Research in Gerontological Nursing最新文献

The current State of the Science Commentary focuses on workforce challenges in the nursing home (NH) setting that lie within the purview of professional nursing-what professional nurses can do to promote high-quality person-centered care within a context of existing resources-individually and broadly across the collective profession. Historically, three models of care delivery have characterized the way in which nursing care is organized and delivered in different settings: primary nursing, functional nursing, and team nursing. Based on the existing evidence, we call for scientific leadership in the redesign, testing, and implementation of a nursing care delivery model that operationalizes relationship-centered team nursing. This integrative model incorporates successful evidence-based approaches that have the potential to improve quality of care, resident quality of life, and staff quality of work life: clear communication, staff empowerment, coaching styles of supervision, and family/care partner involvement in care processes. In addition to the needed evidence base for NH care delivery models, it is imperative that educational programs incorporate content and clinical experiences that will enable the future nursing workforce to fill the leadership gap in NH care delivery. [Research in Gerontological Nursing, 16(1), 5-13.].

Exploratory graph analysis (EGA) based on network theory has been introduced as a highly reliable and effective method to assess scales' dimensionality. We estimated the dimensional network structure of the Revised University of California Los Angeles Loneliness Scale using EGA among a cross-sectional cohort of Korean older adults living alone (N = 1,041). We also evaluated the stability of estimates using a bootstrap version of EGA (bootEGA) and verified the overall fit structure using confirmatory factor analysis (CFA). EGA revealed a two-dimensional structure of the scale initially. The bootEGA result revealed that Item 4 ("I do not feel alone") did not sufficiently load on any dimension, and Item 20 ("There are people I can turn to") was replicated in two or more dimensions. Removing these items resulted in better stability of the dimensions, leading to excellent structural consistency. CFA confirmed a satisfactory fit of the improved structure. [Research in Gerontological Nursing, 16(1), 15-20.].

The current study examined the association between dual filial piety (FP) (reciprocal and authoritarian) and caregiver burden in adult children caregivers and attempted to understand the underlying mechanisms of these links. A cross-sectional study of 222 family caregivers of older relatives in an Arab community in Israel was performed. Data were collected via face-to-face interviews in Arabic using structured questionnaires. Bootstrapping with resampling strategies tested the multiple mediator model. Reciprocal and authoritarian components of FP were associated negatively with caregiver burden. The link with reciprocal FP was partially mediated by role engagement and relationship strain between caregiver and care recipient, whereas the link between authoritarian FP and caregiver burden was mediated by role engagement, but not by relationship strain between caregiver and care recipient. The study highlights the positive effect of cultural values (dual FP) and the underlying mechanisms working against the harmful effects of caregiving stressors in traditional societies, such as Arab-Israeli society. Practitioners should be sensitive to issues of family cultural values and family care among traditional populations. [Research in Gerontological Nursing, 15(6), 293-302.].

Advance care planning (ACP) allows individuals to communicate their wishes for future medical care. ACP is particularly important among those diagnosed with Alzheimer's disease and related dementias (ADRD) due to decline in cognition. In the nursing home setting, conducting ACP with residents with ADRD and their family caregivers is challenging. The purpose of the current integrative review was to: (a) examine the evidence on the process of conducting ACP with residents with ADRD and their family care-givers in nursing home settings, and (b) understand who conducts ACP and when and how ACP is being conducted with residents with ADRD and their family caregivers. Gaps were identified, such as lack of a systematic approach to addressing ACP in nursing homes, lack of clear roles in conducting ACP, family caregivers' and nursing home staff's lack of knowledge and skills to engage in ACP, and lack of diversity in study samples. To improve clinical practice, future studies should explore standardization of the ACP process in the nursing home setting. [Research in Gerontological Nursing, 15(6), 312-320.].

Nursing homes (NHs) are challenged to consistently deliver person-centered care (PCC), or care based on residents' values and preferences. NH staff associate certain resident preferences with risk. However, there are limited evidence-based person-centered risk management strategies to assist NH staff with risky resident preferences. The purpose of the current study was to explore NH staff perceptions of health and safety outcomes associated with honoring NH residents' risky preferences to inform intervention development. This descriptive, qualitative study used sequential focus groups and content analysis, revealing that nursing staff perceive negative and positive outcomes for staff and residents when seeking to honor residents' risky preferences. This finding is supported by three themes: Potential Harms to Staff, Potential Harms to Residents, and Positive Shared Outcomes. These results contribute a set of nurse-driven quality of life and quality of care outcomes for NH staff and residents associated with PCC delivery in NHs. [Research in Gerontological Nursing, 15(6), 271-281.].

