Impact of an educational workshop upon psychiatrists’ attitudes towards delirium care

2017 ◽  
Vol 36 (2) ◽  
pp. 89-98
Author(s):  
N. A. O’Regan ◽  
M. M. Mohamad ◽  
D. J. Meagher
Keyword(s):  
Psychological Symptoms ◽  
Dsm 5 ◽  
Knowledge And Attitudes ◽  
Bedside Test ◽  
Behavioural And Psychological Symptoms ◽  
Hypoactive Delirium ◽  
Perceived Relevance ◽  
Key Aspects ◽  
The Impact ◽  
Educational Workshop

ObjectivesImproving knowledge about delirium care is a key target for health care. We describe the implementation of a four-part workshop focusing upon key aspects of delirium care.MethodsAttitudes towards and understanding of delirium diagnosis and management amongst psychiatrists were surveyed before and immediately after an educational workshop.ResultsThere were 62 participants. Pre-workshop, delirium was rated highly relevant to psychiatry. Overall level of confidence in diagnosis was modest, with the behavioural and psychological symptoms of dementia considered the most challenging differential diagnosis. Only nine participants (15%) correctly identified DSM-5 delirium criteria. Preferred assessment of attention varied with six different approaches endorsed. Confidence was higher for managing hyperactive compared with hypoactive delirium (p<0.001). Pharmacotherapy was more frequently endorsed for hyperactive compared with hypoactive presentations, with haloperidol the most popular agent (p<0.001). A total of 41 (66%) participants completed post-workshop assessments. Post-workshop, there were significant increases to the perceived relevance of delirium (p = 0.003), confidence in overall diagnosis (p<0.001) accuracy of awareness of DSM-5 criteria (p<0.001), and confidence in treating different presentations (p<0.001). The Months Backward Test was the preferred bedside test of attention (38/40 respondents).ConclusionsThis interactive educational intervention impacted positively upon knowledge and attitudes amongst psychiatrists towards key aspects of delirium care. Further investigation can examine the impact upon longer term knowledge and behaviour.

scholarly journals 412 - An Affect Education Model for Caregivers: Managing Behavioural and Psychological Symptoms of Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 128-128
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Rosalind Sham ◽  
Sandra Gardner
Keyword(s):  
Focus Groups ◽  
Psychological Symptoms ◽  
Care Delivery ◽  
Care Providers ◽  
Term Care ◽  
Self Reflection ◽  
Personal Support ◽  
Behavioural And Psychological Symptoms ◽  
Education Model ◽  
The Impact

Introduction:Providing care for people with behavioural and psychological symptoms of dementia is stressful as these individuals are commonly labelled as aggressive or resistant to care. Few studies have evaluated the impact of providing support to professional caregivers working in long-term care. Our mixed methods pilot study evaluated the impact of the innovative Affect Education Model among health care providers from two Toronto nursing homes.Methods:The two-person centred Affect Educational Model through the use of seven questions that encourage self-reflection teaches that problematic behaviours are co-constructed between individuals with BPSD and caregivers. Study procedures included recruiting nursing staff and personal support workers and teaching them the model in five weekly 30-minute group sessions. Qualitative measures in the form of focus groups were obtained. Quantitative measures were obtained through the use of five questionnaires.Results:Qualitative findings from focus groups identified four themes: facilitators and barriers perceived in current care delivery, the impact of the model experience on staff care delivery, reflections on being taught the model, and future model implementation. Quantitative results were also collected and discussed.Conclusions:The use of both pharmacologic and nonpharmacologic treatment of individuals with BPSD may be greatly enhanced by an interpersonal two-person Affect Education Model that emphasizes the importance of calming down and self-reflection. Future directions include expanding the model to family caregivers through the use of multimedia resources.

scholarly journals Administering Virtual Reality Therapy to Manage Behavioural and Psychological Symptoms in Patients with Dementia Admitted to an Acute-care Hospital: Results of a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Lora Appel ◽  
Erika Kisonas ◽  
Eva Appel ◽  
Jennifer Klein ◽  
Deanna Bartlett ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pilot Study ◽  
Acute Care ◽  
Psychological Symptoms ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Care Hospital ◽  
Behavioural And Psychological Symptoms ◽  
Prospective Longitudinal ◽  
The Impact

