This study was done to identify the current status of gerontological nursing education in BSN pro... more This study was done to identify the current status of gerontological nursing education in BSN programs in South Korea and explore directions for improvement in the future. Methods: The participants were 51 schools providing 4-year nursing education programs located in Seoul or one of 6 provinces, Gyeonggi, Gangwon, Chungcheong, Gyeongsang or Jeolla provinces. Questionnaires were developed by 13 experts in gerontological nursing. The questionnaires included items on gerontological nursing curriculum, faculty professionality, and future directions for improving gerontological nursing education. Data were collected via email. Results: Among the school participants, 31.4% of them rated gerontological nursing as a required subject while 50.9% gave two credits for the subject. Of the expert participants, 54.9% reported that credits for gerontological nursing were not sufficient. The experts suggested providing gerontological nursing education as stand-alone courses and included gerontological nursing as an independent subject on the national examination for registered nurses, as this inclusion would improve gerontological nursing education. Conclusion: Over the past 30 years, gerontological nursing in South Korea has evolved. With environmental changes in sociodemographic and healthcare service, it is inevitable that positive changes of gerontological nursing in nursing education must be made.
Purpose: The purpose of this study was to describe the perception of older Korean men regarding h... more Purpose: The purpose of this study was to describe the perception of older Korean men regarding health behaviors. Methods: A qualitative descriptive method was used. A convenience sampling method was used to recruit the participants. Sixteen Korean men aged 65 years or older participated in the first interview and 12 men from the same informants participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis method was used to analyze the data. Results: Six themes regarding health behaviors were identified: doing regular activity, proper control, mastering mind, adapting to change, being with people, and doing cognitive activity. Conclusion: This study is the first qualitative study that explored the perception of health behaviors among older Korean men. The findings provide valuable informations on what older Korean men think about health behaviors and insights for future research, nursing education, and clinical p...
Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access t... more Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. Design: A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). Methods: Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unitbased consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. Findings: Repeated measures analysis of variance showed significant differences between groups in knowledge (p < .001), perceptions (p < .001), and attitudes (p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. Conclusions: The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. Clinical Relevance: These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents. Physical restraint use has many harmful effects for older adults, including death, serious injury, falls, decreased activities of daily living, pressure ulcers, incontinence, and increased duration of hospitalization, as well as fear, anger, humiliation, dehumanization, and powerlessness (Evans, Wood, & Lambert, 2003; Hofmann & Hahn, 2014; Strout, 2010). However, physical restraints have been widely used as "common practice" in many nursing homes around the world. Definitions have varied across countries, prompting a recent Delphi study to develop an internationally accepted definition of physical restraint: "Any action or procedure that prevents a person's free
As the size of the frail older adult population increases, family caregiving is becoming a more i... more As the size of the frail older adult population increases, family caregiving is becoming a more important issue. Caring for frail older relatives has been regarded as both a challenging and rewarding experience. Recently, some published literature reviews have revealed that culture influences the experiences of family caregivers
Korean immigrants are a rapidly growing ethnic group with a non-English speaking background (NESB... more Korean immigrants are a rapidly growing ethnic group with a non-English speaking background (NESB) in the United States. No published study was found that described the post-nursing home placement experiences of Korean immigrant family caregivers. The purpose of this study was to describe the experiences of Korean immigrant caregivers who placed non-English-language speaking (NELS) elderly relatives with dementia in American nursing homes. This study used a qualitative descriptive method, conducting in-depth interviews to obtain data. A purposive sampling method was used to recruit informants in Philadelphia. Ten informants participated in the first interview and 7 informants from the same group participated in the second interview. Symbolic interactionism and cultural models were used as theoretical frameworks. Through a qualitative content analysis of interview data, two underlying themes and six major themes were identified. The two underlying themes, Korean way of thinking and b...
What is already known about the topic? Health greatly affects older adults' quality of life, life... more What is already known about the topic? Health greatly affects older adults' quality of life, life satisfaction, happiness, well-being, and successful aging. Understanding older adults' health perceptions is important because their self-perceptions are important predictors of survival and mortality. During the last two decades, there has been an increase in qualitative studies focused on older adults' health perceptions. There is, however, a scarcity of research integrating the results of these studies. What this paper adds Older adults perceive health as everything, high priority, life process, way of life, or philosophy. Older adults define their health as the ability to do something independently, absence or management of symptoms, acceptance and adjustment with optimism, connectedness with others, and feeling enough energy.