The Checklist for Evidence of Person-Centered Care Approaches for Behavioral and Psychological Symptoms of Distress (BPSD) in Care Plans was developed to assess the person-centeredness of care plans for nursing home residents living with behavioral and psychological symptoms associated with dementia. The purpose of the current study was to evaluate the reliability and validity of a revised version of the Checklist. Data from a larger randomized clinical trial testing the implementation of the Evidence of Integration Triangle for BPSD were used. One hundred seventy-nine care plans for 103 residents were examined. Descriptive statistics, Rasch analysis, and inter-rater reliability were used. The Checklist demonstrated evidence of inter-rater reliability and validity based on model fit and acceptable INFIT and OUTFIT statistics. This study serves as pilot work for future Checklist use and validation efforts on a larger scale. Findings encourage a discourse on the inclusion of BPSD and person-centered approaches in care plans for those living with dementia. [Research in Gerontological Nursing, 15(6), 303-311.].

The current study validated and compared three short Geriatric Depression Scales (GDS), including the GDS-5, D'Ath GDS-4, and van Marwijk GDS-4, among 917 Chinese community-dwelling older adults. The GDS-5, D'Ath GDS-4, and van Marwijk GDS-4 presented satisfactory accuracy against the GDS-15 (area under the curve [AUC] = 0.872 to 0.952), and the GDS-5 and D'Ath GDS-4 had better accuracy than the van Marwijk GDS-4. Satisfactory accuracy (AUC = 0.842 to 0.979) for the three scales was also observed across subgroups by age, sex, education, cognitive function, and multimorbidity. The GDS-5 but not D'Ath GDS-4 and van Marwijk GDS-4 retained a 2-point optimal cutoff for depressive symptoms across subgroups. The GDS-5 (average inter-item correlation coefficient [AIIC] = 0.233) and the D'Ath GDS-4 (AIIC = 0.171) but not van Marwijk GDS-4 (AIIC = 0.128) had acceptable internal consistency. Three scales had stable test-retest reliability within a 1- to 2-week interval (intraclass correlation coefficient = 0.670 to 0.885). The GDS-5 is an accurate and reliable depression screening tool with an invariable optimal cutoff among Chinese community-dwelling older adults. The variable optimal cutoffs for the D'Ath GDS-4 and van Marwijk GDS-4 across subgroups may limit their applicability in this population. [Research in Gerontological Nursing, 15(6), 283-291.].

The current randomized controlled trial investigated the effect of a robotic pet on social and physical frailty in community-dwelling older adults. The intervention group (n = 107) received a robotic pet and the control group (n = 113) received usual care following hospital discharge. Social and physical frailty were measured using the Questionnaire to Define Social Frailty Status and the FRAIL questionnaire. Cognitive function and depression were assessed using the Short Portable Mental Status Questionnaire and Geriatric Depression Scale, respectively. Continuous outcomes were compared between groups using t tests or Wilcoxon rank sum tests, as appropriate. Categorical outcomes were compared between groups using chi-square tests or Fisher's exact tests, as appropriate. Main findings showed the robotic pet positively impacted cognitive status in participants who reported they enjoyed engaging with their pet. This finding supported the theoretical premise of the current study that greater engagement with the robotic pet would yield greater improvement in study outcomes. [Research in Gerontological Nursing, 15(5), 229-237.].

There is a gap in understanding adults' readiness to plan for adaptions across the aging trajectory. The purpose of the current psychometric project was to develop and test the Planning for Aging and Frailty Questionnaire. Clinical experience and extant literature formed the basis for creating items measuring planning for aging. Content validity was established with gerontology and health service research experts. Face validity testing was conducted through two cognitive interviewing and debriefing sessions at a senior center. All survey questions resulted in a content validity index ≥0.80 from experts. Face validity testing involved successful completion of the survey by 12 adults followed by cognitive interviewing/debriefing, resulting in minor changes. The 21-item Planning for Aging and Frailty Questionnaire demonstrates good initial validity and can be used to measure readiness in planning for aging and personal experiences and experiences with others. Further testing with additional usage is warranted. [Research in Gerontological Nursing, 15(5), 239-244.].