Journal of gerontological nursing最新文献

Purpose: To evaluate the feasibility and preliminary outcomes of Age-Friendly Integrative Mobile Services (AIMS), a community-based model guided by the 4Ms Framework to address complex needs of underserved older adults aging in place.

Method: This longitudinal pilot enrolled adults aged ≥65 years who received in-home assessments, a mobile health unit visit, and follow-up encounters at 1 and 3 months. Nurse practitioner-pharmacist collaboration supported medication reviews and personalized care planning.

Results: Seven participants enrolled (mean age = 70 years). Frequent needs included transportation, home modifications, food insecurity, and legal aid. Three participants showed possible cognitive impairment and four were at risk for falls. All received social prescriptions aligned with goals. Interprofessional collaboration resulted in deprescribing and tailored education to improve adherence. Follow up showed increased engagement with services.

Conclusion: The AIMS pilot demonstrated feasibility and acceptability of a nurse-led, person-centered model. Community-based, age-friendly care may address disparities and promote safe aging in place.

Purpose: To describe a systematic process for developing an art making intervention, guided by a previously developed theoretical framework outlining its proposed mechanism of action as a potential pain management strategy for older adults.

Method: A multi-method approach that combined a descriptive qualitative study and survey methodology was used. Initially, a qualitative study with 11 older adults experiencing various chronic pain conditions provided insights into their perspectives on the preliminary intervention. Participants described the intervention, which included drawing, painting, and craft activities, as generally appropriate but in need of revisions to instructional details and difficulty levels. Based on this feedback, we created six independent intervention books featuring activities at three levels of difficulty. A quantitative survey was conducted with five content experts and three experiential experts to collect formative evaluations of the revised intervention.

Results: The eight experts rated the revised intervention highly overall but recommended improving the organization of the written and visual instructions and ensuring the use of age-appropriate language. The final intervention offers 20 art making activities delivered in a home-based, individual format using an art making activity book and YouTube channel.

Conclusion: By using a multi-method design, we tailored the intervention to the unique needs of older adults while grounding it in our theoretical framework describing its proposed mechanism of action for chronic pain management. Future studies are needed to rigorously test our hypotheses and evaluate the intervention's efficacy in reducing pain intensity among older adults.

Purpose: To describe older adults' lived experience with a chronic wound in a long-term care (LTC) facility, with the ultimate goal of enhancing well-being and overall quality of life (QoL).

Method: A descriptive phenomenological design guided by Colaizzi's method was used. Seven cognitively intact LTC residents with chronic wounds were interviewed using a semi-structured guide. Interviews were analyzed inductively through multiple coding cycles, consensus-building, and member checking.

Results: Four interrelated themes were constructed: Lack of Independence, Confinement and Limitations, Interruptions to Daily Life, and Emotional Sequelae. Participants described physical and emotional burdens, a reliance on staff, and disruptions to routines and relationships. Despite challenges, most expressed appreciation for the wound care received in the facility.

Conclusion: Chronic wounds deeply affect quality of life and identity. Clinicians should recognize the emotional and social dimensions of wound care. Results can help guide clinicians in LTC facilities to improve residents' wound healing and promote overall QoL.

Purpose: To evaluate the effects of a 6-week cognitive-behavioral therapy for insomnia (CBT-I) intervention delivered via a WeChat Mini Program on sleep quality and cognitive function among older adults with mild cognitive impairment (MCI) and insomnia.

Method: Sixty older adults were recruited from February 2023 to June 2023, 30 older adults in the experimental group received a 6-week intervention based on the WeChat Mini Program, whereas those in the control group received 6 weeks of online sleep health education. Primary outcomes included sleep quality and cognitive function, and secondary outcomes were sleep hygiene, anxiety, and self-efficacy.

Results: Significant improvements were observed in sleep quality, cognitive function, sleep hygiene, anxiety, and self-efficacy in the experimental group compared to the control group (p < .05). In addition, findings showed significant enhancements in these areas before and after the intervention within the experimental group (p < .05).

Conclusion: Results indicate that the WeChat Mini Program-based CBT-I intervention effectively improved sleep quality and cognitive function, enhanced knowledge and habits related to sleep hygiene, increased self-efficacy, and reduced anxiety in older adults with MCI and insomnia.

Purpose: Private duty nurses and professional caregivers providing nonmedical home care play an important role in supporting older adults, yet they are often underrecognized in Age-Friendly Health System strategies. As the age-friendly care movement grows, there is an opportunity to better integrate these professionals as partners in supporting safe transitions, reducing hospitalizations, and delivering person-centered care aligned with the 4Ms Framework.

Method: Data were drawn from structured assessments completed in 2024 and client/family narratives collected with informed consent. All analyses were descriptive; data were aggregated and de-identified in compliance with HIPAA.

Results: Older adults receiving nonmedical home care demonstrated improvements in management of chronic medical conditions, daily activities, mobility, nutrition, and participation in meaningful routines.

Conclusion: Nonmedical home care extends the 4Ms Framework into the home, enhancing independence and safety. Although findings are preliminary, they suggest consistent in-home support may reduce risks for decline and better align care with what matters most to older adults.

