Thesis (Ph. D.)--University of Washington, 2008. / Vita. Includes bibliographical references (leaves 113-118).

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: School of Nursing. Bibliography: leaves 119-128. Also available online.

Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 4 uppsatser.

Diss. Luleå : Luleå tekniska univ., 2008. / Härtill 4 uppsatser.

No description available.

Selected occupants of University residence hall rooms accommodating three students in a physical facility originally designed for only two occupants were compared to selected occupants of rooms accommodating two residents in a physical facility originally designed for two occupants. They were compared along two psychological dimensions: frustration (stress) and self-perception. Both groups responded to an instrument package consisting of The Student Life Event Questionnaire, The Self Perception Assessment, and The Frustration Assessment. These instruments were designed to measure relative stress levels and relative strengths of self-perception. The returned instrument packages were scored and a comparison was made between the two groups through a series of t tests. The possible relationship between stress and self-perception was assessed through use of the Pearson r. There was no statistically significant difference in the mean scores reported by the two groups on The Student Life Event Questionnaire at the .01 level of significance. A statistically significant difference was found to exist between the scores reported by the two groups on The Self Perception Assessment at the .01 level of significance. The triple occupancy group demonstrated a characteristically lower strength of self-perception. A statistically significant difference was also found to exist between the scores reported by the two groups on The Frustration Assessment at the .01 level of significance. The triple-occupancy group demonstrated a characteristically higher level of stress as exhibited through frustration. Pearson r correlation coefficients revealed that the scores reported by both groups on The Self-Perception Assessment and The Frustration Assessment were not related to any meaningful extent. For the entire sample, the correlation coefficient was .021. Based on these considerations, the recommendation was made that colleges and universities refrain from assigning three students into a physical facility designed for only two occupants. Reasons for this recommendation included the demonstrated detrimental effects of such an arrangement on the personal, social, emotional and educational well-being of the individuals involved.

The main purposes of this thesis were to evaluate a high-intensity functional weight-bearing exercise pro­gramme, regarding its applicability (attendance, achieved intensity, adverse events) as well as its effect on physical functions and activities of daily living (ADL) among older people living in residential care facilities, with a special focus on people with dementia. Furthermore, a main purpose was to systematically review the applicability and effects of physical exercise on physical functions, cognitive functions, and ADL among people with dementia. A high-intensity functional weight-bearing exercise programme that includes lower-limb strength and balance exercises in standing and walking, was evaluated in a randomised controlled trial among 191 older people, dependent in ADL, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ten or more. One hundred (52.4%) of the participants had dementia. Participants were randomised to an exercise programme or a control activity, consisting of 29 supervised sessions over 3 months, as well as to an intake of a protein-enriched energy supplement or a placebo drink immediately after each session. The effect on physical functions was evaluated using the Berg Balance Scale, usual and maximum gait speed, and one-repetition maximum in a leg press machine measuring lower-limb strength. The effect on ADL was evaluated using the Barthel Index. These outcome measures were followed up at 3 and 6 months by blinded assessors and analysed using the intention-to-treat principle. The evaluation of the applicability of the high-intensity functional weight-bearing exercise programme showed that there was a high rate of attendance, a relatively high achieved intensity in the exercises, and all except two adverse events were assessed as minor or temporary and none led to manifest injury or disease. No statistically significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, the applicability of the programme was not associated with the participants’ cognitive function. Significant long-term effects of the exercise programme were seen regarding functional balance, gait ability and lower-limb strength in comparison with the control activity. The intake of the protein-enriched energy supplement did not increase the effect of the training. Age, sex, depression, dementia disorder, nutritional status, and level of functional balance capacity did not influence the effect on functional balance of the high-intensity functional weight-bearing exercise programme. There were no significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a significantly smaller proportion of participants in the exercise group had deteriorated regarding indoor mobility at 3 and 6 months. For people with dementia, there was a significant difference in overall ADL performance in favour of the exercise group at 3 months, but not at 6 months. In a systematic review, randomised controlled trials, evaluating the effects of physical exercise among people with dementia, were identified according to pre-defined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodological quality. Ten studies were included in the review and the majority of the participants were older people with Alzheimer’s disease living in residential care facilities. Four studies reached “moderate” methodological quality and six “low”. The results showed that among older people with Alzheimer’s disease in residential care facilities, combined functional weight-bearing exercise over 12 months at an intended moderate intensity seems applicable for use regarding attendance and adverse events and there is some evidence that the exercise improves walking performance and reduces ADL decline. Furthermore, there is some evidence that walking exercise over 16 weeks performed individually, where the participant walks as far as possible during the session, reduces decline in walking performance, but adverse events need to be evaluated. In conclusion, among older people who are dependent in ADL, living in residential care facilities, and have an MMSE score of 10 or more, a high-intensity functional weight-bearing exercise programme is applicable for use and has positive long-term effects on functional balance, gait ability, and lower-limb strength and seems to reduce ADL decline related to indoor mobility. An intake of a protein-enriched energy supplement immediately after the exercise does not appear to increase the effect of the training. In people with dementia, the exercise programme may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect. The positive results regarding applicability and effects of combined functional weight-bearing exercise among people with dementia is confirmed when the scientific literature is systematically reviewed. It seems to be important that exercise interventions among people with dementia last for at least a few months and that the exercises are task-specific and intended to challenge the individual’s physical capacity. Whether physical exercise can improve cognitive functions among people with dementia remains unclear. There is a need for more exercise studies of high methodological quality among people with dementia disorders.

