used the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture to validate perceived safety culture among personnel (n = 76) in a large Midwestern CCT program. RESULTS Findings revealed significant associations between 1) teamwork and frequency of error reporting (r = .428, P < .001), overall perception of safety (r = .745, P < .001), and perceived patient safety grade (r = -.681, P < .001); 2) between perception of manager actions promoting safety and frequency of error reporting (r = .521, P < .001), overall perception of safety (r = .779, P < .001), and perceived patient safety grade (r = -.756, P < .001); and 3) between communication openness and frequency of error reporting (r = .575, P < .001), overall perception of safety (r = .588, P < .001), and perceived patient safety grade (r = -.627, P < .001). CONCLUSION The study supports other literature showing significant associations among safety culture dimensions and safety outcomes and provides a framework for future research on safety culture in CCT programs.

Influence of Aquariums on Resident Behavior and Staff Satisfaction in Dementia Units

The influence of an aquarium on resident behavior and staff job satisfaction in three dementia units was examined. The sample consisted of 71 individuals with dementia and 71 professional staff. A pretest–posttest design was utilized. Baseline resident behavior and staff satisfaction were obtained, and an aquarium was introduced into the setting. Post-behavioral assessment and job satisfaction surveys were completed. Residents’ behaviors improved along four domains: uncooperative, irrational, sleep, and inappropriate behaviors. The overall residents’ behavior score was significantly improved after an aquarium was introduced, F = 15.60, p < .001. Their mean disruptive behavior score decreased from 67.2 to 58.2. The staff’s satisfaction score significantly improved, F = 35.34, p < .001. Pretest to posttest mean scores improved from 149.4 to 157.9. Aquariums are an innovative way for animal-assisted therapy and nature to be introduced to specialized dementia units in long-term care.

Development and Psychometric Testing of the Dogs and WalkinG Survey (DAWGS)

Purpose Dog owners represent 40% of the population, a promising audience to increase population levels of physical activity. The purpose of this study was to develop and test the psychometric properties of a new instrument to assess social-cognitive theory constructs related to dog walking. Method Dog owners (N = 431) completed the Dogs and WalkinG Survey (DAWGS). Survey items assessed dog-walking behaviors and self-efficacy, social support, outcome expectations, and outcome expectancies for dog walking. Test–retest reliability was assessed among 252 (58%) survey respondents who completed the survey twice. Factorial validity and factorial invariance by age and walking level were tested using confirmatory factor analysis. Results DAWGS items demonstrated moderate test–retest reliability (ρ = .39–.79; k = .41–.89). Acceptable model fit was found for all subscales. All subscales were invariant by age and walking level, except self-efficacy, which showed mixed evidence of invariance. Conclusions The DAWGS is a psychometrically sound instrument for examining individual and interpersonal correlates of dog walking.

Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study

PURPOSE The use of animals in various healthcare settings dates as far back as the 19th century, and is still a widely practiced intervention even today. The use of animals in the acute rehabilitation setting is a common practice that benefits both the patients therapy progression and allows the opportunity for financial reimbursement for the facility. As acute rehabilitation facilities continue to cope with ever changing rules and guidelines, the use of alternate modalities can help the facility overcome difficult challenges while focusing on the needs of the patients. The use of animal assisted therapy is illustrated with a stroke patient at an acute rehabilitation facility who benefited from implementing a pet therapy regimen when regular therapy modalities were not helping. CLINICAL RELEVANCE Incorporating animal assisted therapy in acute rehabilitation settings is described to obtain greater satisfaction for patients and staff and to facilitate reimbursement for rehabilitation settings.

Familism and Health Care Provision to Hispanic Older Adults.

The Hispanic older adult populations rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described.