The quality of care in United States' nursing homes has been of concern to consumers, government agencies, and researchers for several decades. Nurse staffing has been identified as a key factor influencing the quality of care in nursing homes. The purpose of this quantitative, correlational research was to determine if relationships existed between nurse staffing levels and three quality care outcomes in the state of Georgia. Donabedian's quality conceptual framework guided the study. The framework encompasses three interrelated dimensions of quality including structure, process, and outcomes. Nurse staffing levels and facility bed size represented the structure of nursing homes and pressure ulcers, falls with major injury, and urinary tract infections each represented facility outcomes. The sample included 348 nursing homes in Georgia. Data was collected from the Nursing Home Compare website. The predictor variables in this study were nurse staffing levels of registered nurses, licensed practical nurses, certified nursing assistants, and total nurse staffing levels. The outcome variables were pressure ulcers, urinary tract infections, and falls with major injury. A cross sectional design and multiple regressions were used to analyze the relationship between nurse staffing and quality of care outcomes. While the results of the study did not reveal significant relationships between variables, the study nonetheless offers useful insight on how future studies can be enhanced. These findings have implications for social changes as they may help to inform Georgia policy makers in decisions regarding regulations that mandate minimum nurse staffing standards.

This study compares the perceptions of long-term residents in rapidly and moderately growing nonmetropolitan communities regarding the effect of newcomers on the community. Data for the study came from a 1975 survey of 1,065 adults in seven Utah communities. Results show that a significantly larger proportion of long-term residents in rapidly growing communities than in moderately growing communities feel that newcomers are having a bad effect on the community. The relationship between perceived effect of newcomers and various personal attributes are examined with rate of population growth as a control variable. The attributes are: 1) length of residence, 2) age, 3) sex, 4) religious preference, 5) income, 6) proportion family living nearby, and 7) proportion of friends living in the community. Brief attention was given to examining newcomers' perception of the effect newcomers are having on the community with the use of length of residence variable. The differences between the long-term and short-term residents were not statistically significantly different. But because of theoretical and practical consideration the remainder of the analysis focused on the attitude of long-term residents. None of the differences between the subgrouping for the respective attributes were statistically significant in both moderate and rapidly growing communities. In rapidly growing communities only one hypothesis was supported with respect to the differences in attitude towards newcomers. The supported hypothesis was that Mormons would be more likely to perceive the effect of newcomers as being bad than would non-Mormons. within the moderately growing communities, statistically significant differences were found between income groups, but they were not in the direction of the hypothesis. Perhaps the most important evidence that rate of population growth influences the long-term residents' perception of newcomers is that, except for non-Mormons, the percentage feeling that the effect of newcomers was bad was highest in rapidly growing communities. This indicates that the pressures associated with rapid growth are generally perceived across a wide variety of subgroups. The particular exception, the non-Mormons, suggests that in particular cases a subgroup might perceive the changes as beneficial and to view the overall process of growth , including the newcomers, more positively.

Inoculation is a robust theory applied to a variety of health behaviors. Social marketing is designed to change behavior by applying marketing tactics in the context of social change. This study combines inoculation theory with social marketing in the context of substance abuse disorders to promote long-term recovery. This is a pilot project that specifically focuses on the Beacon House, a residential recovery treatment center in Louisville, Kentucky. With the growing drug problem in America, it is necessary to implement effective recovery strategies in treatment programs. The social marketing plan focuses on the target audience to outline potential barriers, motivators, and competition to remaining in long-term recovery. Three intervention strategies were developed as part of the project: a core inoculation message, booster messages, and refusal skills training. These strategies utilize inoculation messages in various ways to address the complexity of long-term recovery. While this study focuses on the Beacon House treatment facility, the concepts can be applied to similar treatment centers.

