Conectar
Animal studies suggest that elevated sympathetic nervous system (SNS) activity can accelerate bone loss. However, this area has not been well researched in humans. High-intensity Resistance and Impact Training (HiRIT) is recognised as an effective treatment for osteoporosis and osteopenia. Alternate forms of exercise such as mind-body exercise may be used to modulate sympathetic activity, which could have an additive benefit for skeletal adaptation when used in conjunction with HiRIT. The aim of this study is to investigate whether the combination of mind-body exercise (Tai Chi) and HiRIT can be used to concurrently modulate SNS activity and improve skeletal health.
The CHILL BONES trial is a semi-randomised controlled trial where consenting adults over 60 years, who have low bone mass (total hip, femoral neck and/or lumbar spine T-score
Ethical approval was granted by the Griffith University Human Research Ethics Committee (GUHREC; GU Ref No: 2023/448). Trial findings will be disseminated to participants via a plain-language summary upon completion. Results will be formally reported through peer-reviewed journals and conference presentations.
ACTRN12623001209684; Australian New Zealand Clinical Trials Registry.
The quality of care provided in long-term care (LTC) homes has been a concern for many years, and the COVID-19 pandemic has further raised awareness of this issue. Care planning helps identify and prioritise areas to improve LTC residents’ health. Data are routinely collected to support care planning, for example, the interRAI LTC facilities instrument and real-time location systems. However, the best way to use these data to inform care planning and decision-making while including residents and family members remains elusive. This study aims to develop a data-informed care planning improvement intervention that uses routinely collected data to guide resident-centred care planning in LTC. Specifically, we will: (1) examine how, where and why routinely collected data are used in current care planning processes in LTC; (2) identify barriers and facilitators to using data to guide care planning from the perspectives of staff, residents and family caregivers; and (3) develop care planning intervention guided by the Behaviour Change Wheel.
An advisory committee of residents, family members and LTC staff will provide study oversight of this interpretive qualitative description study, conducted in LTC homes in Nova Scotia from May 2023 to April 2025. Participants, including LTC residents, their family members and staff, will be invited to participate in two 60–90 min focus groups or 45–60 min individual interviews and/or three 2-hour observation sessions. Data from interviews, focus groups and care observations will be analysed using inductive content analysis to answer the objectives. Next, we will deductively map the identified barriers and facilitators onto the Behaviour Change Wheel, which suggests that Capability, Opportunity and Motivation are needed for a Behaviour to occur (COM-B system). Subsequently, we will have a 1 day advisory committee meeting to: (1) select the intervention components using the APEASE criteria, which asks whether the function is
This study has been approved by the Dalhousie University Health Sciences Research Ethics Board. Informed consent will be obtained from all participants or their substitute decision-makers before they take part in interviews, focus group discussions and care observations. Data will be de-identified, and privacy and confidentiality will be maintained through secure storage and handling of both electronic and physical documents. Study findings will be shared with participants through lay summaries and infographics after the second interview and observation, as well as at the conclusion of the study. Results will also be disseminated to researchers, healthcare professionals and LTC providers across Canada via presentations at local, national and international conferences, publications in open-access journals and through print and video materials tailored to the audience.
Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. The purpose of this mixed-methods study was to determine if simulation accurately captures elderspeak communication by nursing staff in hospital dementia care.
A 3-part mixed-methods design in which (1) three dementia care simulations were designed and validated by a panel of experts, (2) communication by nursing staff completing each simulation was quantitatively compared to communication during actual patient care, and (3) views on the realism were explored using within- and across-case coding.
Three simulations using different modalities (manikin, role-play, and standardised patient) were designed and validated with eight experts using the Lynn Method. Ten nursing staff were audio-recorded and their communication was coded for elderspeak communication. Results for each simulation were compared using Wilcoxon signed-rank test to recordings taken during actual dementia care encounters. Debriefings were coded for realism and results were converged.
The average time using elderspeak during naturalistic care was 29.9% (SD = 20.9%) which did not differ from the average amount of elderspeak used across the three simulations modalities which ranged from 29.1% to 30.4%. Qualitative results suggested a lack of realism with the manikin condition and the nursing staff indicated preference for the simulation with the standardised patient.
Communication elicited in the dementia care simulations was congruent to communication produced in actual dementia care but preference was for the standardised patient.
Elderspeak communication can be accurately produced in the simulated environment which indicates that simulation is a valid method for person-centred communication training in nursing staff.
Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. Elderspeak communication captured in the simulated environment was congruent to communication nursing staff use during actual patient care to hospitalised persons living with dementia. This study empirically identifies that communication is elicited in similar patterns by nursing staff in the simulated environment compared to the naturalistic care environment which demonstrates that simulation can be used as a valid tool for education and research on person-centred communication.
STROBE.
No Patient or Public Contribution.
Facemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks.
Scoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases.
The PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research.
Thirty-nine articles met the inclusion criteria. Seventeen of these were high- or good-quality research studies, and the remaining 22 were non-research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non-transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non-verbal and verbal communication strategies.
Awareness of communication challenges is crucial when wearing facemasks. More high-quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial.
The findings of this scoping review highlight the importance of considering communication challenges while wearing facemasks in the healthcare settings. The review suggests that selecting an appropriate mask type, reducing extraneous noise, verbalizing emotions, and employing clear speech are some strategies that may be effective in mitigating the impact of facemasks on communication between patients and healthcare providers.
FreshRSS 