Research in Gerontological Nursing最新文献

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.

Purpose: To rapidly develop the Attitudes Toward Smart Speaker Integration for Self-Management of Chronic Conditions (ASSIST) survey to evaluate attitudes toward various smart speaker functions for guiding a chronic disease self-management intervention among low-income older adults with chronic conditions and cognitive impairment.

Method: The development process included four phases: conceptualization and survey category determination, item development, content validation, and refinement. An expert panel of nurse researchers and health informatics researchers assisted in identifying self-management categories and developing survey items by providing iterative feedback.

Results: Six major categories of chronic condition self-management were identified. The survey initially comprised 29 items within the six categories, later refined to a final set of 22 items, each reflecting relevant self-management tasks that could be supported by smart speakers.

Conclusion: The ASSIST survey offers a practical tool for assessing perceived usefulness of various smart speaker-based tasks in chronic disease management that can inform an individualized intervention design for underserved older adults with cognitive impairment, although further validation is necessary to broaden its application.

Purpose: To explore the experiences of nurses working with persons living with dementia (PLWD) in perioperative settings.

Method: A study using qualitative description methodology was conducted. We interviewed 20 nurses working on four units in an academic medical center. Conventional content analysis was used to analyze the data.

Results: Five themes were discovered: (1) Nurses' Descriptions of PLWD Perioperative Experience; (2) Nurses' Descriptions of Caregivers' Perioperative Experience; (3) Nurses' Work; (4) Unit Setup and Patient Flow; and (5) Recommendations for Improving Perioperative Care for PLWD. Aspects that complicated care provision included: neuropsychiatric symptoms, cognitive impairment, routine disruption, pain, and insufficient staffing.

Conclusion: Working with PLWD is time-consuming for nurses and they frequently lack knowledge and skills to provide high-quality care. Ways to improve perioperative care for PLWD and their caregivers are summarized, including through nurses' baccalaureate and continuing education.

Purpose: To describe characteristics and outcomes of family caregivers for persons with Parkinson's disease and Lewy body dementia (PD/LBD) and compare them to those of other family caregivers.

Method: Using a California statewide database, we examined caregiver characteristics and outcomes (strain, loneliness, worse health, and depressive symptoms) and compared them by care recipient diagnosis (PD/LBD, Alzheimer's disease and related dementias, or other chronic conditions) using descriptive statistics and multivariable logistic regression.

Results: PD/LBD caregivers were more likely to identify as female, married, and college-educated; engage in high-intensity caregiving; and report their care recipient wakes them or others up at night. In multivariable models, PD/LBD caregiving was associated with worse health. Among PD/LBD caregivers, performing medical/nursing tasks was associated with higher odds of strain, loneliness, worse health, and depressive symptoms.

Conclusion: PD/LBD caregivers are a distinct group who often experience high-demand caregiving. Tailored support can help address the unique needs of this population.

Purpose: To explore the relationship between postural balance and fear of falling (FoF) in older adults, examining the chain mediating roles of activities of daily living (ADLs) and depressive symptoms.

Method: The chain mediating role of ADLs and depressive symptoms between postural balance and FoF was tested using the PROCESS macro for SPSS 26.0.

Results: ADLs and depressive symptoms play a chain mediating role in the relationship between postural balance and FoF. Impaired postural balance is associated with poorer ADLs in older adults and an increased risk of depressive symptoms and FoF.

Conclusion: Targeted interventions can be developed to reduce FoF in older adults by improving postural balance, increasing ADLs, and alleviating depressive symptoms.

Purpose: To preliminarily examine the individual and interaction effects of hypertension and obstructive sleep apnea (OSA) risk on cognitive functions (i.e., global cognition, memory, attention, and executive function).

Method: The current study was a secondary data analysis. Forty older adults were retrieved from a descriptive study. OSA risk was measured by the STOP-BANG questionnaire, and hypertension by self-report and medications used. Spearman rho correlation and two-way analysis of covariance were used in the data analysis.

Results: After controlling for covariates (i.e., age, educational years, health conditions, body mass index, and depressive symptoms), older adults with hypertension had poorer memory and attention; older adults with high OSA risk had poorer memory and better executive function. This interaction effect of hypertension and OSA risk on executive function was significant.

Conclusion: The association between hypertension and memory and attention and between OSA risk and memory in older adults was supported. The interaction effect was found in executive function but unexpected. Future studies are needed to recruit older adults with hypertension and diagnosed OSA to explore these interaction effects.