As older adults live longer, demand for supportive care will increase. Older adults will need a form of long-term care to manage their health and quality of life. As older adults age, they’re susceptible to having one or more chronic conditions. In taking measures to manage the chronic conditions of many older adults, in-home supportive services is a supportive program that provides non-medical personal and instrumental services to help older adults with their activities of daily living. An in-home supportive service allows an older adult to receive assistance and remain comfortably living in his or her home. However, an older adult of low-income status may not receive this information on supportive services. Therefore, this study was designed to assess the level of awareness low-income older adults have on in-home supportive services. This research design was quantitative focusing on measuring the level of awareness among low-income older adults. A survey instrument was created and given to older adults at a senior center of the County of San Bernardino. IBM SPSS Manual on Windows Software was used to input and analyze data. The findings of the study found a low level of awareness of the program called In-Home Supportive Services (IHSS) and participants understanding of in-home supportive services was unclear. This study provides recommendations for social workers to address the barriers of low-income older adults acquiring information on in-home supportive services.

The current study focuses on exploring the effects of previous child neglect on current psychological distress in college students. By bringing attention to the lasting impact of neglect through adulthood, mental health professionals will see the need for increased services for this population. A convenience sample of 93 Master of Social Work students responded to questions geared towards experience of neglect as a child and current psychological distress. Correlation analysis was used to examine the relationship between the two variables. No significant results were found. However, future studies are suggested as alternate versions of this study may support the need for early intervention and treatment services for individuals who have experienced neglect as a child. Recommendations for future studies include using a more diverse population and possibly including a qualitative portion to further explore correlations.

La anemia en niños menores de tres años es un problema de salud pública en el Perú y el mundo. Se estima que la causa principal de la anemia, aunque no la única, es la deficiencia de hierro. Existen muchos estudios y revisiones sobre cómo esta carencia en los infantes impacta negativamente en el desarrollo psicomotor y, a pesar de corregirse la anemia, los niños con este antecedente presentan, a largo plazo, un menor desempeño en las áreas cognitiva, social y emocional. Estos hallazgos se describen en estudios observacionales, de seguimiento, así como en experimentales con grupo control. La anemia puede disminuir el desempeño escolar, y la productividad en la vida adulta, afectando la calidad de vida, y en general la economía de las personas afectadas. Se describen algunos posibles mecanismos de cómo la deficiencia de hierro, con o sin anemia, podría afectar el desarrollo en la infancia; por ello, causa preocupación la alta prevalencia de anemia que se observa en este grupo de edad. La prevención de la anemia en el primer año de vida debe ser la meta para evitar consecuencias en el desarrollo de la persona a largo plazo. / Anemia in children younger than 3 years is a public health problem in Peru and worldwide. It is believed that one of the primary causes of anemia is iron deficiency. Numerous studies and reviews have reported that iron deficiency limited psychomotor development in children and that, despite the correction of anemia, children with iron deficiency experienced poorer long-term performance in cognitive, social, and emotional functioning. These outcomes were reported in observational studies, follow-up studies, and experimental studies with a control group. Anemia can decrease school performance, productivity in adult life, quality of life, and the general income of affected individuals. Here we describe possible mechanisms underlying the effect of iron deficiency, with or without anemia, on childhood development. The high rate of anemia in this age group is a cause for concern. Moreover, anemia should be prevented in the first year of life to avoid long-term negative effects on individual development. / La investigación ha sido financiada por el Instituto Nacional de Salud de Perú. / Revisión por pares

The purpose of this study was to investigate depression and psychotherapy for adults who are in long-term care facilities. Depression is a serious problem for the elderly in general and for residents of nursing homes in particular. The current study drew on the dynamic stress vulnerability approach to explain how illness occurs in older people, using evidence obtained from the biological, social, and psychological domains with respect to depression. The research question addressed the difference in posttreatment depressive symptoms among 6 types of psychotherapy as measured by the Hamilton rating scale for depression (HRSD)? The 6 therapy techniques were (a) cognitive behavioral therapy, (b) supportive psychotherapy, (c) life review therapy, (d) reality oriented therapy, (e) mindfulness training, and (f) affect regulation therapy. A 1-group pretest-posttest research design was used with archival data from de-identified medical records. The analysis of this study controlled for pretreatment depressive symptoms as measured by the HRSD. A statistically significant main effect of psychotherapy was found, revealing a difference in posttreatment depressive symptoms as measured by the HRSD between at least 1 pair of the 6 types of psychotherapy after controlling for pretreatment HRSD. The covariate, pretreatment HRSD, was also statistically significant, indicating a relationship between pretreatment HRSD and posttreatment HRSD when controlling for psychotherapy group. This research study contributes to the breadth of information concerning efficacious treatments for depression among the elderly in nursing homes and can assist researchers, nursing homes, and doctors to promote positive social change by better treating the depressive symptoms in a pretreatment environment.

