Wi, D., C.G. Park, J. Lee, E. Kim, and Y. Kim. 2025, “A Network Analysis of Quality of Life Among Older Adults With Arthritis.” International Journal of Older People Nursing 20, no 1: e70010. https://doi.org/10.1111/opn.70010.
Within the ‘Abstract’ section, the following text, “Sejong-si, South Korea: Implications for Practice. This study highlights the importance of multidimensional care plans to improve the quality of life for older adults with arthritis. Healthcare professionals should adopt care strategies that simultaneously address the key psychological and physical indicators to effectively enhance overall quality of life.” was mistakenly duplicated at the end of the “Conclusion” paragraph and there were some minor typographical errors.
These have now been rectified in the current version.
We apologize for this error.
Falls are a serious complication often associated with stroke in the older population. However, a comprehensive review of risk factors specific to falls in older stroke patients is currently lacking.
To fill this gap by synthesising prospective studies and providing evidence-based insights into the risk factors for falls and recurrent falls in older stroke survivors.
Systematic review and meta-analysis following PRISMA statement.
Two researchers independently screened eligible references and assessed their quality. Pooled summary effects, in the form of odds ratios with 95% confidence intervals, were calculated using a random-effects model.
A systematic search of PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO and CINAHL up to 4 January 2025.
Our systematic review and meta-analysis included 22 studies. We identified five key domains predicting falls: (1) balance and mobility, encompassing impaired mobility, impaired balance, motor impairment and disability in self-care; (2) environmental factors, particularly the use of walking aids; (3) psychological factors, notably depression status; (4) medication factors, including the use of medications; and (5) sociodemographic factors, such as a history of falls. Importantly, a history of falls significantly increases the risk of recurrent falls.
Falls are a pressing concern in older stroke patients, with key risk factors including balance and mobility problems, use of walking aids, depression and medication. Future research should focus on mechanistic insights and tailored prevention strategies for this vulnerable group.
Communication between older persons and nursing assistants is important in providing high-quality, person-centred home care. While previous research has reported on older persons' emotional concerns during home care conversations, there is a need to gain an in-depth understanding of emotional concerns' role in such conversations and how to support the older persons' comfort and well-being. Therefore, this study aimed to explore the nature and focus of emotional communication between older persons and nursing assistants in home care.
A descriptive qualitative design using observational data from 83 audio-recorded home care visits was used to identify and analyse sequences of distressing emotional communication, analysed through thematic analysis.
In this study, four themes were described illustrating how emotional communication between older persons and nursing assistants during home care visits creates opportunities for empathy: (1) recognising empathic opportunities, (2) identifying subtle and vague signs of emotional distress, (3) expressing needs for emotional support, and (4) striving to restore comfort in challenging conversations.
Conversations about older persons' emotions and worries can be complex. The findings indicate a fine line between meaningfulness and discomfort in emotional sequences. Expressions of emotional distress provide empathic opportunities that call for attentiveness and sensitivity from nursing assistants, implying a need for education and training in person-centred communication.
Emotional communication acknowledging empathic opportunities enhances person-centred care by promoting trust, comfort, and well-being. Ultimately, emotional communication reinforces the importance of empathy in home care and creates space for emotional interactions, leading to more supportive relationships.
Schizophrenia is a chronic health condition that poses unique challenges for patients and their family caregivers. This study assessed the association between caregiver burden, sociodemographic characteristics and psychological factors among family caregivers of older persons with schizophrenia.
A mixed methods design was employed in this study. Three hundred and forty respondents were purposively selected to participate in the quantitative aspect of the survey, whereas 20 caregivers were purposively selected to participate in the qualitative phase. The Zarit Burden Interview Scale and Hospital Anxiety and Depression Scale were used to collect quantitative data from family caregivers, and qualitative data were collected through face-to-face, in-depth interviews using a semi-structured interview question guide. The qualitative responses were audio-recorded and transcribed, and the cleaned transcribed data were transferred to Atlas.ti Scientific version 24 for coding the themes and subthemes. SPSS version 29 was used to analyse the cleaned, sorted and coded quantitative data at a statistically significant level of p ≤ 0.05.
The results showed that most family caregivers (60%) were female, aged between 17 and 64 years. Over half (52.6%) of the caregivers experienced severe caregiver burden. An ordinal logistic regression analysis to predict caregiver burden found that several factors were linked to lower caregiver burden, including older age (OR = 0.75, p = 0.042), certain living arrangements (OR = 0.51, p = 0.037) and longer caregiving duration (OR = 0.65, p < 0.001). In contrast, higher burden was strongly associated with depression (OR = 10.39, p < 0.001), anxiety (OR = 2.99, p < 0.001) and being married (OR = 1.65, p = 0.028). Qualitative findings revealed that caregivers experienced profound emotional distress, including anxiety and depression, and significant financial strain due to medication costs and transportation expenses. Qualitative interviews have highlighted emotional distress, financial strain and social isolation as core challenges.
There is a need to provide psychological and social support for family caregivers of older persons with schizophrenia. The government should consider subsidising medication and care costs, similar to existing models for TB and HIV treatments in Nigeria.
Managing pain in older people with hip fractures and cognitive impairment, such as dementia or delirium, presents unique challenges in acute care settings. Cognitive impairment can complicate pain assessment and management, making nurses' roles in identifying and addressing pain particularly critical in this population.
To review the existing research on nurses' experiences in pain management of cognitively impaired older people with a fractured hip in the acute setting.
An integrative review.
Four databases were searched using the PRISMA framework to guide the search and screening. Eligible studies were identified and the quality of each was evaluated using the Mixed Method Appraisal Tool. Thematic analysis was conducted to identify and analyse key themes across all articles.
Nine studies examined nurses' experiences in managing pain for cognitively impaired older people with a fractured hip in the acute setting. Three key themes were identified: communication challenges, the importance of person-specific knowledge and complexities in analgesia administration.
Nurses recognise the importance of pain management in cognitively impaired older people with a fractured hip. There is a reliance on opioid analgesia balanced with the potential for side effects. Effective pain management is challenged by communication barriers and the need for person-specific knowledge, underscoring the complexity of delivering optimal care in this setting.
Managing pain in cognitively impaired older people following a hip fracture can be challenging. Nurses are well placed to contribute to and support quality pain assessment and management in cognitively impaired older people with a fractured hip in the acute setting.
No direct patient or public contribution to the review.
We conducted a systematic search and narrative review of quality improvement in care homes. Our aim was to examine how quality improvement strategies have been adopted and how impact has been assessed in care homes for older people.
Following PRISMA guidelines, we conducted systematic searches of the electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PsycINFO and Applied Social Sciences Index & Abstracts (ASSIA) (2019–2024). We replicated the search strategy of a previously published review. Three co-authors undertook selection and data extraction.
Forty-four articles were included describing varied stages of quality improvement initiatives in care homes. The United States produced the largest number of studies. Quality improvement strategies were often poorly reported. Included papers reported stages of quality improvement from inception to evaluation. Most aimed for improved clinical outcomes, mainly those subject to external scrutiny. Few studies reported impact robustly. Quantitative measures, surveys and qualitative data were reported alongside staff-reported changes. There was no evidence of sustained improvement. There is some evidence of the use of theories, models and frameworks usually associated with implementation and knowledge mobilisation.
Current improvement practice is inconsistent and having limited impact.
We recommend any initiative to enhance resident experience and outcomes should involve establishing a project team, moving away from a deficit model, prioritising areas for improvement, identifying best practice, deciding how to measure improvement, understanding the challenges to best practice, co-designing strategies to effect change, sustaining the improvement, sharing learning and providing clear, detailed and accessible reporting.
Discharge from acute hospital to new care home is a complex and life changing process often involving several key stakeholders in decision-making such as the older person, their significant person and members of the multidisciplinary team. There is limited research exploring the perspectives of these stakeholders, including factors that influence decision-making and how this is communicated.
This study explored how decisions are made to discharge older people directly from hospital to care home, considering the perspectives and experiences of those involved.
A case study design was used to explore the experiences of six older people admitted to acute hospital from home for whom discharge to care home was planned. Six datasets were formed, each comprising semi-structured interviews with the person, their significant person(s) (if applicable), multi-disciplinary professionals and review of health and social-work records. Datasets were analysed using an inductive thematic approach before cross-dataset analysis.
Findings emphasised the complex and personal nature of decision-making. The older person was often keen to talk about their decision. Significant people highlighted the complexity of balancing risk and care needs. However, the magnitude of the decision to older people and their significant persons appeared to go underacknowledged by professionals. The hospital context was significant as a location for decision-making. Communication was integral to the experiences of those involved; however, uncertainty and lack of role clarity impacted this.
This study offers new insights into the complexity of discharge to care home from hospital. This life-changing decision requires greater recognition by professionals. Improved understanding of the process and well-developed communication is central to enhancing the experience for those involved.
The significance of this oftentimes final decision should not be underestimated. The findings indicate a clear need for interdisciplinary education about care home discharge, and the importance of professionals' availability an
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