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Article ; Online: One accurate measurement is worth 1000 expert opinions-Assessing quality care in assisted living.

David, Daniel / Brody, Abraham A

Journal of the American Geriatrics Society

2023 Volume 71, Issue 5, Page(s) 1358–1361

MeSH term(s)	Humans ; Expert Testimony ; Quality of Health Care
Language	English
Publishing date	2023-02-21
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18284
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Article ; Online: An Evolutionary Concept Analysis of the "Fighter" in the Intensive Care Unit.

Moreines, Laura Tycon / Brody, Abraham A / Murali, Komal Patel

Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association

2024 Volume 26, Issue 3, Page(s) 158–165

Abstract: The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on ... ...

Abstract	The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on Rodger's evolutionary method were performed to identify surrogate terms, antecedents, attributes, and consequences pertaining to the "fighter" in the ICU. Thirteen articles with a focus on "the fighter" were included in this analysis. There is a strong desire to remain optimistic and maintain high spirits as a coping mechanism in the face of extreme prognostic uncertainty. Themes that emerged from the literature were the need to find inner strength and persist in the face of adversity. The concept of "the fighter in the ICU" can serve as either adaptive or maladaptive coping, depending on the larger clinical picture. Patient experiences in the ICU are fraught with physical and psychological distress. How the patient and family unit cope during this anxiety-provoking time is based on the individual. Maintaining optimism and identifying as a fighter can be healthy ways to adapt to the circumstances. This concept analysis highlights the importance of holistic care and instilling hope particularly as patients may be nearing the end of life.
MeSH term(s)	Humans ; Intensive Care Units/organization & administration ; Adaptation, Psychological ; Concept Formation
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2070862-2
ISSN	1539-0705 ; 1522-2179
ISSN (online)	1539-0705
ISSN	1522-2179
DOI	10.1097/NJH.0000000000001017
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Article ; Online: Race and Ethnicity Are Related to Undesirable Home Health Care Outcomes in Seriously Ill Older Adults.

Jones, Tessa / Luth, Elizabeth A / Cleland, Charles M / Brody, Abraham A

Journal of the American Medical Directors Association

2024 Volume 25, Issue 6, Page(s) 104983

Abstract: Objectives: Medicare Home Health Care (HHC) services are integral to the care of homebound seriously ill older adults requiring ongoing specialized medical care. Although disparities in health outcomes are well documented in inpatient and primary care, ... ...

Abstract	Objectives: Medicare Home Health Care (HHC) services are integral to the care of homebound seriously ill older adults requiring ongoing specialized medical care. Although disparities in health outcomes are well documented in inpatient and primary care, disparities experienced by historically marginalized racial and ethnic groups underrepresented in HHC are understudied. This study aimed to examine the relationship between individual characteristics and differences in HHC health outcomes for seriously ill older adults. Design: Secondary data analysis, repeated measure. Setting and participants: Seriously ill older adults who received HHC in 2016 in the HHC Outcome and Assessment Information Set (OASIS). Methods: Start of care and discharge data from the 2016 HCC OASIS were used to examine the relationship between individual characteristics and differences in HHC health outcomes identified by the Centers for Medicare and Medicaid Services as key indicators of quality in HHC, including dyspnea, pain frequency, cognitive functioning, and presence of unhealed pressure ulcer stage II or higher. A generalized ordered logit model with partial proportional odds was used for the ordinal categorical outcomes and a logistic regression was used for the binary dependent variable. Results: Findings indicated that of 227,402 seriously ill individuals with an HHC episode in 2016, those from underrepresented racial and ethnic groups had between 14% and 57% higher odds of worse health outcomes compared with non-Hispanic white patients with the exception of pain frequency. Conclusions and implications: For people living with serious illness, there are significant differences in Medicare HHC health outcomes when comparing underrepresented racial or ethnic beneficiaries with white counterparts. More research is needed to understand how health care processes such as referral patterns or time to care initiation, and structural factors such as HHC agency quality and neighborhood social deprivation are related to health differences observed in the population.
Language	English
Publishing date	2024-04-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2024.03.003
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Article ; Online: Nurses, Psychological Distress, and Burnout: Is There an App for That?

Murali, Komal Patel / Brody, Abraham A / Stimpfel, Amy Witkoski

Annals of the American Thoracic Society

2023 Volume 20, Issue 10, Page(s) 1404–1405

MeSH term(s)	Humans ; Mindfulness ; Mobile Applications ; Pilot Projects ; COVID-19 ; Burnout, Professional/psychology ; Burnout, Psychological ; Psychological Distress
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.202307-629ED
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Zs.A 5828: Show issues

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Article ; Online: Adaptation and Piloting for Hospice Social Workers of Aliviado Dementia Care, a Dementia Symptom Management Program.

