Audio presence intervention for decreasing agitation in people with dementia.

Researchers have demonstrated the utility of various nonpharmacologic interventions in decreasing or preventing agitation in elderly nursing home residents with dementia. Auditory intervention strategies are one behavioral approach. We tested a modified version of simulated presence therapy called audio presence intervention (API). In 28 episodes of agitation among seven residents, API produced a significant decline in agitation level as measured by four items from the Haycox Rating Scale. However, in six episodes (four residents), agitation stayed the same or worsened. The results of this study pose more questions than answers and should stimulate nurse researchers to further investigate auditory intervention for control of agitation elders with dementia.

Model selection for covariance structures analysis in nursing research.

Covariance structures analysis is often used in nursing research to appraise statistical models reflecting complex human health processes. The model selection approach in covariance structures analysis is designed to select the "best" model from a specified set of theoretically defensible, competing alternatives, all of which are viewed as approximations. Model selection criteria explicitly incorporate both model misfit in the population and sampling error to evaluate the set of models. The result is that interpretability of model parameters and goodness-of-fit are enhanced simultaneously. Relative merits of the model selection approach are identified in light of technical concerns, parsimony, and use of scientific theory in nursing.

Validation of the structure for the "Clinical Assessment of Confusion-A".

The Clinical Assessment of Confusion-A (CAC-A) is an observational checklist developed for practicing nurses to measure the presence and level of confusion in hospitalized adults. In a previous study, the following dimensions were found using principal factor analysis: cognition, general behavior, motor activity, orientation, psychotic/neurotic behavior, and two uninterpretable factors. A replication study was conducted to evaluate the validity of a statistically derived model for confusion suggested by the CAC-A. Data from a sample of 566 nurses were analyzed. Three theoretically justified statistical models for the structure of confusion were estimated and compared using a model selection approach to covariance structures analysis: a single-factor unidimensional model, an orthogonal six-factor model, and an oblique six-factor model similar to the structure suggested in the development study. The oblique six-factor model provided the best fit in the predictive sense and was the most satisfactory from a theoretical perspective.

Variability in nurse staffing research.

Variability in nurse staffing research has existed and still exists in two major areas: the method of data collection and analysis, and the method of reporting. The authors take a broad look at these two areas of variability and consider the implications for future nurse staffing research. It has become imperative that nurses take responsibility for the determination of what constitutes nursing work and who should perform that work.

Data base management for nursing education. One school's experience with System 1022.

The data base management system (DBMS) is one tool that can greatly facilitate the organization and retrieval of such information. An overview of DBMS is presented for nurse educators with considerations for using and selecting a DBMS. System 1022 (produced by Software House, 1983), is discussed in terms of the process and problems encountered.