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Keywords: Consolidated Framework for Implementation Science; Evidence-based practices; Evidence-based interventions; Implementation and dissemination science; Long-term care EN Consolidated Framework for Implementation Science Evidence-based practices Evidence-based interventions Implementation and dissemination science Long-term care 6 12 7 02/03/22 20220101 NES 220101 At the time of this writing, at least 186,000 nursing home (NH) residents and staff have succumbed to coronavirus disease 2019 (COVID-19; [1]), and countless others have suffered the mental anguish of limited visits from family and isolation. For instance, many NH staff are unfamiliar with evidence-based methods of implementation, including pre-implementation planning, selecting the optimal staff to deliver an intervention, and studying the outcomes of the intervention. In addition, staff engagement across the entire community facilitates implementation, including staff not traditionally included in implementation efforts, such as housekeeping and maintenance ([23]). [Extracted from the article]

This study investigated barriers to fulfilling food preferences from nursing home (NH) residents' perspectives, and the reasons preferences changed (situational dependencies). Interviews were completed with 255 residents in 28 NHs across greater Philadelphia, PA using six food items from the Preferences for Everyday Living Inventory-NH (PELI-NH). Participants were predominantly white (77%), female (67.8%), and widowed (44%) with high school educations (48%). Content analysis was used to identify n = 386 barriers and n = 57 situational dependencies. Participants reported provider policies and staff proficiency as environmental barriers to preference fulfillment regarding what, when, and where to eat. Perceived health and personal resources were barriers to obtaining snacks, take-out, and dining out. Situational dependencies resulted from residents' perceived health and quality of family relationships. Results have implications for providers to centralize food preference fulfillment in care planning, and to use food preferences to address dining quality concerns. [ABSTRACT FROM AUTHOR]

Background and Objectives Nursing homes (NHs) using the Preferences for Everyday Living Inventory (PELI-NH) to assess important preferences and provide person-centered care find the number of items (72) to be a barrier to using the assessment. Research Design and Methods Using a sample of n = 255 NH resident responses to the PELI - NH, we used the 16 preference items from the MDS 3.0 Section F to develop a machine learning recommender system to identify additional PELI-NH items that may be important to specific residents. Much like the Netflix recommender system, our system is based on the concept of collaborative filtering whereby insights and predictions (e.g. filters) are created using the interests and preferences of many users. The algorithm identifies multiple sets of "you might also like" patterns called association rules, based upon responses to the 16 MDS preferences that recommends an additional set of preferences with a high likelihood of being important to a specific resident. Results In the evaluation of the combined apriori and logistic regression approach, we obtained a high recall performance (i.e. the ratio of correctly predicted preferences compared with all predicted preferences and nonpreferences) and high precision (i.e. the ratio of correctly predicted rules with respect to the rules predicted to be true) of 80.2% and 79.2%, respectively. Discussion and Implications The recommender system successfully provides guidance on how to best tailor the preference items asked of residents and can support preference capture in busy clinical environments, contributing to the feasibility of delivering person-centered care. [ABSTRACT FROM AUTHOR]

Abstract Objectives Nursing home (NH) residents' preferences for everyday living are the foundation for delivering individualized person-centered care. Yet, work has not examined what the most and least important preferences of nursing home residents are and if those preferences change over time. Design This study examined the change in nursing home residents' (n = 255) preferences for everyday living over a 3-month period. Participants were recruited from 28 NHs in the suburbs of a major metropolitan East Coast area of the United States. Measures Residents were interviewed face-to-face using the Preferences for Everyday Living Inventory–Nursing Home version at baseline (T1) and 3 months later (T2). Change was analyzed in 2 ways: (1) percentage exact agreement (eg, respondent stated "very important" at both time points) and (2) percentage of preferences that remained either important or not important between T1 and T2. Results Sixteen preferences were rated as very or somewhat important by 90% or more of NH residents. With regard to the stability of preference ratings, findings demonstrate an average exact agreement of 59%, and an average important versus not important agreement of 82%. In addition, 68 of the 72 preferences had 70% or higher stability over time. In other words, the preference either remained "important" or "not important" to the NH resident 3 months later. Preferences in the domain of enlisting others in care had the least amount of change. Conclusion/Implications This study highlights the most important everyday living preferences of NH residents and provides assurance to care providers that the majority of preferences assessed via the PELI are both important to NH residents and stable over time. Preference-based care plans can be designed and used over a 3-month period with confidence by providers. [ABSTRACT FROM AUTHOR]

Objectives Although assessing individual consumer preferences are an important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports. Design A cross-sectional survey design was used. Setting and participants Preference assessment interviews were conducted with 255 nursing home (NH) residents and 528 older adults receiving home and community-based services (HCBS). Measurements The Preferences for Everyday Living Inventory (PELI) was used to collect consumer preference information. Two versions of the PELI were used—the PELI-NH for NH residents and the PELI-HC for clients receiving HCBS and analysis focused on 41 shared items between the 2 versions. All respondents answered PELI questions independently and rated the importance of psychosocial preference items on a scale from not at all to a lot/very important. Results Ten preferences were shared as being important or very important by NH residents and older adults receiving HCBS. Most notably, more than 90% of respondents in each group rated “having regular contact with family” as an important priority. Having privacy, choices about what to eat, when to bathe, and activity options also were important preferences for a majority (77%-93%) in both settings. Conclusion Providers seeking to incorporate preference-based care can utilize study results as a foundation to incorporating important preferences into the care delivery process at the organizational level across care settings. For example, assessing all consumers on this core set of 10 shared preferences can assist with relationship building, transitions in care, and quality improvement. However, preferences with aggregate low-rated levels of importance in this study should not be discredited or eliminated. It is important for providers to understand the unique preference inventory of each older adult, which can then be targeted toward meeting goals for preference fulfillment. This can aid in bringing preferences into practice to improve the quality of care and quality of life to best meet the psychosocial needs of each person. [ABSTRACT FROM AUTHOR]

