Journal of gerontological nursing最新文献

Purpose: The current study developed and tested selected effects of the Together for Life (TFL) program for community-dwelling older adults using an embedded mixed methods design.

Method: Nine community volunteers participated in the training program, and 14 people aged ≥65 years, living alone, enrolled in the study. Home visits were conducted by home health nurses every 2 weeks, supplemented by weekly home visits and phone counseling provided by volunteers, for a duration of 20 weeks. This mixed methods study used quantitative and qualitative approaches. Quantitative data were gathered through a questionnaire survey to assess the intervention's effects on health-related quality of life (HRQOL), loneliness, and depression. The qualitative component focused on participants' evaluation of the program.

Results: Significant changes were noted in HRQOL scores with an effect size of 0.6 (p = 0.01). Results indicated the positive impact of the TFL program on HRQOL among older adults as their health status was continuously monitored by volunteers who provided care and home health nurses who assisted with health management during the coronavirus disease 2019 (COVID-19) pandemic.

Conclusion: In a pandemic, personalized health management, such as regular health check-ins provided by home health nurses and home or phone visits provided by volunteers, is crucial for isolated older adults. This pilot program enhanced participants' HRQOL through continuous health monitoring, volunteer care, and nurse support, even during the COVID-19 pandemic. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Purpose: To explore the experiences of low-income community-dwelling older adults with mild cognitive impairment (MCI) in using multi-technology.

Method: We conducted individual interviews with 14 low-income community-dwelling older adults with MCI aged ≥60 years who participated in a technology-based fall risk assessment study. Interviews were recorded, transcribed, and coded. Two researchers worked together using thematic analysis.

Results: Five themes were generated: Satisfaction With Technology, Benefits of Using Technology, Challenges of Using Technology, Facilitators of Using Technology, and Recommendations for Other Older Adults. All participants acknowledged obtaining information about fall risk, physical activities, and balance performance.

Conclusion: Older adults with MCI were able to follow instructions by completing fall risk assessments. They found technology enjoyable and beneficial considering the tracking capacity and feedback obtained from the technology used. These were vital objective data that encouraged fall prevention efforts. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Purpose: The current study aimed to examine the short-term outcomes and multidimensional factors associated with preoperative sedentary behavior among Chinese older adults with gastric cancer.

Method: An observational study was conducted among older adults with gastric cancer in a tertiary hospital in Jiangsu, China. A total of 393 participants were enrolled by convenience sampling. Sedentary behavior was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Logistic regression was applied to explore the relationship between preoperative sedentary behavior and short-term outcomes. Univariate and multivariate analyses were used to determine the factors associated with participants' sedentary behavior.

Results: Preoperative sedentary behavior was related to multiple outcomes, including total complications, prolonged length of stay, and increased hospitalization costs. Two or more comorbidities and depression were risk factors for sedentary behavior. High-density lipoprotein; female sex; and high school, middle school, and primary school and below educational levels were protective factors for sedentary behavior.

Conclusion: Health care professionals need to simultaneously concentrate on multidimensional aspects linked to sedentary behavior to successfully administer behavioral interventions for enhancing older adults' overall prognosis. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Purpose: To explore the experiences of family caregivers of older adults with dementia in Korea during the coronavirus disease 2019 pandemic.

Method: In-depth interviews were conducted with eight family caregivers of older adults with dementia from September to October 2021. Collected data were analyzed using Giorgi's phenomenological methodology.

Results: Four themes were derived: A Rough Journey With Worry, A Desolate Life in a Disconnected World, Frustration Due to Health Deterioration, and Looking Toward the Future Despite Heavy Responsibility.

Conclusion: This study is meaningful as it increases our understanding of the experiences and needs of individuals with dementia and their family caregivers, and results can assist in finding ways to help them cope with their difficulties during future pandemic situations. [Journal of Gerontological Nursing, 50(10), 42-48.].

Purpose: To examine the use of the PARO robotic pet seal for hospitalized older adults with dementia and compare the effects of PARO use with visits by a human on various outcomes, including physical restraint use, psychotropic medications, bedside sitters, and delirium.

Method: Complete data for 38 participants were analyzed using Mann-Whitney U and chi-square tests.

Results: Participants interacting with PARO spent less time in their interactions; however, they received fewer psychotropic medications and had fewer instances of delirium than those who interacted with human visitors only.

Conclusion: Aspects of hospitalization may limit the time an older adult can sustain attention or be free from interruption; however, short, repeated visits with PARO may affect the development of delirium and decrease use of medications to alter behavior in the hospital setting. [Journal of Gerontological Nursing, 50(10), 11-16.].

