Journal of gerontological nursing最新文献

Purpose: Older people with HIV (OPWH; aged ≥50 years) have unique vulnerabilities to intersecting risks for marginalization and isolation. The current qualitative study explored perceptions of social connection during the coronavirus disease 2019 (COVID-19) pandemic.

Method: Purposive sampling was used to recruit participants from two local community-based organizations (CBOs) in the Greater Boston area. Recruitment occurred through dissemination of flyers by staff of the CBOs. Semi-structured interviews were conducted between October 2021 and March 2022. Data were analyzed using thematic analysis.

Results: Of 22 participants, most were women (63.6%) and Hispanic/Latinx or African American/Black (86.4%). Participants viewed social connection as an important aspect of well-being, but acknowledged that COVID-19 induced social isolation. There were gender differences in social connection. Technology was adopted by all participants that allowed connection to others. Pre-existing relationships with support groups and CBOs facilitated improved social connection and well-being.

Conclusion: Focused attention should be on individuals not linked to CBOs or social services and those who lack access or have barriers to technology use, as they may be at the most significant risk for isolation. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Purpose: To define prescribing cascades (PCs) and provide tools to identify PCs, including the most common PCs described in the literature. PCs lead to the accumulation of medications prescribed to older adults, disproportionately affecting those who often have additional health care complexities, such as multiple chronic conditions and multiple transitions of care.

Method: Review of recent research efforts to identify and describe evolving clinical practice interventions to detect and reverse PCs.

Results: Clinicians can contribute to mitigating PCs through better understanding of how PCs occur in practice. Armed with this knowledge, clinical team members can implement proposed strategies and techniques to engage in primary and secondary prevention of PCs.

Conclusion: Ultimately, PCs are a culprit of preventable medication harm. Several tools are presented, which are initiated through maintaining a high index of suspicion for PCs in the evaluation of a new symptom presentation by older patients. [Journal of Gerontological Nursing, 50(9), 7-11.].

Purpose: To describe successful strategies for the recruitment of diverse community-dwelling older adults for a technology-based fall risk assessment research study during the global coronavirus disease 2019 pandemic.

Method: In this cross-sectional study, 124 adults aged ≥60 years agreed to participate. We used several recruitment strategies, including social media platforms, local community centers, flyers, contacting key persons, word of mouth, and contacting participants from previous research projects.

Results: Targeted and personalized strategies for recruitment, including contacting a key community leader (52.4%, n = 65) and communication with friends and family members (46.7%, n = 58), were the most successful. One (0.8%) participant was recruited from a prior research project. In contrast, individuals were not recruited from posted flyers and social media.

Conclusion: Recruitment can be improved with word of mouth and contacting key persons, such as community leaders, which can be achieved by building a trusted relationship between researchers and community leaders. [Journal of Gerontological Nursing, 50(9), 18-23.].

Purpose: To systematically identify knowledge patterns and gaps in the appropriateness of nursing home (NH) to emergency department (ED) transitional care for older adults with dementia.

Method: A systematic search of multiple information sources was performed from July to August 2023 using predesigned search strategies.

Results: From 13 articles, 54 identified pieces of specific care evidence were grouped into six major care domains: (1) Resource Support for Assessing Transfer Needs and Patient Status; (2) Resource Support, Shared Decision Making, and Early Advance Care Planning; (3) Standardized Multimodal Information Transfer; (4) Designated ED and NH Transition Coordinators; (5) Enhanced Interfacility Collaboration; and (6) Appropriate Transitional Care Education, Research, and Policy Beyond the Transfer Interface.

Conclusion: A comprehensive, consensus-based body of evidence is lacking. Despite person-centered, standardized, and professional resources supporting transitional care, reorienting NH cultural models remains unclear. Gaps include evidence tailored to diverse participants and contexts. Thus, a focus on policies, education, and research is required. [Journal of Gerontological Nursing, 50(9), 37-45.].

Purpose: Older adults frequently encounter health challenges, such as impaired balance and muscle health, which increase risk of falls. The current study investigated the effectiveness of the proprioceptive neuromuscular facilitation (PNF) technique in improving balance and muscle health among older adults with high fall risk.

