Home Adjustment Research Articles

Usability and feasibility of an online intervention for older adults to support changes to routines and the home ('Light, activity and sleep in my daily life')

BackgroundIndoor lighting, exposure to outdoor daylight, physical activity and sleep interact to influence functioning, mood and cicadian rhythm. Older adults (≥ 65 years), who often spend more time at home, are less physically active and experience more sleep problems, could benefit from strategies to support behavioural change and self-managed modifications in the home. The study’s primary objective was to assess the usability and feasibility of the ‘Light, activity and sleep in my daily life’ intervention, delivered as a web-based course.MethodsThis 9-week intervention was delivered in a municipality in Sweden (55.70° N). Participants were eight healthy women (age 71–84), community-living in one-person households. We recruited through municipal staff and posters at senior citizen meeting points. Both qualitative and quantitative data were collected before and after the intervention. The outcome measures were intervention usability (ease of use, usefulness) and study feasibility (e.g., recruitment procedure, online engagement). Measures also included changes to routines and self-managed home adjustments to determine whether the participants applied what they had learnt.ResultsAll participants completed the intervention. Time logged in varied between 25 min and 3 h (M = 1 h 50 min) per week. Seven participants’ system usability scores were between 90 and 100 (‘Excellent’) out of 100. When interviewed, participants reported overall high satisfaction with what they had learnt. Six participants were particularly satisfied with the modules targeting light. Seven participants made changes to their lighting or darkness conditions, such as replaced bulbs with either 3-step dimming or higher colour temperature LEDs (samples were included in the intervention test kit). One suggestion to improve the online delivery was to enable participants to add text comments to the weekly evaluation form.ConclusionsThe web-based intervention was feasible to deliver but time for recruitment should be extended and advertisement in the local newspaper should be considered. Participants’ computer proficiency and access to the internet at home will be critical in a future study with a larger sample. Only minor changes to the online content of the intervention are needed based on participants’ feedback. The intervention will be possible to evaluate in a future pilot study.

Validity and Reliability of the Nursing Home Adjustment Scale for Older Adults in Japan: A Cross-Sectional Study

Validity and Reliability of the Nursing Home Adjustment Scale for Older Adults in Japan: A Cross-Sectional Study

Effect of Meditation on Adjustment of Secondary School Students

In today’s competitive world is growing world where the competition in almost every field which creates its own stress and disturbances, it is important to have good health for better performance. Meditation is a good way to reach a state of mental equanimity where responses to favorable or unfavorable external events are well under the individual’s control and responses are moderate in intensity. Meditation help to improves mental and physical health and maintain happiness and adjustment with his self and his environment. The present study was undertaken with the purpose of studying effect of meditation on adjustment of secondary school students. The study was conducted on a sample of 200 secondary school students of Amritsar District. 100 as control group and 100 as experimental group was selected for the study in two schools. The result indicated that the meditation technique employed by the experimental group helped them to improve their adjustment in home, society, health and education. The significant effect of mediation was found on adjustment of secondary school students.

The effects of resourcefulness-based instrumental reminiscence therapy on psychological adjustment in nursing home residents: a randomised controlled trial.

Older adults do not always adapt successfully to nursing homes. Learning resourcefulness and instrumental reminiscence may contribute to the psychological adjustment made by nursing home residents. How both attributes can be combined to enhance residents' adjustment remains unclear. This study examined the effects of resourcefulness-based instrumental reminiscence therapy (RBIRT) on psychological adjustment, learned resourcefulness, self-efficacy, social support and quality of life (QoL) of nursing home residents. A randomised, controlled, assessor-blinded, parallel-arm trial was conducted between January 2022 and February 2023 in Fujian, China, with 120 participants (intervention = 60, comparison = 60) from two separate nursing homes. The intervention group participants received a 6-week RBIRT, involving Reminiscence Interview, Emotional Venting, Reconstruction Strategies, Planning for the Future and Strengthening Support. The control group participants received routine institutional care. Participants were assessed using the Nursing Home Adjustment Scale, Resourcefulness Scale, General Self-efficacy Scale, Perceived Social Support Scale and the 12-item Short-Form Health Survey. Outcomes were evaluated at baseline (T0), immediately post intervention (T1) and at 1-month (T2) and 3-months (T3) post-intervention. Participants in the intervention group showed significant improvement in 'psychological adjustment,' 'learned resourcefulness,' 'self-efficacy,' 'social support' and 'QoL-mental health dimension' compared to the control group (P < 0.001). These effects were sustained at the 1- and 3-month follow-ups. Innovative RBIRT improved psychological adjustment, learned resourcefulness, self-efficacy, social support and mental health-related QoL among nursing home residents.

