Background: The International Outcome Inventory for Hearing Aids (IOI-HA) was develo developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. Purpose: The purpose of this study was to evaluate the psychometric properties of th the IOI-HA and to establish normative data in a veteran sample. Research Design: Survey. Study Sample: The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Intervention: Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Data Collection and Analysis: Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. Results: A factor analysis showed that the IOI-HA in the veteran sample had the ident identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's α = 0.83), and the test-retest reliability was high ( λ = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were <1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. Conclusions: The results of this study confirmed that the psychometric properties of th the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing on aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

In 2014 Bodenheimer and Sinsky published the Quadruple Aim model, which argued that healthcare provider wellbeing was the missing link to improving patient and population health outcomes, as well as cost containment. Rather than treating burnout, however, experts in fields outside healthcare are finding validity in promoting thriving at work as a means to prevent burnout and improve employee satisfaction, engagement, and productivity. The purposes of this study were to investigate the relationship between thriving and emotional exhaustion (which is widely considered a core element of burnout) in healthcare providers, and the impact thriving had on primary care population health outcomes as measured by quantifiable value-based quality performance metrics. Using Georges' (2013) Emancipatory Theory of Compassion and Bodenheimer and Sinsky's Quadruple Aim as conceptual frameworks, this descriptive, non-experimental study used advanced applied biostatistical techniques to analyze archival data from the December 2018 UCHealth Physician and Advanced Practice Provider Voice Survey as well as provider performance scores from the same time period. Results of the study were mixed, showing that while there is an inverse relationship between thriving and emotional exhaustion in healthcare providers, thriving did not predict population health outcomes. By evaluating thriving in healthcare providers in relation to emotional exhaustion and in context of value-based health care delivery systems, this study was the first of its kind. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Work engagement of registered nurses (RNs) has gained attention in health care, as an organizational process that is requisite to promoting optimal patient outcomes. Improving patient outcomes has caused a movement to examine what can be done to bridge the disparity between good and excellent care. Standards that enhance RN engagement to promote professional care are seen as vital to excellence. Magnet designation, awarded by the American Nurses Credentialing Center, signifies an organization meets such standards. Therefore, the purpose of this study was to evaluate whether a correlation exists between RN engagement and the organizational structures common to Magnet designation. This study also evaluated the influence of social and institutional demographics on the relationship between engagement and Magnet designation. The variables in this study included: age (generation), gender, nursing degree, years of RN experience, years of unit longevity, shift, hours scheduled and worked per week, percentage of time in direct patient care, nursing unit, and shared governance council participation. Finally, this study evaluated the influence of RN perception related to organizational support for work on the relationship between engagement and Magnet designation. A total of 370 RNs in Magnet (n = 220) and non-Magnet (n = 150) designated hospitals completed a 17-item engagement survey and a 15-item demographic survey. Major findings of the study indicated no significant difference in RN engagement between nurses who work at Magnet versus non-Magnet designated hospitals. Within the Magnet sample, significant relationships were found between engagement and shift, years of RN experience in any clinical setting, and RN perceptions related to organizational support for work. Scatter plots for nursing experience showed positive slopes for total engagement, vigor, dedication, and absorption. Post-hoc results for RN perception related to organizational support for work identified the significant areas of engagement were total engagement, vigor, and absorption. No significant post-hoc results were noted for the variable of shift. Through significant and non-significant findings, several insights were gained about engagement. As a result of this study, leadership can better assess the needs of the RN workforce to provide what RNs perceive to be important to professional practice and RN engagement.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24970号 / 医博第5024号 / 新制||医||1069(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 中山 健夫, 教授 川上 浩司, 教授 大鶴 繁 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