Method: A total of 160 older adults with high fall risk were randomized into control and intervention groups. Over 6 months, the control group received standard interventions, while the intervention group received the same interventions and additional PNF training.

Results: Both groups demonstrated improvements in balance function over time, with the intervention group exhibiting significant improvements in Berg Balance Scale scores, Timed Up and Go test times, and 30-Second Chair Stand Test counts (p < 0.05). Bone density significantly increased in the intervention group compared to the control group (p < 0.05), although no substantial differences in lower limb muscle mass were observed. Satisfaction rates were higher and fall incidents fewer in the intervention group.

Conclusion: The PNF technique is effective in enhancing balance function and muscle health in older adults with high fall risk, demonstrating potential in reducing fall risk and improving quality of life among older adults. [Journal of Gerontological Nursing, 50(8), 37-44.].

Purpose: To examine the effect of walking interventions on sleep quality of persons with dementia (PWD) and their caregivers (dyads), and how different companions affect results.

Method: Forty-five dyads were divided into three groups: a control group and two experimental groups (one with a care attendant, one with a family caregiver). The two experimental groups engaged in 120 minutes of walking per week for 24 weeks.

Results: A significant improvement in sleep quality was observed among PWD in the family caregiver group (Wald χ² = 4.55, p = 0.033), whereas there was no improvement in the care attendant group. A slight improvement in sleep quality of family caregivers was also found.

Conclusion: Findings suggest the importance of creating individualized walking activity plans for dyads, incorporating trust and rapport-building strategies to improve sleep quality. [Journal of Gerontological Nursing, 50(8), 46-56.].

Purpose: To examine the relationship of key individual and family self-management theory (IFSMT) components, including self-management process variables on proximal (self-management behaviors) and distal (falls) outcomes in older adults.

Method: A secondary data analysis was conducted using data of 99 older adults living in continuing care retirement communities in the U.S. Midwest. Descriptive statistics, multiple regression, and logistic regression were performed to analyze the data.

Results: The multiple regression model demonstrated a positive association between self-efficacy for physical activity and steps per day. The logistic regression model showed that high expectations regarding aging are associated with reduced likelihood of meeting daily protein intake.

Conclusion: Key components of the IFSMT, such as self-efficacy, steps per day, and expectations regarding aging, are important when designing self-management interventions to prevent falls. [Journal of Gerontological Nursing, 50(8), 19-28.].

Purpose: To identify the impact of psychosocial factors on quality of life (QoL) of older adults hospitalized and isolated after contracting coronavirus disease 2019 (COVID-19).

Method: Data were collected between April 30 and June 18, 2022, from 117 discharged older adults who were in isolation for COVID-19 treatment in a tertiary hospital in South Korea.

Results: Of participants, 33.3% were at high risk for posttraumatic stress symptoms (PTSS), and 21.4% of participants were identified as having severe depressive symptoms. Participants' QoL negatively correlated with PTSS, depressive symptoms, and fear of social stigma. Depressive symptoms were the primary psychosocial factor identified as significantly affecting QoL (β = -0.682, p < 0.001), and the explanatory power of the regression model was 41.2%.

Conclusion: To enhance QoL of older adults who have experienced hospitalization and isolation due to COVID-19, identifying pertinent psychosocial factors, especially depressive symptoms, is necessary. [Journal of Gerontological Nursing, 50(8), 29-36.].

Purpose: To explore the association between lifelong learning (LL) and successful aging and discover ways that primary care nurses (PCNs) may facilitate successful aging by promoting LL.

Method: A narrative review of international evidence from Google Scholar, PubMed, CINAHL Plus, Ovid, and ProQuest was conducted. Twenty-one articles were reviewed. A theoretical framework supported by Troutman-Jordan's theory of successful aging and Baltes and Baltes' model of selection, optimization, and compensation were implemented to examine and illustrate findings.

Results: Evidence consistently showed a positive correlation between LL and successful aging.

Conclusion: Promotion of successful aging is an important consideration in PCN practice. This study brings awareness to the value of LL in achieving that goal. Incorporating strategies, such as encouraging creative activities and healthy behaviors, cultivating positive perceptions about aging, and helping patients meet their perceived needs, fosters coping with growing older. [Journal of Gerontological Nursing, 50(8), 11-17.].