Turkish validity and reliability study of the nursing home adjustment scale

BackgroundAdapting to a nursing home has a significant effect on facilitating the transition to a nursing home. However, a tailored nursing home adjustment scale for Turkish nursing home residents is not yet available. The purpose of this study was to translate the nursing home adjustment scale from English to Turkish and assess its reliability and validity in a sample of nursing home residents in Turkey.MethodsA total of 202 older adults from four nursing homes were included in this study. The reliability of the Turkish nursing home adjustment scale was tested using Cronbach’s alpha values for internal consistency. Exploratory and confirmatory factor analyses were used to examine the factor structure, whereas correlation analysis was conducted for convergent validity.ResultsThe Turkish version displayed satisfying internal consistency (Cronbach’s alpha = 0.88) and perfect convergent validity for life satisfaction (r = 0.482). The Turkish scale included five factors: difficulty fitting in, acceptance of new residence, emotional distress, depressed mood, and relationship development.ConclusionThe findings indicate that the Turkish version of the scale is a valid and reliable tool for measuring the level of nursing home adjustment among older adults in Turkey.

Factors associated with adaptation level in the older adult residential care facilities: a path analysis.

It has become very common for older adults to relocate to residential care facilities. Yet whether older adults adapt to life in a long-term care residential facility through perception, reflection, and conscious behavioral choices is a challenging social issue. Previous research has shown that adaptation is influenced by physical, mental, psychological, social systems, and other debris factors. However, existing knowledge is often based on unidirectional relationships between these factors and adaptation. Few studies have formally examined bivariate relationships between these factors, and the influence of adaptation between these factors internally remains unclear. Therefore, there is a need to examine the structural causality of adaptation in residential care facilities influenced by a combination of physical, emotional, social and psychological factors, life satisfaction, and social support. The present cross-sectional study recruited older adults from three residential care facilities in Henan province, China, through convenience sampling. The Chinese Nursing Home Adjustment Scale (NHAS), Geriatric Depression Scale-15 (GDS-15) and Social Support Scale (SSRS), Satisfaction with Life Scale (SWLS), and Barthel Index were employed to measure the older adult' adjustment level, depression level, social support, satisfaction with life, and self-care ability of the BMC, respectively. The relationships between depression, social support, self-care, satisfaction with life, and adaptation were analyzed and a structural equation model was developed. A total of 210 participants completed the questionnaire. The model demonstrated an acceptable fit of the data. The results showed that the difference between life satisfaction and depression on the level of adaptation was 60 and 23%, respectively. Social support and life satisfaction had a positive direct effect on the level of adaptation, both showing a positive correlation with the level of adaptation. Depression, on the other hand, have a direct effect on the level of adaptation and showed a negative correlation with the level of adaptation. Self-care ability indirectly influenced adaptation mediated by social support. Social support has a positive impact on both life satisfaction and depression, which in turn promotes adaptation. As a major source of social support, family members and nursing home staff in residential care facilities can enhance social support for older people through improved interaction, which can have a meaningful and positive impact on levels of adjustment. The model demonstrates the strengthening and weakening of social support, self-care, life satisfaction, and depression levels, which can help inform the development of relevant care health strategies for older people to promote levels of adjustment and improve quality of life.

