Abstract

Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. Agitated nursing home residents are more likely to be physically or chemically restrained, to fall and to have a lower quality of life. Current strategies to reduce agitated behavior tend to be costly.

This dissertation research examined a relatively inexpensive intervention to reduce the agitated behavior of cognitively impaired nursing home residents. The specific aim was to compare the effect of calming music or hand massage or a combination of calming music and hand massage on the level and type of agitated behavior over time. This four group, repeated measures design used the Progressively Lowered Stress Threshold model (Hall & Buckwalter, 1987) to test the effect of exposure to calming music and hand massage on agitation. This model proposes that in the context of agitation, the stress response can be altered and functionally adaptive behavior achieved by modifying environmental demands and controlling for factors that correlate with the perception of stress.

Power calculations indicated that a sample size of 68 would be adequate to detect significant results. Subjects were randomly assigned to one of four intervention groups: (1) calming music, (2)hand massage, (3) calming music and hand massage simultaneously, or (4) control. Level of agitation was assessed during each of four ten minute observation periods, immediately before the intervention, during the intervention, immediately after the intervention, and at 60 minutes.

Each of the experimental interventions produced a reduction in agitation that was greater than that achieved in the absence of any intervention. The benefit was sustained and increased over time. The level of increased benefit over tune was similar in each of the experimental intervention groups. When syndromes of agitated behaviors were examined separately, there were differential levels of reduction of physically aggressive, physically non-aggressive and verbally agitated behaviors. Results of this study provide information on an easily administered intervention that can improve the quality of life for nursing home residents and potentially decrease the cost of their care.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9920645; ProQuest document ID: 304514952. The author still retains copyright.

Author Details

Dr. Ruth M. Remington, PhD, RN

Sigma Membership

Rho Phi

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Nursing Home Residents, Calming Interventions, Cognitive Disorders

Advisors

Gilbert, Dorothy Ann

Advisor

Dorothy Ann Gilbert

Degree

PhD

Degree Grantor

University of Massachusetts, Amherst

Degree Year

1999

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2020-08-07

Full Text of Presentation

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