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研究生:王瑞淇
研究生(外文):Jui-Chi Wang
論文名稱:失智住民沐浴環境因素與攻擊行為之探討
論文名稱(外文):The Environmental Factors Related Aggressive Behavioral Durning Bathing Among Dementia Residents
指導教授:李明德 博士
指導教授(外文):Ming-Der Lee, Ph.D.
口試委員:李慈音 副教授唐進勝 副教授謝碧晴
口試日期:2013-06-06
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:長期照護研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:109
中文關鍵詞:失智住民、沐浴環境、攻擊行為
外文關鍵詞:Dementia Residents , Bathing Environment, Aggressive Behavior
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失智症目前是全世界觀注之議題,隨著失智病程的進展,患者認知程度逐漸下降,當失智住民的認知功能屬中度,其日常生活活動的清潔(沐浴)大多需要照顧人員的協助;研究發現照顧人員協助失智住民沐浴的照護活動,住民最容易誘發攻擊行為,其盛行率約有40-73%,特別攻擊行為大都朝向照顧人員攻擊(78.8%),導致照顧服務人員身體受到傷害,如:皮膚抓傷、紅腫、瘀青、腹部挫傷等,心理傷害,如:哭泣、挫折、易怒、焦慮、無望感等,進而增加照顧服務人員的高離職率71.1%。當沐浴環境未能控制在合宜的溫度、濕度狀態或室內過度吵雜時,更加造成失智住民出現攻擊行為的發生,因此本研究針對沐浴物理環境的溫度、濕度、噪音與失智住民沐浴誘發攻擊行為之相關性加以探討。
本研究係以重複測量的研究設計,在北區一家失智症照護之長期照護機構,針對9位失智住民沐浴連續觀察2個月共77沐浴人次;研究者將住民沐浴發為三階段(沐浴準備期、沐浴工作期、沐浴結束期),以溫濕度計、噪音計實際監測住民沐浴物理環境,同時由研究機構護理人員協助觀察、並收集記錄住民於沐浴過程中發生攻擊行為事件的實際狀況。本研究之測量問卷尚包括有:失智住民基本屬性、認知程度(MMSE)、依賴程度(ADL)。
本研究結果顯示:(1)失智住民沐浴三階段(準備期、工作期及結束期)誘發攻擊行為發生率各為:22.08%,50.65%及28.57%,以沐浴工作期之發生率為最高。(2)在誘發失智住民沐浴攻擊行為之影響因素上,本研究發現包括住民年齡、認知程度(MMSE)、沐浴環境的噪音等因素;且由推論統計分析可知,失智住民在「沐浴準備期」中平均噪音每增加1dB(A)時,住民誘發攻擊行為的勝算會增加13%;而當、噪音最大值每增加1dB(A)時,住民誘發攻擊行為的勝算會增加12%;此外,在「沐浴工作期」中當環境中的平均噪音每增加1dB(A)時,住民攻擊行為之勝算高達65%,而噪音最大值每增加1dB(A),住民誘發攻擊行為勝算亦會增加37%;至於當「沐浴結束期」,環境中的平均噪音每增加1dB(A)時,會誘發住民攻擊行為之勝算會增加36%,另對於環境中的噪音最大值當增加1dB(A)時,失智住民誘發攻擊行為之勝算則增加37%。
本研究結果之發現除提供失智住民問題行為與環境因素間的重視外,另也建議未來在臨床失智住民照護實務上,或許可將沐浴物理環境特別加強照護工作人員之在職教育重要議題,同時在沐浴照護的流程上應有更為明確的標準作業流程,其中例如:置物車上需使用塑膠材質、置物車四周增製防護墊、吹風機宜採低噪音量及沐浴室溫之控制等注意事項,以能減少失智住民於沐浴過程中產生過多的環境干擾而誘發其問題行為發生產生攻擊狀況等。
Dementia is currently one of the major clinical issues that the world focuses on. With the progression of dementia, the degree of cognitive declines gradually over time. According to previous studies, when dementia patients with moderate cognitive functions most of the daily cleaning activities (e.g. bathing) professional personnel’s assistance. Studies also found that bath care activities of patients with dementia assisted by nurse’s are most likely to induce aggressive behavior,
(prevalence rate of around 40-73%) with most aggressive attack (78.8%) toward to the assistant personnel. This results body injury on the care services personnel, including but not limited to: skin scratches, redness, bruising, and abdominal contusion. In addition to body injury the psychological issues raised from the care services personnel including: crying, frustration, irritability, anxiety, and hopelessness; leading to an increased high turnover rate of care services personnel (~71.1%). It is assumed that when bathing environment can not be controlled at the appropriate temperature, humidity, state or indoor excessively noisy, it is more likely to induce more aggressive behavior from dementia residents. In this study, correlation between the parameters of physical bathing environment (temperature, humidity, noise) and the aggressive behaviors caused by dementia residents will be explored.
The objective of this study was to describe the study design, using a long-term care facilities for dementia residents located at the Northern Taiwan as a model system to investigate the correlation between the environmental parameters and bath-induced aggressive behavior event from the dementia residents. Baths of nine dementia patients were continuously monitored for 2 months (total of 77 bath events); and all baths were divided into three-phase including the bath preparation, the bathing work, and the bath at
iv
the end. All physical bathing environments were monitored using a hygrometer, and a noise meter. Any observed behavior of dementia residents was recorded by the agent nurses. The measurement questionnaire used in
this study included: the basic properties of patients with dementia, cognitive level (MMSE), and dependence (ADL).
The results from this study demonstrated: (1) the prevalences of bath-induced aggressive behavior of dementia residents were: 22.08% during bathing preparation, 50.65% during bath work, and 28.57% at he end of bath ; (2) the influencing factors that induce aggressive behavior from dementia residents during bath include: the resident’s age, cognitive level (MMSE), and the noise of the shower environment. It indicates that the increasing 1 dB (A) of the maximum noise and the average noise at the prevalence of bath, the chances of induced aggressive behavior from dementia patients is increased by 13% and 12%, respectively. The increasing 1 dB (A) of the maximum noise and the average noise during bath working period, the aggressive behavior of dementia patients also increased by 65% and 37%, respectively. On the other hand, the increasing 1 dB (A) of the maximum noise and the average noise at the end of bath, the chances of induced aggressive behavior from dementia patients increased by 37% and 36%, respectively.
In th perspective of clinical practice, this study suggested that , the agency should be in charge of all bathing environment related issues, providing better in-service education for all employees, developing more smooth bathing processes, applying plastic or additional protective pad around the compartment cars , and using low noise hair dryers after bathing processes to reduce the aggressive behaviors from dementia residenets.
目 錄
中文摘要 ................................................................................................................................ i
英文摘要 .............................................................................................................................. iiI
目錄 ....................................................................................................................................... V
表次 ..................................................................................................................................... viI
圖次 .................................................................................................................................... viiI
第一章 緒論 ............................................................ 1
第一節 研究背景與動機............................................... 1
第二節 研究目的..................................................... 4
第二章 文獻查證 ........................................................ 5
第一節 失智症行為精神症狀之概述..................................... 5
第二節 攻擊行為之概述.............................................. 15
第三節 物理環境與行為之相關性...................................... 21
第四節 沐浴物理環境和失智住民行為精神症狀之實證研究................ 32
第五節 研究架構.................................................... 37
第六節 研究假設.................................................... 38
第七節 名詞界定.................................................... 39
第三章 研究方法 ....................................................... 41
第一節 研究設計.................................................... 41
第二節 研究對象與樣本.............................................. 41
第三節 研究步驟.................................................... 42
第四節 研究工具及信效度檢定........................................ 45
第五節 資料處理與分析.............................................. 48
第六節 倫理考量.................................................... 50
第四章 研究結果 ....................................................... 51
第一節 失智住民沐浴期間誘發攻擊行為之描述性分析.................... 52
第二節 失智住民的人口學屬性........................................ 59
第三節 住民沐浴的時間及物理環境之描述性分析........................ 60
第四節 住民沐浴誘發攻擊行為各變項之間關係.......................... 63
第五節 住民沐浴誘發攻擊行為的影響因子.............................. 69
第五章 討論 ........................................................... 75
第一節 失智住民之人口屬性.......................................... 75
第二節 住民沐浴誘發攻擊行為之現況.................................. 79
第三節 失智住民基本屬性、沐浴間物理環境與住民沐浴誘發攻擊行為相關
因素分析 ................................................... 81
第四節 失智住民基本屬性、沐浴間物理環境與住民沐浴誘發攻擊行為之影響
因子 ....................................................... 86
第六章 結論、建議與限制 ............................................... 88
第一節 結論........................................................ 89
第二節 研究限制.................................................... 88
第三節 建議........................................................ 90
參考資料 .............................................................. 92
中文部分........................................................... 92
英文部分........................................................... 95
附錄 ................................................................. 104
附錄一 簡易智能狀態測驗(MMSE)..................................... 104
附錄二 日常生活功能量表........................................... 105
附錄三 人體試驗計畫執行許可書..................................... 106
附錄四 住民沐浴誘發攻擊行為事件登錄表............................. 107
附錄五 住民誘發攻擊行為事件及沐浴物理環境溫度/濕度/噪音登錄表..... 108
附錄六 環境測量平面圖............................................. 109
中文相關文獻
國際失智症協會(Alzheimer's Disease International;ADI)http://www.alz.co.uk/
世界衛生組織-歐洲辦事處www.euro.who.int
聯合國http://unstats.un.org/unsd/default.htm
台灣失智症協會(Taiwan Dementia Society;TDS)http://www.tada2002.org.tw/
美國阿茲海默症協會(Alzheimer's Association )http://www.alz.org/index.asp
美國健康照護協會America Health Care Association;AHCA,2002
台灣臨床失智症學會(Taiwan Dementia Society;TDS)http://www.tds.org.tw/html/front/bin/home.phtml
行政院環境保護署http://ivy1.epa.gov.tw
江哲銘、周伯丞(1999)。應在室內物理環境品質定量化之應用-以高齡者安養中心為例。建築學報,1-20。
余文俊、廖主民(2009)。如何減少運動場上發生攻擊行為?以Berkowitz的認知-新聯想分析模式探討。中華體育季刊, 23(4),107-115。
林俊德(1991)。噪音與健康。工業安全衛生,(24)52-55。
林麗嬋(1995)。老人癡呆患者的躁動行為。醫學繼續教育, 5(5)666-670。
林一真、林麗嬋 (2004)。行政院國家科學委員會專題研究計畫-機構用 Cohen-Mansfield 躁動量表中文版之檢定。計畫編號:NSC92-2314-B-010-045。
林婉婷、林麗嬋(2004)。失智症患者躁動行為評估之問題-北部某一機構為例。長期照護雜誌,8(4)451-466。
林金定、嚴嘉楓、陳美花(2005)。質性研究方法:訪談模式與實施步驟分析。身心障礙研究,3(2)132-133。
林麗嬋(2005)。國家衛生研究院整合醫藥衛生科技研究計畫-失智症老人躁動行為介入方案。計畫編號:NHRI-EX94-9326PI。
林忠順、張可臻、陳昭源(2008)。失智症合併精神行為症狀的診斷及照護。基層醫學 23(6)153-157。
林偉伶(2010)。阿茲海默氏症老人問題行為相關因素及意義探討。未發表碩士論文,台南:國立成功大學老年學研究所。
吳惠琪、張學善(2011)。醫療機構護理人員情緒智慧與職業倦怠關係之研究。澄清醫護管理雜誌,7(4),12-22。
高純潔(2004)。機構失智長者的問題行為。長期照護雜誌,8(2)251-261。
高潔純、林麗嬋(2005)。從安全概念探討失智者遊走行為的處置。長期照護雜誌,9(3)223- 232
余文俊、廖主民(2009)。如何減少運動場上發生攻擊行為?以Berkowitz 的認知-新聯想分析模式探討,中華體育季刊,23(4) 107-116。
紐文英(2001)。身心障礙者行為問題處理:正向行為支持取向。台北:心理。
許銘文(2009)。九十八年度健康室內環境診斷諮詢服務計畫。內政部建築研究所補助計畫成果報告。新北市:內政部建築研究所。
張文芸(1996)。 痴呆症老人問題行為的認識。護理雜誌 ,43(4) 85-91。
張文芸(1999)。行政院衛生署八十九年度委託研究計畫-護理之家失智老人問題行為照護方案之建立與應用於護理佐理員訓練之成效探討。計畫編號:DOH89-TD-1184。
黃麗玉、黃珊、蕭世槐、王美文(2004)。南部某醫學中心急診加護病房噪音改善方案。護理雜誌,51(1) 58-69。
黃正平(2006)。失智症之行為精神症狀。台灣精神醫學, 20(1)3-17。
黃士賓(2006)。住宅室內生活噪音源及居民反應之調查。建築學報,56,165-182。
傅中玲(2008)。台灣失智症現況。台灣老年醫學暨老年學雜誌,3(3) 169-181。
郭慧婷(2009)。失智症之妄想症狀。諮商與輔導,(287)20-23。
53(10),20-23。
劉淑芬、蔡淑芬、盧春火、賴俊雄、吳聰能(1999)。醫院噪音危害及厭煩度調查研究。公共衛生, 26(2)141-154。
楊長苓(2000)。執行研究工作坊系列一:訪談法(1)。婦女與兩性研究通訊,56, 6-7。
楊曼華、林麗嬋(2004)。失智患者的日落症候群。長期照護雜誌,8(4)467-473。
鄧光瑞、陳長安(1994)。癡呆症及其護理原則。榮總護理, 11(3) 228-235。
謝美芬、顏兆熊 (2008)。失智症患者之行為精神症狀的處置。基層醫學,23 (7)203-207。
謝昌成、劉昱志、& 劉鎮嘉 (2008)。失智症的行為及精神症狀處理。基層醫學,22(4)116-122。
羅美芳(2004) 行政院國家科學委員會專題研究計畫-老年失智患者躁動行為之研究。計畫編號:NSC92-2314-B-002-283。
英文相關文獻
Algase, D., Beck, C., Kolanowski, A., Whall, A., Berent, S., Richards, K., et al. (1996). Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer's Disease and Other Dementias, 11(6), 10-19.
Almvik, R., Rasmussen, K., & Woods, P. (2006). Challenging behaviour in the elderly-monitoring violent incidents. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 21(4), 368-374.
Anthony ,V., Arundel,Elia ,M., Sterling,t.,Judith H. Biggin,t and Theodor D. Sterling(1998)Indirect Health Effects of Relative Humidity
in Indoor Environments, Environmental Health ,65.351-361.
Annick Alpérovitch., et al,(2009) .Relationship Between Blood Pressure and Outdoor Temperature in a Large Sample of Elderly IndividualsThe Three-City , JAMA ,169(1),75-80.
Åström, S; Bucht, G ; Eisemann,M (2002).Incidence of violence towards staff caring for the elderly. Scandinavian Journal of Caring Sciences,16(1), 66–72.
Åström, S ; Karlsson, S &Sandvide ,Å (2004) Staff's experience of and the management of violent incidents in elderly care. Scandinavian Journal of Caring Sciences, 18(4), 410-416.
Bandura, A. (1973). Aggression: A social learning analysis. Englewood Cliffs, NJ: Prentice-Hall.
Ballard, C., Lowery, K., Powell, I., O'Brien, J., & James, I. (2000). Impact of behavioral and psychological symptoms of dementia on caregivers. International Psychogeriatrics, 12(S1), 93-105.
Beck, C., Frank, L., Chumbler, N., O'Sullivan, P., Vogelpohl, T., Rasin, J., et al. (1998). Correlates of disruptive behavior in severely cognitively impaired nursing home residents. The Gerontologist, 38(2), 189-198.
Beck, C., Richards, K., Lambert, C., Doan, R., Landes, R. D., Whall, A., et al. (2011). Factors Associated with Problematic Vocalizations in Nursing Home Residents With Dementia. The Gerontologis, 51(2), 1-16.
Berkowitz, Leonard(1990) On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45(4), , 494-503.
Bharathan, T., Glodan, D,. Ramesh, A .,B Vardhini, Baccash, E .,P Kiselev, Goldenberg,G.,(2009)What do patterns of noise in a teaching hospital and nursing home suggest?.Noise Health,9(35),31-34.
Brawley, E. (2002). Bathing environments: How to improve the bathing experience. Alzheimer's Care Today, 3(1), 38-41.
Buffum, M., Miaskowski, C., Sands, L., & Brod, M. (2001). A pilot study of the relationship between discomfort and agitation in patients with dementia. Geriatric Nursing, 22(2), 80-85.
Buhr, G. T., & White, H. K. (2006). Difficult behaviors in long-term care patients with dementia. [Article]. Journal of the American Medical Directors Association, 7(3), 180-192.
Burgio, L. D., Butler, F. R., Roth, D. L., Hardin, J. M., Hsu, C. C., & Ung, K. (2000). Agitation in nursing home residents: the role of gender and social context. International Psychogeriatrics, 12(04), 495-511.
Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly: II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34(10), 722-727.
Cohen-Mansfield, JMarx, MS,Rosenthal, AS.(1989) .A description of agitation in a nursing home. Journal of Gerontology,44(3),77-87.
Cohen-Mansfield, J. (1991). Instruction Manual for the Cohen-Mansfield Agitation Inventory (CMAI). Research Institute of the Hebrew Home of Greater Washington.
Cohen-Mansfield, J. (1995). Assessment of disruptive behavior/agitation in the elderly: Function, methods, and difficulties. Journal of geriatric psychiatry and neurology, 8(1), 52-60.
Cohen-Mansfield, J. (2007). Temporal patterns of agitation in dementia. American Journal of Geriatric Psych, 15(5), 395-405.
Cohen-Mansfield, J.,Billig, N.(1987). Agitated behaviors in the elderly: I. A conceptual review; II. Preliminary results in the cognitively deteriorated. Alzheimer Disease & Associated Disorders,1(2) ,108.
Cohen Mansfield, J., & Libin, A. (2004). Assessment of agitation in elderly patients with dementia: correlations between informant rating and direct observation. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 19(9), 881-891.
Cohen-Mansfield, J., & Libin, A. (2005). Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromes. Journal of psychiatric research, 39(3), 325-332.
Cohen-Mansfield, J., Marx, M. S., & Werner, P. (1992). Agitation in elderly persons: an integrative report of findings in a nursing home. International Psychogeriatrics, 4(04), 221-240.
Cohen-Mansfield, J., & Parpura-Gill, A. (2007). Bathing: A framework for intervention focusing on psychosocial, architectural and human factors considerations. [Article]. Archives of Gerontology and Geriatrics, 45(2), 121-135.
Cohen-Mansfield, J., & Werner, P. (1995). Environmental influences on agitation: An integrative summary of an observational study. American Journal of Alzheimer's Disease and Other Dementias, 10(1), 32-39.
Cohen-Mansfield, J., & Werner, P. (1997). Management of verbally disruptive behaviors in nursing home residents. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 52(6), M369-377.
Cohen-Mansfield, J., Werner, P., & Marx, M. S. (1989). An observational study of agitation in agitated nursing home residents. International Psychogeriatrics, 1(02), 153-165.
Cohen-Mansfield, J. (1991). Instruction Manual for the Cohen-Mansfield Agitation Inventory (CMAI). Research Institute of the Hebrew Home of Greater Washington.
Cohen-Mansfield, J., Werner, P., & Reisberg, B. (1995). Temporal order of cognitive and functional loss in a nursing home population. Journal of the American Geriatrics Societys, 43(9),974-978.
Colombo, M., Vitali, S., Cairati, M., Perelli-Cippo, R., Bessi, O., Gioia, P., et al. (2001). Wanderers: features, findings, issues. Archives of gerontology and geriatrics. Supplement, 7, 99-106.
Cornali, C.,Franzoni, S.,Riello, R.,Ghianda, D.,Frisoni, GB.,Trabucchi, M.,(2004) Effect of High Climate Temperature on the Behavioral and Psychological Symptoms of Dementia, Journal of the American Medical Directors Association. 5(3), 161-166.
Crum, R. M., Anthony, J. C., Bassett, S. S., & Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA: the journal of the American Medical Association, 269(18), 2386-2391.
Deguchi, A., Nakamura, S., Yoneyama, S., Hamaguchi, H., Kawamura, Y., Horio, S., et al. (1999). Improving symptoms of senile dementia by a night-time spa bathing. [Article]. Archives of Gerontology and Geriatrics, 29(3), 267-273.
Dettmore, D., Kolanowski, A., & Boustani, M. (2009). Aggression in persons with dementia: Use of nursing theory to guide clinical practice. Geriatric Nursing, 30(1), 8-17.
Dollard, J., Doob, L., Miller, N., Mowrer, O. H., & Sears, R. R. (1939). Frustration
and Aggression. New Haven, CT: Yale University Press.
Falk, S. A., & Woods, N. F. (1973). Hospital noise¡Xlevels and potential health hazards. New England Journal of Medicine, 289(15), 774-781.