BACKGROUND As Virtual Reality (VR) technologies become increasingly accessible and affordable, clinicians are eager to try VR-therapy as a novel means to manage Behavioural and Psychological Symptoms of Dementia (BPSD) which are exacerbated during acute-care hospitalization, with the goal of reducing the use for antipsychotics, sedatives, and physical restraints, associated with negative side-effects, increased length of stay, and caregiver burden. To date no evaluations of immersive VR-therapy have been reported for patients with dementia in acute-care hospitals. OBJECTIVE Determine the feasibility (acceptance, comfort, safety) of using immersive VR-therapy for people living with dementia (mild, moderate, and advanced) during acute-care hospitalization, and explore its potential to manage BPSD. METHODS A prospective longitudinal pilot-study was conducted at a community teaching hospital in Toronto. Ten patients over 65 years (mean = 87) diagnosed with dementia, participated in one or more sessions of viewing immersive 360° VR-footage of nature scenes displayed on Samsung Gear-VR head-mounted-display. The mixed-methods study included patient chart review, standardized observations during intervention, and pre- and post-intervention semi-structured interviews about the VR experience. RESULTS All recruited participants completed the study. Seven out of ten participants displayed enjoyment or relaxation during a VR session, which averaged 6 minutes per viewing. One participant experienced dizziness; no interference between VR equipment and hearing aids or medical devices was reported. CONCLUSIONS It is feasible to expose older adults with various degrees of dementia admitted to an acute-care hospital, to immersive VR-therapy. This pilot provides the basis for conducting the first RCT to evaluate the impact of VR-therapy on managing BPSD in acute-care hospitals. CLINICALTRIAL Research Ethics Board ID: 748-1806-Mis-321 Clinical Trials.gov registration: NCT03941119

The impact of vascular burden on behavioural and psychological symptoms in older adults with dementia: the BEVASDE study

2019 ◽  
Vol 41 (1) ◽  
pp. 165-174 ◽  
Author(s):  
Raquel Manso-Calderón ◽  
Purificación Cacabelos-Pérez ◽  
María D. Sevillano-García ◽  
María E. Herrero-Prieto ◽  
Rogelio González-Sarmiento
Keyword(s):  
Older Adults ◽  
Psychological Symptoms ◽  
Behavioural And Psychological Symptoms ◽  
The Impact ◽  
Vascular Burden

scholarly journals Behavioural and Psychological Symptoms of Dementia: Correlates and Impact on Caregiver Distress

2017 ◽  
Vol 7 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Adreesh Mukherjee ◽  
Atanu Biswas ◽  
Arijit Roy ◽  
Samar Biswas ◽  
Goutam Gangopadhyay ◽  
...  
Keyword(s):  
Psychological Symptoms ◽  
Lewy Bodies ◽  
Cross Sectional Study ◽  
Caregiver Distress ◽  
Cross Sectional ◽  
Dementia Patients ◽  
Behavioural And Psychological Symptoms ◽  
Severity Of Dementia ◽  
Distress Scale ◽  
The Impact

Aims: To evaluate the behavioural and psychological symptoms of dementia (BPSD), to determine their correlation with types and stages of dementia and patient demographics, and to assess the impact on caregiver distress. Methods: This cross-sectional study recruited consecutive dementia patients and caregivers who attended our cognitive clinic. Standard criteria were used to classify types of dementia. BPSD were assessed with the Neuropsychiatric Inventory, and its distress scale was used for caregiver distress. Results: Of a total 107 patients, nearly all (99.1%) had at least one BPSD; 71% had ≥4 symptoms. Most frequent were apathy and agitation, followed by irritability, sleep and appetite disorders, and mood disorders; disinhibition and euphoria were least frequent. BPSD were less prominent with increasing age; males showed more agitation. Apathy and eating disorders were more prevalent in the rural community. BPSD were highest in frontotemporal dementia (FTD), followed by dementia with Lewy bodies (DLB), and least in vascular dementia. Hallucinations were more common in DLB, aberrant motor behaviour in FTD. All domains of BPSD, except for anxiety and euphoria, were more prominent with increasing severity of dementia. Increasing BPSD (except for euphoria) caused higher caregiver distress. Conclusion: BPSD are universally present, bear correlates with dementia type and severity, and cause significant caregiver distress.