Purpose: To map existing literature to understand the impact of mobile health (mHealth) interventions on older adult patients' self-efficacy in adhering to prescribed treatment plans for heart failure (HF).

Method: The current scoping review examined peer-reviewed studies identified in PubMed, CINAHL, and SCOPUS, with data screening and extraction conducted independently by two reviewers to ensure accuracy and minimize bias.

Results: The search yielded 731 articles, of which 16 were included in the final review. After examining all studies, three key themes were examined in detail: Medication Adherence, Self-Care Adherence, and Engagement With mHealth Services.

Conclusion: mHealth apps have shown promising effects on medication and treatment adherence in patients with HF. However, modifications addressing the specific needs of older populations are necessary to effectively implement these tools. Comprehensive feasibility trials on a larger scale are essential for fully understanding the potential effectiveness and implementation requirements of these interventions.

Purpose: Dementia, including Alzheimer's disease, poses complex challenges requiring health care providers to respond with empathy and skill. The current study examined whether a simulation-based dementia education intervention could enhance empathy in health care students.

Methods: Using embedded mixed methods, one-group quasi-experimental design, empathy levels in 125 pre-licensure nursing and graduate occupational therapy students were measured via the Kiersma-Chen Empathy Scale-Revised (KCES-R) before, immediately after, and 6 weeks post-simulation. In addition, 36 post-debriefing focus groups explored student experiences qualitatively.

Results: Findings showed significant empathy score increases across all time points (F[2,124] = 17.02, p < 0.001). Thematic analysis revealed five themes: The Illusion of Empathy, Developing Empathetic Skills, Confronting Uncomfortable Truths, The Eureka Moment: Transformative Realizations, and Empathy and Power Dynamics.

Conclusion: Findings suggest that simulation-based dementia experience improves empathy and motivates students to provide better care. Experiential learning is critical to preparing future health care professionals to meet the growing demands of dementia care.

Purpose: To examine the food consumed by older adults and their physical activity to determine which dietary components (carbohydrates, proteins, and fats) are associated with physical activity and establish a respective baseline.

Method: A total of 1,353 older adults (755 males, 598 females) were recruited from the 9th Korea National Health and Nutrition Examination Survey. Participants' physical activity and food intake were assessed.

Results: According to the amount of protein consumed by males and females, significant differences in moderate physical activity (p = 0.047 and p = 0.007, respectively) and moderate-to-vigorous physical activity (p = 0.026 and p = 0.027, respectively) were identified. In the unadjusted model, participants who met the recommended protein intake (odds ratio [OR] = 6.9, 95% confidence interval [CI] [1.52, 31.35]) were more likely to have higher levels of physical activity than those who did not meet the recommended protein intake. Associations with meeting the recommended protein intake (OR = 9.73, 95% CI [1.21, 78.05]) were attenuated after adjusting (sex, age, skeletal muscle index) for covariates. Protein intake and amount of physical activity were positively correlated across all participants (r = 0.184, p < 0.05).

Conclusion: Older adults should consume the recommended amount of protein to increase physical activity, which improves their health. Protein intake has a positive effect on physical performance by influencing muscle mass and function of older adults.

Purpose: The current study examined differences in senior nursing students' knowledge, attitudes, and perceived competency about older adults, based on enrollment in Bachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN), and Practical Nursing (PN) programs offering gerontological nursing curricula content.

Method: A nonexperimental, descriptive survey design was used. A total of 145 senior nursing students from five pre-licensure programs in Florida completed a 92-item survey incorporating the Palmore Facts on Aging Quiz 2, Kogan's Attitudes Toward Old People Scale, and the Hartford Geriatric Nurse Competency Tool. Data were analyzed using analysis of variance (ANOVA), multivariate ANOVA, and Pearson correlation.

Results: Students demonstrated limited knowledge about older adults but reported high perceived competency. A statistically significant difference in knowledge was found between program types, with PN students scoring highest. A moderate positive correlation existed between knowledge and attitudes. No significant differences were found for attitudes or perceived competency by program.

Conclusion: The current study underscores the need to systematically design an evidence-based curriculum inclusive of gerontological nursing content across BSN, ADN, and PN programs to prepare the future nursing workforce to care for older adults.

Purpose: Routinely listening to personalized music selections has been shown to reduce agitation, the most common symptom of Alzheimer's disease and related dementias. The purpose of the current study was to assess changes in participant agitation by providing a 6-week personalized music listening (PML) intervention of 30 minutes to 10 nursing home residents with dementia.

Method: The Cohen-Mansfield Agitation Inventory (CMAI) was administered every 2 weeks throughout the study period. The objective was to see if PML would reduce symptoms of agitation, as measured by participants' CMAI scores.

Results: Results from a one-way repeated measures analysis of variance showed improvement in CMAI scores pre- versus post-intervention. Using a Greenhouse-Geisser correction, CMAI score reduction was statistically significant at different time points of the study (F [1.487, 13.886] = 4.63, p = 0.044).

Conclusion: Results suggest that PML can be an effective and low-cost means for improving dementia-related agitation in the short term.