Journal of Korean Academy of Community Health Nursing, 2011
This study was conducted to evaluate the effects of a dementia education program for Korean older... more This study was conducted to evaluate the effects of a dementia education program for Korean older adults who resided in community. Methods: The research adopted the non-equivalent control group pretestposttest design. A total of 66 older adults completed the study (31 older adults in the experimental group and 35 in the control group). The Experimental group participated in a six-session dementia education program for three weeks. The effects of the dementia education program were evaluated using the measures of knowledge of dementia and attitude toward dementia. Data were analyzed using independent sample t-test with SPSS/WIN 18.0. Results: There was a significant change in the knowledge of dementia in the experimental group (t=2.75, p =.008). Although there was an increase in attitude toward dementia in the experimental group, the change was not statistically significant (t=1.26, p =.212). Conclusion: The results indicated that the dementia education program is effective in improving the knowledge of dementia among community-dwelling older adults. There is a need to develop more effective dementia education programs designed to improve older adults' attitude toward dementia. Further research is needed using a highly rigorous research methodology.
There are few studies globally regarding the barriers to restraint-reduction. The purpose of this... more There are few studies globally regarding the barriers to restraint-reduction. The purpose of this study was to describe the views of nursing staff (both nurses and geriatric care assistants) regarding the barriers to reducing physical restraint use in Korean nursing homes. Forty registered nurse and geriatric care assistant informants participated in the first round of interviews and 16 of them participated in second confirmatory interviews. All interviews were conducted on site, one-on-one and face-to-face, using semi-structured interview protocols. Qualitative descriptive method was used and qualitative content analysis was employed. Six themes were identified: (a) being too busy, (b) lack of resources, (c) beliefs and concerns, (d) lack of education, (e) differences and inconsistencies, and (f) relationship issues. The findings of this study provide a valuable basis for developing restraint reduction education programs. Korean national leaders and nursing homes should develop and employ practice guidelines regarding restraints, support nursing staff to follow the guidelines, provide more practical and professional education, employ alternative equipment, use a multidisciplinary team approach, and engage volunteers in care support as well as employ more nursing staff to achieve restraint-free care.
The purpose of this article is to describe Korean immigrant caregivers’ experiences regarding Ame... more The purpose of this article is to describe Korean immigrant caregivers’ experiences regarding American nursing home placement of their non-English-speaking older relatives with dementia. Qualitative descriptive methods and qualitative content analysis were used. A total of 17 semistructured interviews were conducted with 10 Korean immigrant family caregivers. The “Korean way of thinking” emerged as a fundamental cultural belief about caregiving. Six major themes were identified: (a) I never thought about a nursing home; (b) If I think in a Korean way, I feel . . . ; (c) Nursing home staff cannot communicate with . . . ; (d) My care recipient maintains Korean culture; (e) Nursing home services are better than expected but . . . ; and (f) My care recipient is more vulnerable because of dementia. This study provides valuable insights for health care providers about communication and cultural issues of immigrant caregivers for non-English-speaking older relatives with dementia.
The aim of this paper is to clarify the concept of agitation in dementia through analysing defini... more The aim of this paper is to clarify the concept of agitation in dementia through analysing definitions, critical attributes, components, boundaries, antecedents and consequences of agitation. Background. The concept of agitation is not well defined. In addition, there exists much confusion about the characteristics and boundaries of agitation, as well as the distinction between agitation and related concepts. Recently developed theoretical models for agitation in dementia require new interpretation and conceptualization of agitation. Methods. Morse's method of critical appraisal of the literature was used. In addition, some parts of Rodgers' evolutionary method were employed. Data were selected using six electronic databases and the key words 'agitation', 'agitated', 'dementia', 'demented' and 'Alzheimer'. The analysis included 86 empirical or theoretical papers and one book. Results. A transition from the observer's perspective to the patient's perspective in the interpretation of agitation was found. Five critical attributes of agitation in dementia were identified: excessive, inappropriate, repetitive, non-specific and observable. Patient factors, interpersonal factors, environmental factors and restraint were identified as precipitating antecedents. Mediating antecedents included discomfort, unmet need and misinterpretation. Consequences of agitation were identified at the levels of patient, caregiver and others. Conclusions. This transition in perspectives has important implications as it can change health providers' attitudes and responses to agitation and lead to patientfocused and individualized care. Researchers and clinicians are encouraged to avoid labelling agitated behaviour as 'disturbing behaviour'.
