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Reducing Antipsychotic Medication Use in Nursing Homes: A Qualitative Study of Nursing Staff Perceptions.
Simmons SF, Bonnett KR, Hollingsworth E, Kim J, Powers J, Habermann R, Newhouse P, Schlundt DG
(2018) Gerontologist 58: e239-e250
MeSH Terms: Accidental Falls, Adult, Antipsychotic Agents, Attitude of Health Personnel, Dementia, Female, Humans, Male, Middle Aged, Needs Assessment, Nursing Homes, Nursing Staff, Prescription Drug Overuse, Qualitative Research, Quality of Life, Social Perception
Show Abstract · Added March 3, 2020
Background and Objectives - The purpose of this study was to use qualitative methods to explore nursing home staff perceptions of antipsychotic medication use and identify both benefits and barriers to reducing inappropriate use from their perspective.
Research Design and Methods - Focus groups were conducted with a total of 29 staff in three community nursing homes that served both short and long-stay resident populations.
Results - The majority (69%) of the staff participants were licensed nurses. Participants expressed many potential benefits of antipsychotic medication reduction with four primary themes: (a) Improvement in quality of life, (b) Improvement in family satisfaction, (c) Reduction in falls, and (d) Improvement in the facility Quality Indicator score (regulatory compliance). Participants also highlighted important barriers they face when attempting to reduce or withdraw antipsychotic medications including: (a) Family resistance, (b) Potential for worsening or return of symptoms or behaviors, (c) Lack of effectiveness and/or lack of staff resources to consistently implement nonpharmacological management strategies, and (d) Risk aversion of staff and environmental safety concerns.
Discussion and Implications - Nursing home staff recognize the value of reducing antipsychotic medications; however, they also experience multiple barriers to reduction in routine clinical practice. Achievement of further reductions in antipsychotic medication use will require significant additional efforts and adequate clinical personnel to address these barriers.
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MeSH Terms
Community-Engaged Strategies to Promote Relevance of Research Capacity-Building Efforts Targeting Community Organizations.
Cunningham J, Miller ST, Joosten Y, Elzey JD, Israel T, King C, Luther P, Vaughn Y, Wilkins CH
(2015) Clin Transl Sci 8: 513-7
MeSH Terms: Biomedical Research, Capacity Building, Community-Based Participatory Research, Community-Institutional Relations, Cooperative Behavior, Humans, Interdisciplinary Communication, Needs Assessment, Program Development, Public Opinion, Research Design, Surveys and Questionnaires
Show Abstract · Added July 28, 2016
OBJECTIVE - The study goal is to highlight strategies for promoting relevance of research capacity-building efforts targeting community organizations (CO)s.
METHODS - Two community partners, representing two COs, were invited to participate in CO research development trainings, Community Research Forums (Forum)s. Their contributions were documented via Forum document review. Forum participants, representatives from other COs, completed post-Forum surveys to identify additional training needs and rate Forum impact relative to their training expectations. A content-based analysis and descriptive statistics were used to summarize needs assessment- and impact-related survey responses, respectively.
RESULTS - Community partners were involved in eight Forum-related activities including marketing (planning), facilitation (implementation), and manuscript coauthorship (dissemination). Eighty-one individuals, representing 55 COs, attended the Forums. Needs assessment responses revealed a desire for additional assistance with existing Forum topics (e.g., defining research priorities) and a need for new ones (e.g., promoting organizational buy in for research). Ninety-one percent of participants agreed that the Forum demonstrated the value of research to COs and how to create a research agenda.
CONCLUSIONS - Including community partners in all Forum phases ensured that CO perspectives were integrated throughout. Post-Forum needs and impact assessment results will help in tailoring, where needed, future training topics and strategies, respectively.
© 2015 Wiley Periodicals, Inc.
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12 MeSH Terms
Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9-10, 2013.
Van Wagoner DR, Piccini JP, Albert CM, Anderson ME, Benjamin EJ, Brundel B, Califf RM, Calkins H, Chen PS, Chiamvimonvat N, Darbar D, Eckhardt LL, Ellinor PT, Exner DV, Fogel RI, Gillis AM, Healey J, Hohnloser SH, Kamel H, Lathrop DA, Lip GY, Mehra R, Narayan SM, Olgin J, Packer D, Peters NS, Roden DM, Ross HM, Sheldon R, Wehrens XH
(2015) Heart Rhythm 12: e5-e29
MeSH Terms: Anti-Arrhythmia Agents, Atrial Fibrillation, Biomedical Research, Electric Countershock, Humans, Needs Assessment, Risk Factors
Added January 20, 2015
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7 MeSH Terms
Update in interventional pulmonology: a prologue to a new review series.
