Research in Gerontological Nursing最新文献

Purpose: To gain a deeper understanding of Black older adults' (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course.

Method: Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process.

Results: Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results.

Conclusion: Although participants faced ACEs including racism, they found strategies to help them actively cope. [Research in Gerontological Nursing, 18(2), 57-67.].

Purpose: Loneliness screening is recommended as best practice in primary care for older adults, yet it is not widely implemented. The purpose of the current study was to assess feasibility of a loneliness screening and referral program (SOCIAL Rx) in a primary care practice.

Method: Loneliness was assessed using the 3-item UCLA Loneliness Scale and curated referrals were provided for those who screened positive. Outcome measures were organized using the RE-AIM framework domains of reach, effectiveness, and adoption. Qualitative interviews were conducted to explore feasibility/acceptability and patient preferences regarding referrals.

Results: Eighty-one percent of patients were screened for loneliness; 33.3% were somewhat lonely and 17.7% were very lonely. Fifty-two percent of those who were lonely were provided a referral, and 40% of providers referred ≥50% of eligible patients.

Conclusion: Loneliness was prevalent in this population of older adults, highlighting the imperative for screening and intervention. [Research in Gerontological Nursing, 18(2), 69-80.].

Purpose: To develop a predictive model for fall risk in pre-frail older adults, providing a basis for early identification and prevention of falls among this population.

Method: This was a multicenter prospective cohort study. A total of 473 pre-frail older adults were included, 335 as the training set and 142 as the test set. Univariate and stepwise binary logistic regression analyses were conducted to identify the relationship between pre-frail and fall risk and establish the frailty risk prediction nomogram. The nomogram was constructed based on the results of logistic regression. The model assessment relied on the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, calibration curves, and decision curve analysis.

Results: Fall incidence rate among pre-frail older adults within 6 months was 13.63%. The final fall risk prediction model identified that sex, history of falls in the past year, visual impairment, increased nocturia, and fear of falling are the most critical risk factors for falls in pre-frail older adults. The model exhibited good accuracy in the testing set, with an area under the ROC curve of 0.825 (95% confidence interval [0.736, 0.914]).

Conclusion: Pre-frail older adults have a higher incidence of falls. The logistic regression model constructed in this study shows promising predictive capabilities and can be used as a screening tool to identify pre-frail older adults at high risk of falls in clinical practice. We anticipate that this model will assist clinical nurses in enhancing the efficiency of fall prevention efforts and reducing the incidence of falls among pre-frail older adults. [Research in Gerontological Nursing, 18(1), 29-39.].

Purpose: To explore cultural factors related to resilience among Black/African American Alzheimer's disease and related dementias (ADRD) partner caregivers.

Method: This study used a qualitative design. An adapted Resilience Framework informed the in-depth interviews with 10 Black/African American ADRD partner caregivers.

Results: Four major themes emerged: Unfolding Process of ADRD Discovery, Resilience is Multifaceted in Caregiving, Resilience is an Adaptive Process, and Cultural Heritage Shapes Caregivers' Resilience Experiences. The major themes include a total of 18 subthemes.

Conclusion: Findings provide an in-depth understanding of how race, ethnicity, and cultural positive adaptive factors influence resilience among diverse ADRD partner caregivers. [Research in Gerontological Nursing, 18(1), 21-28.].

The rising prevalence of Alzheimer's disease and Alzheimer's disease-related dementias has led to renewed public discourse and policy changes in response to the care needs of persons living with dementia and their care partners. Comprehensive dementia care models are central to many recent policy initiatives, most notably the Centers for Medicare & Medicaid Services Guiding an Improved Dementia Experience model. Gerontological nursing research is uniquely positioned to design and lead research investigating the effectiveness of these initiatives, as well as the dissemination and scaling of existing comprehensive dementia care models. The current Annual State of the Science Review provides an overview of the current state of comprehensive dementia care models in the United States and relevant policies. Challenges and opportunities for nursing education, research, and implementation across the translational research continuum are also outlined. [Research in Gerontological Nursing, 18(1), 7-16.].

Purpose: Despite the benefits of outdoor activity in older adults, a paucity of research explores factors associated with the frequency of older adults going outdoors. The aim of the current study was to investigate if factors of cognitive status, physical performance, and neighborhood characteristics were associated with outdoor frequency among older adults.

Method: This cross-sectional study used National Health and Aging Trends Study data to characterize outdoor frequency among Medicare beneficiaries by participant demographics, health, and neighborhood characteristics, and estimated relationships between participant factors and outdoor frequency.

Results: The sample included 3,368 participants. The majority (51.6%) were aged 75 to 84 years and female (57.2%). Most (60.4%) participants went outside daily. Probable dementia, physical limitations, and presence of street disorder and sidewalk continuity were associated with decreased outdoor frequency.

Conclusion: Research is needed to develop interventions addressing neighborhood conditions and promoting outdoor activity among older adults living with dementia and physical limitations. [Research in Gerontological Nursing, 18(1), 40-52.].

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.].