Farrell Miller, M. (1997). Physical aggressive resident behavior during hygienic care. J Gerontol Nurs, 23(5), 24-39.
Folstein, M. (1985). The meaning of cognitive impairment in the elderly. Journal of the American Geriatrics Society, 33(4), 228-235.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 12(3),189-198.
Freyne, A., & Wrigley, M. (1996). Aggressive incidents towards staff by elderly patients with dementia in a long-stay ward. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 11(1), 57-63.
Heather A. Cooke(2006). Organization and physical envioronmental correlate of bathing-related agitation in dementia special care unite . SIMON FRASER UNIVERSITY.
Gates, D., Fitzwater, E., & Deets, C. (2003). Development of instruments to assess assaultive behavior in nursing homes. Journal of Gerontological Nursing, 29(8), 37-45.
Gates, D., Fitzwater, E., & Succop, P. (2003). Relationships of stressors, strain, and anger to caregiver assaults. Issues in Mental Health Nursing, 24(8), 775-793.
Gates, D., Fitzwater, E., & Succop, P. (2005). Reducing assaults against nursing home caregivers. Nursing Research, 54(2), 119-127.
Grant, L., Kane, R., Potthoff, S., & Ryden, M. (1996). Staff training and turnover in alzheimer special care units: Comparisons with non-special care units*:: More dementia-specific training resources should be made available to all staff to 59
improve training effectiveness and reduce turnover. Geriatric Nursing, 17(6), 278-282.
Gruber-Baldini, A. L., Boustani, M., Sloane, P. D., & Zimmerman, S. (2004). Behavioral symptoms in residential care/assisted living facilities: Prevalence, risk factors, and medication management. Journal of the American Geriatrics Society, 52(10), 1610-1617.
Hall, K. A., & O'Connor, D. W. (2004). Correlates of aggressive behavior in dementia. International Psychogeriatrics, 16(02), 141-158.
Heather A. Cooke(2006) Organization and physical envioronmental correlate of bathing-related agitation in dementia special care unite, MASTER OF ARTS.SIMON FRASER UNIVERSITY.
Herrmann, N., & Black, S. E. (2000). Behavioral disturbances in dementia. Neurology, 55(9), 1247-1248.
Hoeffer, B., Rader, J., McKenzie, D., Lavelle, M., & Stewart, B. (1997). Reducing aggressive behavior during bathing cognitively impaired nursing home residents. Journal of Gerontological Nursing, 23(5), 16-23.
Hoeffer, B., Talerico, K., Rasin, J., Mitchell, C., Stewart, B., McKenzie, D., et al.
(2006). Assisting cognitively impaired nursing home residents with bathing: Effects of two bathing interventions on caregiving. The Gerontologist, 46(4), 524-532.
Holtzer, R., Tang, M. X., Devanand, D., Albert, S. M., Wegesin, D. J., Marder, K., et al. (2003). Psychopathological features in Alzheimer's disease: course and relationship with cognitive status. Journal of the American Geriatrics Society, 51(7), 953-960.
Hopman Rock, M., Tak, E. C. P. M., & Staats, P. G. M. (2001). Development and validation of the Observation List for early signs of Dementia (OLD). INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 16(4), 406-414.
Horvath, S.M. Rochelle, R.D. (. 1977)Hypothermia in the aged. Environ Health Perspect.20,127–130.
Ikedaa, N. M. M., Shinagawaa, R. F. S., Toyotaa, T. I. T. M. Y., Matsumotoa, T., Adachia, H., & Tanabea, N. H. H. (2007). Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community. Dement Geriatr Cogn Disord,23, 219-224.
Ivey,M.A. Sineon,D.T. Monteil, M.A. (2003)Climatic variables are associated with seasonal acute asthma admissions to accident and emergency room facilities in Trinidad, West Indies. Clinical & Experimental Allergy,33(11).1526–1530. Jong Kwan Ryu., Jin Yong Jeon(2011). Influence of noise sensitivity on annoyance of indoor and outdoor noises in residential buildings. Journal of the Acoustical Society of America, 116(6). 336-340
Josep Garre-Olmo,ea tl( 2012) Environmental Determinants of Quality of Life in Nursing Home Residents with Severe Dementia Clinical Investigations. The American Geriatrics Society,60(7).1230-1236
Josefsson, K., Sonde, L., & Wahlin, T. B. R. (2007). Violence in municipal care of older people in Sweden as perceived by registered nurses. Journal of Clinical Nursing, 16(5), 900-910.