Purpose This paper aims to review literature related to the experiences of family caregivers afte... more Purpose This paper aims to review literature related to the experiences of family caregivers after institutionalization of their older relatives. Methods Thirty-one research-based articles were reviewed for information on the following six dimensions: caregivers' involvement in care; the effects of institutionalization on mental health of caregivers; predictors of caregivers' mental health; caregivers' feelings; caregivers' difficulties and needs; and interventions for caregivers. Results Family caregivers continued their caregiver roles after institutionalization. There was a significant decrease in the caregivers' burden after institutionalization. Depression in caregivers, however, was not significantly reduced. The predictors of caregivers' mental health included characteristics of care recipients, caregivers, and institutions as well as interactions. After institutionalization, caregivers experienced positive feelings, negative feelings, and mixed feelings. Caregivers encountered many difficulties related to care recipients' decreasing cognitive functions, care recipients' behavioral problems, and institutional problems. Interventions improved caregivers' outcomes, care recipients' outcomes, staff members' outcomes, and the communication/relationships among the three groups. Conclusion This review expands existing knowledge and provides valuable information. Nurses and researchers need to conduct more research related to family caregivers' difficulties and needs. Future studies should develop more effective interventions and test the effects of interventions on family caregivers as well as care recipients and staff members.
This well-conducted review concluded that sensory interventions were the only type of non-pharmac... more This well-conducted review concluded that sensory interventions were the only type of non-pharmacological intervention in older adults with dementia to show beneficial effects in reducing agitation. These conclusions are likely to be reliable but, as the authors acknowledged, should be interpreted with some caution given the small sample sizes and variability in the interventions. Authors' objectives To determine the effectiveness of non-pharmacological interventions for agitation in older adults with dementia. Searching MEDLINE, CINAHL, PsycINFO, AgeLine, EBM Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), ACP Journal Club and ISI index were searched from inception to June 2004. Search terms were reported. References of review articles and potentially relevant studies were screened. The review was restricted to published studies in English or Korean.
Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access t... more Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. Design: A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). Methods: Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unit-based consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. Findings: Repeated measures analysis of variance showed significant differences between groups in knowledge (p < .001), perceptions (p < .001), and attitudes (p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. Conclusions: The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. Clinical Relevance: These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents.
This study was done to identify the current status of gerontological nursing education in BSN pro... more This study was done to identify the current status of gerontological nursing education in BSN programs in South Korea and explore directions for improvement in the future. Methods: The participants were 51 schools providing 4-year nursing education programs located in Seoul or one of 6 provinces, Gyeonggi, Gangwon, Chungcheong, Gyeongsang or Jeolla provinces. Questionnaires were developed by 13 experts in gerontological nursing. The questionnaires included items on gerontological nursing curriculum, faculty professionality, and future directions for improving gerontological nursing education. Data were collected via email. Results: Among the school participants, 31.4% of them rated gerontological nursing as a required subject while 50.9% gave two credits for the subject. Of the expert participants, 54.9% reported that credits for gerontological nursing were not sufficient. The experts suggested providing gerontological nursing education as stand-alone courses and included gerontological nursing as an independent subject on the national examination for registered nurses, as this inclusion would improve gerontological nursing education. Conclusion: Over the past 30 years, gerontological nursing in South Korea has evolved. With environmental changes in sociodemographic and healthcare service, it is inevitable that positive changes of gerontological nursing in nursing education must be made.
Purpose: The purpose of this study was to describe the perception of older Korean men regarding h... more Purpose: The purpose of this study was to describe the perception of older Korean men regarding health behaviors. Methods: A qualitative descriptive method was used. A convenience sampling method was used to recruit the participants. Sixteen Korean men aged 65 years or older participated in the first interview and 12 men from the same informants participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis method was used to analyze the data. Results: Six themes regarding health behaviors were identified: doing regular activity, proper control, mastering mind, adapting to change, being with people, and doing cognitive activity. Conclusion: This study is the first qualitative study that explored the perception of health behaviors among older Korean men. The findings provide valuable informations on what older Korean men think about health behaviors and insights for future research, nursing education, and clinical p...
Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access t... more Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. Design: A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). Methods: Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unitbased consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. Findings: Repeated measures analysis of variance showed significant differences between groups in knowledge (p < .001), perceptions (p < .001), and attitudes (p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. Conclusions: The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. Clinical Relevance: These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents. Physical restraint use has many harmful effects for older adults, including death, serious injury, falls, decreased activities of daily living, pressure ulcers, incontinence, and increased duration of hospitalization, as well as fear, anger, humiliation, dehumanization, and powerlessness (Evans, Wood, & Lambert, 2003; Hofmann & Hahn, 2014; Strout, 2010). However, physical restraints have been widely used as "common practice" in many nursing homes around the world. Definitions have varied across countries, prompting a recent Delphi study to develop an internationally accepted definition of physical restraint: "Any action or procedure that prevents a person's free
As the size of the frail older adult population increases, family caregiving is becoming a more i... more As the size of the frail older adult population increases, family caregiving is becoming a more important issue. Caring for frail older relatives has been regarded as both a challenging and rewarding experience. Recently, some published literature reviews have revealed that culture influences the experiences of family caregivers
Korean immigrants are a rapidly growing ethnic group with a non-English speaking background (NESB... more Korean immigrants are a rapidly growing ethnic group with a non-English speaking background (NESB) in the United States. No published study was found that described the post-nursing home placement experiences of Korean immigrant family caregivers. The purpose of this study was to describe the experiences of Korean immigrant caregivers who placed non-English-language speaking (NELS) elderly relatives with dementia in American nursing homes. This study used a qualitative descriptive method, conducting in-depth interviews to obtain data. A purposive sampling method was used to recruit informants in Philadelphia. Ten informants participated in the first interview and 7 informants from the same group participated in the second interview. Symbolic interactionism and cultural models were used as theoretical frameworks. Through a qualitative content analysis of interview data, two underlying themes and six major themes were identified. The two underlying themes, Korean way of thinking and b...
What is already known about the topic? Health greatly affects older adults' quality of life, life... more What is already known about the topic? Health greatly affects older adults' quality of life, life satisfaction, happiness, well-being, and successful aging. Understanding older adults' health perceptions is important because their self-perceptions are important predictors of survival and mortality. During the last two decades, there has been an increase in qualitative studies focused on older adults' health perceptions. There is, however, a scarcity of research integrating the results of these studies. What this paper adds Older adults perceive health as everything, high priority, life process, way of life, or philosophy. Older adults define their health as the ability to do something independently, absence or management of symptoms, acceptance and adjustment with optimism, connectedness with others, and feeling enough energy.
Journal of Korean Academy of Community Health Nursing, 2011
This study was conducted to evaluate the effects of a dementia education program for Korean older... more This study was conducted to evaluate the effects of a dementia education program for Korean older adults who resided in community. Methods: The research adopted the non-equivalent control group pretestposttest design. A total of 66 older adults completed the study (31 older adults in the experimental group and 35 in the control group). The Experimental group participated in a six-session dementia education program for three weeks. The effects of the dementia education program were evaluated using the measures of knowledge of dementia and attitude toward dementia. Data were analyzed using independent sample t-test with SPSS/WIN 18.0. Results: There was a significant change in the knowledge of dementia in the experimental group (t=2.75, p =.008). Although there was an increase in attitude toward dementia in the experimental group, the change was not statistically significant (t=1.26, p =.212). Conclusion: The results indicated that the dementia education program is effective in improving the knowledge of dementia among community-dwelling older adults. There is a need to develop more effective dementia education programs designed to improve older adults' attitude toward dementia. Further research is needed using a highly rigorous research methodology.
There are few studies globally regarding the barriers to restraint-reduction. The purpose of this... more There are few studies globally regarding the barriers to restraint-reduction. The purpose of this study was to describe the views of nursing staff (both nurses and geriatric care assistants) regarding the barriers to reducing physical restraint use in Korean nursing homes. Forty registered nurse and geriatric care assistant informants participated in the first round of interviews and 16 of them participated in second confirmatory interviews. All interviews were conducted on site, one-on-one and face-to-face, using semi-structured interview protocols. Qualitative descriptive method was used and qualitative content analysis was employed. Six themes were identified: (a) being too busy, (b) lack of resources, (c) beliefs and concerns, (d) lack of education, (e) differences and inconsistencies, and (f) relationship issues. The findings of this study provide a valuable basis for developing restraint reduction education programs. Korean national leaders and nursing homes should develop and employ practice guidelines regarding restraints, support nursing staff to follow the guidelines, provide more practical and professional education, employ alternative equipment, use a multidisciplinary team approach, and engage volunteers in care support as well as employ more nursing staff to achieve restraint-free care.
