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The Source of Purchased Medications and Its Impact on Medication Mistakes and Hospitalizations. 外购药品来源及其对用药错误和住院的影响。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2022-03-01 DOI: 10.3928/19404921-20220131-02
Martha C Coates, Janeway Granche, Justine S Sefcik, Rose Ann DiMaria-Ghalili

Older adults self-administer prescribed medication regimens to treat chronic diseases, which can lead to mismanagement, medication-related harm, and hospitalization. Using the National Health and Aging Trends Study (NHATS) dataset, we examined the extent to which the medication source could impact the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling adults aged ≥65 years who managed medications independently (N = 3,899). The majority (65%) picked up medications, 18% had medications delivered, and 17% used both methods. Compared to those picking up their medications, those using delivery only were less likely to have a hospital stay (odds ratio [OR] = 0.61, 95% confidence interval [CI] [0.51, 0.94]) but had no difference in odds of medication mistakes (OR = 1.13, 95% CI [0.57, 2.23]). Those using both methods were more likely to report hospital stays (OR = 1.43, 95% CI [1.11, 1.85]) and medication mistakes (OR = 1.65, 95% CI [1.00, 2.73]). Health care providers should consider medication source when assessing older adults' ability to safely self-manage medications. [Research in Gerontological Nursing, 15(2), 69-75.].

老年人自行使用处方药物治疗慢性病,这可能导致管理不善、药物相关伤害和住院。使用国家健康和老龄化趋势研究(NHATS)数据集,我们检查了药物来源可能影响≥65岁独立管理药物的社区居住成年人自我报告用药错误和住院的程度(N = 3899)。大多数(65%)接受药物治疗,18%的人接受药物治疗,17%的人同时使用两种方法。与拿起药物的患者相比,仅使用送药的患者住院的可能性较小(优势比[OR] = 0.61, 95%可信区间[CI][0.51, 0.94]),但用药错误的几率没有差异(OR = 1.13, 95% CI[0.57, 2.23])。使用这两种方法的患者更有可能报告住院时间(OR = 1.43, 95% CI[1.11, 1.85])和用药错误(OR = 1.65, 95% CI[1.00, 2.73])。卫生保健提供者在评估老年人安全自我管理药物的能力时应考虑药物来源。老年护理研究,15(2),69-75。
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引用次数: 1
The Intersections of Structural Racism and Ageism in the Time of COVID-19: A Call to Action for Gerontological Nursing Science. 2019冠状病毒病时期结构性种族主义和年龄歧视的交叉点:老年护理科学的行动呼吁。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2022-01-01 DOI: 10.3928/19404921-20211209-03
Sheria G Robinson-Lane, Laura Block, Barbara J Bowers, Pamela Z Cacchione, Andrea Gilmore-Bykovskyi

The health consequences of systemic racism and ageism have received growing attention as the coronavirus disease 2019 pandemic has illuminated long-standing inadequacies and injustices that are structurally engrained in our health systems. The current State of the Science Commentary addresses the intersecting influences of systemic racism and ageism, and other "-isms" that conspire to create disparate health outcomes for older adults from historically excluded and marginalized backgrounds. We focus specifically on the long-term care sector as a representative microcosm of structural inequities, while recognizing that these unjust barriers to health are widespread, endemic, and pervasive. We present a call to action for gerontological nursing science to engage deeply and robustly in these realities, and the ethical and scientific imperative they present to ensure that all older adults encounter just conditions for maximizing their health and well-being. [Research in Gerontological Nursing, 15(1), 6-13.].

