Frank Morgan Jones Fund Sponsored Research Pilots 2001 "A program to Develop Continuing Research in Gero-Oncology: Delineation and Management of Symptoms Experienced by People with Head and Neck Cancer" PI: Sarah Kagan Period: January 1, 2001 through December 31, 2001 Project Summary The pilot will investigate the relationship of chemosensory impairment after head and neck cancer surgery to depressed mood with the outcome measure of weight maintenance. This quasi-experimental study will address the relationship of the key variables --along with age, caregiver status, stage of disease, and means of feeding--through the UCSF symptom management model, using a unidirectional hypothesis and a hierarchical regression analysis. The investigation to include will use E-mail to communicate with patients for post-operative symptom management and include investigation of symptom experience and management on sleep, sleep disturbance, body image and adjustment concerns for people with head and neck cancer. Research partners represent interdisciplinary work in cancer and gero-oncology.
"Palliative Care in Nursing Homes" PI: Neville Strumpf Period: May 1, 2001 through May 1, 2002 Project Summary The goal of the pilot project is to build upon research that developed and tested a palliative care model for persons dying in nursing homes. Nearly 20 percent of American deaths occur in nursing homes each year. The project is designed to complete tasks that will enable dissemination of research findings and development of an implementation strategy to complete a national demonstration of this care model. The replication of the developed palliative care model of excellence used for end-of-life care will expand the science upon which pervious palliative care research was conducted in nursing home settings. The intervention is based on basic principles of palliative care, use of an interdisciplinary palliative care team trained in concepts and practice of palliative care, and using of nursing consultation to enhance advance care planning, pain and symptom management and bereavement and psychosocial support.
2002
“Exploring the Relationships of OASIS Data to Home Care Outcomes” PI: Kathy Bowles Period: April 1, 2002 to April 1, 2003 Project Summary: The purpose of the study is to explore the relationships within a set of existing data collected from patients discharged from home care to the outcomes of an episode of home care. The study has important implications for effectively meeting the needs of older adults by helping home care organizations make accurate clinical decisions and target resources to the appropriate patients. The Outcomes Assessment Information Set (Oasis) data base will be the source used to identify the specific patient functional status characteristics that are associated with the need for continued care versus discharge from service. An Oasis sample data set will be selected for exploratory analyses that include cluster analysis to determine patterns in the data or multiple regression analysis to determine predictors of re-certification for more home care, hospitalization, or discharge without further service. Data mining techniques will be applied to explore for relationships among the data not expected or found with traditional regression. This study has the potential of providing a predictive profile of the characteristics of patients that can be used to identify similar patients for re-certification or intervention to prevent re-hospitalization.
“Does an Early State Support Group Affect AD Patients’ Quality of Life Coping Strategies, Depression and Insight?” PI: Val Cotter Period: April, 2002 to April, 2003 Project Summary: The purpose of the study is to investigate whether a support group intervention for persons with early stage Alzheimer’s disease (AD) affects quality of life (QOL), coping strategies, depression and insight into their health and AD. Sixteen patients and sixteen caregivers will be included in the study. A gerontology nurse practitioner and master’s prepared social worker will facilitate the 8 weekly, 90-minute semi-structured discussions using a curriculum tested in previous pilot work. The intervention model encourages group dynamics to discuss and communicate feelings regarding memory loss and focuses on techniques that enhance each person’s capabilities for lifestyle adjustments. A team of two part-time support group facilitators and one part-time research assistant will be used. Data will be collected at two time points: baseline and post-intervention (within four-weeks following the completion of the support group). Primary endpoint is patient self-reports of quality of life ratings, secondary measures of depression, and insight using 6-item appreciation of health and AD. Participants will also be asked to complete an evaluation that incorporates their reactions and overall impressions of the intervention.
“Evaluation of the Accuracy of Height Assessment in Pre-Menopausal Women” PI: Anne McGinley/Terri Lipman Period: July 1, 2002 to June 30, 2003 Project Summary: The assessment of adult women height is a diagnostic standard of care for osteoporosis and to determine the need for hormonal replacement therapy. Historical research findings indicate that there exists minimal quality assurance related to the technique and precision of linear measurement. Height measurements are frequently inaccurate due to measurements obtained by untrained observers using inaccurate techniques with faulty equipment. The purpose of this study is to examine the accuracy of pre- and post- menopausal women height measurement data applying for comparison purposes a practice model previously developed for accurate growth measurement in young children. The study will use researcher clinical observations to ascertain the standards and techniques employed for linear measurement of a selected group of adult women. A portable stadiometer will then be used to record height measurements comparing for accuracy with the previously recorded measurements.