Psychometric properties of the Chinese version of the Nursing Home Adjustment Scale (C-NHAS) in Central China: Classical test theory and item response theory

Evidence for the nursing home adjustment scale (NHAS)’ s applicability in less developed regions of China is still absent. Besides, there is a need to provide further validity evidence for the NHAS using modern test theory. This study aims to investigate the psychometric properties of the Chinese version of the NHAS (C-NHAS) in a sample of nursing home residents in central China. A total of 761 older adults who lived in 21 nursing homes in Hunan Province, China, were investigated from July 2021 to December 2021. The C-NHAS yielded a four-factor structure and showed good reliability and validity. The difficulty of items matched most individuals’ ability, while a small number of individuals with low ability had no items for matching. The results indicated the C-NHAS is a reliable and valid instrument while the high difficulty may restrict the performance of the C-NHAS among the less educated older adults.

Nursing home adjustment in China: mediating and moderating effects

PurposeAdjusting to nursing homes contributes to successful aging in older adults. However, the effect of stress on psychological adjustment in nursing home residents is unclear. Therefore, this study aimed to explore the relationship between stress and psychological adjustment among nursing home residents.MethodsThis was a cross-sectional, multicenter survey. A total of 386 residents from 11 nursing homes were included in the study. Bootstrapping with resampling strategies was used to examine multiple mediators and the moderator effect. This research conforms with the STROBE checklist.ResultsPath analysis demonstrated that stress directly negatively predicted the psychological adjustment of nursing home residents. It also indirectly predicted psychological adjustment through the mediating role of learned resourcefulness and self-efficacy, as well as the chain mediating role of both. Social support played a moderating role in the path of stress to learned resourcefulness.ConclusionThis study revealed the mechanism underlying the effect of stress on psychological adjustment in nursing home residents without cognitive impairment and walking difficulties. It further suggests that health providers could enhance older adults' learned resourcefulness, self-efficacy, and social support to assist them in adjusting to nursing home life.

Home adjustment of secondary school students of working and non-working women

The Secondary school students who are passing through the stage of adolescent is in a period of stress and strain. Generally in this period adolescent feel more difficulties of adjustment in relation to their home, school, society and health etc. IN fact, the mystery of our Indian mother’s responsibility is to take care of their kith and kins and other family members. But in current situation it is based on purely vigilant multi role player specially caring and daring. So the present study was conducted to investigate the home adjustment of secondary school students of both working and non-working women.

Effects of oral health intervention strategies on cognition and microbiota alterations in patients with mild Alzheimer's disease: A randomized controlled trial

We explored the effects of an oral health intervention on the oral microbiome and cognitive function of patients with mild Alzheimer's disease (AD) and determined the influence on disease progression. Sixty-six patients with mild AD were randomly assigned to intervention or control groups and received a 24-week oral health intervention and routine care, respectively. Data were collected at baseline and week 24. 16 S rRNA sequencing was used to analyze oral microbiota. After 24 weeks of oral health intervention, Kayser-Jones Brief Oral Health Status Examination (BOHSE), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Nursing Home Adjustment Scale (NHAS), and Alzheimer's Disease Cooperative Study-ADL (ADCS-ADL) scores were different between groups (p < 0.05). Subgingival plaque in patients with AD showed significant differences in the diversity and abundance of oral microbiomes, with a higher abundance of normal oral flora in the intervention group. We found oral health intervention strategies are effective in modifying subgingival microbiota differences and slowing cognitive decline in mild AD patients.

Effect of mandibular advancement device in the treatment of obstructive sleep apnea