Knowledge of a nursing home resident’s everyday living preferences provides the foundation for ongoing individualized care planning. Objective:The purpose of this study is to identify nursing home (NH) staff perceptions of facilitators and barriers to learning about and meeting residents’ preferences and reasons why staff feel residents change their minds about preferences. Methods:Focus group sessions and interviews were conducted with 36 NH staff members working in a facility that has been actively assessing resident preferences for five years. Results:Thematic codes classifying facilitators, barriers, and dependencies were identified. Staff shared ways they are able to help meet residents’ preferences as well as barriers to fulfilling resident preferences through their own behaviors, facility characteristics, the social environment, and resident characteristics. In addition, staff believe that residents change their minds about important preferences ‘depending on’ several factors including; global environmental characteristics, social environment, resident characteristics, and general staff perceptions. Conclusions:This work identifies key facilitators and barriers to consider when implementing quality improvement efforts designed to improve the person-centered nature of care in nursing homes and is intended to further inform the culture change movement, which aims to transform NHs by empowering staff and delivering person-centered care. [ABSTRACT FROM AUTHOR]

Objectives. This randomized controlled study tested the effectiveness of individualized activities, led by certified nursing assistants (CNAs), to increase positive and reduce negative affect and behavior among nursing home residents with dementia.Method. Nursing home residents with mild to advanced dementia (N = 180) were randomly assigned to usual care (UC, n = 93) or 1 of 2 experimental conditions. Residents in the attention control group (AC, N = 43) participated in standardized one-to-one activities with their CNAs. Individualized Positive Psychosocial Intervention (IPPI) participants (n = 44) received a CNA-led activity matched to their interests and ability. Outcomes were residents’ positive and negative affect and verbal and nonverbal behavior.Results. The IPPI and AC groups experienced similar benefits—more pleasure, alertness, engagement, positive touch, and positive verbal behavior—compared with UC. The AC group displayed more anger, uncooperativeness, and very negative verbal behavior than UC or IPPI.Discussion. This study demonstrates the value of individualized activities for nursing home residents with dementia. In a stringent test, residents were happier and less angry during a customized intervention compared with a standardized intervention. Even brief individualized CNA-led activities bring pleasure to nursing home residents and constitute an effective strategy to enhance positive affect and engagement in persons with dementia. [ABSTRACT FROM PUBLISHER]

Preferences are the expression of an individual's basic psychosocial needs and are related to care outcomes. The current study tested the consistency of 87 individuals' everyday preferences over 1 week, comparing responses of nursing home residents (Preferences are the expression of an individual's basic psychosocial needs and are related to care outcomes. The current study tested the consistency of 87 individuals' everyday preferences over 1 week, comparing responses of nursing home residents (n = 37; mean age = 82) and university students (n = 50; mean age = 20). Participants completed the Preferences for Everyday Living Inventory at baseline and 5 to 7 days later. Preference consistency was calculated three ways: (a) correlations (range = 0.11 to 0.90); (b) overall percent of exact agreement (e.g., response was "very important" at both time points) (66.1%); and © responses collapsed as "important" or "not important" (increase in percent agreement to 86.6%). Personal care preferences were more stable, whereas leisure activities were less stable. The groups did not have significant differences in consistency. Some preferences are more consistent than others; age and frailty do not appear to be related to preference instability. [Journal of Gerontological Nursing, 40(10), 34-46.] [ABSTRACT FROM AUTHOR]

An abstract of the article "Transitions in Care Among Older Adults Receiving Long-Term Services and Supports" by Mark P. Toles, Katherine M. Abbott, Karen B. Hirschman and Mary D. Naylor is presented.

Objectives Advance knowledge about changes in multiple dimensions of health related quality of life (HRQoL) among older adults receiving long-term services and supports (LTSS) over time and across settings. Design A prospective, observational, longitudinal cohort design. Setting Nursing homes (NHs), assisted living facilities (ALFs), community. Participants A total of 470 older adults who were first-time recipients of LTSS. Measurement Single-item quality-of-life measure assessed every 3 months over 2 years. HRQoL domains of emotional status, functional status, and social support were measured using standardized instruments. Results Multivariable mixed effects model with time varying covariates revealed that quality-of-life ratings decreased over time ( P < .001). Quality-of-life ratings were higher among enrollees with fewer depressive symptoms ( P < .001), higher general physical function ( P < .001), enhanced emotional well-being ( P < .001), and greater social support ( P = .004). Ratings also were higher among those with increased deficits in activities of daily living ( P = .02). Ratings were highest among enrollees who received LTSS from ALFs, followed by NHs, then home and community-based services (H&CBS), but only findings between ALFs and H&CBS were statistically significant ( P < .001). Finally, ratings tended to decrease over time among enrollees with greater cognitive impairment and increase over time among enrollees with less cognitive impairment ( P < .001). Conclusions Findings advance knowledge regarding what is arguably the most important outcome of elderly LTSS recipients: quality of life. Understanding associations between multiple HRQoL domains and quality of life over time and directly from LTSS recipients represents a critical step in enhancing care processes and outcomes of this vulnerable population. [ABSTRACT FROM AUTHOR]