<p>Older adults admitted to hospital often must make discharge decisions about whether they will be able to safely manage at home. Decision-making for clients and teams is supported by occupational therapy assessment. This thesis presents three manuscripts from a single study that was designed to address a need for evidence of validity of two measures for predicting harm.</p> <p>The design was a prospective observational study in which older adults from an inpatient unit (n=47) were followed for six months for reports of incidents of harm. Baseline data included independent variables (e.g. age, sex, education, living alone, comorbidities, caregiving hours, ADL score) and scores on two measures: the Assessment of Motor and Process Skills (AMPS) and the Cognitive Performance Test (CPT).</p> <p>The first manuscript contributed needed validation evidence for the CPT. The CPT correlated moderately with cognitive measures, and scores were not affected by age, and years of education. The CPT differentiated impaired persons differently from other measures. Results highlighted that further evidence to test the CPT against a criterion related to outcomes in the community was needed.</p> <p>The second manuscript tested the trustworthiness of the outcome “incidents of harm”. Test-retest reliability was high and validation against daily logs and medical charts supported this method of measurement of incident of harm.</p> <p>The third manuscript determined whether the AMPS and CPT were valid for predicting incidents of harm after discharge. The results showed that, compared with all independent variables, AMPS-Process scores were the most significant predictor of harm outcome. The CPT had a high specificity for identifying persons who did not have harm. Living alone, age and sex contributed to the prediction of harm. The implications of these results are that scores on the measures can inform patients, families and the team about older adults’ risk of incidents of harm after discharge.</p> / Doctor of Philosophy (PhD)

The study sought to research and develops a universal palliative care measurement tool that will track the performance of informal caregivers to dying persons across the diversity of the South African cultural and religious groupings. The major inferences drawn from this study was that a generic domain, sub-items and intervals could be identified for palliative care; that a reliable measurement tool could be developed and that outcomes of care programs for dying persons in terms of effectiveness and efficiency could be numerically quantified. With the ability to measure now been realised, the ability to manage the outcomes became the new challenge. / Nursing Sciences / M.A. (Health Studies)

The study sought to research and develops a universal palliative care measurement tool that will track the performance of informal caregivers to dying persons across the diversity of the South African cultural and religious groupings. The major inferences drawn from this study was that a generic domain, sub-items and intervals could be identified for palliative care; that a reliable measurement tool could be developed and that outcomes of care programs for dying persons in terms of effectiveness and efficiency could be numerically quantified. With the ability to measure now been realised, the ability to manage the outcomes became the new challenge. / Nursing Sciences / M.A. (Health Studies)

The relationship between Public Administration and the people is one that requires legitimacy and compromise in order to solve complex problems. Individuals with intellectual and developmental disabilities (IDD) and their families during the last fifty years have put forth an agenda that calls for the advancement of rights for the disabled and more integration into the larger society. In this arena, government, with post civil rights legislation like the 1990 Americans with Disabilities Act (ADA), plays a huge role in promoting social awareness and bringing down barriers of stigmatization, understanding, and access. This struggle is fought on many fronts. A significant part of the effort focuses on moving the locus of long-term care of the disabled, including the IDD population, from an institutional setting to the least restrictive setting that will foster social ties and integration. Since the early 1980s as part of this effort to deinstitutionalize the disabled, legislation at both the federal and state level has supported and incentivized the creation of Home and Community Based Service (HCBS) programs. HCBS waivers, as they are typically called, are also promoted as a means of containing government expenditures for long-term care. However, the effectiveness of these waivers is poorly understood. The critical questions being - Do HCBS waivers promote and create an environment that increases awareness of the needs of IDD individuals? Do the programs help reduce stigmatization, promote understanding, and increase access to services and activities that foster social interaction? Or, do HCBS waivers create a new "iron cage" where the intellectually or developmentally disabled are once again relegated to existing as second class citizens? In this research, programs are mapped and then evaluated to paint a better picture of how HCBS waivers change long-term care. / This research combines qualitative and quantitative approaches to triangulate on these phenoamea as a means to investigate when and how HCBS waiver programs facilitate, promote, or stifle the social integration of those with IDD. How does social integration manifest itself in the quality long-term care of those who often cannot take care of themselves? / by Enrique M. Perez. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001). / The implications of this study are that feeling empowered to participate in diabetes self-care management may result in improved glycemic control. Positive diabetes outcomes have been linked in the literature with persons feeling empowered to participate in diabetes self-care. The significance of the findings from this study is that given the relationship between empowerment and glycemic control, nurses should support the empowerment model of diabetes teaching. Diabetes education should provide written materials that are culturally sensitive for African American elders. / by Bridgette M. Johnson. / Thesis (Ph.D.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.