Abstract Background Obstructive sleep apnea (OSA) is a situation of repetitive and interrupted collapse of the upper airways (UAs) during sleep. The physiopathology of OSA is multifactorial. Provided that continuous positive airway pressure is the gold standard for treatment of OSA, the American Academy of Sleep Medicine in 2015 stated that mandibular advancement device (MAD) was indicated as a first-line therapy for mild OSA and a second-line therapy for moderate to severe OSA with lower BMI. Aim This study is aimed to evaluate the MAD success rate in patient with OSA and to assess improvement in sleep quality. Patients and methods This was a prospective one-group pretest–post-test quasiexperimental study carried out on 30 patients with OSA admitted to the sleep center at Chest Medicine Department of Mansoura University Hospitals through the period from February 2019 to January 2021. All patients had thorough clinical examination. The clinical assessment was scored according to the following questionnaires: the Epworth Sleepiness Scale, the Berlin questionnaire, the STOP-Bang questionnaire, and the Pittsburgh sleep quality index. Patients also had polysomnography, drug-induced sleep endoscopy, and dental volumetric computerized tomography (CT) scan. All patients were treated by MAD, and then patients began home adjustment as patients were instructed to advance the device 0.5 mm each night as tolerated. After two weeks, patients repeated PSG and CBCT to assess airway volume and airway area after treatment of OSA by the MAD. Results A total of 30 patients with OSA were included, comprising 14 males and 16 females, with a mean age of 42.9 ± 7.0 years. The types of UA obstruction were detected by both drug-induced sleep endoscopy (DISE) and dental volumetric cone-beam CT (CBCT). A total of 30 patients were studied and showed that multiple-level obstruction was the most frequent type of UA obstruction detected by both dental volumetric CBCT and DISE, representing 53.3 and 60%, respectively. Regarding polysomnographic data of the studied patients before and after treatment by MAD, there is very high significant improvement of apnea-hypopnea index among the studied patients whose were treated by MAD. Conclusion MAD has a high success rate in treatment of OSA and improves sleep quality. DISE and CBCT can be useful tools for assessing the success of MAD in the treatment of OSA.

Effects of an emotional support programme on older adults living in nursing homes: A quasi-experimental study

This study aimed to examine the feasibility and validity of an emotional support programme developed for older adults living in nursing homes, using a quasi-experimental design. Older adults in the intervention group attended a 12-week emotional support programme while those in the control group received usual care. Outcome variables, assessed at baseline and at 1-month and 3-month follow ups, included nursing home adjustment, perceived social support, and quality of life. Group-by-time interaction effects were found concerning nursing home adjustment and perceived social support. Significant improvements in the two variables were observed in the intervention group, but no significant difference was found in quality of life. The emotional support programme based on social learning theory resulted in significant improvements in nursing home adjustment and perceived social support. To respond to the demands of an ageing society, further studies are needed on this topic.

Risk Adjustment in Home and Community Based Services Outcome Measurement.

The purpose of this study was to review and evaluate existing research that used risk adjusters in disability research. Risk adjustment controls for individual characteristics of persons when examining outcomes. We have conducted a systematic review and an evaluation of existing studies that included risk adjusters for outcomes of people with disabilities receiving services (home or community based). The process included coding each study according to the type(s) of risk adjusters employed and their relation to the specific population and outcomes within a framework. Panels were utilized to prioritize the risk adjusters. Findings indicate that four risk adjusters can be tentatively recommended as potential candidate risk adjusters: chronic conditions, functional disability, mental health status, and cognitive functioning. Holistic Health and Functioning far outweighed other outcomes studied to date. Further, there is a need for testing recommended risk adjusters across multiple outcomes and different populations of people with disabilities.

A preliminary examination of key strategies, challenges, and benefits of remote learning expressed by parents during the COVID-19 pandemic.

Among the many impacts of the Coronavirus disease (COVID-19) pandemic, one of the most dramatic was the immediate closure of in-person schooling in March/April 2020 when parents were faced with much greater responsibility in supporting their children's learning. Despite this, few studies have examined parents' own perspectives of this experience. The aims of this preliminary study were to (a) identify challenges, benefits, and useful strategies related to remote learning and (b) examine differences in findings across two countries, between parents of youth with and without attention-deficit/hyperactivity disorder (ADHD), and between parents of children and adolescents. To address these aims, parent responses to open-ended questions on the Home Adjustment to COVID-19 Scale (HACS; Becker, Breaux, et al., 2020) were examined across three studies conducted in the United States and Australia (N = 606, children: 68.5% male, ages 6-17 years). The challenges most frequently expressed by parents included the child's difficulty staying on task (23.8% of parents), lack of motivation (18.3%), remote learning factors (17.8%), and lack of social interaction (14.4%). The most frequently expressed strategy related to using routines and schedules (58.2%) and the biggest benefit was more family time (20.3%). Findings were largely consistent across countries, ADHD status, and age, with a few notable group differences. Given that the most common challenges involved child- (e.g., difficulties with staying on task and motivation), parent- (e.g., balancing remote learning with work responsibilities), and school- (e.g., remote instruction difficulties) related factors, there is a need for improved support across these systems going forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Caregiver Involvement in MS: Duty or Disruption?

