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The perceived behavior and barriers of community care professionals in encouraging functional activities of older adults

Background: Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version. Methods: Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach’s alpha coefficients. Results: The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach’s alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients’ context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83). Conclusions: The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.

Development and usability of the MAINtAIN, an inventory assessing nursing staff behavior to optimize and maintain functional activity among nursing home residents

Background: Functional decline is common in nursing home residents. Nursing staff can help prevent this decline, by encouraging residents to be more active in functional activities. Questionnaires measuring the extent to which nursing staff encourage functional activity among residents are lacking. In addition, there are no measurement instruments to gain insight into nursing staff perceived barriers and facilitators to this behavior. The aim of this study was to develop, and study the usability, of the MAastrIcht Nurses Activities INventory (MAINtAIN), an inventory assessing a) the extent to which nursing staff perceive to perform behaviors that optimize and maintain functional activity among nursing home residents and b) the perceived barriers and facilitators related to this behavior. Methods: Using a mixed-methods approach the MAINtAIN was developed and its usability was studied. Development was based on literature, expert opinions, focus group (N = 3) and individual interviews (N = 14) with residents and staff from nine nursing homes in the Netherlands. Usability was studied in a cross-sectional study with 37 nurses and certified nurse assistants; data were analyzed using descriptive statistics. Results: Development of the MAINtAIN resulted in two distinctive parts: MAINtAIN-behaviors and MAINtAIN-barriers. MAINtAIN-behaviors, targeting nursing staff behavior to optimize and maintain functional activity, includes 19 items covering activities of daily living, household activities, and miscellaneous activities. MAINtAIN-barriers addresses the perceived barriers and facilitators related to this behavior and comprises 33 items covering barriers and facilitators related to the residents, the professionals, the social context, and the organizational and economic context. The usability study showed that the inventory was not difficult to complete, that items and response options were clear,and that the number of missing values was low. Few items showed a floor or ceiling effect. Conclusions: The newly developed inventory MAINtAIN provides a usable method for researchers and nursing homes to obtain insight into nursing staff perceived behavior in optimizing functional activity among residents and their perceived barriers and facilitators related to this behavior. Outcomes of the MAINtAIN may contribute to change in nursing staff behavior and may improve nursing care. Further research with regard to the psychometric properties of the MAINtAIN is recommended.

Determining aspects of text difficulty for the Sign Language of the Netherlands (NGT) Functional Assessment instrument

In this paper we describe our work in progress on the development of a set of criteria to predict text difficulty in Sign Language of the Netherlands (NGT). These texts are used in a four year bachelor program, which is being brought in line with the Common European Framework of Reference for Languages (Council of Europe, 2001). Production and interaction proficiency are assessed through the NGT Functional Assessment instrument, adapted from the Sign Language Proficiency Interview (Caccamise & Samar, 2009). With this test we were able to determine that after one year of NGT-study students produce NGT at CEFR-level A2, after two years they sign at level B1, and after four years they are proficient in NGT on CEFR-level B2. As a result of that we were able to identify NGT texts that were matched to the level of students at certain stages in their studies with a CEFR-level. These texts were then analysed for sign familiarity, morpheme-sign rate, use of space and use of non-manual signals. All of these elements appear to be relevant for the determination of a good alignment between the difficulty of NGT signed texts and the targeted CEFR level, although only the morpheme-sign rate appears to be a decisive indicator

When and how do peers stimulate engaging in desirable difficulties

Supplemental instruction, also known as Peer Assisted Study Sessions (SI-PASS), is a well-established form of peer learning that has been implemented in higher education institutions across the globe and that coincides with learning gains for participants. While the effects on learning gains have been extensively studied with quasi-experiments, the underlying mechanisms that make SI-PASS effective are less well understood. This study explored what benefits students thought SI-PASS offered and through which mechanisms. We studied this by interviewing 14 students who participated in SI-PASS during a field experiment that reliably found a significant impact of SI-PASS on performance. The students were asked to expand on if and why they thought SI-PASS was effective. Thematic analysis and independent coding indicated an interplay of three main drivers. SI-PASS was experienced as effective because it stimulated the use of effective study techniques and social learning. These drivers were facilitated and enhanced by a pedagogical climate that lowered the threshold to engage in collaborative learning and effective study techniques. These findings could help pinpoint what elements should be highlighted during the preparation of SI-leaders and what aspects should be monitored and tested when implementing or studying SI-PASS.

Promoting functional activity among nursing home residents

Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.

Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties