International Journal of Older People Nursing最新文献

Introduction

This scoping review explores available evidence on strategies to guide the prevention of constipation in people with dementia.

Methods

A systematic literature search was conducted across eight electronic databases. Two researchers independently conducted data screening, extraction, analysis and charting using a standardised data extraction tool for obtaining information about studies.

Results

We identified seven studies, including three randomised controlled trials, carried out between 1997 and 2019. A range of nonpharmacological strategies was utilised to reduce the risk of developing constipation in people who live with dementia.

Implications for Practice

Strategies identified through this review could guide the care of people with dementia in preventing constipation by emphasising the importance of lifestyle and environmental changes to support regular, soft-formed bowel movements.

Introduction

Person-centred care is widely recognised as the gold standard of quality in terms of gerontological care approaches and offers an alternative to traditional, medically oriented models. The Person-Centered Care Assessment Tool (P-CAT), developed by Edvardsson et al. (2010), is one of the most extensively studied instruments for adaptation and validation across countries. However, its structural invariance remains questionable, with the number of factors varying from one to three depending on the study. Currently, no validated French version exists. This study aims to explore the psychometric properties of the French version of the P-CAT among nursing home staff.

Methods

We translated the P-CAT into French. A total of 473 participants, recruited in 41 nursing homes and divided into two independent samples, completed several questionnaires including the P-CAT. We conducted exploratory and confirmatory factor analyses and assessed reliability, as well as convergent and divergent validity of the P-CAT.

Results

Exploratory and confirmatory factor analyses supported a three-factor structure with adequate internal consistency (ω = 0.79). The three dimensions are related to the following: Organisational and environmental support; care planning; and adaptability to the residents' needs. Good convergent validity and divergent validity were documented.

Conclusion

The French version of the P-CAT demonstrated good psychometric properties and a structural invariance among nursing home staff. It can be used in research and practice to assess person-centredness in gerontological care settings.

Introduction

Questionnaires are commonly used for rapid frailty assessment. However, which scale is most appropriate for the identification of frailty in older adults with cancer remains unclear.

Objective

A diagnostic meta-analysis was conducted to examine the sensitivity and specificity of questionnaire-based assessment tools in detecting frailty among older adults with cancer.

Methods

Five databases were searched for eligible studies from inception to January 26, 2025. Study quality was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies tool. The pooled sensitivity and specificity of the frailty assessment tools were assessed through a bivariate random-effects model. Factors influencing the heterogeneity of sensitivity and specificity values were assessed through moderator analysis, which comprised a subgroup analysis and metaregression.

Results

Five questionnaire-based tools (i.e., the Edmonton Frailty Scale, FRAIL scale, Groningen Frailty Indikator [GFI], Tilburg Frailty Indikator, and Vulnerable Elders Survey-13 [VES-13]) for assessing frailty in older adults with cancer were identified in the literature; the most commonly used were the GFI and VES-13. The sensitivity and specificity of the GFI (67% and 81%, respectively) and VES-13 (65% and 81%) were calculated. Studies with a high proportion of male participants had poorer GFI sensitivity. Older patient samples were associated with lower VES-13 sensitivity, and a high prevalence of frailty or patients having stage III–IV cancer was associated with higher sensitivity.

Conclusion

The GFI and VES-13 demonstrated high specificity but low sensitivity for frailty assessment in older adults with cancer. Frequent assessment with the GFI or VES-13 is recommended to improve frailty detection.

Implications for Practice

Health-care professionals, including oncology nurses, care managers, and oncologists, can incorporate the GFI and VES-13 into cancer care settings to improve early frailty detection and management.

Pre-Registration: The study protocol was registered at PROSPERO (CRD42024505836)

Introduction

The ability to care for a frail older partner late in life often entails the need for support and help from others, a need that sometimes can go unmet. Exploring spouses' views of emotional and existential support can guide further development of supportive structures, which in turn can promote family caregivers' existential health and well-being. Therefore, the aim of this study was to explore what spouses experience as supportive of their emotional and existential concerns when caring, or after having cared for, a frail partner late in life.

Methods

The study was explorative and based on multistage focus group interviews with older spouses (n = 10) divided in two groups who met three times each. The data were analysed using conventional content analysis. The checklist ‘Consolidated criteria for reporting qualitative research’ (COREQ) was followed when presenting the study.

Results

The spouses described the importance of an atmosphere in which being sad was allowed for as much time as needed; it was safe to share experiences together with others, they could receive compassion and comfort from others, and they were free to feel hope, let their previous life go and dare to think of their future.

Conclusion

Providing emotional and existential support creates an atmosphere that allows older spouses to reflect together with others, listening to their own and others' thoughts, and thus be able to put feelings and experiences into words. A suggestion for organising such support considers the physical, social, personal and spiritual dimensions of people's lifeworlds.

Implications for Practice

Nursing interventions aimed at improving emotional and existential support for older spouses should primarily target transitional phases in life and focus on relational aspects.

Background

The Caregiver Reaction Assessment Scale is a widely used tool for evaluating the experiences of informal caregivers of older adults. Despite its global application, researchers from different countries have reported varying psychometric properties for the CRA, and a comprehensive evaluation of its overall psychometric quality remains lacking. Given the increasing reliance on informal caregivers in ageing populations worldwide, understanding the reliability and validity of the CRA is critical for improving caregiver support and enhancing care outcomes for older adults.

Objectives

This study aims to (1) systematically review the psychometric properties of the CRA scale using the Consensus-based Standards for the Selection of Health Measurement Instruments methodology and (2) conduct a meta-analysis of Cronbach's alpha across different versions of the CRA scale to assess its internal consistency.

Methods

We systematically searched 10 electronic databases from their inception to May 17, 2024, with an update on February 13, 2025. Two researchers independently screened and extracted data. Methodological quality was assessed using the COSMIN checklist, and a random-effects meta-analysis of Cronbach's alpha was performed. Measurement properties were rated according to updated COSMIN standards, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Results

A total of 21 studies were included in the review. The meta-analysis revealed acceptable internal consistency for the CRA scale, with Cronbach's alpha values ranging from 0.76 to 0.79. Based on COSMIN standards, one version of the CRA scale is recommended for use, 14 versions are weakly recommended and six versions do not meet validity or consistency standards.

Conclusion

The CRA scale is a reliable tool for assessing the experiences of informal caregivers of older adults and demonstrates potential for broader application in other informal caregiver groups. However, limited research on cross-cultural validity, stability, measurement error and criterion validity highlights the need for future studies to address these gaps by rigorously following COSMIN methodology.

Implications for Practice

The findings suggest that the CRA