Research in Gerontological Nursing最新文献

Purpose: To consider the value of a multiple measurement assessment approach to determine evidence of dementia for inclusion in research studies.

Method: The current descriptive study used screening data from a study implementing a pain clinical practice guideline in nursing homes. Descriptive statistics and structural equation modeling were used to test the measurement model of cognition.

Results: A total of 111 individuals were included. The model fit the data; however, two direct resident assessments indicated that 10% and 21% of participants had no dementia based on the Brief Interview for Mental Status and Pizza Test, respectively. All informant-based measures indicated that participants had dementia with the exception of one individual based on the AD8.

Conclusion: Findings supported the practicality of using a single direct assessment completed by the participant to identify whether the individual had evidence of cognitive impairment.

Purpose: Sleep disturbances are common among family caregivers of persons living with dementia (PLWD), yet few interventions are designed to address these sleep challenges. Existing sleep interventions often overlook the specific barriers and facilitators that shape caregivers' sleep experiences. A clearer understanding of these factors is essential for developing tailored, acceptable, and effective interventions to support caregiver sleep health.

Method: The current secondary data analysis used a qualitative descriptive design. Nineteen family caregivers of PLWD who provided unpaid care for >4 hours per day and had insomnia symptoms (Insomnia Severity Index score >5) participated in the current study. Semi-structured interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis.

Results: Caregivers, on average, were aged 63 years (SD = 8.2 years), and primarily female (57.9%), White (68.4%), and spouses (78.9%). Themes for barriers to good sleep were: (1) Connectedness of the PLWD Behavior With Caregiver Sleep, (2) Caregiver Responsibilities and Worries, and (3) Pre-Existing Sleep Problems and Age-Related Health Conditions. Themes for facilitators of good sleep were: (1) Physical Activity and Mindfulness Practices, (2) Using Sleep Hygiene Strategies, and (3) Preferring Nonpharmacological Sleep Solutions Despite Medication Benefits.

Conclusion: The current study identified several modifiable barriers and facilitators that can inform future interventions. These findings underscore the need for early, proactive interventions that incorporate nonpharmacological strategies and consider the interconnected nature of sleep within the caregiving relationship.

Purpose: To identify the attributes, antecedents, consequences, surrogate terms, and related terms of nursing leadership in nursing homes (NHs).

Method: Rodgers' evolutionary concept analysis was used to examine nursing leadership in NHs.

Results: Findings highlight attributes of nurse leaders in NHs and how these attributes set the concept apart from closely related terms, such as RN or clinical leadership.

Conclusion: Nursing leadership is often used interchangeably with surrogate and related terms. This intermingling can undermine the role of nursing leaders in NHs, inhibiting true collaboration and fostering incorrect expectations among interprofessional colleagues in the care setting, operational leaders (e.g., physicians, nursing home administrators), and policymakers around key decisions that impact nursing and ultimately the outcomes of those living and receiving care in NHs.

Purpose: Patient activation encompasses the knowledge, skills, confidence, and willingness to manage health, particularly critical for people with Parkinson's disease (PD) in effective disease management. The current study investigated the relationship between patient activation and health behaviors.

Method: Participants (N = 57) were recruited via social media. Patient activation was measured using the Patient Activation Measure^® (PAM^®), and health behaviors were assessed through the Health-Promoting Lifestyle Profile II (HPLP-II). Partial correlation analyzed associations, and analysis of variance (ANOVA) tested differences across groups.

Results: Patient activation was significantly correlated with overall health behaviors (r = 0.64, p < 0.001) and all subscales, including health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management (range = 0.39 to 0.64). A one-way ANOVA confirmed significant differences in health behaviors across activation levels.

Conclusion: Higher patient activation is associated with better health-promoting behaviors in people with PD. Assessing activation may help tailor interventions to support healthy aging in this population.

Purpose: To compare balance, physical performance, and plantar tactile sensory (PTS) of older adult women before and after 8-week (24 training sessions) balance circuit training (BCT) or high-intensity functional training (HIFT).

Method: Forty-five older adult women were randomly allocated into groups: BCT, HIFT, and control (CG). The BCT group performed a seven-station exercise circuit, whereas the HIFT group performed six calisthenic exercises. Balance and physical performance were assessed using the Berg Balance Scale (BBS) and Short Physical Performance Battery (SPPB), respectively. PTS in the plantar region was evaluated through monofilaments. Within and between-group comparisons were performed.

Results: SPPB score and PTS improved significantly in the BCT and HIFT groups, and were significantly different from the CG. BBS score also improved significantly in the BCT and HIFT groups, but only the BCT group score was significantly different from the CG score.

Conclusion: BCT and HIFT interventions were shown to improve balance, physical performance, and PTS among older adult women.

Purpose: To evaluate the effectiveness of a mobile health application (app), Aged Smart-Care (ASC), on improvement of health behaviors and quality of life among community-dwelling older adults.

Method: A total of 230 participants were randomly assigned to either the intervention group (n = 115), which used the ASC app, or control group (n = 115), which received standard health management and a home health self-management manual. The ASC app provided personalized disease management, dietary advice, exercise recommendations, medication guidance, and access to health care consultations during daytime business hours. Follow up was conducted via telephone.

Results: The intervention group had significant improvements in body mass index, daily alcohol consumption, daily smoking quantity, weekly exercise frequency, self-efficacy, medication adherence, number of physician visits, and quality of life metrics. Notably, improvements were seen in physical functioning, physical role, general health, vitality, social functioning, emotional role, and mental health dimensions (p < 0.05); however, no significant differences were observed in the bodily pain dimension of quality of life or number of hospitalizations (p > 0.05).

Conclusion: The current study demonstrates that mobile health apps, such as ASC, can effectively enhance health behaviors and quality of life in older adults.

Purpose: Understanding how social media use (SMU) embedded in daily routines influences mental health in older adulthood is crucial. We explored whether integration-based SMU relates to depressive symptoms and whether social support mediates that link, considering online network size.

Method: A cross-sectional survey of 371 community-dwelling adults aged ≥55 years measured SMU integration, social support, depressive symptoms, demographics, health, and network size. Mediation analysis with bias-corrected bootstrapping assessed direct and indirect paths.

Results: Greater SMU integration corresponded with slightly higher depressive scores. Higher social support predicted lower symptoms but did not explain the SMU-depression association. Participants with medium-sized networks reported the strongest support; larger networks offered no additional benefit.

Conclusion: Deeply embedding social media in daily routines may modestly intensify depressive feelings, whereas maintaining a moderate circle of online ties seems most supportive. Interventions should foster balanced engagement and manageable networks among older adult users.

Purpose: To codify functional ability measures using administrative claims data to identify individuals for palliative care and examine their associations with mortality.

Method: A retrospective cohort analysis of July 2022-June 2023 administrative claims data for 6,625 Medicare Advantage plan enrollees identified functional ability measures-activities of daily living (ADL), feeding and respiratory support, physical therapy and occupational therapy (PT/OT), and skilled nursing-as key mortality predictors. Logistic regression tested associations between functional ability and mortality.

Results: One hundred eighty-six (4.6%) individuals died during the study period. PT/OT services were associated with lower odds of mortality (adjusted odds ratio = 0.74, 95% confidence interval [0.65, 0.85]). ADL support, skilled nursing, and pain management were associated with higher odds of mortality.

Conclusion: Attention to whether a seriously ill individual is receiving PT/OT, ADL support, or skilled nursing may help make timely referrals to palliative care.

Purpose: We examined the relationship between state-level equity scores as it relates to protections and supports of sexual and gender minority (SGM) individuals at the state level and psychosocial caregiving outcomes among SGM caregivers of people living with Alzheimer's disease and related dementias (ADRD).

Method: Data collected from SGM caregivers of people with ADRD were combined with publicly available state-level equity scores. We used mixed linear models to examine the relationships between equity scores and levels of family quality of life and depressive symptoms.

Results: SGM caregivers living in low-equity states experienced significantly more microaggressions, poorer family quality of life, and greater levels of caregiver stigma and depressive symptoms. Equity score was a significant predictor of family quality of life.

Conclusion: Future research to understand the influence of the policy context in which SGM caregivers live is needed to create tailored supports to promote their well-being.