Research in Gerontological Nursing最新文献

Purpose: To investigate risk factors for falls in hospitalized older adults to justify the adoption of targeted nursing measures.

Method: Meta-analysis was used to synthesize national and international published studies on risk factors for falls in hospitalized older adults.

Results: A total of 10 studies were included. Administration of psychotropic drugs, limb weakness, weak walking ability or unsteady gait, visual impairment, and history of falls were risk factors for the occur-rence of falls in hospitalized older adults. Administration of psychotropic drugs had the highest association with falls (odds ratio [OR] = 1.86; 95% confidence interval [CI] [0.58, 3.14]) followed by limb weakness (OR = 1.59; 95% CI [0.26, 2.92]) and visual impairment (OR = 1.51; 95% CI [0.22, 2.80]). The lowest combined OR for the association between weak walking ability or unsteady gait and falls was 1.05 (95% CI [0.60, 1.50]) compared with 1.38 (95% CI [1.15, 1.60]) for history of falls.

Conclusion: The current meta-analysis derived risk factors for falls in hospitalized older adults, with results having greater stability and reliability than those of a single study. [Research in Gerontological Nursing, 17(5), 238-245.].

Purpose: In dementia family caregiving, caregiver psychopathology has been frequently identified as a possible risk factor for the use of physically abusive, psychologically abusive, and neglectful behaviors toward care recipients. Yet, the mechanistic role of psychopathology in the use of these behaviors is not understood. The purpose of the current study is to determine the role of caregiver mental health in their daily risk of engaging in physically and psychologically aggressive and neglectful behaviors toward their care recipient with dementia.

Method: We used an intensive longitudinal design to survey family caregivers daily over 21 days. Using generalized linear mixed models, we evaluated the differential impact of caregivers' (N = 453) experience of major depression and generalized anxiety disorders measured at baseline versus 9,513 daily ratings of depressive and anxiety symptom severity, and interactions across levels, on the daily odds of engaging in physically abusive, psychologically abusive, and neglectful behaviors.

Results: Caregivers with clinically significant depression or anxiety at baseline had higher daily odds of engaging in each type of abusive and neglectful behavior. Worsened depressive symptoms (compared to individuals' average across all days) on a given day were associated with increased odds of engaging in psychologically and physically aggressive behaviors on the same day. Worsened anxiety symptoms on a given day were associated with increased odds of psychologically aggressive and neglectful behaviors.

Conclusion: A key finding was lack of a significant interaction effect between depression and anxiety disorders and mental health symptomology on the daily odds of engaging in abusive and neglectful behaviors. This finding indicates that daily depressive and anxiety symptoms are generalizable intervention targets across the family caregiver population and do not only increase risk among family caregivers with depressive and anxiety disorders. [Research in Gerontological Nursing, 17(5), 227-236.].

Purpose: Coexisting dementia and rapid eye movement sleep behavior disorder (RBD) can negatively impact persons with dementia (PWD) and their family caregivers. Little research has investigated the relationship of sleep disturbance (i.e., RBD) in PWD-caregiver dyads who live together. Thus, we aimed to examine the impact of RBD symptoms on sleep quality of PWD and their family caregivers and describe sleep interrelationships.

Method: This mixed methods study analyzed qualitative and quantitative data (wearable devices, semi-structured interviews, sleep diaries, and sleep quality surveys). Two dyads' sleep parameters and sleep experiences are reported.

Results: Findings demonstrated that RBD symptoms in PWD affected sleep quality negatively (frequent awakening during the night and shortened deep sleep).

Conclusion: Current findings highlight the importance of RBD assessment and management for PWD, as it could help improve caregivers' and PWDs' sleep quality and well-being. [Research in Gerontological Nursing, 17(5), 247-255.].

Purpose: To understand whether a culture-based multicomponent cognitive training program is feasible and tolerable for persons with dementia (PWD) in day care centers in Taiwan, and to examine the effectiveness of a 16-week program in preventing declines in cognitive function and self-care, as well as the development of depressed mood and behavioral problems.

