Journal of gerontological nursing最新文献

Purpose: To determine the mediating effects of the quality of family caregivers' relationships with their older adult care recipients on the association between care-giver burden and caregivers' mental health and perceived general health.

Method: Participants included 2,431 family/informal caregivers from the 2022 National Study of Caregiving. Mediator path analysis models adjusting for caregivers' age, sex, and race/ethnicity were used to test the direct and indirect effects of caregiver burden on mental health and perceived general health via the caregiving relationship.

Results: Quality of the caregiving relationship partially mediated the association between caregiver burden and mental health, and also partially mediated the association between caregiver burden and perceived general health.

Conclusion: Caregiver burden and quality of the caregiving relationship are influential factors in caregiver health. Strategies addressing caregiver burden and the caregiving relationship simultaneously could yield potential benefits. [Journal of Gerontological Nursing, 51(5), 27-34.].

Purpose: To assess geriatric care competencies of nurses in home health care (HHC) settings in Saudi Arabia and explore the factors influencing these competencies.

Method: A cross-sectional design was used. Data were collected using the Gerontological Nursing Competence Scale among 393 RNs working in HHC units in the Riyadh and Qassim regions.

Results: Nurses demonstrated high competence in ensuring safe living environments and addressing nutritional needs. However, weaker competencies were noted in supporting older adults' sexuality and managing ethical challenges. Specialized training and shorter work hours were significantly associated with higher self-perceived competency levels. This finding may suggest that reduced working hours allows nurses to engage in continuing education, skill development, and quality-focused care, rather than indicating lack of clinical experience.

Conclusion: Findings highlight strengths and gaps in geriatric care competencies among HHC nurses, emphasizing the need for targeted training to address weaknesses in sensitive areas, including sexual health, ethical dilemmas, and communication challenges in end-of-life care. [Journal of Gerontological Nursing, 51(5), 35-45.].

As the Administration for Community Living (ACL) reaches its 13th year as an organization within the U.S. Department of Health and Human Services, current plans for restructuring will result in its closing. The current article reflects on the policies and programs led by the ACL for more than a decade, promoting the health and independence of older adults and people living with disabilities, including their families and caregivers. A brief overview of exemplars focused on family caregivers, fall prevention, and home- and community-based services highlight the potential impact of the closing of the ACL on vulnerable communities. As a result, a list of growing organizations and advocates, including health care and scientific professional groups, have voiced their concerns for the future without the ACL and limited details regarding the continuation of services and resources. The historic nature of these changes calls for gerontological nurse leaders, clinicians, and researchers to stay informed and engaged in support of the population and communities we serve. [Journal of Gerontological Nursing, 51(5), 7-11.].

Purpose: The current study examined the mediating effect of the meaning of work in the relationship between quality of life and experiences with ageism and social exclusion among working older adults.

Method: A cross-sectional correlational design was used. Data were collected using self-administered questionnaires between October 1 and November 30, 2019, and were analyzed using Pearson correlation coefficients and multiple linear regression.

Results: Quality of life correlated positively with the meaning of work and inversely with experiencing ageism and social exclusion. Meaning of work partially affected ageism's and social exclusion's respective relationships with quality of life.

Conclusion: Nursing interventions (to improve older adults' quality of life) could include strategies to reduce working older adults' ageism experiences and social exclusion and enhance the meaning of their work. Findings contribute to providing data for developing industrial nursing policies and guidelines to maximize the quality of life of working older adults. [Journal of Gerontological Nursing, 51(5), 46-54.].

Purpose: To evaluate the effectiveness of self-hydration management interventions for middle-aged and older adults without cognitive impairment.

Method: A systematic review and meta-analysis was conducted. Studies published from January 2010 to May 2024 were included. A total of 1,065 articles were reviewed, leading to the selection of 20 eligible articles; of these, five were considered suitable for inclusion.

Results: The analysis showed a significant increase in total daily fluid intake and urine volume in intervention groups compared to control groups. This improvement demonstrates the effectiveness of various self-hydration management interventions.

Conclusion: Nurse-led self-hydration management interventions are effective and provide valuable guidance for middle-aged and older adults. [Journal of Gerontological Nursing, 51(5), 17-25.].

Purpose: The purpose of this 8-week interdisciplinary educational program was to provide evidence-based fall prevention information to adults aged ≥65 years residing in an assisted living community.

Method: Eight 1-hour sessions on fall education were performed by interdisciplinary experts at an assisted living community. Control and intervention groups completed four assessments at baseline and completion of the program.

