2.50
Hdl Handle:
http://hdl.handle.net/10755/163756
Category:
Abstract
Type:
Presentation
Title:
Influence of Methods on Findings From Cognitively Impaired Older Adults
Author(s):
Amella, Elaine
Author Details:
Elaine J. Amella, Medical University of South Carolina, Charleston, South Carolina, USA, email: amellaej@musc.edu
Abstract:
The NINR and NIA have made provision of health care to older adults with chronic illnesses a priority funding issue. Older adults, especially those over the age of 85, are the fastest growing portion of the population and have an increased incidence of cognitive impairment, approaching 50%. Most affected persons will eventually need extensive support of their ADLs from nurses and caregivers. To develop effective strategies to describe and intervene in the care for these persons who may be verbally unavailable to accurately report, researchers need to use innovative methods of data collection. Specifically, researchers need to develop a repertoire of methods to capture meaning from behavior. As behavior is often unpredictable among persons with cognitive impairments, characterizing and categorizing behavior becomes exquisitely challenging for the researcher. Moreover, the method of data collection, real-time observation versus caregiver recall, may influence the findings. Problems with Various Types of Methods: Persons with moderate to severe cognitive impairments may not be amenable to assessment techniques designed for persons able to recall and accurately report information. Caregivers' reports of behavior or responses are filtered through the lens of their perception. Informal caregivers may report what they wish was occurring while formal caregivers may be influenced by the context of care. Real-time observation is in its nascent stage in this population. Several methods are available to researchers at this time: 1) caregiver's report of aggregate data (e.g., behavior over the past 7 days), 2) caregiver's report is compared to researcher's observation in specific domains, 3) researcher observes using a taxonomy of behaviors/ responses, 4) researcher observes creating a system for interpreting data. Five representative instruments/ methods will be discussed: the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, Marx, Rosenthal, 1989), the Interaction Behavior Measure (McCrosky & Wright, 1971), the Communication Observation and Communication Assessment Scale (Tappen, Williams-Burgess, Edelstein, Roukey & Fishman, 1997) description of interactions using hand-held computers (Robinson, 1996) and micro-analysis of videotapes of feeding interactions (Phillips & VanOrt, 1993). All of these instruments or methods can be used to evaluate behavior of persons with cognitive impairments. All tap the domains of behavior, yet the method influences the report of those behaviors which influences research findings. Discussion: Discussion will focus on a critique of existing real-time observational research concerning persons with cognitive impairments. The validity of this type of research will be discussed compared to caregiver report. The resource-intense nature of real-time observation methods will be juxtaposed against the pragmatics of caregiver report. Finally, one study that compared findings from the Minimum Data Set -- Behavioral Assessment, which was completed by a nurse using informants, and the Mini-Mental Status Examination, which was completed by researchers who tested individuals with cognitive impairments, will be discussed as one exemplar of this type of methodological work.. Overall, real-time observation will be recommended as the preferred method of evaluating outcomes among persons with cognitive impairments.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
ENRS 13th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Atlantic City, New Jersey, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleInfluence of Methods on Findings From Cognitively Impaired Older Adultsen_GB
dc.contributor.authorAmella, Elaineen_US
dc.author.detailsElaine J. Amella, Medical University of South Carolina, Charleston, South Carolina, USA, email: amellaej@musc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163756-
dc.description.abstractThe NINR and NIA have made provision of health care to older adults with chronic illnesses a priority funding issue. Older adults, especially those over the age of 85, are the fastest growing portion of the population and have an increased incidence of cognitive impairment, approaching 50%. Most affected persons will eventually need extensive support of their ADLs from nurses and caregivers. To develop effective strategies to describe and intervene in the care for these persons who may be verbally unavailable to accurately report, researchers need to use innovative methods of data collection. Specifically, researchers need to develop a repertoire of methods to capture meaning from behavior. As behavior is often unpredictable among persons with cognitive impairments, characterizing and categorizing behavior becomes exquisitely challenging for the researcher. Moreover, the method of data collection, real-time observation versus caregiver recall, may influence the findings. Problems with Various Types of Methods: Persons with moderate to severe cognitive impairments may not be amenable to assessment techniques designed for persons able to recall and accurately report information. Caregivers' reports of behavior or responses are filtered through the lens of their perception. Informal caregivers may report what they wish was occurring while formal caregivers may be influenced by the context of care. Real-time observation is in its nascent stage in this population. Several methods are available to researchers at this time: 1) caregiver's report of aggregate data (e.g., behavior over the past 7 days), 2) caregiver's report is compared to researcher's observation in specific domains, 3) researcher observes using a taxonomy of behaviors/ responses, 4) researcher observes creating a system for interpreting data. Five representative instruments/ methods will be discussed: the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, Marx, Rosenthal, 1989), the Interaction Behavior Measure (McCrosky & Wright, 1971), the Communication Observation and Communication Assessment Scale (Tappen, Williams-Burgess, Edelstein, Roukey & Fishman, 1997) description of interactions using hand-held computers (Robinson, 1996) and micro-analysis of videotapes of feeding interactions (Phillips & VanOrt, 1993). All of these instruments or methods can be used to evaluate behavior of persons with cognitive impairments. All tap the domains of behavior, yet the method influences the report of those behaviors which influences research findings. Discussion: Discussion will focus on a critique of existing real-time observational research concerning persons with cognitive impairments. The validity of this type of research will be discussed compared to caregiver report. The resource-intense nature of real-time observation methods will be juxtaposed against the pragmatics of caregiver report. Finally, one study that compared findings from the Minimum Data Set -- Behavioral Assessment, which was completed by a nurse using informants, and the Mini-Mental Status Examination, which was completed by researchers who tested individuals with cognitive impairments, will be discussed as one exemplar of this type of methodological work.. Overall, real-time observation will be recommended as the preferred method of evaluating outcomes among persons with cognitive impairments.en_GB
dc.date.available2011-10-27T11:13:16Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:13:16Z-
dc.conference.date2001en_US
dc.conference.nameENRS 13th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationAtlantic City, New Jersey, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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