Journal of gerontological nursing最新文献

Purpose: To describe a model of nurse-led age-friendly care in the acute care setting and associated processes and outcomes aligned with the 4Ms Framework.

Method: We implemented the Supporting Older Adults at Risk Model-a novel model of care that includes primary care geriatric nurse practitioner co-management and AGS CoCare^®:HELP-and used descriptive statistics to evaluate outcomes aligned with each of the 4Ms: What Matters, Medication, Mentation, and Mobility.

Results: Advance care planning conversations were documented for 81% of the selected sample, resulting in subsequent family meetings and goal-concordant care. Beers Criteria^® and anticholinergic medications were identified and reduced. Mobility goals were identified for 100% of the selected sample and mobility was maintained or improved for 46%. Addressing mentation was done in alignment with What Matters.

Conclusion: Nurses are well-positioned to lead age-friendly care and drive optimal outcomes in the acute care setting, especially considering the geriatrician work-force shortage.

Purpose: The current study examined RNs' practical experiences in managing behavioral and psychological symptoms of dementia (BPSD) and delirium superimposed on dementia (DSD) in long-term care hospitals.

Method: In-depth, one-on-one interviews were conducted with 18 RNs-including charge nurses, head nurses, and general staff-at two long-term care hospitals.

Results: Nurses reported significant challenges in distinguishing and managing BPSD and/or DSD due to limited symptom-specific knowledge, overlapping clinical presentations in older adults, and resource constraints. Despite these barriers, they actively applied practical strategies to interpret symptoms and initiate appropriate interventions.

Conclusion: Findings highlight the need for targeted education and structured clinical support to strengthen nurses' capacity to differentiate and manage BPSD and DSD. Enhancing institutional systems and interdisciplinary collaboration is essential to improving dementia care in long-term care hospitals.

Purpose: To examine factors influencing use of mobile health applications (apps) among older adults using the Technology Acceptance Model (TAM).

Method: Data from the University of Michigan National Poll on Healthy Aging (N = 1,013 adults aged ≥65 years) were analyzed. Descriptive statistics and chi-square tests identified demographic factors associated with mobile health app use. Informatics experts categorized reasons for use and non-use via TAM constructs, perceived usefulness (PU) and perceived ease of use (PEOU).

Results: Only 27.2% of participants used mobile health apps. App use correlated with demographics and home internet accessibility, although the effect sizes were small. PU motivators included tracking health and seeking information. Barriers to PU and PEOU included lack of interest, awareness, and discomfort with technology.

Conclusion: Addressing PU and PEOU is essential to improve app adoption among older adults. Nurses can enhance adoption by promoting digital literacy and supporting user-centered app design with simple navigation and larger fonts.

Purpose: To examine the association between serum 25-hydroxyvitamin D3 (25[OH]D3) levels and depressive symptoms among rural older adults in South Korea and explore implications for gerontological nursing.

Method: The current cross-sectional study used 2022 national survey data from 456 rural adults aged ≥65 years. Depressive symptoms, measured using the Patient Health Questionnaire-9 (PHQ-9), and vitamin D status (<20 ng/mL vs. ≥20 ng/mL) were analyzed using adjusted logistic and linear regression.

Results: Vitamin D deficiency was significantly associated with greater odds of depressive symptoms (odds ratio = 2.59, p < .001), and lower serum 25(OH)D3 levels were independently associated with higher PHQ-9 scores (β = -0.177, p < .001). Female sex was also a significant predictor.

Conclusion: Vitamin D deficiency may be a modifiable factor in depression screening. Including vitamin D assessment in gerontological nursing practice may support early identification and prevention in rural older adults.

Purpose: To investigate the effect of home-visit cognitive function training among National Long-Term Care Insurance (LTCI) beneficiaries with dementia in Korea.

Method: We performed propensity score matching and difference-in-differences analysis over data from the National Health Insurance Service. The experimental group (n = 215) received home-visit cognitive function training for dementia for ≥6 months. Participants in the control group received general home-visit care.

Results: Physical function score increased significantly according to the time effect; the interaction term between time (at 12 months) and home-visit cognitive function training was significant. The interaction term was not significant for cognitive function.

Conclusion: Home-visit cognitive function training had a partial effect among LTCI beneficiaries with dementia in Korea. Health care workers specializing in dementia should be educated as professionals who provide nonpharmacological intervention programs.

Purpose: To investigate the prevalence of and factors associated with subjective cognitive decline (SCD) in middle-aged adults.

Method: The current cross-sectional study used convenience sampling to recruit community-dwelling adults aged 50 to 64 years. Data collected included demographics, disease characteristics, frailty, depression, sleep quality, and social support. A logistic regression model identified significant risk factors related to SCD.

