Impacts of dance on agitation and anxiety among persons living with dementia: An integrative review.

INTRODUCTION: Individuals living with dementia are likely to experience one or more neuropsychiatric symptoms on a daily basis. Dance has the potential to positively impact and reduce these symptoms. This integrative review was conducted to identify the impacts of dance on agitation and anxiety among those living with dementia. METHODS: An integrative review methodology guided the literature search and evaluation. Thirty-Nine papers were retrieved from the initial search. Five studies were included in the review. The Mixed Methods Appraisal Tool was used to assess the quality of relevant articles. RESULTS: Three quantitative and 2 qualitative studies were reviewed. Three out of 4 studies found dance positively impacted agitation. While 1 out of 2 studies reported improvements in anxiety. DISCUSSION: This review suggests that dance has the potential to impact anxiety and agitation symptoms of persons living with dementia. However, the evidence is weak and further research is warranted.

Mismatch between subjective and objective motor improvements with adapted tango intervention in older adults.

PURPOSE: The purpose of this study was to determine the relationship between objective and subjective findings of motor function measures in older adults following a 12-week adapted tango intervention. METHODS: A quasi-experimental repeated-measures design was used. Secondary analysis of the experimental group (Tango) data is reported here. The study took place in diverse senior independent living communities in an urban metropolitan area. Sixty-two older adults participated (n = 62, age: M = 82.3, SD = 8.8 years). Participants were assigned to 20 sessions of 90-min tango classes over 12 weeks. Motor function, depression, mental, and physical quality of life were measured before and after intervention. At post-test, satisfaction and subjective measures of motor function were assessed by participants indicating their level of agreement with statements that they improved in objective domains of motor function. Correlations were performed between subjectively rated agreement and changes in motor function, depression, and quality of life. RESULTS: A strong negative correlation was found between subjective ratings and empirically observed improvements in balance (r = -.423) and endurance (r = -.241), although participant ratings correlated moderately with manual dual tasking (r = .319) and weakly correlated with lower body strength (r = .188). Decreased depression was correlated with subjectively improved lower body strength (r = .271) and endurance (r = .254). Improved mental quality of life was strongly (r = .423) correlated with subjectively improved balance and moderately correlated with improved manual dual tasking (r = .306). CONCLUSION: After rehabilitation, even with improved depression and quality of life, older adults may not perceive empirically observed motor function improvements, particularly in balance and lower body strength. This study informs clinicians on the importance of assessing subjective data during rehabilitation to provide older adults with person-centred care.

Emergency Nursing Policy and Hypertension Awareness: an Integrative Review of the Literature.

PURPOSE OF REVIEW: This study aims to systematically examine the literature on nursing policy and hypertension (HTN) awareness in the emergency department (ED). RECENT FINDINGS: The electronic databases searched included Pubmed, OVID, CINAHL, and Web of Science. Studies were limited by adult, English language, and peer-reviewed articles published in the USA between the years 2015 and 2018. Our literature search allowed for quantitative and qualitative studies with a focus on nursing policy and adult patients treated in the ED who have HTN or elevated BP. Eight quantitative studies were retained for review and appraisal, and were rated to be of moderate quality evidence. Findings were summarized under three themes: BP reassessment, referral, and practice. The role of ED nurses in the screening and referral of this patient population remains largely uncharacterized. More robust trials are critically needed to improve practice and outcomes for patients with uncontrolled HTN. Clinical trials are needed to examine the efficacy of ED-based interventions on BP control, using multi-disciplinary samples of ED clinicians.

Effects of line dancing on physical function and perceived limitation in older adults with self-reported mobility limitations.