Jones, Tessa M / Brody, Abraham A

The American journal of hospice & palliative care

2020 Volume 38, Issue 5, Page(s) 452–458

Abstract: Background: Forty-five percent of hospice patients currently have a primary or secondary diagnosis of Alzheimer's disease or related disorders. However, few programs have focused specifically on assisting hospices in providing evidence-based symptom ... ...

Abstract	Background: Forty-five percent of hospice patients currently have a primary or secondary diagnosis of Alzheimer's disease or related disorders. However, few programs have focused specifically on assisting hospices in providing evidence-based symptom management to persons living with dementia (PLWD). Objective: To adapt and pilot the training component of Aliviado Dementia Care, a dementia symptom management quality improvement program originally developed for home healthcare, for use by social workers as part of the hospice interdisciplinary team. Design: A prospective pre-post design was utilized, measuring knowledge, confidence, and attitudes at baseline, and immediately and 1-month post-training. Analysis was performed using paired t-tests and repeated measures ANOVA. Subjects: Hospice social workers currently practicing in the United States with at least 1 year of experience. Measurements: The Dementia Symptom Knowledge Assessment and a post-training continuing education evaluation form. Results: Forty-six subjects were enrolled, of whom 26 completed the first post-test and 23 both post-tests. There was a poor baseline level of knowledge and confidence in caring for PLWD. Significant improvements occurred following training, particularly in implementing non-pharmacologic interventions for behavioral and psychological symptoms of dementia (BPSD) (16.64% increase, p < .0001) and confidence in managing behavioral symptoms (16.86%, p = .01) and depression (25.18%, p < .0001). Changes were maintained over time. All respondents were either very satisfied or satisfied with the quality and content of the program. Conclusions: The training modules of Aliviado Dementia Care were successfully tailored for use by hospice social workers, showing significant improvement in knowledge and confidence in caring for behavioral symptoms in PLWD. Future work will examine whether the larger program, including this training, can subsequently improve patient outcomes in hospice.
MeSH term(s)	Dementia/therapy ; Hospice Care ; Hospices ; Humans ; Prospective Studies ; Social Workers ; United States
Language	English
Publishing date	2020-10-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909120962459
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Article ; Online: Defining Telepresence as Experienced in Telehealth Encounters: A Dimensional Analysis.

Groom, Lisa L / Brody, Abraham A / Squires, Allison P

Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing

2021 Volume 53, Issue 6, Page(s) 709–717

Abstract: Purpose: Telehealth's uptake has increased substantially in recent years, with an especially large jump in 2020 due to the emergence of COVID-19. This article provides background on and explores "telepresence" in healthcare literature. Telepresence ... ...

Abstract	Purpose: Telehealth's uptake has increased substantially in recent years, with an especially large jump in 2020 due to the emergence of COVID-19. This article provides background on and explores "telepresence" in healthcare literature. Telepresence strongly impacts the patient experience, but it is poorly defined in current research. The aim was to conceptually define telepresence using qualitative methods. Design: Dimensional analysis was used to analyze telepresence in clinical literature and create a clearer definition of telepresence as a concept. Multiple databases were searched for articles related to telepresence. Thirteen international articles related to telepresence were selected for analysis. Methods: Dimensional analysis allowed for multiple viewpoints to be explored within each distinct context and perspective. Findings: Twenty-five dimensions were discovered within the articles, which were synthesized to seven core dimensions of telepresence: connection, technological mediation, experienced realism, trust, being supportive, collaboration, and emotional consequence. Conclusions: Telepresence is highly impactful on the patient's experience of telehealth care visits. The conceptual map produced by this dimensional analysis provides direction for clinicians to improve their ability to be present with patients during telehealth care. Potential implications include a starting point for future qualitative research, and the use of this dimensional analysis to inform clinical guidelines, improve clinician training, and assist in the development of new care models. Clinical relevance: A telepresence definition brings clarity to an ill-defined concept. COVID-19 magnifies the need for a better understanding of telepresence, which allows clinicians to improve telehealth encounters.
MeSH term(s)	COVID-19 ; Delivery of Health Care ; Humans ; Qualitative Research ; SARS-CoV-2 ; Telemedicine
Language	English
Publishing date	2021-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2008214-9
ISSN	1547-5069 ; 1527-6546
ISSN (online)	1547-5069
ISSN	1527-6546
DOI	10.1111/jnu.12684
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Article ; Online: Complex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic Conditions.

Murali, Komal Patel / Merriman, John D / Yu, Gary / Vorderstrasse, Allison / Kelley, Amy S / Brody, Abraham A

Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association

2023 Volume 25, Issue 3, Page(s) 146–155

Abstract: Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary ... ...