随着2019年冠状病毒病大流行暴露出我们卫生系统中长期存在的结构性不足和不公正,系统性种族主义和年龄歧视的健康后果受到越来越多的关注。本期《科学状况评论》探讨了系统性种族主义和年龄歧视以及其他“主义”的交叉影响,这些“主义”共同造成了历史上被排斥和边缘化背景的老年人的不同健康结果。我们特别关注长期护理部门,将其作为结构性不平等的代表性缩影,同时认识到这些不公正的健康障碍是广泛、流行和普遍的。我们呼吁老年护理科学采取行动,深入而有力地参与这些现实,以及他们提出的伦理和科学要求,以确保所有老年人都能最大限度地获得健康和福祉。老年护理研究,15(1),6-13。
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引用次数: 6
A Psychometric Analysis of the 20-item Revised University of California Los Angeles Loneliness Scale Among Korean Older Adults Living Alone. 20项加州大学洛杉矶分校修订的韩国独居老年人孤独感量表的心理测量分析。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 Epub Date: 2021-10-04 DOI: 10.3928/19404921-20210924-03
Chiyoung Lee, Belong Cho, Qing Yang, Sun Ju Chang, So-Im Ryu, Eun-Young Noh, Yeon-Hwan Park

The current study aimed to explore the factor structure of the Korean version of the Revised University of California Los Angeles loneliness scale for the Korean older adult population. Analyses were based on a cross-sectional cohort of 1,041 community-dwelling older adults (age ≥65 years) living alone in one Korean city. Exploratory factor analysis (EFA) was conducted to determine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to ascertain the validity of the outcomes. For reliability, Cronbach's alpha was computed. Based on EFA and CFA results, a two-factor structure was found. The first factor reflected "intimate loneliness" and the second "relational loneliness." Derived factors demonstrated satisfactory reliability (>0.8). The two factors of loneliness identified in this study could be considered when attempting to treat loneliness among older adults. Nevertheless, future studies should confirm the findings of this study and evaluate aspects of validity beyond factorial validity to further support the conceptual separation of the two identified factors. [Research in Gerontological Nursing, 14(6), 305-316.].

本研究旨在探讨加州大学洛杉矶分校修订版韩国老年人孤独感量表的因素结构。分析基于一个韩国城市的1041名独居社区老年人(年龄≥65岁)的横断面队列。采用探索性因子分析(EFA)确定量表的基本结构,采用验证性因子分析(CFA)确定结果的效度。为了提高可靠性,我们计算了Cronbach’s alpha。基于EFA和CFA结果,发现了一个双因素结构。第一个因素反映了“亲密孤独”,第二个因素反映了“关系孤独”。导出因子具有令人满意的信度(>0.8)。当试图治疗老年人的孤独感时,本研究中确定的两个孤独因素可以被考虑。然而,未来的研究应该证实本研究的结果,并评估除因子效度之外的效度方面,以进一步支持两个已确定因素的概念分离。老年护理研究,14(6),305-316。
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引用次数: 5
Changes in Physical and Cognitive Function Predict Sedentary Behavior in Older Adults With Mild Cognitive Impairment. 身体和认知功能的变化可预测轻度认知障碍老年人的久坐行为。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 DOI: 10.3928/19404921-20211021-01
Mary Elizabeth Bowen, Beatrice Gaynor, Lorraine J Phillips

The current longitudinal study examined the influence of cognitive and lower extremity function on sedentary behavior continuously over 6 months in community-dwelling older adults with mild cognitive impairment (MCI). Multilevel models examined Montreal Cognitive Assessment (MoCA) change scores and the Short Physical Performance Battery (SPPB) on percent time in sedentary behavior among 17 older adults with MCI (50 to 74 observations for analysis). Sedentary behavior was measured daily and averaged monthly using wrist-worn actigraphy. Each 1-unit decrease in MoCA score was associated with an increase of 2 percentage points in sedentary behavior (p ≤ 0.01). In addition, each 1-unit decrease in chair stand score (lower extremity strength) was associated with an increase of 5 percentage points in sedentary behavior (p ≤ 0.01). Older adults experiencing cognitive decline and concurrent changes in lower extremity strength had the sharpest increase in sedentary behavior. Findings suggest lower body strengthening interventions may reduce sedentary behavior time and subsequently preserve physical functioning in this vulnerable population. [Research in Gerontological Nursing, 14(6), 285-291.].