Multiple sclerosis (MS) is a complex condition with numerous physical, cognitive and emotional symptoms. These may necessitate significant, permanent lifestyle changes for people with multiple sclerosis (PwMS) and their caregivers and families, meaning it is important in contemporary neurological practice to consider including families and/or caregivers in the management of MS. However, existing evidence suggests that family involvement is not always beneficial; for example, it can exert either a strong positive or negative influence on the ability of PwMS to achieve optimal outcomes from their treatment and disease management. This paper, based on a live debate between neurologists and PwMS, examines the current perceptions on constructive involvement of families and caregivers in consultations for and management of MS, and reveals several areas where additional studies are warranted. Shared decision-making in MS has historically been a collaboration solely between healthcare professionals (HCPs) and PwMS, but PwMS are now more frequently being accompanied to appointments by a support person. This paper encourages HCPs to understand the dynamics between PwMS and their support person, and to individualize consultations and information accordingly. Family and caregiver involvement in the provision of care for PwMS needs to be for the benefit of, and at the discretion of, the PwMS. Support for families of PwMS, although important, may be more effectively and appropriately delivered through other channels outside of the clinical setting. Educating HCPs on the current patient experience to enable them to provide improved personalized care will ensure a mutualistic, patient-centred relationship with PwMS, which will help to optimize outcomes. Communication tools may also facilitate these interactions.

Home Adjustment, School Adjustment and Social Adjustment of Higher Secondary School Students: A Review

Adjustment is a process that is supposed to lead to a person's happy and contented life. It establishes a balance between requirements and capacity to meet them, persuades those concerned to adapt their lifestyles to the demands of the circumstances, and provides the strength and capability to bring about desired changes in environmental conditions. The study suggested that schools must emphasize teaching students how to adjust to themselves and their surroundings, rather than just excellent academic achievement. Schools must hold regular sessions with student's parents to keep them informed about their children's progress. Schools must keep a separate record of students' behaviour inside the school and identify emotionally immature students. This will help them to give counseling. All the schools must be upgraded with modern amenities such as a well-equipped laboratory, a well-stocked library, and well-organized classrooms. In the classroom, a technique of group discussion and other curricular activities might be organized. As a result, the student's adjustment will improve. This study presents a review of literature on the topic. This paper is an attempt to reviews the papers from 2010 to 2020.

Entry and Passage Variables Associated with Nursing Home Adjustment in Older Adults with Dementia

A theory-guided non-experimental, descriptive, correlational design was used to evaluate how entry and passage variables were related to nursing home adjustment for individuals with dementia. Older adults with dementia may be unable to speak for themselves, therefore proxy responses of Certified Nursing Assistants (CNAs) provided the data for completion of the Nursing Home Adjustment Scale.1 Guided by the Meleis’ Theory of Transitions, entry level factors (i.e. age, previous residence, gender, and choice), and passage variables (i.e. length of stay, extent of dementia, functional abilities, and depression) were entered into a regression equation as predictors of nursing home adjustment. Information about extent of dementia, functional abilities and depression was derived from the Minimum Data Set (MDS) maintained for all residents per Medicare and Medicaid guidelines. Descriptive and inferential statistics were calculated using IBM Statistical Package for the Social Sciences (SPSS) 26.0 software. Results indicated an inverse relationship between nursing home adjustment and depression as measured by the PHQ-9. There was no support for relationships among other variables. CNA proxy responses were found to be reliable in that they were significantly correlated with nursing responses on the same measure. This study supports the use of CNA proxy responses as a method to evaluate the experience of individuals with dementia.

