Purpose: Dementia and altered cognitive function are highly prevalent among older adults with mild cognitive impairment (MCI); hence, prevention is necessary before it develops into dementia. Treatment adherence-medication adherence and physical activity-is essential to prevent and delay dementia; however, comprehensive interventions to promote it in this population are lacking. This study aimed to develop a program for treatment adherence utilizing an Internet of Things (IoT) device.
Methods: The six-step mapping protocol was used to develop the IoT-based treatment adherence intervention (ITAI). The intervention was based on a literature review, expert opinions, and input from older adults with MCI.
Results: In Step 1, a needs assessment was conducted to gain insights into health problems and their underlying determinants. In Steps 2 and 3, performance objectives were identified for behavior change and selected theoretical and evidence-based methods were linked to the intervention outcomes. In Step 4, the ITAI was designed with components and materials consistent with the identified change goals and methods, and specific intervention components were developed. In Step 5, implementation plans and solutions to barriers to its application were identified. In Step 6, the plan to evaluate intervention effectiveness was outlined.
Conclusion: The Intervention Mapping provided a systematic procedure for developing an ITAI for older adults with MCI and preparing a randomized controlled trial. Utilizing Intervention Mapping is useful as ITAI systematically processes treatment adherence for MCI using the IoT and is acceptable and valid. ITAI is expected to increase medication adherence and physical activity in older adults with MCI.
Purpose: The objective of this study was to explore nurses' perception of their roles in shared decision-making about caring for older adults with a chronic disease.
Methods: This study was a qualitative descriptive study. Ten nurses participated in the focus group interviews. The collected data were analyzed using qualitative content analysis to explore nurses' roles in shared decision-making about caring for older adults with a chronic disease.
Results: Nurses' shared decision-making experiences about caring for older adults with a chronic disease yielded four main themes and ten categories including 'facilitating involvement in decision-making', 'providing information for decision-making', 'respecting patient values and preferences', 'evaluating the outcome of decision-making'.
Conclusion: This study explored nurses' roles in shared decision-making about caring for older adults with a chronic disease. Nurses can enhance the shared decision-making process by identifying the decision needs and facilitating decision-making.
Purpose: This study aimed to evaluate the implementation of a Spirit program, which consists of physical and mental training for older adults who can perform independent activities as nursing home residents.
Methods: In July 2022, the researchers interviewed seven older adults who had attended the Spirit program and two caregivers at a nursing home in Surakarta, Indonesia. The researchers applied the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework during interviews. We measured participant engagement with the Spirit program, effectiveness to assess perceived benefits, adoption to gauge nursing homes' willingness to adopt the Spirit program, implementation to evaluate consistent execution, and maintenance to assess future program sustainability.
Results: Older adults who could carry out independent activities participated in the Spirit program. The Spirit program adds new activities that they can perform, which have various benefits, including increased happiness, stamina, and sleep quality. The participants expressed receiving instructions regarding the Spirit program from caregivers without any pressure to participate, with instructors guiding the exercises and regular schedule management. Older adults move well; however, some experience obstacles while performing balance exercises. None of the participants experienced injuries while participating in the program. A program's continuity can be supported by the availability of tools that are easily accessible to older adults.
Conclusion: The program improved the quality of life of older adults who can move independently as nursing home residents.
Purpose: This study was performed to identify the factors influencing falls in the community-dwelling elderly using the raw data of the 2020 National Survey of Older People.
Methods: The study included 9,920 community-dwelling seniors aged 65 years and older. The data were analyzed using a complex sampling design univariate logistic regression analysis.
Results: Although the subjects of this study were 9,920 people, it can be generalized to 7,617,710 people because it is a probability sample using the stratified systematic sampling with cluster plots. As a result of this study, the fall rate of community-dwelling elderly was 6.4% and the weighted percentage was 7.1%. Satisfaction with economic status, number of chronic diseases, use of medical facilities, smoking, limitation of lower muscle strength, decreased visual acuity, limitation of daily living function, and housing type were identified as factors influencing falls in older people dwelling in the community.
Conclusion: Based on the variables identified in this study, it is necessary for nurses to select high-risk groups for falls and to actively develop and implement nursing interventions to prevent falls.
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