“Developing a Palliative Care Program in the Nursing Home: “A Ethnographic Study” PI: Nancy Hodgson and Anne Power Period: August 1, 2002 to July 31, 2003 Project Summary: The purpose of the project is 1) to identify the circumstances and conditions that give rise to the development of a palliative care program (PCP) in one long-term care facility, 2) to explore the meaning of palliative care for members of the core health care team, 3) to learn how this process is experienced by core members of the health care team, and 4) to learn how participant’s beliefs and attitudes about end-of-life care shape the development of a palliative care program. A model for developing a PCP will be constructed based on the analysis of resident and staff data. These findings can be then used to develop larger joint projects with HCGNE with the aim of developing recommendations for initiating and implementing future sustainable palliative care programs in long term care.
“Illness Narratives of Women with Long-Term Urinary Incontinence” PI: Christine Bradway (Penn doctoral candidate) Period: August 2, 2002 to December, 31, 2003 Project Summary: The purpose of this study is to examine the subjective, lived experience of women who suffer from long-term urinary incontinence (UI) and to show how cultural models help define that experience. The specific aims of the study are to describe and analyze 1) what UI means, and 2) how that meaning is constructed by women with long-term UI. Individual narratives of women with long-term UI will be described and if possible, a cultural model for long-term UI will be identified. At study completion, a research report will be compiled to represent the stories told by women with long-term UI, in order to understand their experiences, and to highlight cultural themes.
“A Clinical Database to Facilitate Research with Frail Older Adults” PI: L. Evans Period: May 1, 2002 to September 31, 2002 Project Summary: The purpose of this project is to prepare an integrated electronic database containing critical data elements for the EPR system that can be used by faculty and student researchers interested in studying phenomena related to care of frail elders. Selected CARE Program date elements compiled from approximately, 300 patient records will be migrated to this designed integrated database. With the completion of this initial step, a planned longer term process of preparing a meta data dictionary of clinical and research databases in gerontologic nursing is anticipated to support future research work.
2003
“Discharge Patterns of Fallers Who Present to the Emergency Room: PI: M. Marenberg Period: February 1, 2003 to May 31, 2003 Project Summary: The project is an ancillary study to Exercise & Training Model research (RO1,Strumpf) to compare the demographic and fall characteristics of those who entered the study, and those who did not using an intervention trial to determine if exercise can reduce risk factors for frail elderly who presented to the emergency room for a fall.
“A Strategic Plan for Dissemination of Gerontologic Nursing Research through a Consultation Service Model” PI: E. Sullivan-Marx Period: March 1, 2003 to June 15, 2003 Project Summary: The purpose of this proposal is to develop a strategic plan to expand the research and enhance the impact of the Penn Nursing Network’s Gerontological Nursing Consultation Service (PNN Consulting/GNCS). This strategic plan will provide an evaluation of the current status of business growth and resource efficiency, identify operational and organizational requirements to sustain and improve the consultation service, create a brand identify and strategy to expand the impact of the GNCS, and determine opportunities to integrate scholarship and education within the scope of the School of Nursing’s and Penn’s HCGNE mission.
“Effectiveness of Ambulatory Outpatient Rehabilitation for Cognitively Impaired Elders” PI: Fang Yu (Doctoral Candidate) Period: March 1, 2003 to December 31, 2003 Project Summary: The purpose of this retrospective cohort study is to explore differences in rehabilitation interventions and outcomes between elders with cognitive impairment and those with normal cognitive function in a sample of elders admitted to a Comprehensive Outpatient Rehabilitation Facility (CORF). An electronic descriptive database will be constructed of key patient variables from the CARE program clinical records for analysis to determine rehabilitation outcomes (functional gain, rehabilitation efficiency, number of days of service and discharge destination) to determine statistical significance of rehabilitative intervention.
“Post-Fall Assessment: Development and Validation of a Tool for Use with Older Adults in Nursing Homes” PI: Deanna-Gray-Miceli (post-doctoral fellow) Period: March 20, 2003 to September 15, 2003 Project Summary: The project study supports Phase I of a research study to validate a post-fall assessment tool using expert review by a panel of geriatric clinicians (physicians and gerontological nurse practitioners) to determine content validity (i.e., the extent to which the post-fall assessment tool covers the relevant information needed to identify the underlying etiology of the fall).
“Relationships Among Sleepiness, Cognition, Mood, and Self-Care in Persons with Heart Failure” PI: Barbara Riegel Period: June 1, 2003 to May 31, 2004 Project Summary: Poor self-care is common in elders with heart failure. The project study exams the relationship between sleepiness as a contributor to poor self-care through its effects on cognition and mood. The study is to generate pilot data testing the relationships among these variables using sleepiness as a significant predictor of cognitive deficits, distressed mood and poor self-care.
