Research in Gerontological Nursing最新文献

The current study aimed to describe formal caregiver burden of nursing assistants in nursing homes. A descriptive, cross-sectional, convergent mixed methods approach identified attributes of formal caregiver burden using phenomenological interviews and established self-report measures. Themes included nursing assistants' experiences of stress, close relationships, extensive assistance of residents, balancing needs and routines, and feeling accomplished. Self-report measures demonstrated moderate stress, moderate caring behaviors, responsibility, and competence. MDS 3.0 results showed moderate cognitive impairment, minimal depressive symptoms, and decreased functional status of residents. The mixed methods synthesis confirmed the presence of five attributes of formal caregiver burden: perceived stress, caring for another, dependency of the older adult, responsibility, and competence. Burnout was not confirmed. Future investigation of attributes among a larger, diverse sample of nursing assistants, residents, and nursing homes will advance knowledge and inform research design and methods of interventions. [Research in Gerontological Nursing, 16(5), 231-240.].

Guided by the RE-AIM framework, the current study sought to examine the relationship between perceived needs of older adults living in publicly supported housing and loneliness. Participants were males and females aged 70 to 83 years who identified as White or Chinese. Using the Camberwell Assessment of Need Short Appraisal Schedule and UCLA Loneliness Scale, the relationship between residents' needs and loneliness was assessed to guide the development of interventions. Results revealed residents self-reported 54% of their needs were met and rated their loneliness at a score of 36.5 (moderate level). Furthermore, there was a medium positive correlation between unmet needs and loneliness whereby high unmet needs were associated with higher loneliness scores. Findings suggest that these older adults living in publicly supported housing are vulnerable to the negative consequences of loneliness. Implementing equitable and inclusive interventions to address the impact of loneliness in the context of social determinants of health is warranted. [Research in Gerontological Nursing, 16(5), 217-223.].

The current study examined racial and ethnic differences in psychological, behavioral, and metabolic risk factors for cardiovascular disease (CVD) and CVD conditions among family caregivers (FCGs) of persons with dementia. We used the 2015-2020 Behavioral Risk Factor Surveillance System data. The sample included a total of 6,132 FCGs of persons with dementia. Compared to non-Hispanic White FCGs, non-Hispanic Black and non-Hispanic Asian FCGs were less likely to have depression. The Other racial/ethnic FCG group was more likely to currently smoke. Non-Hispanic Black FCGs were less likely to have exercised, more likely to be obese, and more likely to have been diagnosed with diabetes. No differences in CVD conditions (e.g., angina/coronary heart disease, stroke, myocardial infarction) were detected between racial/ethnic minority FCGs and non-Hispanic White FCGs. Future studies should investigate relationships between racial/ethnic minority-specific caregiving and CVD by including a larger, racially and ethnically diverse population of FCGs. [Research in Gerontological Nursing, 16(5), 241-249.].

The current study evaluated the effect of comprehensive geriatric assessment (CGA) and multidisciplinary treatment followed by a nurse-guided transitional care bridge program in 100 hospitalized older adults. In the intervention group, CGA and multidisciplinary care were performed. The control group was provided with guideline-associated treatment. Study outcomes comprised the 6-month Katz Index of Independence in Activities of Daily Living (ADL) score, Lawton Instrumental ADL (IADL) score, and unplanned hospital readmission rate. There were no differences in mean 6-month Katz ADL scores between intervention and control groups; however, significant differences were found between groups in IADL score and unplanned hospital readmission rate. CGA followed by nurse-guided transitional care stabilized patients' IADL score and improved hospital readmission rate. The current results informed that combining CGA with multidisciplinary continuous nursing is an effective and feasible working pattern; however, more exploratory work is needed. [Research in Gerontological Nursing, 16(5), 224-230.].

Despite the increase in older adults receiving kidney transplantation (KT), little is known about their experience and adaptation process after KT. The current study aimed to explore the process of adaptation after KT in older adult recipients using a qualitative design and grounded theory methodology. Sixteen recipients who had KT at age ≥60 years and received follow-up care were recruited at a university hospital in South Korea. Data were collected from July to December 2017 through in-depth interviews with individual participants. The core theme of the adaptation process after KT in older adult recipients was A Journey of Straining to Save the Last Lifeline. The adaptation process comprised three stages: confusion, depression, and compromise. Tailored interventions based on the in-depth understanding of the adaptation process found in the current study are needed to improve adaptation after KT in older adult recipients. [Research in Gerontological Nursing, 16(4), 183-193.].

With an aging population, increasing numbers of older adults are assuming a caregiving role, including performing complex care procedures, such as wound care. Access to and use of resources are associated with better physical and mental health for caregivers. A thematic analysis of qualitative interviews with adult caregivers aged ≥65 years performing wound care identified seven resources supportive of the caregiver role, including: (a) access to expert guidance from health care professionals; (b) written instructions; (c) relationships with health care professionals for obtaining wound care supplies; (d) need for additional medical equipment; (e) financial resources; (f) coverage for caregiver personal time; and (g) select persons for caregiver social and emotional support. Given that older adults are increasingly cast into caregiver roles in the home setting, providing resources to sustain care recipients and their caregivers is critical. [Research in Gerontological Nursing, 16(4), 194-201.].

Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].

The current retrospective descriptive study evaluated nursing practice variations on pain management in older adults with dementia admitted to an acute geriatrics unit (AGU) before (2018) and during (2021) the coronavirus disease 2019 (COVID-19) pandemic. Data were gathered from electronic health records. Pain intensity was evaluated a median of 1.9 times per day of stay in the pre-COVID-19 sample, whereas in the COVID-19 sample, the median was 0.7 times per day of stay. Median number of analgesic administrations per day of stay and mean percentage of clinical care records that mentioned pain were higher in patients admitted during the pandemic. Variations in nursing care organization in the AGU due to the COVID-19 pandemic had an impact on the patterns of pain management nursing practice in older adults with dementia. [Research in Gerontological Nursing, 16(4), 173-182.].

The purpose of the current study was to evaluate treatment fidelity (i.e., the extent to which an intervention is provided as intended) in the Family-Centered Function-Focused Care (Fam-FFC) intervention. This was a descriptive study using data collected during intervention activities throughout the course of the Fam-FFC study. Specific measures included Environment and Policy Assessments, Fam-FFC Knowledge Test, Goal Attainment Scale, Function-Focused Care Behavior Checklist, and completion of the FamPath Audit. Delivery was provided as intended. Staff demonstrated intervention skills with only one Fam-FFC research nurse needing retraining. Receipt was based on Fam-FFC Knowledge Test scores >80%, with the majority of participants reporting goal achievement as expected or higher than expected and slight improvement in environments and policies to better support Fam-FFC. Lastly, enactment was based on evidence that in 67% of observations staff provided at least one function-focused care intervention. Findings from this study will be used to adapt the intervention to reach all staff, increase ways to change environments and policies, consider ways to more comprehensively evaluate enactment of function-focused care during real-world interactions, and consider the characteristics of nursing staff and whether a relationship exists between staff characteristics and providing function-focused care. [Research in Gerontological Nursing, 16(4), 165-171.].