Maldonado F, Edell ES, Barron PJ, Yung RC
(2014) Respirology 19: 471
MeSH Terms: Bronchoscopy, Disease Management, Humans, Inventions, Models, Educational, Needs Assessment, Pulmonary Medicine, Respiratory Tract Diseases
Added July 28, 2015
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8 MeSH Terms
Prevalence of syphilis among antenatal clinic attendees in Karachi: imperative to begin universal screening in Pakistan.
Shah SA, Kristensen S, Memon MA, Usman G, Ghazi A, John R, Sathiakumar N, Vermund SH
(2011) J Pak Med Assoc 61: 993-7
MeSH Terms: Adult, Cross-Sectional Studies, Female, Humans, Male, Needs Assessment, Pakistan, Pregnancy, Pregnancy Complications, Infectious, Prenatal Diagnosis, Prevalence, Risk Factors, Substance-Related Disorders, Surveys and Questionnaires, Syphilis, Treponema pallidum, Urban Health Services
Show Abstract · Added March 5, 2014
OBJECTIVES - To assess the prevalence and associated risk factors of syphilis among antenatal clinic attendees by a multi-center cross-sectional study in Karachi, Pakistan.
METHODS - We administered a structured questionnaire and obtained a blood sample for syphilis serology (rapid plasma reagin test with Treponema pallidum hemagglutination assay confirmation) from all women giving informed consent over six weeks in 2007. Prevalence was calculated at 95% confidence intervals. Multivariate analysis was adapted to assess risk factors.
RESULTS - There were seven (0.9%) confirmed cases of syphilis (95% CI: 0.4, 1.8) in a sample size of 800 women recruited from three urban sites (-1% refusal rate). Women who lived in an area where male drug use is prevalent had 1.5% higher prevalence rates than women from the other two sites 0.5%.
CONCLUSIONS - We documented higher-than-expected syphilis seroprevalence rates in a low risk population of antenatal clinic attendees in Pakistan. Bridge populations for syphilis may include drug users, who are usually married, and Hijras or their clients. In accordance with our results, the national policy for syphilis control in Pakistan should be modified to include universal syphilis screening in antenatal clinics with subsequent partner notification.
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17 MeSH Terms
How does health information influence African American men's health behavior?
Griffith DM, Ellis KR, Ober Allen J
(2012) Am J Mens Health 6: 156-63
MeSH Terms: Adult, African Americans, Consumer Health Information, Cultural Characteristics, Focus Groups, Health Behavior, Humans, Male, Men's Health, Middle Aged, Needs Assessment, Patient Acceptance of Health Care, Qualitative Research, Socioeconomic Factors, United States, Urban Population
Show Abstract · Added March 27, 2014
Few researchers have examined where African American men obtain, process, and use health information. A thematic analysis of data from eighteen exploratory focus groups conducted with 154 urban African American men aged 32 years and older revealed that men received health information from a variety of sources, including health professionals, media, and members of their social networks. At times, information raised their awareness of health issues, but trust in the source of the information influenced how this information was perceived. Medical professionals were the most common source of health information, but family members were the most trusted source of health information. Health problems and social support increased men's motivation to use health information in order to improve their health and healthy behaviors. These findings illustrate that it is critical to identify factors that influence what information men choose to believe and follow or decide to ignore.
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16 MeSH Terms
The occurrence of velopharyngeal insufficiency in Pierre Robin Sequence patients.
Goudy S, Ingraham C, Canady J
(2011) Int J Pediatr Otorhinolaryngol 75: 1252-4
MeSH Terms: Child, Child, Preschool, Cleft Palate, Female, Humans, Incidence, Male, Needs Assessment, Pierre Robin Syndrome, Postoperative Complications, Retrospective Studies, Speech, Treatment Outcome, Velopharyngeal Insufficiency
Show Abstract · Added May 30, 2014
OBJECTIVE - Children born with Pierre-Robin Sequence (PRS) have cleft palate, micrognathia, and macroglossia. After the repair of the cleft palate, velopharyngeal insufficiency (VPI) can occur in a subset of patients. We hypothesize that the need for the surgical correction of VPI in PRS children is no different than cleft palate only (CPO) patients.
METHODS - A retrospective study of 21 children with non-syndromic PRS who were matched to 42 non-syndromic, CPO controls for age and sex. We reviewed incidence of VPI, the need for secondary speech surgery, and speech outcomes post-operatively.