Method: This study was a 4-month cluster randomized controlled trial. PWD (N = 56) who met sample selection criteria were recruited from five day care centers and assigned to the experimental or comparison group. Participants in the experimental group received a series of culture-based multicomponent cognitive training activities via research assistants and day care center caregivers for 16 weeks. Participants in the comparison group received usual daily activities. Time attending activities and degree of participation were used as criteria for determining feasibility and tolerability of the program.

Results: Results confirmed the feasibility of culture-based multicomponent cognitive training activities if the activities were guided by caregivers. Results also showed participants in the experimental group had statistically significant improvements in cognitive function. Activities of daily living performance, depressed mood, and behavioral problems showed non-significant improvements.

Conclusion: The current study suggests that this program can assist PWD in preventing declines in self-care and the development of behavioral and psychological problems, and improve their cognitive function. Further research with a larger sample size and staff training should be considered to test the effectiveness of this program. [Research in Gerontological Nursing, 17(5), 257-264.].

Purpose: To examine the validity and usability of a paper log for evaluating exercise duration in older women.

Method: Data from 23 females (mean age = 70.4 years) who completed an 8-week pilot randomized controlled trial investigating the effects of yoga and aerobic/strength training on knee osteoarthritis were included in this secondary analysis. Participants were asked to complete a paper log and video recording of their home exercise sessions.

Results: Concurrent validity was high between minutes reported on the paper logs and video recordings during Weeks 2 to 7 (r = 0.878). Usability was high, with participants completing 79% to 91% of paper logs and 74% to 100% of video diaries weekly. Overall minutes reported on the paper exercise logs and video diaries were positively correlated to Physical Activity Scale for the Elderly scores at 8 weeks.

Conclusion: Exercise logs are a valid and useful method in assessing adherence to prescribed exercise duration in unsupervised home programs. [Research in Gerontological Nursing, 17(5), 219-225.].

Purpose: To explore the needs of family caregivers (FCs) and how these are addressed in long-term care facilities (LTCFs).

Method: A descriptive qualitative study was performed, using semi-structured interviews with 23 FCs from seven LTCFs in Japan.

Results: Inductive content analysis revealed three main themes: Coexistent Needs Related to Residents' and FCs' Own Well-Being, Means by Which FCs Promote Residents' and Their Own Well-Being, and Managing Conflicting Needs by Prioritizing and Compromising. FCs recognized that their needs relate to the well-being of residents and themselves, and both needs coexist. To address these multifaceted needs, FCs engaged in various activities while seeking support. However, limited availability of means often made it challenging to meet multiple needs simultaneously, leading FCs to manage these conflicting needs by prioritizing or compromising.

Conclusion: The current study underscores the significance of comprehensive support that simultaneously addresses FCs' conflicting needs, rather than approaching each need separately. [Research in Gerontological Nursing, 17(4), 177-187.].

Purpose: To evaluate the implementation of MOVIN, a multicomponent mobility intervention, by a nurse-led team and measure the effectiveness on unit-level outcomes.

Method: A pragmatic quasi-experimental study was conducted on an inpatient adult medical unit. Evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Interviews with 13 organizational partners were conducted to understand barriers and facilitators to adoption. Thematic analysis was used to analyze the data. Quantitative data to determine effectiveness on distance of patient ambulation and percent of patients ambulated by nursing staff were analyzed using an interrupted time series.

Results: A significant increase in total weekly distances for patient ambulation and percent of patients ambulated by nursing staff occurred between preintervention, intervention, and postintervention periods. Themes for adoption included: Value, Immediate Feedback, Inclusive Implementation, Resource Needs, and Lack of Organizational Evidence. The nurse-led team demonstrated high fidelity to maintaining the core components of MOVIN.

Conclusion: A nurse-led team can successfully launch a multicomponent mobility intervention and sustain impact. RE-AIM supported assessments of key partners at multiple organizational levels, capturing critical unit level outcomes. Multiple methods for data collection and analysis yielded rich results to inform future dissemination of MOVIN. [Research in Gerontological Nursing, 17(4), 189-201.].