Abstract	Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary data analysis of a multisite randomized clinical trial in palliative care was to elucidate the clinical profile and complex care needs of seriously ill adults with multiple chronic conditions and to highlight key differences among those with and without cancer at the end of life. Of the 213 (74.2%) older adults who met criteria for multiple chronic conditions (eg, 2 or more chronic conditions requiring regular care with limitations of daily living), 49% had a diagnosis of cancer. Hospice enrollment was operationalized as an indicator for severity of illness and allowed for the capture of complex care needs of those deemed to be nearing the end of life. Individuals with cancer had complex symptomatology with a higher prevalence of nausea, drowsiness, and poor appetite and end of life and lower hospice enrollment. Individuals with multiple chronic conditions without cancer had lower functional status, greater number of medications, and higher hospice enrollment. The care of seriously ill older adults with multiple chronic conditions requires tailored approaches to improve outcomes and quality of care across health care settings, particularly at the end of life.
MeSH term(s)	Humans ; Aged ; Multiple Chronic Conditions ; Palliative Care ; Hospice Care ; Death ; Neoplasms/complications ; Neoplasms/therapy
Language	English
Publishing date	2023-04-11
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2070862-2
ISSN	1539-0705 ; 1522-2179
ISSN (online)	1539-0705
ISSN	1522-2179
DOI	10.1097/NJH.0000000000000946
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Article ; Online: What's next for Hospital at Home Programs in the United States: A clarion call for permanent, person-centered solutions.

Brody, Abraham A / Dorfman, Eve / Caspers, Christopher G / Sadarangani, Tina R

Journal of the American Geriatrics Society

2022 Volume 71, Issue 1, Page(s) 11–14

MeSH term(s)	Humans ; Hospitals ; United States ; Patient-Centered Care ; Home Care Services ; Health Services for the Aged
Language	English
Publishing date	2022-11-02
Publishing country	United States
Document type	Editorial
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18089
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Article ; Online: "I Have a Lotta Sad Feelin'" - Unaddressed Mental Health Needs and Self-Support Strategies in Medicaid-Funded Assisted Living.

David, Daniel / Lassell, Rebecca K F / Mazor, Melissa / Brody, Abraham A / Schulman-Green, Dena

Journal of the American Medical Directors Association

2023 Volume 24, Issue 6, Page(s) 833–840

Abstract: Objective: To investigate mental health needs and barriers to seeking mental health support in Medicaid-funded Assisted Living Facility (M-ALF).: Design: A multimethod, qualitative-dominant descriptive design using questionnaires and semistructured ... ...

Abstract	Objective: To investigate mental health needs and barriers to seeking mental health support in Medicaid-funded Assisted Living Facility (M-ALF). Design: A multimethod, qualitative-dominant descriptive design using questionnaires and semistructured interviews. Setting and participants: The study occurred at a M-ALF in the Bronx, New York. A researcher in residence recruited 13 residents (11 Black or African American, 2 Asian) using purposive sampling. Methods: Demographic data and mental health indicators (depression, anxiety, stress, hopelessness) were measured with questionnaires (Center for Epidemiological Studies Depression Scale, Edmonton Symptom Assessment System, Perceived Stress Scale, Beck Hopelessness Survey) and analyzed with descriptive statistics. Interviews were conducted between June and November 2021, transcribed, and analyzed using conventional content analysis. Results: Thirteen residents (mean age: 73.4 years, mean length of stay: 3.5 years; range: 1.0-7.5) completed data collection. Quantitatively indicators of unmet mental health were common. Qualitatively, residents reported barriers to mental health access to address depression, anxiety, and substance use. This was accompanied by concerns surrounding loss of autonomy, mistrust for M-ALF organizational support, isolation and uncertainty about how to receive mental health support. Perspectives were shaped by past experiences with institutional living, serious illness, and being unhoused. Themes and subthemes were (1) mental health need (unmet mental health need, depression, and anxiety and seeking support through non-mental health resources) and (2) barriers to mental health support (dissatisfaction with M-ALF care, perceived threats to autonomy, desire for autonomy that leads to diminished care seeking). Conclusion and implications: Residents of M-ALF have mental health needs for which care is stymied by loss of autonomy, lack of resources, and the M-ALF environment. Residents use unconventional resources to address needs that may be neither efficient nor effective. Novel mental health interventions and processes are needed to improve mental health access and should prioritize residents' desire for autonomy and the unique circumstances of living in M-ALF.
MeSH term(s)	United States ; Humans ; Aged ; Medicaid ; Mental Health ; Patient Acceptance of Health Care ; Surveys and Questionnaires ; New York
Language	English
Publishing date	2023-05-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.04.002
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Book: Palliative care for uncommon disorders

Brody, Abraham A

2014

Institution	Hospice and Palliative Nurses Association,
Author's details	edited by Abraham A. Brody
MeSH term(s)	Palliative Care ; Hospice Care
Language	English
Document type	Book
ISBN	9781934654392 ; 1934654396
Database	Catalogue of the US National Library of Medicine (NLM)

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