Thesis (M.S.)--University of Michigan, 1978.

Thesis (M.S.)--University of Michigan, 1978.

Sammanfattning Bakgrund: Många äldre bor på vård- och omsorgsboenden i Sverige idag. För de äldre som flyttar in på ett vård- och omsorgsboende kan flytten innebära att skiljas från sin invanda miljö och allt som är familjärt, vilket kan leda till lägre livskvalitet. Det finns kopplingar mellan miljö och hälsa, där sjuksköterskan har en viktig roll gällande vårdmiljöns utformning och dess betydelse för hälsa.   Syfte: Syftet med litteratursammanställningen var att beskriva faktorer i vårdmiljön på vård- och omsorgsboenden och vilken betydelse dessa faktorer har för livskvalitet hos äldre. Vidare var syftet att beskriva utvalda artiklars urvalsgrupp.   Metod: Litteratursammanställningen baseras på 15 vetenskapliga artiklar som var publicerade mellan 2005-2015. Artikelsökningen genomfördes i databaserna Cinahl, Medline och PsycINFO.   Huvudresultat: Resultatet visade att både fysiska och psykosociala faktorer i vårdmiljön hade betydelse för äldres livskvalitet. De fysiska faktorerna innefattade egna rum där rummets placering var av betydelse, personlig miljö med tillgång till personliga tillhörigheter samt möjlighet till att kunna socialisera sig med andra. De psykosociala faktorerna omfattade det sociala klimatet på vård- och omsorgsboendet där personalen hade en stor betydelse, sociala relationer samt individuella aspekter såsom attityd till det egna åldrandet samt känslor av tillit och trygghet.   Slutsats: Genom att redogöra för faktorer i miljön på vård- och omsorgsboenden och dess betydelse för äldres livskvalitet kan sjuksköterskor erhålla kunskap vilken kan användas som redskap vid utformningen av vårdmiljön. Sjuksköterskan kan, genom att tillgodogöra sig aktuell kunskap, öka livskvaliteten hos äldre på vård- och omsorgsboenden. / Abstract Background: Many elderly live in residential facilities in Sweden today. For older people who move into a residential facility the move can mean being separated from their familiar environment and all that is familiar, which can lead to a lower quality of life. There are links between environment and health, where the nurse has an important role in the current health environment design and its importance for health.   Aim: The aimwas to compilecurrent researchtoillustrate theenvironmental factors thataffect thequality of lifeof the elderly inresidential facilitiesand to describeincluded articlesfocus groups.   Method: Literature summary is based on 15 scientific articles published between the years 2005-2015. The articles were found in the databases Cinahl, Medline and PsychInfo.   Result: The results showed that both physical and psychosocial factors in the environment were important to the elderlies quality of life. The physical factors included individual rooms, personalized environment and to be able to socialize with others. The psychosocial factors included the social climate where the staff had a great importance, social relationships and attitudes to their own aging, and feelings of trust and security.   Conclusion: By accounting for the factors in the environment at residential facilities, and its importance to the elderlies quality of life, nurses can obtain knowledge which can be used in the environmental design. Nurses can, by assimilating current knowledge, enhance the quality of life of the elderly in residential facilities.