INTRODUCTION: Older adults with mobility limitations are at greater risk for aging-related declines in physical function. Line dancing is a popular form of exercise that can be modified, and is thus feasible for older adults with mobility limitations. PURPOSE: The purpose of this study was to assess the effects of 8 weeks of line dancing on balance, muscle strength, lower extremity function, endurance, gait speed, and perceived mobility limitations. METHODS: An experimental design randomly assigned older adults to either an 8-week line dancing or usual care group. The convenience sample consisted of 23 participants with mobility limitations (age range: 65-93 years). The intervention used simple routines from novice line dance classes. At baseline and at 8 weeks, balance, knee muscle strength, lower extremity function, endurance, gait speed, and mobility limitations were measured. ANCOVA tests were conducted on each dependent variable to assess the effects of the intervention over time. RESULTS: Results found significant positive differences for the intervention group in lower extremity function (p < 0.01); endurance (p < 0.01); gait speed (p < 0.001); and self-reported mobility limitations (p < 0.05). CONCLUSIONS: Eight weeks of line dancing significantly improved physical function and reduced self-reported mobility limitations in these individuals. Line dancing could be recommended by clinicians as a potential adjunct therapy that addresses mobility limitations. Implications for Rehabilitation Line dancing may be an alternative exercise for older adults who need modifications due to mobility limitations. Line dancing incorporates cognitive and motor control. Line dancing can be performed alone or in a group setting. Dancing improves balance which can reduce risk of falls.

Effects of walking trainings on walking function among stroke survivors: a systematic review.

Physical function is often compromised as a result of stroke event. Although interventions propose different strategies that seek to improve stroke survivors' physical function, a need remains to evaluate walking training studies aimed at improving such physical function. The aim of this review was to assess the available literature that highlights the impact of walking training on enhancing walking for stroke survivors. We performed a systematic literature review of online databases - Google Scholar, PubMed, CINHAL, Cochrane Library, Scopus, and EBSCO - with the following inclusion criteria: manuscript published from 2005 to 2016, written in English, with treatment and control groups, for walking training studies aimed at improving physical function among stroke survivors. Findings indicated that walking speed, walking distance, and gait speed were the most used outcome variables for measuring improved physical function among stroke survivors. Importantly, proposed interventions involved either overground or treadmill walking trainings, if not both. Preserved locomotor improvements were not noted in all interventions at follow-up. Some interventions that used walking treadmill training augmented by auditory stimulations reported significant improvements in physical function compared with overground walking training augmented by auditory stimulations. The imperative to improve physical function among stroke survivors with physical impairment is paramount, as it allows survivors to be socially, emotionally, and physically more independent. In general, we note an insufficiency of research on the interaction between physical function and socialization among stroke survivors.

The impact of nursing interventions: overview of effective interventions, outcomes, measures, and priorities for future research.

The purpose of this article is to present findings from a review of published systematic/integrative reviews and meta-analyses on nursing interventions and patient outcomes in acute care settings. A literature search was conducted for the period 1999-2005, producing 4,000 systematic/integrative reviews and 500 meta-analyses covering seven topics selected by the authors: elder care, caregivers, developmental care of neonates and infants, symptom management, pressure ulcer prevention/treatment, incontinence, and staffing. The association between nursing care interventions/processes and patient outcomes in acute care settings was found to be limited in the articles reviewed. The strongest evidence was for the use of patient risk-assessment tools and interventions implemented by nurses to prevent patient harm. We observed significant variation in methods to measure the effect of independent variables (nursing interventions) on patient outcomes. Results indicate the need for more research measuring the effect of specific nursing interventions that may impact acute care patient outcomes.

Engaging nurse leaders in health services research.

OBJECTIVE: To describe effective methods to engage nurse leaders in structured interview research. BACKGROUND: The American Organization of Nurse Executives has identified the support of nurse leader participation in research as a key strategy to achieving its education and research objectives, particularly with regard to identifying and documenting nursing sensitive outcomes. Previous studies have delineated several methods to increase participation. METHODS: Nurse leaders of California labor and delivery units reporting more than 50 deliveries during 2002 were asked to participate in a structured interview about staffing and clinical policies on their unit. Recruitment methodology involved 3 levels of intervention, including introductory letters, follow-up contacts, and personal encouragement from senior regional leaders and nurse executives. RESULTS: Of the 268 eligible hospitals, 225 (84%) participated in the study. Fifty-four percent (n = 114) of the structured interviews were scheduled upon initial and second contacts by the research coordinator, and 73% (n = 161) were completed at the first scheduled appointment. Unit managers or directors personally completed 91% (n = 205) of the interviews, with only 20 (8.9%) designated to a staff nurse. CONCLUSIONS: Nurse leader participation is essential to the success of research dependent on collecting information regarding nurse practices and clinical processes. Using a multilevel approach to engage nurse leaders in research, such as endorsements and "detailing" by opinion leaders, phone calls, electronic mail, and incentives, is an effective strategy.