当前的纵向研究调查了认知和下肢功能对社区居住的轻度认知障碍老年人(MCI)连续6个月久坐行为的影响。多层模型检查了蒙特利尔认知评估(MoCA)变化分数和短时间体力表现电池(SPPB)对17名老年轻度认知障碍患者久坐行为的百分比(50至74个观察值用于分析)。使用腕带活动记录仪测量每天和平均每月的久坐行为。MoCA评分每降低1个单位,久坐行为增加2个百分点(p≤0.01)。此外,椅子站立得分(下肢力量)每降低1个单位,久坐行为增加5个百分点(p≤0.01)。经历认知能力下降和同时下肢力量变化的老年人,久坐行为的增加幅度最大。研究结果表明,下肢强化干预可以减少久坐行为的时间,从而保持弱势群体的身体功能。老年护理研究,14(6),285-291。
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引用次数: 1
Navigating Research in a Pandemic: Implications for Publication. 在大流行中导航研究:对出版物的影响。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 DOI: 10.3928/19404921-20211103-01
Heather M Young, Janice F Bell
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引用次数: 0
New Problems and Iatrogenic Events Among Older Adults in the First 30 Days of Post-Acute Rehabilitation. 老年人急性康复后前30天的新问题和医源性事件。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 Epub Date: 2021-10-04 DOI: 10.3928/19404921-20210924-02
Michelle Simpson, Christine R Kovach

The current prospective study of 126 older adults examined the new problems and iatrogenic events developing in post-acute rehabilitation. Data were extracted from the electronic health record and a consensual agreement process was used for coding. Of the 578 new problems, 66% (n = 381) were not related to the primary problem treated at the hospital; 41.7% (n = 241) were iatrogenic adverse events. The median problem-free duration was 3 days and median duration to a moderate to severe problem was 8 days. Medication-related adverse events were common. This study did not show that comorbidity or functional level should be used in determining the likelihood of older adults developing new problems or iatrogenic events during post-acute rehabilitation. Inferential findings suggest older adults with a psychiatric diagnosis, cognitive impairment, or failure to thrive may require extra measures, such as comprehensive assessment and early intervention, to prevent new problems and iatrogenic events. [Research in Gerontological Nursing, 14(6), 293-304.].

目前对126名老年人的前瞻性研究调查了急性康复后出现的新问题和医源性事件。从电子健康记录中提取数据,并采用协商一致的协议程序进行编码。在578个新问题中,66% (n = 381)与在医院治疗的主要问题无关;41.7% (n = 241)为医源性不良事件。无问题持续时间中位数为3天,中度至重度问题持续时间中位数为8天。与药物相关的不良事件很常见。该研究并未表明合并症或功能水平应用于确定老年人急性康复后出现新问题或医源性事件的可能性。推断结果表明,患有精神疾病诊断、认知障碍或发育不良的老年人可能需要额外的措施,如全面评估和早期干预,以防止新的问题和医源性事件。老年护理研究,14(6),293-304。
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引用次数: 0
Understanding Nursing Home Residents' Lives Through the Lens of Selection, Optimization, and Compensation Theory. 从选择、优化与补偿理论的视角看养老院居民的生活。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 Epub Date: 2021-10-04 DOI: 10.3928/19404921-20210924-04
Amanda M Runyan, Louis J Medvene, Carissa K Coleman, Anthony DiLollo

The current study examined the importance of personal goals to residents; assessed whether goal-related behavior was associated with mental health factors (i.e., depression, experiential avoidance, and quality of life); and explored residents' use of selection, optimization, and compensation (SOC) strategies. Interviews were conducted with eight residents at a nursing home along with paper-and-pencil measures of mental health factors. Transcripts were coded first for goal content and subsequently analyzed using an exploratory qualitative method. Most residents (five of eight) denied having goals. Experiential avoidance and depression were significantly negatively correlated with goal content; quality of life was significantly positively correlated with goal content. Eleven themes derived from exploratory analysis suggest SOC processes were important in residents' lives. The study demonstrated the relevance of SOC for residents' quality of life. The potential for developing person-centered interventions to evoke implicit goals and facilitate attainment is discussed. [Research in Gerontological Nursing, 14(6), 277-284.].