RESULTS - Secondary surgery to correct VPI was necessary in 3 of 21 (14.29%) PRS patients (2 Pharyngeal Flaps, 1 Z-plasty), vs. 10 of 42 (23.81%) CPO (9 Pharyngeal Flaps, 1 Z-plasty) controls. Mean age for VPI surgery for PRS vs. controls: 5.33 vs. 6.41 years, respectively. For final speech outcomes, 73.68% of PRS vs. 71.88% of controls showed no evidence of hypernasality, 89.47% of PRS patients vs. 93.75% of controls showed no evidence of hyponasality, and 76.47% of PRS patients vs. 78.13% of controls had normal velopharyngeal competence (p>0.90 for all three measures).
CONCLUSION - Our findings suggest that children born with a Pierre-Robin Sequence do not have a higher rate of post-operative VPI after cleft palate repair and are no more likely to require additional surgical intervention.
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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14 MeSH Terms
Reflections on the initial multinational response to the earthquake in Haiti.
Hopmeier MJ, Pape JW, Paulison D, Carmona R, Davis T, Peleg K, Shenhar G, Conway-Welch C, Vermund SH, Nicotera J, Kellermann AL
(2010) Popul Health Manag 13: 105-13
MeSH Terms: Disaster Planning, Earthquakes, Haiti, Humans, International Cooperation, Needs Assessment, Organizations, Relief Work, United Nations
Added March 5, 2014
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9 MeSH Terms
Assessing community readiness for change in the Nashville Hispanic community through participatory research.
Hull PC, Canedo J, Aquilera J, Garcia E, Lira I, Reyes F
(2008) Prog Community Health Partnersh 2: 185-94
MeSH Terms: Adolescent, Adult, Community Health Services, Community Networks, Community Participation, Community-Based Participatory Research, Female, Health Planning, Health Promotion, Hispanic Americans, Humans, Male, Middle Aged, Needs Assessment, Patient Acceptance of Health Care, Tennessee, Urban Population, Young Adult
Show Abstract · Added March 5, 2014
BACKGROUND - "New-growth communities" with rapidly growing Hispanic populations often have little experience with addressing the needs of this population. "Community readiness for change" is the degree to which a community is prepared to take action on an issue.
OBJECTIVES - This study assessed the stage of community readiness for change in the area of Hispanic health in Nashville, using the community readiness model (CRM) and a community-based participatory research (CBPR) approach, through a partnership between an academic research center and a nonprofit, grassroots, Hispanic organization.
METHODS - Qualitative and quantitative data were collected by trained community interviewers and the academic researcher using a semistructured questionnaire based on the CRM. The sample of key informants included (1) a purposive sample of 18 organizations, and (2) a convenience sample of 50 Hispanic community members.
RESULTS - The organizations were at a higher stage (stage 5, preparation) than the Hispanic community members were (stage 4, preplanning), particularly in the dimensions of Leadership, Resources, and Knowledge of Efforts. The community members were also aware of fewer local efforts focused on Hispanic health than the organizations (average of 4.5 vs. 7.6).
CONCLUSIONS - Recommendations were made for stageappropriate, community-level interventions. The assessment results are being used by Nashville Latino Health Coalition (NLHC) to plan collaborative initiatives to address Hispanic health needs in Nashville. This study demonstrates the utility of the CRM as a model for assessing a community's stage of readiness to take action, and the feasibility of applying it using a CBPR approach in a "new-growth" Hispanic community.
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18 MeSH Terms
Factors influencing prostate cancer screening in low-income African Americans in Tennessee.
Patel K, Kenerson D, Wang H, Brown B, Pinkerton H, Burress M, Cooper L, Canto M, Ukoli F, Hargreaves M
(2010) J Health Care Poor Underserved 21: 114-26
MeSH Terms: African Americans, Aged, Community Health Services, Early Detection of Cancer, Health Services Accessibility, Health Surveys, Humans, Income, Male, Middle Aged, Needs Assessment, Patient Acceptance of Health Care, Prostatic Neoplasms, Socioeconomic Factors, Tennessee, Urban Health
Show Abstract · Added March 27, 2014
This study examined demographic and lifestyle factors that influenced decisions to get screened for prostate cancer in low-income African Americans in three urban Tennessee cities. It also examined obstacles to getting screened. As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American men 45 years and older (n=293) were selected from the Meharry CNP community survey database. Participants from Nashville, those who were older, obese, and who had health insurance were more likely to have been screened (p<.05). Additionally, there were associations between obstacles to screening (such as cost and transportation) and geographic region (p<.05). Educational interventions aimed at improving prostate cancer knowledge and screening rates should incorporate information about obstacles to and predictors of screening.
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16 MeSH Terms