Results: In total, 200 middle-aged adults participated in the study, with a 15% prevalence of SCD. Multiple logistic regression models revealed that chronic diseases, smoking, and poor sleep quality were significantly associated with increased SCD. Specifically, participants with chronic diseases (odds ratio [OR] = 2.99, 95% confidence interval [CI] [1.27, 7.04]), those who smoked (OR = 3.51, 95% CI [1.23, 10.02]), and those reporting poor sleep quality (OR = 3.18, 95% CI [1.36, 7.49]) had significantly higher likelihoods of experiencing SCD compared to their counterparts.

Conclusion: This study identified significant associations among chronic disease status, smoking, and poor sleep quality and the presence of SCD among middle-aged adults. Although causal relationships cannot be established, findings highlight the need for greater attention to cognitive health in individuals with these risk profiles. Further longitudinal research is warranted to clarify temporal relationships and assess the potential value of targeted monitoring strategies in at-risk populations.

Purpose: To examine the relationship between cognition and pain among community-dwelling older adults using the Omaha System.

Method: A quantitative longitudinal retrospective correlational study was performed. Patterns of pain and cognition in adults aged ≥65 years from the Omaha System data were obtained. Four groups of individuals with pain, cognition, both, and neither were compared on admission and discharge, including changes between and within groups.

Results: Findings from 6,546 patients demonstrated the cognition group gained the most from nursing interventions. The cognition and both groups' knowledge, behavior, and status ratings differed on admission, but the difference was minimized on discharge.

Conclusion: Lower cognitive functioning may impede patient expression of pain and/or accurate assessment of pain by nurses. When assessing pain status in older adults, nurses should account for possible effects of cognition problems, and the use of objective assessment is preferred for this population.

Purpose: To evaluate the effectiveness of an information-motivation-behavioral skills (IMB) model-based sarcopenia prevention program.

Method: A quasi-experimental study was conducted with 50 older adults from senior centers in South Korea, divided into experimental (n = 25) and control (n = 25) groups. The 12-session intervention program spanned 6 weeks, comprising structured physical activity exercises, nutritional education focusing on protein and vitamin D intake, and motivational strategies aimed at sustaining behavior change. Data were analyzed, applying logistic regression, t tests, and Mann-Whitney U tests for group comparisons.

Results: The experimental group showed significant improvements in physical performance (odds ratio [OR] = 2.37, 95% confidence interval [1.42, 107.74], p = .002) and sarcopenia-related quality of life (t = 8.02, p < .001). However, no significant changes in muscle mass (OR = 3.12, p = 1.000) or muscle strength (OR = 2.00, p = .153) were observed.

Conclusion: The IMB model-based program improved physical performance and quality of life in older adults, making it a viable nursing intervention for sarcopenia prevention. Further studies should explore long-term adherence and intervention effectiveness over extended periods.

Purpose: To examine whether psychotropic medications (antipsychotics, sedatives, antiseizures, antidepressants, and anxiolytics) and opioids were associated with physical function in hospitalized older adults with dementia.

Method: A secondary analysis was conducted using baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle randomized controlled trial (N = 368). It was hypothesized that when controlling for age, sex, race, comorbidities, cognitive function, and pain, use of psychotropic medications and opioids would be negatively associated with physical function.

Results: Overall, 72.5% (n = 230) of participants used psychotropic medications and 18.8% (n = 69) used opioids. Neither was associated with physical function. However, comorbidities, cognition, and pain significantly influenced function, with fewer comorbidities, better cognition, and less pain linked to greater independence.

Conclusion: Findings support prior research showing lack of association between psychotropic medication and opioid use with physical function in hospitalized older adults with dementia; however, additional research may be necessary to investigate the importance of pain control in optimizing function in older adults with dementia.

Purpose: To explore family care partners' (FCPs) experiences with delirium superimposed on dementia (DSD) and identify their needs and preferences for education, support, and resources.

Method: A qualitative descriptive design was used. Data from 16 FCPs were collected using demographic surveys and semi-structured interviews, which were conducted via telephone and/or Zoom video conference. Thematic analysis identified key patterns and themes.

Results: Five key themes were identified: (1) Caught Off Guard: Emotional Strain and Sudden Shifts in DSD; (2) No Two Days the Same: Adapting to the Shifting Demands of DSD Care; (3) Bridging the Gaps: Navigating Support, Advocacy, and Communication in DSD Care; (4) Stabilizing Strategies: Reassuring Presence, Comfort, and Mobility in DSD Care; and (5) Wanting to Help, Not Knowing How.

Conclusion: Findings emphasize the need to educate and support FCPs through clinician-led training and community resources to improve caregiving confidence, effectiveness, and dyadic well-being.