“A comparison of Idiopathic and Secondary Diagnosis of Elder Persons with Restless Legs Syndrome (RLS)” PI: Norma Cuellar Period: November 1, 2003 to August 31, 2004 Project Summary: The descriptive comparative project study will examine if differences exist between primary and idiopathic diagnosis of older adults with Restless Leg Syndrome (RLS) and the effects of this diagnosis on sleep, symptom severity, fatigue, depression and quality of life. A variety of measurement instruments will be used to generate data necessary for further examination of conventional and non-conventional RLS treatment interventions.
2004
“Organizational Culture in Nursing Homes” PI: C. Scalzi and L. Evans Period: March 1, 2004 to February 29, 2005 Project Summary: The project will build on a previous study that examined cultural change in nursing home settings. This project will examine organizational culture, its patterns, and its susceptibility to adaptation of a patient focused intervention. Pilot resources will also be used to support a systematic review of the literature and manuscript preparation. Findings from this pilot will support a NIH or comparable grant submission to conduct a larger scale study that employs secondary analysis to further test this cultural change intervention across multiple nursing home facilities in various geographic regions.
“The Effects of Informal Caregivers on the Outcomes of Older Adults Receiving Home Health Care” PI: Eunhee Cho (doctoral student) Period: March 01, 2004 to February 28, 2005 Project Summary: The purpose of this secondary analysis is to evaluate the effects of informal caregiving on the type of primary caregiver (i.e., spouse, offspring, relative, non-relative, paid helper) on the outcomes of elders receiving home health care. The project will compare changes in functional status and depression symptoms, as well as differences in the rates and timing of re-hospitalization over a 60 day period among patients who do and those who do not receive informal care in addition to home health care.
“A Description of Enrollment in a Program of All-Inclusive Care for the Elderly (PACE)" PI: Anna Beeber (doctoral student) Period: February 01, 2004 to June 1, 2005 Project Summary: The purpose of this qualitative descriptive study is to describe enrollment in a Program of All-Inclusive Care for the Elderly (PACE) from the perspective of elders and others involved in enrollment. This project will address what is enrollment; when, how and why do elders enroll; what events contribute or lead to enrollment from the perspective of elders and families, informal caregivers and providers of health and social services. This project provides opportunities to examine why nursing home eligible elders choose the PACE program rather than institutional care.
“The Impact of the Prospective Payment System on Psychiatric Home Health Care for Depressed Older Adults” PI: Yu Ru Lin (doctoral student) Period: September 1, 2004 to December 30, 2004 Project Summary: This descriptive comparative study focuses on an examination of the Prospective Payment System (PPS) reimbursement methodology as it affects access to quality of psychiatric home health care services for vulnerable older adults with depression as defined by the International Statistical Classification of Diseases. Pre- and post- depressed older client receiving psychiatric home health care will be examined to determine if there are any differences for these individuals related to physical functioning levels and service utilization. Project results provide an opportunity to gain additional knowledge related to how a home care reimbursement system may affect the provision and quality of psychiatric home care services.
“Non-pharmacological intervention for agitation in dementia: Meta-Analysis” (Pilot I) PI: Eun-Hi Kong (doctoral student) Period: November 1, 2004 to October 30, 2005 Project Summary: The purpose of this project is to complete a systematic meta-analysis review of the literature related to non-pharmacological interventions for agitation in dementia. A comprehensive evaluation of research evidence based on “best practices” methodology will be used to ascertain the strength of evidence used to support specific protocols examined, to resolve uncertainty when original research disagrees, and to identify gaps in knowledge where further study is needed.
2005
“Knowledge Discovery Modeling to Support Clinical Decision Making in Predicting Hospital Acquired Pressure Ulcers” PI: Tae Young Kim (doctoral student) Period: January 1, 2005 to August 31, 2005 Project Summary: The purpose of the project is to explore the multidimensional relationships between pressure ulcer formation and risk factors depending on the subjects’ characteristics and to obtain a better understanding of contributing factors that are highly correlated with pressure ulcer development in hospitalized adults. The project will identify the best set of predictive risk factors and explore the applicability of various predictive models to identify at-risk patients admitted.
“The lived experiences of Korean immigrant caregivers after nursing home placement of their elderly non-English speaking (NELS) relatives with dementia" (Pilot II) PI: Eun-Hi Kong (doctoral candidate) Period: March 1, 2005 through March 1, 2006 Project Summary: The study evaluates the described experiences of Korean immigrant caregivers who place non-English language speaking elderly relatives with dementia in American nursing homes. Symbolic interactionism and cultural models are two theoretical frameworks which will be used to guide this project.