Results: Both groups had decreased Timed Up and Go (TUG) and Fear of Falling scores. The intervention group had increased scores on the knowledge of falling questionnaire, whereas the control group had decreased scores, indicating the education was effective in increasing knowledge of falls. Although not statistically significant, these results are clinically significant and reveal the positive effects of the interdisciplinary program.

Conclusion: Fall prevention education was successful in increasing older adults' knowledge about fall risk factors. There were decreases in TUG and Fear of Falling scores, revealing a positive impact of the program. [Journal of Gerontological Nursing, 51(5), 13-16.].

Purpose: Older adults have a strong desire to self-manage their overall well-being, including their mental health. However, there is a risk that low mood could be associated with aging, normalized and accepted, and impacts help-seeking behavior by older adults. Thus, the current study explored how older adults in New Zealand manage low mood.

Method: This qualitative descriptive study was embedded in a study exploring community-dwelling older adults' well-being. Semi-structured interviews were conducted with 37 older adults aged between 66 and 99 years (mean age = 83 years). Reflexive thematic analysis was used to analyze the data.

Results: Four themes emerged: (1) Noticing, Normalizing, and Thinking Differently; (2) Engaging in Meaningful Activities; (3) Connecting With Others; and (4) Seeking Help. Importantly, older adults developed positive ways of managing low mood.

Conclusion: Successful strategies older adults implemented can be shared, challenging stereotypes that low mood is specifically part of the aging process. For nurses, greater awareness of the strategies older adults use to combat low mood is vital to ensure they can maintain overall well-being. [Journal of Gerontological Nursing, 51(4), 29-35.].

Purpose: To explore how social media affects older adults' subjective well-being (SWB) through underlying mechanisms.

Method: Path analysis was performed with 106 Chinese older adults to examine the effects of social media's interactive communication, information acquisition, and leisure and entertainment on SWB via social support, self-efficacy, and depressive symptoms.

Results: The model fit well (χ²/df = 5.28, goodness of fit index = 0.86). Social support mediated the positive relationship between interactive communication and SWB, and self-efficacy mediated the positive relationship between information acquisition and SWB. Leisure and entertainment activities on social media showed no significant association with SWB.

Conclusion: Social media addresses social support deficits from physical limitations and enhances self-efficacy through information retrieval, thus improving SWB. Findings elucidate how social media influences SWB in older adults, offering theoretical guidance for interventions to enhance their well-being. [Journal of Gerontological Nursing, 51(4), 47-56.].

Purpose: As the global population ages, long-term/post-acute care (LTPAC) systems face challenges in ensuring quality care for older adults with complex medical needs. Using health information technology (IT) is a promising strategy to address these challenges. However, evidence gaps remain regarding barriers and facilitators to technology integration in LTPAC. Thus, the current study explored barriers and facilitators to technology adoption in emerging models of care for older adults through the International Summit on Innovation and Technology for the Care of Older People (IS-ITCOP).

Method: The IS-ITCOP Summit, held in June 2024, brought together 47 interdisciplinary experts from eight countries. Qualitative data were collected via facilitated discussion groups and analyzed using two approaches: human-coded thematic analysis and ChatGPT 4.0-driven analysis.

Results: Shared themes included technology barriers, ethical considerations, workforce challenges, and patient-centered care. Human analysis emphasized abstract themes, whereas ChatGPT provided granular insights on emerging technologies.

Conclusion: Combining human and artificial intelligence-driven analyses enriched understanding, highlighting opportunities and challenges for integrating IT into LTPAC systems. [Journal of Gerontological Nursing, 51(4), 6-11.].

Purpose: To summarize current evidence on the effectiveness of digital health interventions in improving the mental health of people with dementia (PWD) and their caregivers.

Method: Four databases were searched for peer-reviewed articles from January 2013 to September 2023. Two reviewers screened titles and abstracts, and a third settled disagreements. At least two reviewers completed full-text reviews and reached consensus through discussion. Three reviewers abstracted the data. At least two reviewers conducted quality appraisals, with discrepancies resolved by a third reviewer.

Results: Nineteen articles met inclusion criteria. Evidence suggests digital health interventions improve caregivers' burden, depression, stress, quality of life, anxiety, coping, and well-being. No significant changes were found in caregivers' mood or mental health outcomes for PWD.

Conclusion: Digital mental health interventions supporting PWD and caregivers are evolving. Further research should use more diverse and larger samples. Enhancing nurse participation in digital mental health design, implementation, and evaluation is crucial. [Journal of Gerontological Nursing, 51(4), 19-28.].