The purpose of this article is to describe Korean immigrant caregivers’ experiences regarding Ame... more The purpose of this article is to describe Korean immigrant caregivers’ experiences regarding American nursing home placement of their non-English-speaking older relatives with dementia. Qualitative descriptive methods and qualitative content analysis were used. A total of 17 semistructured interviews were conducted with 10 Korean immigrant family caregivers. The “Korean way of thinking” emerged as a fundamental cultural belief about caregiving. Six major themes were identified: (a) I never thought about a nursing home; (b) If I think in a Korean way, I feel . . . ; (c) Nursing home staff cannot communicate with . . . ; (d) My care recipient maintains Korean culture; (e) Nursing home services are better than expected but . . . ; and (f) My care recipient is more vulnerable because of dementia. This study provides valuable insights for health care providers about communication and cultural issues of immigrant caregivers for non-English-speaking older relatives with dementia.
The aim of this paper is to clarify the concept of agitation in dementia through analysing defini... more The aim of this paper is to clarify the concept of agitation in dementia through analysing definitions, critical attributes, components, boundaries, antecedents and consequences of agitation. Background. The concept of agitation is not well defined. In addition, there exists much confusion about the characteristics and boundaries of agitation, as well as the distinction between agitation and related concepts. Recently developed theoretical models for agitation in dementia require new interpretation and conceptualization of agitation. Methods. Morse's method of critical appraisal of the literature was used. In addition, some parts of Rodgers' evolutionary method were employed. Data were selected using six electronic databases and the key words 'agitation', 'agitated', 'dementia', 'demented' and 'Alzheimer'. The analysis included 86 empirical or theoretical papers and one book. Results. A transition from the observer's perspective to the patient's perspective in the interpretation of agitation was found. Five critical attributes of agitation in dementia were identified: excessive, inappropriate, repetitive, non-specific and observable. Patient factors, interpersonal factors, environmental factors and restraint were identified as precipitating antecedents. Mediating antecedents included discomfort, unmet need and misinterpretation. Consequences of agitation were identified at the levels of patient, caregiver and others. Conclusions. This transition in perspectives has important implications as it can change health providers' attitudes and responses to agitation and lead to patientfocused and individualized care. Researchers and clinicians are encouraged to avoid labelling agitated behaviour as 'disturbing behaviour'.
Purpose This paper aims to review literature related to the experiences of family caregivers afte... more Purpose This paper aims to review literature related to the experiences of family caregivers after institutionalization of their older relatives. Methods Thirty-one research-based articles were reviewed for information on the following six dimensions: caregivers' involvement in care; the effects of institutionalization on mental health of caregivers; predictors of caregivers' mental health; caregivers' feelings; caregivers' difficulties and needs; and interventions for caregivers. Results Family caregivers continued their caregiver roles after institutionalization. There was a significant decrease in the caregivers' burden after institutionalization. Depression in caregivers, however, was not significantly reduced. The predictors of caregivers' mental health included characteristics of care recipients, caregivers, and institutions as well as interactions. After institutionalization, caregivers experienced positive feelings, negative feelings, and mixed feelings. Caregivers encountered many difficulties related to care recipients' decreasing cognitive functions, care recipients' behavioral problems, and institutional problems. Interventions improved caregivers' outcomes, care recipients' outcomes, staff members' outcomes, and the communication/relationships among the three groups. Conclusion This review expands existing knowledge and provides valuable information. Nurses and researchers need to conduct more research related to family caregivers' difficulties and needs. Future studies should develop more effective interventions and test the effects of interventions on family caregivers as well as care recipients and staff members.
This well-conducted review concluded that sensory interventions were the only type of non-pharmac... more This well-conducted review concluded that sensory interventions were the only type of non-pharmacological intervention in older adults with dementia to show beneficial effects in reducing agitation. These conclusions are likely to be reliable but, as the authors acknowledged, should be interpreted with some caution given the small sample sizes and variability in the interventions. Authors' objectives To determine the effectiveness of non-pharmacological interventions for agitation in older adults with dementia. Searching MEDLINE, CINAHL, PsycINFO, AgeLine, EBM Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), ACP Journal Club and ISI index were searched from inception to June 2004. Search terms were reported. References of review articles and potentially relevant studies were screened. The review was restricted to published studies in English or Korean.
Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access t... more Purpose: Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. Design: A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). Methods: Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unit-based consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. Findings: Repeated measures analysis of variance showed significant differences between groups in knowledge (p < .001), perceptions (p < .001), and attitudes (p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. Conclusions: The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. Clinical Relevance: These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents.
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