Research in Gerontological Nursing最新文献

Global population aging presents an urgent challenge and significant opportunity to transform how health systems deliver care to older adults. The Age-Friendly Health Systems (AFHS) initiative, grounded in the 4Ms framework-What Matters, Medication, Mobility, and Mentation-was developed to improve outcomes for older adults by promoting optimal function, supporting autonomy in care decisions, and preventing iatrogenic complications. AFHS offers a comprehensive, integrated approach that can be implemented across diverse care settings. However, much of the existing evidence on AFHS effectiveness focuses on implementation processes rather than outcomes that reflect older adults' lived experiences and overall well-being. Moreover, current research highlights fragmentation in model evaluation, with considerable variability in how the 4Ms are implemented and measured. The current Annual State of the Science Review synthesizes existing studies on 4Ms implementation, examines the measures used, identifies barriers and facilitators to implementation, and outlines future directions for advancing AFHS research and practice.

Purpose: To explore advance care planning (ACP) and end-of-life (EOL) communication and decision-making experiences of African American family caregivers of nursing home residents with Alzheimer's disease and related dementias (ADRD).

Method: The study used a descriptive qualitative design with semi-structured interviews. African American family caregivers of nursing home residents diagnosed with ADRD with documented POLST were interviewed. Sixteen participants were recruited from eight nursing homes in a large Midwestern city.

Results: Three major themes were developed and highlighted that ACP and EOL conversations occurred at different points within the health care system and were facilitated by family caregivers' knowledge of residents' wishes for EOL care and the faith/spirituality of the family caregiver/resident. Conversations were challenged by caregivers' lack of understanding of medical terminology and lack of providers available to educate them.

Conclusion: ACP and EOL decision-making with African American family caregivers of nursing home residents with ADRD is a process that is affected by nursing home challenges, such as physician shortage. In making ACP and EOL decisions, African American family caregivers relied on their faith as well as their knowledge of wishes the resident with ADRD had verbalized or documented.

Purpose: Advance care planning (ACP) promotion in Japan is insufficient, particularly with consideration of incorporating an individual's cherished personal values. The current study examined actual awareness and intention toward ACP among older adults living alone (OALA) aiming to identify facilitators and barriers to ACP focusing on cherished personal values for this specific cohort.

Method: A semi-structured questionnaire survey was conducted with 300 OALA in Japan to explore their cherished personal values and awareness of ACP. Potential factors influencing intentions regarding ACP among OALA were examined.

Results: Multivariate logistic regression analysis revealed that holding multiple personal values was significantly associated with a positive intention toward ACP among OALA, regardless of the specific types of values identified.

Conclusion: Recognizing multiple cherished personal values is crucial for successful ACP among OALA. A guiding tool supporting the identification of these values is needed to facilitate ACP among OALA.

Purpose: Older family care partners of persons with heart failure (HF-FCPs) face physical, psychosocial, and financial burden, yet their self-care difficulties and unmet needs remain poorly understood. We examined older HF-FCPs' self-management challenges, care-related needs, and health status.

Method: A qualitative study was conducted using semi-structured, one-on-one interviews with 15 HF-FCPs between September 2022 and January 2023.

Results: HF-FCPs (mean age = 65.9 years [SD = 4.4 years]) were predominantly female (n = 11) and spouses (n = 13), providing care for 9.3 years and 35.4 hours per week. Arthritis was the most common chronic condition among HF-FCPs, followed by obesity and hearing or vision impairments. Four key themes emerged: Self-Management Challenges, Motivation for Self-Care, Need for Social Connection, and Need for Caregiver Resources in Supporting Patients With HF.

Conclusion: Findings highlight the need to develop and implement caregiver-centered health programs tailored to the unique needs of older HF-FCPs.

Purpose: To examine the relationship between care recipient occurrence and frequency of hospitalization and caregiver well-being.

Method: A cross-sectional, secondary analysis was conducted using data from the Caregiving in the United States 2020 survey. Outcomes of interest were the occurrence and incidence of care recipient hospitalization. Dependent variables included domains of caregiver well-being, including physical strain, emotional strain, overall health, and meaning attributed to caregiving.

Results: Multivariate regression indicated a strong association between care recipient hospitalization and caregiver general health, physical strain, and emotional strain. The association was sustained for increased number of hospitalizations.

Conclusion: The current study highlights components of caregiver well-being that may be affected by the hospitalization of a care recipient. Health care systems may need to include supportive methods for caregivers and their care recipients going through care transitions.

Purpose: The incarcerated population is rapidly aging. Transitions into, out of, and between prisons are common among justice-involved older adults, yet transition experiences remain poorly understood. The purpose of the current scoping review was to examine literature on transitions into, out of, and between prisons experienced by justice-involved older adults.

Method: We conducted a scoping review to understand the current state of the literature. Databases searched included PubMed, CINAHL, and PsycINFO.

Results: Nineteen studies were eligible for inclusion. Most examined transitions out of prison. Factors influencing transitions into and out of prison include individual vulnerability, family structure, and adjustment and coping. Studies also found that transitions into prison can influence transitions out of prison. No studies examined transitions between prisons.

Conclusion: Multiple factors influence justice-involved older adults' transitions that could be targeted by correctional and community-based nursing interventions. Research should investigate the full range of transitions experienced by justice-involved older adults.

Purpose: Family surrogate decision-makers in nursing homes (NHs) face complex challenges, influenced by communication quality, trust, and cultural norms. The current study examined how communication fosters trust to enhance surrogate self-efficacy in Israeli NHs, where cultural values strongly shape caregiving and decision-making.

Method: Data from 235 family caregivers of individuals with moderate to advanced dementia in Israeli NHs were analyzed using validated scales and mediation analysis (Hayes' PROCESS Macro).

Results: Communication quality positively correlated with trust and self-efficacy; trust fully mediated this relationship.

Conclusion: Trust-building communication is crucial for empowering surrogates within the unique Israeli cultural context, improving decision confidence and care quality. Future work should explore culturally tailored interventions to support diverse caregiving families.