Fall Incidence Prevention in Elderly Nursing Home Residents – Nursing Homes Example

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"Fall Incidence Prevention in Elderly Nursing Home Residents" is an outstanding example of a paper on nursing homes.   What is the research problem and is it clearly stated in the paper? The study is investigating the effects of lavender olfactory stimulation intervention on fall incidence in elderly nursing home residents (Sakamoto et al. , 2012). - How important is the problem to nursing? To guide research towards acquiring data to validate or invalidate the research hypotheses and hence offer a solution to falling cases in the elderly nursing home residents (Sakamoto et al. , 2012). - What is the justification for this study?

The identification of falls as a major problem in the community-dwelling elderly adults and even so in frail elderly adults residing in institutions as well as analysis that half of nursing home residents fall annually two to three times that of community residents is the justification of this study (Sakamoto et al. , 2012). - Are there hypotheses, questions, or objectives stated? The hypotheses of this study are that lavender olfactory stimulation can help reduce cases of falls in nursing home residents. It is also It is hypothesized that lavender (Lavandula angustifolia), used in aromatherapy as a relaxant, has multiple ameliorating effects on fall-related risk factors in elderly adults (Sakamoto et al. , 2012). - What theoretical or conceptual framework was used for the study?

Was it clearly identified or only implied? The flow of events from the start of the study to the of the study shows the outcomes in the placebo group and the Lavender group using a flow chart is the conceptual framework while the description of the same process is the theoretical framework. - How is the framework linked to the research purpose?

The framework links to the research purpose in that it investigates the effects of lavender in relation to placebo and hence ascertaining the hypothesis of the study (Sakamoto et al. , 2012). - How current is the research literature reviewed (consider the publication date of the paper)? The oldest reference is 1982, the rest of the review comes from recent publications hence we can consider the research literature review current assuming that the data drawing was not skewed towards the older documents (Sakamoto et al. , 2012). - Is the literature review organized logically?

Yes, by outlining supportive data from publications as well as giving verified facts about Lavender. - Does the literature review adequately support the need for the study? It supports in that it outlines the hypothesized data, which cultivates the urge to carry out research to verify or invalidate the hypotheses. Methods -What is the study design? The study adopts a correlational design. -Does the design fit the purpose of the study? (Explain your answer. ) Yes as it aims at comparing lavender treatment and placebo, on falls of elder people -How is the design linked to the sampling method and statistical analysis?

The design fits the purpose of the study since it establishes a comparison of Lavender effects and placebo effects on elder people (Sakamoto et al. , 2012). -Describe the sample as stated in the article. Is it adequately and clearly described in the article? The sample as stated in the article is evenly distributed, fairly and randomly picked, and has observed both statistical obligations as well as ethical obligations. Apparently, the article has a clear description of the sample that includes one hundred and forty-five nursing home residents aged 65 and older (Sakamoto et al. , 2012). -Is the sampling procedure discussed in detail?

Evidently, the sampling procedure brings a clear picture and understanding of a proper random sample hence discussed in details -What do the authors provide as justification for the size of the sample? The authors focused on the number of falls per person-year based on data from similar nursing homes in Japan (Sakamoto et al. , 2012). -Describe the study protocol (treatment and/or procedures): is it clear and concise?

The study samples its population, observes ethics, commences testing, records the findings, discusses the results, and draws an informed conclusion (Sakamoto et al. , 2012). -What instruments are described in the article? The number of resident falls, functional ability (assessed using the Barthel Index), cognitive function (Mini-Mental State Examination (MMSE)), and behavioural and psychological problems associated with dementia (Cohen-Mansfield Agitation Inventory (CMAI)) (Sakamoto et al. , 2012). -Does each instrument measure the concept it is intended to measure? (Is the concept definition consistent with the Operational definition? ) They are consistent with the operational definition. -Does the author(s) present information on the reliability and validity of the instruments?

Yes, by describing all measures, and the scientific methods required in research. -How does the author address threats to internal and external validity that are inherent in the study design? The author address threats to internal and external validity that are inherent in the study design by sticking to scientific methods as well as avoiding assumptions. -What evidence is provided regarding human subjects review and approval discussed? Some of the subjects agreed to participate while others declined to give consent to the study, while others dropped from the study. -Are there indications of any ethical concerns?

Ethical concerns are taken care of where sampled subjects were to give informed consent to the study. -Is the study described with enough detail for replication? The authors describe the study with enough detail for replication, gives relevant information to ensure every result is substantial, and all methods are clear. Results -How are the characteristics of the sample described? The author describes the characteristics of the Sample by comparing lavender and placebo group in the study.

The sample included one hundred and forty-five nursing home residents aged 65 and older (Sakamoto et al. , 2012). -Are the research questions/hypotheses answered separately? The study answers the research questions separately where lavender proves to be a better solution for falls. -What types of data were collected? The major data collected was the number of falls on both lavender and placebo. -What data analysis procedures are used to answer the research questions? (Explain your answer. ) Analysis for main outcomes, including the time to first fall and the number of falls per person-year relied on an intention to treat analysis.

Kaplan– Meier analyses and log-rank statistics compared the proportion of fallers to non-fallers over time between groups (Sakamoto et al. , 2012). -Are tables, charts, and/or graphs used to present the data? There is the use of a chart in drawing the conceptual framework. -Does the text supplement or repeat the data in the tables? The text supplements data in the table. -Briefly summarize the findings and analyze the results. There were 62 falls reported during the follow-up period, two resulted in injury, a subdural hemorrhage in the lavender group and a femoral neck fracture in the placebo group (Sakamoto et al. , 2012).

The percentages of participants who fell at least once during the 12-month study period were 35.6% (lavender group) and 50% (placebo) (Sakamoto et al. , 2012). Discussion/Implications for practice -Does the author relate the findings to the study’ s purpose (or research objectives/hypotheses/questions)? Yes, the author relates findings to the study purpose by giving the findings, which directly validate the hypotheses. -How do the findings of the study compare with findings from previous studies? The finding of the study is similar to the findings drawn in the literature review. -Does the author discuss the findings that conflict with previous work?

From my understanding of the report, the author does not discuss the findings that conflict with previous work. -What limitations of the study are discussed in terms of practice and future research? The study considered the fact that some old people lack a sense of taste. It also took place within residents home and hence not proven to function in the normal society. The residents’ staff and staff partial blinding may have caused some bias and there is insufficient data that allows lavender to apply on falls resulting from injurious cases. -What new research emerged from this study?

Daily olfactory stimulation with lavender may prevent falls in elderly nursing home residents. Further studies with large sample sizes comprising multiple ethnic groups are necessary to confirm these findings. -What is the potential for use in nursing practice? There is potential use in nursing homes to treat BPSD Overall Presentation and a final summary -Does the title accurately describe the type of study, major variables, and target population? From my understanding, it does as it considers all of them in its phrasing. -Does the abstract accurately represent the study?

Yes, by giving an overview of the study. -Is the report logically consistent? It is, in measurement, in procedures, in the analysis as well as the results -Is the writing style clear and concise? Yes, and gives only the relevant information (Sakamoto et al. , 2012).

References

Sakamoto, Y., Ebihara, S., Ebihara, T., Tomita, N., Toba, K., Freeman, S., & ... Kohzuki, M.(2012). Fall Prevention Using Olfactory Stimulation with Lavender Odor in Elderly Nursing Home Residents: A Randomized Controlled Trial... [corrected][published erratum appears in J AM GERIATR SOC 2012 Nov; 60(11): 2193]. Journal of the American Geriatrics Society, 60(6), 1005-1011. doi:10.1111/j.1532-5415.2012.03977.x
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