Research in Gerontological Nursing最新文献

Purpose: To test a pilot home-telehealth program to enhance functional ability, physical performance, and objective physical activity in Veterans after hospital discharge.

Method: A physical activity trainer and multidisciplinary team supported the progression of rehabilitation goals via a 6-month home exercise program. Pilot program feasibility, including recruitment, retention, reasons for early withdrawal, differences between those who did and did not complete the program, and completion of outcome measures are reported. Outcomes include changes in functional ability, physical performance, and physical activity (using actigraphy) from baseline to endpoint.

Results: Twenty-one of 45 Veterans enrolled did not complete the 6-month program. No baseline differences were found comparing completers and non-completers. The majority of completers (n = 24) were White men with a mean age of 74 years (SD = 8 years, range = 64 to 93 years) and included those with no (n = 8), mild (n = 13), and moderate (n = 3) cognitive impairment. Although there were borderline improvements in functional ability and physical performance from baseline to endpoint, mean steps per day increased from 2,206 (SD = 1,780) to 3,888 (SD = 2,895) (p = 0.04).

Conclusion: The pilot home-telehealth program is feasible and may address declines in function and activity observed during hospital-to-home transitions, including among those with cognitive impairment. [Research in Gerontological Nursing, 17(6), 271-279.].

Purpose: To develop an exploratory survey measuring family caregiver use of elements of pain assessment in people living with dementia (PLWD).

Method: A survey development process was conducted: Phase 1 (item development), Phase 2 (content validity), and Phase 3 (face validity).

Results: A set of survey questions was developed, and their wording modified after review by experts in survey question writing. Content experts rated the exploratory questions as having item content validity indices (I-CVI) from 0.25 to 1. Questions were further tested with a sample of family caregivers (N = 10) who supported face validity and content validity for questions with a low I-CVI. The final survey has eight quantitative and two free-text questions.

Conclusion: This survey can be used for exploratory purposes to describe pain assessment by family caregivers of PLWD; however, further validation is needed for uses beyond exploratory work. [Research in Gerontological Nursing, 17(6), 308-316.].

Purpose: Pressure ulcers (PUs) are serious health outcomes for nursing home (NH) residents and are considered important nursing sensitive quality indicators, as professional nursing care can prevent PUs. The purpose of the current study was to investigate related factors of PUs for NH residents.

Method: A cross-sectional design was used. From August 27, 2021, to March 25, 2022, data were collected from 51 NHs in Korea. Facility, nurse staffing, and resident characteristics were selected as independent variables. The response variable was the number of residents with PUs in the 3 months following admission in each NH.

Results: We used sparse logistic regression to analyze the data. Mean number of residents with PUs per NH was 1.12 (SD = 2.13). When RNs' hours per resident day increased by 1 hour, the number of residents with PUs decreased 0.011 times (p = 0.046). When the ratio of grade 1 residents in each NH increased 1%, the odds of residents with PUs increased 13% (p = 0.036).

Conclusion: Providing high-quality, nursing sensitive care is an essential factor to decrease PUs for NH residents. Providing sufficient RN care is urgently necessary to develop solutions to preventable health conditions for these individuals. [Research in Gerontological Nursing, 17(6), 281-290.].

Purpose: To evaluate the effectiveness of a nursing intervention based on the integration theory of health behavior change (ITHBC) in older adults with type 2 diabetes mellitus (T2DM) and frailty.

Method: This cluster randomized controlled trial has a two-group pre-/posttest design. The intervention group received a 12-week nursing intervention based on the ITHBC and routine health education, whereas the control group only received routine health education. Self-management, frailty, quality of life, fasting blood glucose, body mass index (BMI), grip strength, and functional mobility were measured.

Results: Seventy-one participants (intervention group, n = 35; control group, n = 36) completed the entire study. After the intervention, participants in the intervention group exhibited significant improvements in self-management (all p < 0.001), frailty level (p = 0.006), quality of life (all p < 0.001), and grip strength (p < 0.05), and maintained ideal fasting blood glucose levels (p < 0.05) compared to participants in the control group. However, there were no statistically significant differences in BMI and functional mobility (p > 0.05).

Conclusion: The 12-week nursing intervention based on the ITHBC could enhance self-management, reduce frailty, improve quality of life and grip strength, and maintain optimal fasting blood glucose levels in older adults with T2DM. [Research in Gerontological Nursing, 17(6), 293-306.].

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.].