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The experience of "doing well" in older nursing home residents: Bringing the past to the present
Though discussions of well-being and quality of life for older adults in American nursing homes have flourished over the past decade, relatively few studies have explored these notions from the perspective of older residents themselves. The purpose of this research is to understand experiences and perceptions of "doing well" in older nursing home residents.
Using interview, observational and interpretive methods, this qualitative study explored the phenomenon of "doing well" from the perspective of frail older adults (>=65 years old) living in two nursing homes, one private for-profit and the other government sponsored. Data were collected in three overlapping phases: (a) initial interviews exploring the participants‘ experiences and perceptions of how well they are doing, (b) participant observation focusing on daily activities and experiences of residents and the environment of the nursing home, and (c) follow-up interviews to clarify understandings of doing well that surfaced during the initial interview and observation phases.
Data analysis resulted in identification of an over arching theme, bringing the past to the present, and three sub themes: (a) familiar territory, (b) family bonds, and (c) settled in. Major factors that facilitated doing well included advocacy, control of discomfort, and breaking the routine. Findings prompted fusion of reinterpreted concepts from the life course capital (LCC) discourse with Kayser-Jones‘ nursing home environment framework to develop a heuristic for understanding biographically informed resources that residents rely on to do well.
This study is a first step in understanding what it means for residents to "do well" in a structured long-term care setting. Discerning factors related to the experience of doing well may provide a foundation for development of health care policies and direct caregiver approaches that support the transition and adjustment of older adults to congregate living environments and contribute to subjective quality of life....
Choices related to maximizing quality of life at end of life
Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of ...
Attentive presence: A lived experience of human becoming
Attentive presence involves a vigorous rhythmical flow of relating to another, it makes explicit that the other is cherished, and it is inextricably related to the way people make choices about what is important. It is a universal lived experience that is important to health and quality of life. The purposes of this research were to identify the structure of the lived experience of being attentively present to another and to contribute to knowledge about human becoming, the nursing theory that guided this study. Participants included 11 families whose members ranged in age from 7 to 81 years. These family members were persons living in the community who were willing to share their experience of being attentively present to another with the researcher during dialogical engagement. The Parse research method was used to answer the research question: What is the structure of the lived experience of being attentively present to another? The processes of dialogical engagement, extraction-synthesis, and heuristic interpretation were used for data gathering and analysis. The central finding of this study is the structure: The lived experience of being attentively present to another is penetrating engaging, as shifting with the cherished arises with quieting-disquieting regard. This structure is comprised of three core concepts, penetrating engaging, shifting with the cherished, and quieting-disquieting regard. These core concepts reflect the unitary experience of being attentively present to another for the participants in this study. Using the participants' descriptions, the findings are discussed in relation to how they enhance understanding about human becoming and in relation to how they can inform future research and practice....
Partners together in health: Health-related quality of life outcomes in coronary artery bypass patients and partners
Coronary artery bypass (CAB) surgery patients experience profound declines in physical, psychological, and relational health-related quality of life (HRQOL) following surgery. The purpose of this study was to examine HRQOL ...
Predictors of quality of life of elderly end-stage renal disease patients: An application of Roy's Model
There is increasing recognition that what matters most to chronically ill patients is how well they are able to function and how they evaluate the quality of day-to-life. Understanding the impact of chronic illness and ...
Factors that influence health-related quality of life and satisfaction with care among adults at a community-based AIDS service organization
The purpose of this study was two-fold: (a) to describe health-related quality of life and satisfaction with care among adults at a community-based AIDS service organization, and (b) to identify the socio-demographic ...
Treatment-related decisional conflict, quality of life, and comorbid illness in older adults with cancer
(2018-05-09)
As the aging population the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults will be confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional conflict, quality of life and comorbidity in older adults with cancer. An anonymous survey method was employed. The criteria for inclusion in this study were: (a) 65 years of age or older, (b) English-speaking, (c) ability to read English at an eighth grade level, (d) having a current cancer diagnosis, and (e) currently receiving cancer treatment. A sample size of 200 was recruited for this study from outpatient medical oncology, radiation oncology and palliative care practices in New Jersey. The participants completed four instruments including: (a) Decisional Conflict Scale (DCS), (b) Self- Administered Comorbidity Questionnaire (SCQ), (c) European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and (d) Demographic Information Form (DIF). Bivariate relationships existed between increased levels of decisional conflict and increased quality of life (p = .009) and quality of life and comorbidity (p = .001). All six regression models achieved significance (p < .001). Three to five statistically significant relationships were identified in each of the six regression models. Positive relationships existed between decisional conflict and financial problems, physical function, and global health status/quality of life. Increased emotional function may be predictive of decreased decisional conflict in all of the regression models. Other negative relationships existed between decisional conflict and cognitive function, diarrhea, spiritual support, insomnia, year diagnosed, fatigue, and nausea/vomiting. With their focus on patient-centered care, nurses are a crucial component of the multidisciplinary cancer team that can empower older cancer patients to communicate their values and preferences regarding cancer treatment....
Health related quality of life in adolescent and young adult retinoblastoma survivors
Retinoblastoma (RB) is the most common malignant intraocular tumor occurring in childhood. While survival rates in the United States (U.S.) are high, children are left with the impact of treatment including enucleation, ...
Effects of exercise on physiologic and psychologic outcomes in patients with end stage renal disease on hemodialysis: A quasi-experimental study in Lebanon
End stage renal disease (ESRD) is a public health problem that is expected to continue to rise and has overwhelming effects on individuals’ psychological, physical, and emotional wellbeing. Treatment options include ...
The relationship between perceived quality of life and attitudes toward advance directive decisions in older adult nursing home residents
The purpose of this study was to examine the relationship between the perceived quality of life and attitudes toward advance directive decisions based on the resuscitation status of older adults who resided in nursing ...