Journal of gerontological nursing最新文献

Purpose: To investigate modifiable environmental work factors impacting long-term care (LTC) workers' mood symptoms. This is a first step in creating interventions that can improve mood symptoms and reduce turnover.

Method: This descriptive study used baseline data from a trial within six worksites (N = 112). Through self-reported surveys, mood symptoms were analyzed using the 21-item version of the Depression Anxiety and Stress Scale, and environmental factors, such as job demands, decision authority, job duties, social support, and organizational justice, were measured using the Job Strain Model tool.

Results: After controlling for age, organizational justice (β = 0.361, p ≤ 0.001) significantly influenced mood symptoms and explained 15% of the variance in mood symptoms.

Conclusion: Organizational justice may reduce mood symptoms in LTC staff. These findings offer managers and researchers insights for potential interventions with this population.

Purpose: To determine whether psychological distress mediates the relationship between social isolation and frailty among older people living with HIV (PLWH) in China.

Method: A quantitative cross-sectional study was conducted. A convenience sample of 342 eligible older PLWH were identified between December 2022 and October 2023. Data were collected through in-person surveys and structured questionnaires designed to collect data on sociodemographic characteristics, social isolation, frailty, and psychological distress with standard measures, including the Tilburg Frailty Indicator, Lubben Social Network Scale-6, and Distress Thermometer.

Results: Overall prevalence of major variables among participants was reported as follows: social isolation (57.3%), frailty (39.5%), and psychological distress (25.8%). Mediation analysis showed that an association between social isolation and frailty was mediated by psychological distress. Psychological distress partially mediated the relationship between social isolation and frailty, accounting for 30.4% of the total effect.

Conclusion: Higher levels of social isolation and greater levels of psychological distress may be significant risk factors for frailty among older PLWH. Levels of social isolation influence frailty directly and indirectly through a psychological distress pathway.

Purpose: Persons with dementia (PWD) often encounter challenges in effectively managing their medications, which can result in medication deviation. The objective of the current study is to provide references for enhancing the management of medication deviations among PWD.

Method: A comprehensive literature search was conducted across six databases (PubMed, ProQuest, Web of Science, CNKI, Wanfang, VIP) to identify cross-sectional and cohort studies investigating medication deviations in PWD, published between January 1, 2015, and March 1, 2025. A scoping review methodology was used to summarize and analyze the basic characteristics, assessment tools, types of medication deviations, and influencing factors of included studies.

Results: Twenty-one studies were included. Most used the Beers Criteria^® or STOPP criteria to assess medication deviations. Risk factors for deviations were categorized into three domains: individual factors (e.g., advanced age, cognitive impairment), caregiver-related factors (e.g., insufficient supervision), and medication-related factors (e.g., polypharmacy). Potentially inappropriate medications were the most prevalent type of deviation, with reported rates ranging from 12.2% to 85%.

Conclusion: Medication deviations are pervasive in dementia populations. Strengthening medication management protocols-including systematic medication reviews, caregiver education, and multidisciplinary interventions-is critical to reducing adverse drug events and preventable hospital readmissions. Future research should prioritize standardized assessment tools and context-specific strategies tailored to the neurobehavioral complexities of dementia.

Increasing efforts to improve mobility and promote exercise that facilitates healthy aging have generated new opportunities for policymakers and nurses. With the popularity of wearable devices, such as smartwatches, on the rise, governments, health systems, national organizations, and insurance payers are actively engaged in identifying use cases for these devices that help patients manage their conditions in real-world settings; however, less attention has been paid to using wearable devices to prevent the development of risk factors for chronic disease. This is particularly true regarding musculoskeletal (MSK) care, for which a growing number of digital platforms have recently been validated. Numerous pathways for policy reform to support the adoption of wearable devices in everyday living during the preventive phase of MSK disorders have been identified, each of which requires the expertise and engagement of gerontological nurses to shift the focus of aging care from disease management to prevention.

Purpose: Maintaining optimal glycemic control, as measured by hemoglobin A1c (HbA1c), is critical for preventing diabetes-related complications in older adults. The current study investigated determinants of glycemic control in older adults with diabetes in South Korea, aligning with the latest clinical guidelines from the American Diabetes Association and World Health Organization.

Method: This cross-sectional study analyzed data from the 2022 Korea National Health and Nutrition Examination Survey. A total of 372 adults aged ≥65 years with physician-diagnosed diabetes were included. Participants were categorized into well-controlled (HbA1c <7%) and poorly controlled (HbA1c ≥7%) groups. Factors influencing glycemic control, including psychological distress, physical activity, and socioeconomic variables, were assessed using binary logistic regression.

Results: Depression (Patient Health Questionnaire-9 ≥4; odds ratio [OR] = 1.986, p = 0.019), anxiety (General Anxiety Disorder-7 ≥2; OR = 1.800, p = 0.041), and insufficient strength training (<2 times/week; OR = 0.496, p = 0.025) were significant predictors of poor glycemic control. Current smoking was also associated with elevated HbA1c (OR = 2.228, p = 0.030). No significant associations were observed for demographic or socioeconomic factors.

Conclusion: Psychological distress, insufficient strength training, and smoking are key modifiable predictors of poor glycemic control in older adults with diabetes. These findings highlight the need for integrated interventions that address mental health support, lifestyle modifications, and smoking cessation in diabetes management for older adults. Further longitudinal studies are recommended to confirm causality.

Purpose: Challenging behaviors of residents with dementia represent a major concern in nursing homes (NHs). Although various studies have investigated the effects of staff training in challenging behavior management, few have explored their impact on laypeople's perceptions. However, NH professionals routinely interact with laypeople, such as current and prospective residents and their families, volunteers, and community partners. The current study examined the effect of person-centered staff training on naïve individuals' perceptions of staff competence.

Method: Twenty-two NH professionals completed person-centered care training in challenging behavior management and responded to a clinical vignette before and after training. Their responses were evaluated by 59 naïve assessors for relevance, confidence, and competence. In addition, two trained assessors were recruited to explore whether their informed evaluations corroborated naïve assessors' impressions.

Results: Relevance, confidence, and competence improved significantly according to naïve and trained assessors. NH professionals also reported feeling more competent.

Conclusion: Multiple measures indicate improved staff performance following training. Future studies should examine how laypeople's perceptions of staff competence influence their experiences in NHs and impact NH attractiveness.