Kobayashi, N., & Yamamoto, M. (2004). Impact of the stage of dementia on the time required for bathing-related care: a pilot study in a Japanese nursing home. International Journal of Nursing Studies, 41(7), 767-774.
Kolanowski, A. M., & Garr, M. (1999). The relation of premorbid factors to aggressive physical behavior in dementia. Journal of Neuroscience Nursing, 31(5), 278-284.
Kolanowski, A. M., Litaker, M. S., & Baumann, M. A. (2002). Theory-based intervention for dementia behaviors: A within-person analysis over time. Applied Nursing Research, 15(2), 87-96.
Kovach, C., & Meyer-Arnold, E. (1996). Coping with conflicting agendas: The
100
bathing experience of cognitively impaired older adults. Research and Theory for Nursing Practice, 10(1), 23-36.
Kovach, C., & Meyer-Arnold, E. (1997). Preventing agitated behaviors during bath time. Geriatric nursing (New York, NY), 18(3), 112-114.
Kenneth J. Mukamal, Gregory A. Wellenius, Helen H. Suh&Murray A. Mittleman,MD.(2009).Weather and air pollution as triggers of severe headaches. Neurology ,72 (10) 922-927.
Karin .Josefsson., Lars Sonde., Tarja-Brita& Robins Wahlin(2007) Violence in municipal care of older people in Sweden as perceived by registered nurses. Journal of Clinical Nursing, 16(5),900–910.
Laura L.Joosse (2009) The environmental influences of sound and space related to agitation in people with demental , The university of with Wisconsin-Milwankee
Matteau, E., Landreville, P., Laplante, L., & Laplante, C. (2003). Disruptive vocalizations: A means to communicate in dementia? American Journal of Alzheimer's Disease and Other Dementias, 18(3), 147-153.
Miedema, H. M. E., & Vos, H. (1998). Exposure-response relationships for transportation noise. The Journal of the Acoustical Society of America, 104(6), 3432-3445.
Miller, R. (1994). Managing disruptive responses to bathing by elderly residents. Strategies for the cognitively impaired. Journal of Gerontological Nursing, 20(11), 35-43.
Namazi, K., & Johnson, B. (1996). Issues related to behavior and the physical environment: Bathing cognitively impaired patients*:: Little attention has been directed to understanding the source of the stress or developing strategies that might mitigate problem bathing behaviors among patients with dementia. Geriatric Nursing, 17(5), 234-238.
Passchier-Vermeer, W., & Passchier, W. F. (2000). Noise exposure and public health. Environmental Health Perspectives, 108(Suppl 1), 123-131.
Philip,et al.( 1995). Bathing Persons With Dementia. Gerontologist,35, 672 – 678.
RADER, J., & BARRICK, A. (2000). Ways that work: bathing without a battle. Alzheimer's Care Today, 1(4), 35-49.
Rader, J., Barrick, A. L., Hoeffer, B., Sloane, P. D., McKenzie, D., Talerico, K. A., et al. (2006). The bathing of older adults with dementia. [Article]. American Journal of Nursing, 106(4), 40-48.
Ragneskog H, G. L., Josefsson K, Kihlgren M. (1998). Probable reasons for expressed agitation in persons with dementia. Clin Nurs Res. , May;7(2):189-206.
101
Rasin, J., & Barrick, A. (2004). Bathing Patients with Dementia: Concentrating on the patient's needs rather than merely the task. AJN The American Journal of Nursing, 104(3), 30-32.
Rovner, B. W., German, P. S., Broadhead, J., Morriss, R. K., Brant, L. J., Blaustein, J., et al. (1990). The prevalence and management of dementia and other psychiatric disorders in nursing homes. International Psychogeriatrics, 2(01), 13-24.
Rovner, B. W., Kafonek, S., Filipp, L., Lucas, M., & Folstein, M. (1986). Prevalence of mental illness in a community nursing home. American Journal of psychiatry, 143(11), 1446-1449.
Ryden, M.B.(1988). Aggressive behavior in persons with dementia who live in the community.Alzheimer Disease & Associated Disorders ,2(4) ,342.