scholarly journals Evaluating the Utility of a Structured Clinical Protocol for Reducing the Impact of Behavioural and Psychological Symptoms of Dementia in Progressive Neurological Diseases: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Nicholas P. Ryan ◽  
Laura Scott ◽  
Maryanne McPhee ◽  
Susan Mathers ◽  
Marie-Claire Davis ◽  
...  
Keyword(s):  
Job Stress ◽  
Psychological Symptoms ◽  
Neurological Diseases ◽  
Aged Care ◽  
Medium Effect ◽  
Residential Aged Care ◽  
Secondary Outcome ◽  
Clinical Protocol ◽  
Behavioural And Psychological Symptoms ◽  
The Impact

Objectives. Behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both aged care residents and staff. Despite the high prevalence of BPSD in progressive neurological diseases (PNDs) such as multiple sclerosis, Huntington’s disease, and Parkinson’s disease, the utility of a structured clinical protocol for reducing BPSD has not been systematically evaluated in PND populations. Method. Staff (n=51) and individuals with a diagnosis of PND (n=13) were recruited into the study, which aimed to evaluate the efficacy of a PND-specific structured clinical protocol for reducing the impact of BPSD in residential aged care (RAC) and specialist disability accommodation (SDA) facilities. Staff were trained in the clinical protocol through face-to-face workshops, which were followed by 9 weeks of intensive clinical supervision to a subset of staff (“behaviour champions”). Staff and resident outcome measures were administered preintervention and immediately following the intervention. The primary outcome was frequency and severity of BPSD, measured using the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). The secondary outcome was staff coping assessed using the Strain in Dementia Care Scale (SDCS). Results. In SDA, significant reductions in staff ratings of job-related stress were observed alongside a statistically significant decrease in BPSD from T1 to T2. In RAC, there was no significant time effect for BPSD or staff coping; however, a medium effect size was observed for staff job stress. Conclusions. Staff training and clinical support in the use of a structured clinical protocol for managing BPSD were linked to reductions in staff job stress, which may in turn increase staff capacity to identify indicators of resident distress and respond accordingly. Site variation in outcomes may relate to organisational and workforce-level barriers that may be unique to the RAC context and should be systematically addressed in future RCT studies of larger PND samples.

Particularities of the independent auditor's report on reliability of accounting (financial) statements for 2019: COVID-19 as qualitatively essential information (Part 2)

2020 ◽  
Vol 23 (7) ◽  
pp. 777-799
Author(s):  
O.I. Shvyreva ◽  
Z.I. Kruglyak ◽  
A.V. Petukh
Keyword(s):  
Financial Reporting ◽  
Financial Statements ◽  
Economic Situation ◽  
Risk Disclosure ◽  
Essential Information ◽  
Logical Method ◽  
Annual Reporting ◽  
The Face ◽  
Key Aspects ◽  
The Impact

Subject. This article discusses the issues related to the practice of financial reporting in the face of uncertainties caused by the coronavirus contagion, as well as the specifics of the audit strategy and formation of an audit opinion on this reporting. Objectives. The article aims to identify the quality characteristics of financial reporting prepared in the context of the COVID-19 pandemic and justify the key aspects of assurance engagement completion in an extremely uncertain epidemiological and economic situation. Methods. For the study, we used an abstract-logical method, content analysis techniques, systematization, and classification. Results. Analyzing the impact of the extremely uncertain epidemiological and economic situation on financial statements, the article clarifies aspects of disclosure of events after the reporting date and threats to business continuity in the annual reporting of economic entities. The article identifies possible alternative procedures and algorithms to obtain proper evidence when it is insufficient in the face of the inability to meet certain audit standards requirements in a remote audit environment. The article defines the impact of COVID-19 risk disclosure on the structure of the audit report and opinion. Relevance. The results of the study can be used in the practical activities of economic entities that prepare financial statements in the face of significant uncertainty, as well as auditors and audit organizations.

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