Journal of gerontological nursing最新文献

Purpose: Iron deficiency (ID) is common in older adults and is associated with adverse clinical outcomes. Oral iron is often limited by poor absorption and gastrointestinal intolerance. The current article reviews considerations for intravenous (IV) iron therapy in older adults with ID.

Method: To review IV iron efficacy, safety, and practical use in older adults.

Results: IV iron effectively restores iron stores; improves hemoglobin, functional status, and quality of life; and reduces transfusion requirements. Comorbidities, such as chronic kidney disease, heart failure, and gastrointestinal disorders, frequently necessitate IV iron therapy. Risks include allergic reactions, infusion reactions, hypophosphatemia, and transient hypotension, although serious adverse events are rare. Therapy should be individualized based on comorbidities and practical considerations.

Conclusion: IV iron is a safe and effective option for older adults, offering reliable and rapid repletion when oral iron is ineffective or contraindicated. Clinicians must weigh benefits and risks to optimize outcomes.

Purpose: To identify latent profiles of ego depletion among older adults with type 2 diabetes mellitus (T2DM), and analyze how these profiles relate to health promotion behaviors.

Method: A cross-sectional study surveyed 220 older adults with T2DM on ego depletion and health promotion behaviors. Latent profile analysis identified distinct profiles of ego depletion, and multinomial logistic regression explored their links to health promotion behaviors.

Results: Latent profile analysis revealed three distinct profiles: high cognitive depletion, high behavioral depletion, and high emotional depletion. The high behavioral depletion profile was associated with fewer complications, more hypoglycemia, better stress management, greater enjoyment of life, and increased health responsibility. The high emotional depletion profile had lower levels of physical activity, reduced risk reduction behaviors, poorer stress management, and less adherence to a healthy diet.

Conclusion: Tailored interventions addressing ego depletion are crucial for improving health promotion behaviors in this population.

Purpose: Falls are a leading cause of morbidity and mortality among older adults. The Age-Friendly Health Systems 4Ms Framework identifies objective mobility screening and follow up as essential health care for older adults, yet objective mobility screening is challenging to complete and often missed in primary care appointments.

Method: In the current project, objective mobility screening was changed from Timed Up and Go to visual gait speed in a geriatrics primary care clinic in a Plan, Do, Study, Act rapid process improvement project with four 2-week cycles. Data were collected through electronic health record audits and surveys.

Results: Objective mobility screening using the visual gait speed test increased from 32% to 61% during the improvement period. Follow-up mobility actions also improved during this time.

Conclusion: Adoption of the visual gait speed test for mobility screening can successfully occur and improve in a geriatric primary care clinic setting during an 8-week improvement period.

Purpose: With the increasing aging population, the demand for long-term care (LTC) services, particularly in nursing homes, is expected to rise substantially. Interest in working in LTC has been low but the Teaching Nursing Home Collaborative is trying to combat this lack of interest. In the state of Pennsylvania, three universities participated in the collaborative adding clinical experiences in nursing homes for nursing students.

Method: The experience of three universities establishing clinical in nursing homes was evaluated and suggestions for improving the clinical experience were included.

Results: Students attend clinical rotations at nursing homes/LTC from 6 to 12 hours and from one to multiple days over one semester. Clinical rotations are placed in one to three courses offering a variety of experiences and assignments.

Conclusion: Well prepared faculty and an established agenda for the clinical experience are essential.

Purpose: To implement an Age-Friendly Health System (AFHS) in a Veterans Health Administration nursing home using shared decision-making and goal-concordant care, achieve Institute for Healthcare Improvement recognition, and assess patient perceptions of care.

Method: This pilot study took place over 3 months and included 35 patients aged ≥65 years. Pre- and post-implementation chart reviews assessed documentation of the 4Ms (What Matters, Medication, Mentation, Mobility). After implementation, 12 patients completed the collaboRATE survey to evaluate shared decision-making and goal-concordant care.

Results: Documentation of all 4Ms improved. The collaboRATE top score was 83%, with a mean score of 3.94 of 4, indicating high levels of perceived shared decision-making.

Conclusion: Implementing the AFHS 4Ms Framework in a nursing home setting is feasible and supports high-quality, person-centered care. Results suggest strong alignment with the 4Ms and what matters most to older adults.

Purpose: Social support networks are essential for maintaining quality of life among older adults, particularly in nursing homes where loneliness and isolation are common. The current study analyzed the perceived impact of formal and informal social support networks on emotional well-being and evaluated recreational activities as factors promoting social connections among older adult residents in Spain.

Method: A qualitative study was conducted using semi-structured interviews with seven nursing home residents. Data were analyzed thematically to identify key aspects of social support and well-being.

Results: Participants highlighted the importance of family visits, peer relationships, and nursing staff support in enhancing emotional well-being. Although many reported satisfaction with their social environment, some expressed a need for more diverse recreational activities to foster social interaction. Maintaining external connections was also deemed essential.

Conclusion: Strengthening social support networks and increasing opportunities for meaningful social engagement can significantly improve the emotional well-being of older adults residing in long-term care facilities.

Purpose: To describe second-year nursing students' perception and clinical learning experiences related to the Age-Friendly Care 4Ms Framework.

Method: A qualitative exploratory study using inductive thematic analysis of student-generated clinical reflections and course artifacts was performed. Data were coded independently by researchers and synthesized into themes to ensure analytic rigor and accuracy.

Results: Five themes emerged and included Challenging Assumptions, Upholding Dignity and Personhood, Communication and Connection, Staff Engagement and Family Involvement, and Shared Humanity.

Conclusion: Integration of the 4Ms Framework into early clinical education fostered empathy, critical thinking, and professional growth. Students' perceptions evolved toward person-centered care and highlighted the richness of nursing home experiences in shaping professional identity. Embedding structured, age-friendly clinical experiences in nursing education can shift attitudes, enhance communication skills, and better prepare students to work effectively with older adults living in nursing homes.

Purpose: To systematically develop and evaluate the psychometric properties of a Chinese version of the Self-Reporting Age-Friendly Environment Assessment Tool (CS-AFEAT).

Method: The CS-AFEAT was developed based on literature review, semi-structured interviews with older adults, and a two-round Delphi procedure. Older adults (N = 836) from Guangdong Province were chosen to complete a survey using a convenience sampling method to test validity and reliability. One half of the sample was randomly selected for exploratory factor analysis (EFA), and the other half for confirmatory factor analysis (CFA). Internal consistency reliability was tested using Cronbach's alpha.

Results: A questionnaire comprising 61 items and six domains was constructed. All items had significant discrimination and had a strong relationship with the total score of the tool. In EFA and CFA, the factor loading of each item was >0.70. During CFA, the composite reliabilities of all domains were >0.90. The content validity index of the overall tool was 0.980. Cronbach's alpha of the overall tool was 0.962.

Conclusion: This scale can contribute to establishing age-friendly home and community environments. It may be a valuable reference for community service centers to assess and enhance their services, considering factors such as limited workforce and resources. Moreover, this scale can facilitate continuous improvement and long-term development of age-friendly care communities.