Purpose: To examine the feasibility and acceptability of progressive whole-body resistance training with social support reinforcement for older adults living alone.

Method: This mixed methods single-group pilot study examined an intervention provided over 3 nonconsecutive days per week for 12 weeks. We evaluated quantitative data on recruitment, uptake, retention, and adherence, and measured pretest and posttest outcome scores on body composition, physical function, and psychosocial health. We conducted a focus group interview to collect qualitative data on participants' perspectives.

Results: Seven participants (five women and two men) completed the program (attendance rate = 88.9%). Physical function and psychosocial health improved, but soft lean and skeletal muscle mass decreased. Five themes emerged from the qualitative data.

Conclusion: Results support the feasibility and benefits of this intervention program for older adults living alone despite challenges with recruitment and uptake. [Journal of Gerontological Nursing, 50(10), 34-41.].

Purpose: To review support systems for nursing home caregivers (NHCGs) that were implemented during the first year of the coronavirus disease 2019 (COVID-19) pandemic.

Method: Database searches in PubMed, ScienceDirect, and CINAHL resulted in five publications.

Results: Studies differed in design, interventions, and outcomes. An urgent eye movement desensitization and reprocessing protocol was feasible and effective among nurses in services highly mobilized during the acute phase of the pandemic. The "self-help plus" psychological intervention was not associated with significant reductions in anxiety or posttraumatic symptoms but prompted exploration of non-specific factors influencing its effectiveness. The Extension for Community Healthcare Outcomes in Long-Term Care of the Elderly virtual program increased confidence among NHCGs. Self-compassion training was associated with positive changes for certified nursing assistants. Weekly debriefing sessions implemented at one hospital highlighted pathogenic and salutogenic factors.

Conclusion: The COVID-19 pandemic had a marked psychosocial impact on NHCGs and necessitated targeted interventions. Despite their limitations, these promising studies provided insights into potential support avenues. Policy considerations should stress the pivotal role of advanced practice nurses in shaping supportive work environments. Future research should focus on robust assessments of the efficacy of psychosocial interventions for NHCGs facing ongoing challenges posed by the pandemic, and even recurrent viral epidemics. [Journal of Gerontological Nursing, 50(10), 24-33.].

Purpose: To explore barriers and facilitators to nurses' provision of sexual and reproductive health (SRH) care to community-dwelling older adults.

Method: An integrative literature review was performed using Whittemore and Knafl's method. Three databases were searched for research conducted between 2012 and 2023, and the Mixed Methods Appraisal Tool was used to determine the quality of included studies.

Results: Nine studies were ultimately included for analysis, and themes were Barriers to SRH Care and Facilitators of SRH Care. Barriers to SRH Care included: nurses' lack of knowledge about older adults' sexual health, discomfort discussing sexual topics, age-related stereotypes regarding older adults' sexuality, and older adults' lack of knowledge of and reluctance to discuss sexuality and sexual health issues. Facilitators of SRH Care included: gender of health care provider, nursing education on effective communication strategies, encouraging open dialogue to challenge ageist perceptions, and sexual education for older adults.

Conclusion: Findings underscore the impact of stigma and negative ageist assumptions on whether discussions about SRH occur between nurses and older adults. There is a need for comprehensive education for nurses and older adults about SRH to recognize sexual health needs and promote open and constructive conversations. Moreover, research about how to best facilitate older adults' SRH is needed. [Journal of Gerontological Nursing, 50(10), 17-23.].

Purpose: To use machine learning techniques with sensor data to predict fall risk in older adults aging in place.

Method: We tested the feasibility of using anomaly detection on a dataset comprising 315 days of continuous unobtrusive sensor data obtained from a single participant to predict fall risk within a 10-day window. Predictions were validated with performance metrics, including accuracy, F1 score, and receiver operating characteristic-area under curve (ROC-AUC), using actual falls documented in the electronic health record.

Results: The model resulted with accuracy = 0.96 (95% confidence interval [CI] [0.94, 0.99]), F1 = 0.78 (95% CI [0.73, 0.83]), and ROC-AUC = 0.89 (95% CI [0.85, 0.93]).

Conclusion: The application of anomaly detection on sensor data may provide a timely and valid indication of fall risk in older adults within a 10-day window. Further research and validation are warranted to confirm these findings and expand the scope of application in the domain of older adult care and health care support. [Journal of Gerontological Nursing, 50(10), 7-10.].