本研究考察了个人目标对居民的重要性;评估目标相关行为是否与心理健康因素(即抑郁、经验回避和生活质量)相关;探索居民对选择、优化和补偿(SOC)策略的使用。研究人员对一家养老院的8名住院者进行了访谈,并对心理健康因素进行了纸笔测量。转录本首先编码为目标内容,随后使用探索性定性方法进行分析。大多数居民(8人中有5人)否认有目标。体验回避和抑郁与目标内容呈显著负相关;生活质量与目标内容呈显著正相关。探索性分析得出的11个主题表明,SOC过程在居民生活中很重要。本研究证明了SOC与居民生活质量的相关性。潜在的发展以人为中心的干预措施,唤起隐性目标和促进实现进行了讨论。老年护理研究,14(6),277-284。
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引用次数: 0
Animal-Assisted Interventions for Dementia: A Systematic Review. 动物辅助干预痴呆:系统综述。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-11-01 Epub Date: 2021-10-04 DOI: 10.3928/19404921-20210924-01
Jennifer R Babka, Kari R Lane, Rebecca A Johnson

Behavioral and psychological symptoms of dementia (BPSD) can be devastating for people who have dementia and their families. More than 5 million Americans are living with dementia, and approximately 97% of these individuals have BPSD, including agitation, aggression, anxiety, depression, apathy, sleep disturbances, wandering, and disinhibition. Animal-assisted interventions (AAI) have increasingly been used to treat these symptoms in individuals with dementia and constitute an optimal nonpharmacological treatment strategy. The current review aims to explore the literature regarding AAI in treating BPSD. Of 3,573 publications reviewed, 15 articles met inclusion criteria. All studies included a type of AAI exploring BPSD within individuals with dementia. The systematic review unveils AAI may be beneficial for those with dementia; however, further research is necessary to address limitations in the existing literature. [Research in Gerontological Nursing, 14(6), 317-324.].

痴呆症的行为和心理症状(BPSD)对痴呆症患者及其家人来说可能是毁灭性的。超过500万美国人患有痴呆症,其中大约97%的人患有BPSD,包括躁动、攻击、焦虑、抑郁、冷漠、睡眠障碍、徘徊和去抑制。动物辅助干预(AAI)已越来越多地用于治疗痴呆症患者的这些症状,并构成了最佳的非药物治疗策略。本综述旨在探讨AAI治疗BPSD的相关文献。在审查的3,573份出版物中,有15篇文章符合纳入标准。所有的研究都包括一种探索痴呆患者中BPSD的AAI类型。系统评价显示AAI可能对痴呆症患者有益;然而,需要进一步的研究来解决现有文献的局限性。老年护理研究,14(6),317-324。
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引用次数: 4
Qualitative Insights into the Working Conditions of Personal Support Workers in Long-Term Care in the Context of a Person-Centered Communication Training Intervention. 以人为本的沟通训练干预下长期照护中个人支持工作者工作状况的质性洞察
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-09-01 Epub Date: 2021-07-22 DOI: 10.3928/19404921-20210708-01
Marie Y Savundranayagam, Susan Maureen Docherty-Skippen, Shalane R Basque

The current study reports on qualitative insights into the working conditions of personal support workers (PSWs) in long-term care (LTC) homes within the context of a person-centered communication training intervention. PSWs (N = 39) employed at one of four LTC homes in southwestern Ontario, Canada, participated in a series of 1-hour focus groups before, during, and after a 2-week person-centered communication training program for formal caregivers of persons living with dementia (PLWD). Textual data from focus group conversations were coded and organized into themes following an interpretive description research design. Three overarching themes emerged related to the working conditions of PSWs in LTC: (1) dementia care is complex, (2) there is a lack of trained staff to provide person-centered dementia care, and (3) residents' families are not appropriately situated in residents' care circles. Four overarching themes emerged related to the impact of those working conditions: (a) PSW occupational burnout, (b) poor resident care, (c) frustrated and disengaged families, and (d) PSW job attrition. These findings offer LTC employers and administrators opportunities to ameliorate working conditions to better support person-centered dementia care. [Research in Gerontological Nursing, 14(5), 245-253.].