Ryden, M., Bossenmaier, M., & McLachlan, C. (1991). Agressive behavior in cognitively impaired nursing home residents. Research in Nursing & Health, 14(2), 87-95.
Salib and Sarp(1999)Does the weather influence Does the weather influence dementia admissions? International Journal of Geriatric Psychiatry,14(11).925-935
Schreiner, A. (2001). Aggressive behaviors among demented nursing home residents in Japan. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 16(2), 209-215.
Schreiner, A.S.Yamamoto, E.Shiotani, H.(2000) .Agitated behavior in elderly nursing home residents with dementia in Japan. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,55(3),180-186.
Shah, S.Vanclay, F.Cooper, B.(1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of clinical epidemiology.42(8) 703-709.
Slone, D., & Gleason, C. (1999). Behavior management planning for problem behaviors in Dementia: A practical model. Professional Psychology: Research and Practice, 30(1), 27-36.
Sloane, P. D., Rader, J., Barrick, A.-L., Hoeffer, B., Dwyer, S., McKenzie, D., et al. (1995). Bathing Persons With Dementia. Gerontologist, 35, 672 – 678.
Sloane, P. D., Hoeffer, B., Mitchell, C. M., McKenzie, D. A., Barrick, A. L., Rader, J., et al. (2004). Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: A randomized, controlled trial. Journal of the American Geriatrics Society, 52(11), 1795-1804.
Smoboontanont Wilaipu,(2000) Antecedents of assaultive behavior in Alzheimers, a dissertation summitted to the faculty of the university of north carolina.
102
Somboontanont, W., Sloane, P., Floyd, F., Holditch-Davis, D., Hogue, C., & MadelineMitchell, C. (2004). Assaultive behavior in Alzheimer disease: identifying immediate antecedents during bathing. Journal of Gerontological Nursing, 30(9), 22-29.
Sutor, B., Rummans, T., & Smith, G. (2001). Assessment and management of behavioral disturbances in nursing home patients with dementia.
Swaab, D. F., Fliers, E., & Partiman, T. (1985). The suprachiasmatic nucleus of the human brain in relation to sex, age and senile dementia. Brain Research, 342(1), 37-44.
Talerico, K.A. Evans, L.K. Strumpf, NE(2002) Mental health correlates of aggression in nursing home residents with dementia. The Gerontologist.4(2),169.
Tochihara, Y., & Kmura, Y. (1998). THERMAL RESPONSES TO AIR TEMPERATURE BEFORE, DURING AND AF'TER BATHING.
Vance, D., Burgio, L., Roth, D., Stevens, A., Fairchild, J., & Yurick, A. (2003).Predictors of agitation in nursing home residents. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58(2), P129-137.
Voyer, P., Verreault, R., Azizah, G., Desrosiers, J., Champoux, N., & Bedard, A. (2005). Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities. BMC geriatrics, 5(1).5- 13.
Wen-Harn Pan.,Lung-An Li.,Ming-JanTsai(1995)Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly Chinese.THE LANCE,345(11).353-355
WESTERBERG, K., & STRANDBERG, S. (2007). Showering is More than Resistance: Cognitive Interview Sequences in Residential Homes for Elderly Clients with Dementia. Qualitative Research in Psychology, 4(1), 15-28.
Whall, A., Colling, K., Son, G., Kim, H., & Beck, C. (2005). Geographic and Seasonal Variations in Shower Bath Heat and Humidity: Relationship to Aggressive Behavior Among Nursing Home Residents With Dementia.
Whall, A. L., Colling, K. B., Kolanowski, A., Kim, H., Son Hong, G.-R., DeCicco, B., et al. (2008). Factors associated with aggressive behavior among nursing home residents with dementia. [; Research Support, N.I.H., Extramural]. Gerontologist, 48(6), 721-731.
W-H. Pan,L-A. Li, M-J. Tsai.(1995).Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly,THE LANCET,345(8946), 353–355.
Zeller, A., Hahn, S., Needham, I., Kok, G., Dassen, T., & Halfens, R. J. G. (2009).
103
Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review. Geriatric Nursing, 30(3), 174-187.
Zahari Taha and Ruhaizin Sulaiman (2010). Perceived Kitchen Environment among Malaysian Elderly. American J. of Engineering and Applied Sciences ,3 (2).270-276

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