The major goal of this revision is to expand our investigation into the relationships among resident personal characteristics, environmental context, and agitation in the nursing home (NH) using a computer-assisted system of real time behavioral observation. However, in response to preliminary findings from our agitation intervention research, we propose to extend our original aims from the context of an intervention trial. Our original study allowed us to develop a real-time observational system that has been used by the applicant in numerous additional studies and has also been adopted by other research teams. The previous application produced a number of intriguing findings regarding agitation, including precise descriptive data and predictors of occurrence, duration and temporal patterns; sequential conditional probabilities of agitation given staff touch and verbal interaction and exploratory structural equation modeling (SEM) relating agitation, cognitive and functional status, and resident gender over time. The proposal for continuation has 3 specific aims:
Aim 1 : using our system of observation, we will examine the effects of two promising and practical interventions for agitation: environmental white noise and soothing spoken word audiotapes, both delivered to residents via earphones. Intervention groups will be compared to a no treatment control group. An uncomplicated staff management system will be integrated with both intervention protocols to encourage nursing assistants (NAs) compliance with the treatment protocols;
Aim 2; we will examine NA compliance with the protocol and resident response to the interventions over a 12 month period;
Aim 3 : we will continue to examine the relationship among resident personal characteristics, environmental context and agitation both cross-sectionally and longitudinally using SEM. In these analyses, intervention will be considered just one of many variables that can affect agitation over time. We are proposing to expand our investigations by discriminating additional subclassifications of agitation, refining our entry criteria to allow entry of only clinically significant agitated residents, and measuring agitation intensity and resident affect.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR002988-06
Application #
2891225
Study Section
Nursing Research Study Section (NURS)
Program Officer
Mann Koepke, Kathy M
Project Start
1991-09-30
Project End
2002-06-30
Budget Start
1999-07-01
Budget End
2000-06-30
Support Year
6
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Alabama in Tuscaloosa
Department
Type
Schools of Social Work
DUNS #
City
Tuscaloosa
State
AL
Country
United States
Zip Code
35487
Norton, Misti J; Allen, Rebecca S; Snow, A Lynn et al. (2010) Predictors of need-driven behaviors in nursing home residents with dementia and associated certified nursing assistant burden. Aging Ment Health 14:303-9
Burkhalter, Carmen L; Allen, Rebecca S; Skaar, Denell C et al. (2009) Examining the effectiveness of traditional audiological assessments for nursing home residents with dementia-related behaviors. J Am Acad Audiol 20:529-38
Burgio, Louis D; Park, Nan Sook; Hardin, J Michael et al. (2007) A longitudinal examination of agitation and resident characteristics in the nursing home. Gerontologist 47:642-9
Allen, Rebecca S; Burgio, Louis D; Fisher, Susan E et al. (2005) Behavioral characteristics of agitated nursing home residents with dementia at the end of life. Gerontologist 45:661-6
Vance, David E; Burgio, Louis D; Roth, David L et al. (2003) Predictors of agitation in nursing home residents. J Gerontol B Psychol Sci Soc Sci 58:P129-37
Allen, Rebecca S; Burgio, Louis D; Roth, David L et al. (2003) The Revised Memory and Behavior Problems Checklist--Nursing Home: instrument development and measurement of burden among certified nursing assistants. Psychol Aging 18:886-95
Fisher, Susan E; Burgio, Louis D; Thorn, Beverly E et al. (2002) Pain assessment and management in cognitively impaired nursing home residents: association of certified nursing assistant pain report, Minimum Data Set pain report, and analgesic medication use. J Am Geriatr Soc 50:152-6
Burgio, L D; Scilley, K; Hardin, J M et al. (2001) Temporal patterns of disruptive vocalization in elderly nursing home residents. Int J Geriatr Psychiatry 16:378-86
Burgio, L; Scilley, K; Hardin, J M et al. (1996) Environmental ""white noise"": an intervention for verbally agitated nursing home residents. J Gerontol B Psychol Sci Soc Sci 51:P364-73
Yurick, A; Burgio, L; Paton, S M (1995) Assessing disruptive behaviors of nursing home residents: use of microcomputer technology to promote objectivity in planning nursing interventions. J Gerontol Nurs 21:29-34