“The Relationship Among Sleep, Breathing, and Neurobehavior in COPD” PI: Judith L. Reishstein (post-doctoral fellow) Period: March 1, 2005 to February 28, 2006 Project Summary: The purpose of this study is to identify sleep-related variables associated with decreased neurobehavioral function in people with Chronic Obstructive Pulmonary Disease (COPD). This cross-sectional project aims to test the central hypothesis that neurobehavioral deficits in COPD are determined by the interaction of sleep quality (sleep duration and fragmentation) and hypoxemia, controlling the influence of age, gender, education level, and disease severity.
“Hypertension African-American Elders Use of Spirituality in the Decision to Adhere to Anti-hypertension Medication” PI: Lisa Lewis Period: November 5, 2005 to February 28, 2006 Project Summary: The purpose of this study is to explore the use of spirituality in the decision making process to adhere to antihypertensive medications in a group of frail African-American elders who have hypertension. It is anticipated that the result of this proposed study will develop knowledge and provide insight related to the way hypertensive African-American elders use spirituality to make decisions about their adherence to antihypertensive medication.
2006
“Interventions for Early Recognition and Management of Delirium in Hospitalized Older Adults: A Meta-Analysis” PI: Neville Strumpf and Beth Ann Swan Period: January 1, 2006 to December 31, 2006 Project Summary: The study aims to conduct a meta-analysis of interventions for early recognition and management of delirium in hospitalized older adults. A comprehensive literature review will be conducted using PubMed, MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, and HealthStar databases. A knowledge synthesis table will be created identifying the research and evidence base. Following these review meta-analytic methods will be employed to code study characteristics and analyze results.
“Facilitators and Impediments to Nursing Home Culture Change: A Descriptive Multiple Case Study of Organizational Culture from the Perspective of Licensed Nurses" PI: Jennifer Bellot(doctoral candidate) Period: January 1, 2006 through May 31, 2007 Project Summary: The study employs descriptive multiple case study methodology to explore nurses' experiences of culture change and aspects of culture change adoption within the nursing home setting environment. It aims to introduce new methods of measurement of clinical experiences, perceptions and organizational characteristics that either facilitate or impede the adoption of a culture change structure.
"Psychometric Testing of Barriers to Health Care Scale" PI: Stacen Keating (doctoral candidate) Period: January 1, 2006 through June 6, 2006 Project Summary: The purpose of this study using a cross-sectional survey design will be to test reliability and validity of the psychometric properties of the Barriers to Health Care Scale for older minority (Hispanic) adults. A clearer understanding of these barriers to care faced by older minority adults may lead to the design and implementation of innovations in care for this vulnerable population. Though the reasons for problems with access to care are unclear, this project will provide an opportunity to obtain a clearer understanding of the barriers to care faced by older minority adults.
2007
"Reducing HIV Transmission Behaviors Among HIV Seropositive African American Men Fifty Years and Older" PI: Christopher Coleman Period: April 2, 2007 through March 31, 2008 Project Summary: The epidemic of human immunodeficiency virus (HIV) infection is a well-recognized global phenomenon. Less well recognized, unfortunately, is the growing threat of HIV among aging adults. The purpose of this study is to explore the particular risk factors of HIV infected African American middle-aged and older men and to test the feasibility of a theory based intervention to reduce risky sexual behavior in ethnic minority men residing within an urban area. The behavioral intervention will be tested aimed at increasing 1) consistent use of condoms, 2) disclosure of HIV status to sexual partners, and 3) adherence to Highly Active Antiretroviral Therapy (HART).
"Factors Influencing Inner City Older Adults' Non-Urgent ED Visits" PI: Deborah D'Avolio (PI) Period: June 1, 2007 to June 30, 2008 Project Summary: The study will examine factors, which lead vulnerable older adults to the Emergency Department (ED) for non-urgent care. The research aims are to describe the socio-demographic and illness characteristics of older adults seeking non-urgent care in the ED; identify the health care needs of older adults and factors associated with use and outcomes of the ED visit; and, examine the relationships between health services access, emergency services utilization, and perceived health to overall quality of life.
“How do family caregivers’ beliefs about dementia differ among Caucasian Americans, Korean Americans, and Koreans?” PI: Eun-Hi Kong and Lois Evans Period: July 1, 2007 – July 30, 2009 Project Summary: The purpose of this study is to describe and compare the beliefs about dementia held by Caucasian American, Korean American, and Korean family caregivers of elders with dementia. The study will explore how these beliefs of dementia differentially affect help-seeking behaviors among the three cultural groups. It will also help health care providers to develop culturally appropriate care for minority family caregivers of elders with dementia.
Copyright © 2007 Foulkeways
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About Us | Community Life | Quality First Program | Services | Health Services | Apartments | Rates | Contact Us
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