Home Adjustment among High School Students in Relation to Their Gender and Residence Area

The present study aimed to know the home adjustment among high school students. It also aimed to check home adjustment with reference to gender and residence area. High School Adjustment Inventory (HSAI) constructed by A. K. Singh and A. Sen Gupta (2011) was used. The sample constituted total 120 high school students out of which 60 were from boys students (30 urban area and 30 rural area) and 60 from girl students (30 urban area and 30 rural area). The data was collected from Patan District. The data was scored, analyzed as per the manual. ‘F’ test was being calculated. The result showed that (1) There is significant difference in the mean score of home adjustment among the boys and girls high school students. The girls high school students group is having batter home adjustment than boys high school students group, (2) There is no significant difference in the mean score of home adjustment among the high school students of urban area and rural area and (3) There is no significant difference in the interactive effect of the mean scores of home adjustment with regards to the gender and residence area.

Outcome assesment of acute ischemic stroke by NIHSS score

In view of the long-term disabilities caused by stroke the need for an accurate early prediction of future functional abilities is paramount for setting therapeutic goals, starting early rehabilitation planning, implementing home adjustments and community support tailored to patients needs, and informing patients about their prospects and prognosis.in this study we have assessed significance of the national institute of health stroke scale (NIHSS) score on the day of admission in predicting the severity and outcome on 30 day ,in acute stroke patients. It is a observational prospective study, study conducted on 93 patients of stroke who were admitted in Shri B M Patil Medical College hospital who were diagnosed and admitted with acute stroke on the basis of the History, Clinical examination and proved on CT/MRI scan. Patients were selected on the basis of the inclusion and exclusion criteria. NIHSS score is noted on the day of admission and then after 30days of stroke and the patient is independent at home or requires assistance is also noted and statistically analyzed. This study was conducted between December 2017 to July 2019. In this study, after 1 month of stroke among 3 patients who had baseline NIHSS score 1-4, all 3(100%) are independent at home, among 73 patients who had baseline NIHSS score 5-15, 47(64.4%) are independent and 26(35.6%) required assistance, among 7 patients who had score 16-20, 1(14.3%) patient was independent at home, 6(85.7%) required assistance, and among 10 patients who had score more than 20, 7(70%) died, 3(30%) required assistance and none of them are home independent. With the p value &amp;#60;0.001 which is statistically significant.Baseline NIHSS score helps in predicting the outcome of the patient. Lesser the baseline score better will be the outcome.

Interventions to Improve the Transition From Home to a Nursing Home: A Scoping Review.

Background and ObjectivesThe transition from home to a nursing home is a stressful event for both older persons and informal caregivers. Currently, this transition process is often fragmented, which can create a vicious cycle of health care-related events. Knowledge of existing care interventions can prevent or break this cycle. This project aims to summarize existing interventions for improving transitional care, identifying their effectiveness and key components.Research Design and MethodsA scoping review was performed within the European TRANS-SENIOR consortium. The databases PubMed, EMBASE (Excerpta Medica Database), PsycINFO, Medline, and CINAHL (Cumulated Index to Nursing and Allied Health Literature) were searched. Studies were included if they described interventions designed to improve the transition from home to a nursing home.Results17 studies were identified, describing 13 interventions. The majority of these interventions focused on nursing home adjustment with 1 study including the entire transition pathway. The study identified 8 multicomponent and 5 single-component interventions. From the multicomponent interventions, 7 main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. The study outcomes were heterogeneous, making them difficult to compare. The study outcomes varied, with studies often reporting nonsignificant changes for the main outcome measures.Discussion and ImplicationsThere is a mismatch between the theory on optimal transitional care and current transitional care interventions, as they often lack a comprehensive approach. This research is the first step toward a uniform definition of optimal transitional care and a tool to improve/develop (future) transitional care initiatives on the pathway from home to a nursing home.