Falls and injuries related to falls are some of the most common and costly incidents that occur in the long-term care environment. Purposeful hourly rounding is a proactive way for nursing staff to identify patient needs and demonstrate positive fall prevention outcomes. This project examined a process improvement endeavor of a long-term care unit that experienced an increase in the number of falls over 3 months. The purpose was to evaluate whether staff education and implementation of an evidence-based hourly rounding program would affect the number of patient falls. The Johns Hopkins nursing evidence-based conceptual model, Kurt Lewin's change model, and the Shewhart cycle process improvement model were used to implement the change process as well as the Studer Group best practice hourly rounding tools. A sample of 40 residents was included in a quantitative descriptive design describing the implementation of hourly rounding. Staff were educated 30 days prior to implementation. Pre and post project fall rates were retrieved from the VA fall data management system and revealed a 55% decrease over 3 months post staff education. The use of evidence-based hourly rounding measures increased over the same time period. Nurse leaders must ensure rounding programs are evidence-based, clearly defined in policies, and include robust education plans. There are limited studies on the relationship between education and hourly rounding; therefore, future studies should focus on outcomes of initial and ongoing education for program success and sustainability. Falls are a healthcare concern nurses must address at any point-of-care to promote public safety through prevention and to facilitate positive social change by providing a safe hospital environment.

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the program have on improving nursing geriatric knowledge, retention, and job satisfaction by project end? Guided by the advancing research and clinical practice through close collaboration (ARCC) model for evidence-based practice (EBP), the learning needs of nurses in the LTC setting were assessed. The 6-week education program was designed to provide education on the basics of geriatric care, pharmacology and aging, symptom evaluation, dementia care, and geriatric physical assessment. Project participants consisted of 8 nurses who volunteered to take part in the program. The program was evaluated using a pre-test and post-test method to examine nurse's knowledge before and after the education program. Using a paired t test, the results indicated a significant increase (p<.05) between the mean pre-test (3.75) and mean post-test (4.25) scores of nurse knowledge of geriatric care. The education program improved participant knowledge of geriatric care. Positive social change will be achieved with this scholarly project as nurses with greater knowledge gain confidence, strengthen decision making and clinical skills, and improve patient outcomes in the LTC setting.

The high turnover rate of graduate nurses is a challenge in the United States' hospitals because of high job dissatisfaction rates. The premature disaffiliation of the graduate nurses is costly for organizations and can significantly affect the quality and safety of patient care due to the inadequate supply of adequately prepared staff nurses, particularly in the long-term acute care hospitals. The purpose of the project was to decrease the turnover rate of graduate nurses in a long-term acute care setting from 40% to 20% through modification of the nurse residency program by applying an intervention based on Bauer and Erdogan's theory of organizational socialization. The intervention included provision of psychosocial and educational support to the graduate nurses in addition to the formal classroom learning and a preceptorship with experienced registered nurses. The project used a prospective descriptive design to examine whether the provision of psychosocial and educational support intervention to all newly hired graduate nurses for four weeks beyond the existing residency program would improve the nurses' perceptions on items of the Casey-Fink Graduate Nurse Experience Survey and decrease the turnover rate from 40% to 20%. Eighteen nurses completed the survey at eight weeks (the end of the existing residency program) and at 12 weeks (when four additional weeks of psychosocial and education support ended). The pretest and posttest survey results were compared using descriptive statistics. The graduate nurses' self-reported confidence level, job satisfaction level, and role transition experiences all improved after the intervention. The social change resulting from the project was positive residency learning experience for the graduate nurses that may result in better patient care, commitment to the organization, and retention of nurses.