本研究在以人为本的沟通训练干预的背景下,对长期照护(LTC)家庭中个人支持工作者(psw)的工作条件进行了定性分析。在加拿大安大略省西南部的四个LTC家庭之一工作的psw (N = 39),在为期两周的以人为中心的痴呆症患者(PLWD)正式照护者沟通培训计划之前、期间和之后,参加了一系列1小时的焦点小组。焦点小组对话的文本数据被编码并按照解释性描述研究设计组织成主题。与LTC的psw工作条件相关的三个主要主题是:(1)痴呆症护理复杂;(2)缺乏训练有素的人员来提供以人为本的痴呆症护理;(3)居民家庭没有适当地位于居民护理圈中。与这些工作条件的影响相关的四个总体主题出现了:(a) PSW职业倦怠,(b)差的住院护理,(c)沮丧和不参与的家庭,以及(d) PSW工作流失。这些发现为LTC雇主和管理人员提供了改善工作条件的机会,以更好地支持以人为本的痴呆症护理。老年护理研究,14(5),245-253。
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引用次数: 3
Integration of Health Information Technology and Promotion of Personhood in Family-Centered Dementia Care: Intervention Trial. 在以家庭为中心的失智症照护中整合健康资讯科技与提升人格:干预试验。
IF 1.6 4区 医学 Q3 NURSING Pub Date : 2021-09-01 DOI: 10.3928/19404921-20210825-02
Ellen L Brown, Nicole Ruggiano, Lisa Roberts, Peter J Clarke, Debra Lee Davis, Marc Agronin, David S Geldmacher, Monica Strauss Hough, Mariateresa Teri H Muñoz, C Victoria Framil, Xin Yang

Alzheimer's disease and related dementias (ADRD) often result in communication deficits that can lead to negative health outcomes as well as complications for caregiving and clinical care. Although augmentative and alternative communication (AAC) devices have demonstrated efficacy in assisting persons living with dementia (PLWD) in communicating, few devices offer customization for the person's care preferences (e.g., clothing, food, activities) or are designed for integration into clinical care and caregiving. To address this issue, our research team is developing a novel electronic AAC prototype with a touchscreen to promote communication and personhood for PLWD. The current article describes the development of this technology and uses the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement to describe the clinical trial that is planned to test its efficacy.

Targets: PLWD and their care partners.

Intervention description: Use of AAC Plus to promote communication and personhood for PLWD.

Mechanisms of action: AAC Plus will provide PLWD and care partners a way to communicate PLWD's daily preferences and provide clinical data for health care providers.

Outcomes: Determine whether enhanced communication of daily preferences of PLWD will improve quality of life of PLWD and their care partners.

Trial registration: ClinicalTrials.gov Identifier: NCT04571502 (Date of registration October 1, 2020). [Research in Gerontological Nursing, 14(5), 225-234.].

阿尔茨海默病和相关痴呆(ADRD)通常会导致沟通缺陷,从而导致负面的健康结果以及护理和临床护理并发症。虽然辅助和替代沟通(AAC)设备在帮助痴呆症患者沟通方面已被证明有效,但很少有设备可以根据患者的护理偏好(例如,服装、食物、活动)进行定制,或设计用于整合临床护理和护理。为了解决这个问题,我们的研究团队正在开发一种带有触摸屏的新型电子AAC原型,以促进PLWD的沟通和个性。当前的文章描述了这项技术的发展,并使用标准方案项目:介入性试验建议(SPIRIT) 2013声明来描述计划测试其有效性的临床试验。目标:残疾人福利组织及其护理伙伴。干预措施描述:使用AAC Plus来促进PLWD的沟通和人格。作用机制:AAC Plus将为PLWD和护理合作伙伴提供一种沟通PLWD日常偏好的方式,并为卫生保健提供者提供临床数据。结果:确定加强PLWD日常偏好的沟通是否会改善PLWD及其护理伙伴的生活质量。试验注册:ClinicalTrials.gov标识符:NCT04571502(注册日期:2020年10月1日)。老年护理研究,14(5),225-234。
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引用次数: 1
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Research in Gerontological Nursing
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