Functional health literacy: an issue in African-American and other ethnic and racial communities.

The purpose of this study was two-fold: to identify and assess the functional health literacy level among a group of African-American adults and to determine the feasibility of conducting a functional health literacy assessment in community-based settings, primary, and acute care settings. This was an exploratory descriptive study done to ascertain the degree of health literacy among a sample of respondents from vulnerable populations including African-Americans and Hispanics. The total sample was comprised of 190 (N = 190) men and women in Los Angeles and New York. This included a sample of 81 (n = 81) African-American participants and 16 (n = 16) Hispanic participants. The average age of the total sample was 43 years of age, and 47% of the total sample was male, while 53% were female. The average age of the African-American sample was 41 years Conversely, 53% of the African-American sample was male, while 47% of the sample was female. The Modified Test of Functional Health Literacy in Adults (TOFHLA) survey instrument, developed by Williams and Colleagues (1995), was administered to participants to assess health literacy. The TOFHLA consisted of a Reading Comprehension component that contained 39 multiple-choice questions. Findings from this study suggest that patients who have marginal or inadequate functional health literacy will have difficulty reading, understanding, and interpreting most written health texts and instructions In addition, patients with marginal or inadequatefunctional health literacy scores are more likely to misunderstand directions for health care. Consequently, these patients are also more likely to take medications incorrectly and more likely to fail to follow a prescribed diet or treatment regimen.

Quality of care in African-American communities and the nursing shortage.

The National Black Nurses Foundation commissioned a research project to determine the effect of the nursing shortage on African-American communities. The W.K. Kellogg Foundation funded the project as part of a multiphase project aimed at identifying issues related to the nursing shortage among ethnic people of color communities and developing policy recommendations around the supply of nurses to serve those communities. The study was conducted over a six-month period by the nursing research investigative team at Cedars-Sinai Medical Center and Burns and Allen Research Institute in Los Angeles, California. One hundred (N=100) nurse leaders from communities across the United States participated in the research. Each leader completed a questionnaire regarding the existence of the nursing shortage in their community and the effect of the shortage on access to services, clinical quality and the retention and recruitment of nurses. Leaders were queried on nurse vacancy and turnover within their communities, incidence of adverse events and the ability of institutions to meet the demands for nursing and health services in their communities. Forty-five percent of the organizations in the study were reported to be single facilities and 55% consisted of integrated health systems. Respondents identified five major issues resulting from nurse vacancies in their communities: closure of acute care beds or clinical services, delays in providing treatment to patients, inability to retain nurses due to increased workload and decreased nurse satisfaction, diminished capacity to address chronic health problems in their communities and increased incidence of adverse patient events. African-American nurse leaders reported higher rates of nurse vacancy and turnover; higher incidence of adverse events and greater difficulty providing access to health care than was reported in the literature. Nurse vacancy and turnover rates are higher than reported national averages. The study suggests the need for further research at the community level in addition to acute care settings to ameliorate the potential adverse effects of nursing work force shortages on the health of African-American communities. Further research examining the effectiveness of interventions at increasing the supply, improving the retention of nurses at all levels and the effect of increased supply and the utilization of nurses in African-American communities should be conducted. The study reported in this edition of the Journal of the National Black Nurses Association is the first in a series of reports on the nursing shortage and its effect on access to care, the recruitment and retention of ethnic nurses in the pipeline and leadership and policy strategies required to assure the availability of a qualified work force to meet current and future health care demand.