Geriatric Nursing最新文献_第10页

Healthcare workers’ perspectives on evidence-based infection control in South Korean nursing homes: A qualitative study 韩国养老院医护人员对循证感染控制的看法：一项定性研究

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103874

Yu Mi Yi PhD , Soo Min Lee PhD , Eun-Young Noh PhD , Yeon-Hwan Park PhD

Infection prevention is critical for improving safety and care quality, reducing mortality, and enhancing the quality of life in nursing homes for older adults. These establishments often lack standardized guidelines, and have inconsistent protocols. This study evaluated the Evidence-Based Guidelines for Nursing Home Infection Control in South Korea (ENIK) by examining healthcare workers’ (HCWs) experiences. Five focus groups, involving 28 HCWs in total, were analyzed using qualitative content analysis and the Systems Engineering Initiative for Patient Safety framework. Participants reported improved infection prevention and control after ENIK implementation. Key motivators included knowledge acquisition, retraining, and positive experiences. Challenges involved staff turnover and external control factors. Clear job roles enhanced efficiency and confidence. Supportive resources (hand hygiene tools, infection control specialists, checklists, and visual aids) and organizational measures (rewards, teamwork, and control systems) were essential in streamlining infection management. ENIK fostered knowledge, clear roles, resource availability, and systematic management, enhancing infection control and care quality.

预防感染对于改善养老院的安全和护理质量、降低死亡率和提高老年人的生活质量至关重要。这些机构往往缺乏标准化的指导方针，并且有不一致的协议。本研究通过检查医护人员（HCWs）的经验，评估了韩国疗养院感染控制循证指南（ENIK）。使用定性内容分析和患者安全系统工程倡议框架对五个焦点小组进行了分析，共涉及28个卫生保健中心。参与者报告了ENIK实施后感染预防和控制的改善。主要的激励因素包括知识获取、再培训和积极的经历。挑战涉及人员流动和外部控制因素。明确的工作角色提高了效率和信心。支持性资源（手卫生工具、感染控制专家、检查清单和视觉辅助工具）和组织措施（奖励、团队合作和控制系统）对于简化感染管理至关重要。ENIK促进了知识、明确角色、资源可用性和系统管理，提高了感染控制和护理质量。

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引用次数: 0

Difficulties measuring a polypharmacy quality indicator in Switzerland’s residential long-term care institutions - a mixed-methods study 衡量瑞士长期护理机构多药质量指标的困难——一项混合方法研究。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103861

Magdalena Osińska MScN , Carla Meyer-Massetti PhD, MSc Pharmacy , Naomi Welte MSc Pharmacy , Franziska Zúñiga PhD

Polypharmacy is widespread in residential long-term care (RLTC), increasing the risk of medication-related problems. Switzerland’s RLTC institutions must report polypharmacy (defined as ≥ 9 active substances) as part of a national health-care quality indicator (QI) initiative.

This sequential explanatory mixed-methods study assessed the quality of data collected to calculate a polypharmacy QI across 14 RLTC institutions in German-speaking Switzerland, aiming to recommend improvements. A validation study assessed inter-rater reliability, subsequently, medication lists of individual patients with different medication counts were discussed with RLTC staff to explore the issues affecting those calculations.

Institutions and study researchers calculated different numbers of active substances in 65.3 % of the 580 residents assessed, and recorded an overall prevalence of polypharmacy of 45.5 % and 47.4 %, respectively.

Solid master data, unambiguous counting rules, and electronic algorithms are necessary to calculate reliable polypharmacy QIs. Additional measures, like medication reviews, might facilitate distinctions between appropriate and inappropriate polypharmacy.

多种用药在住院长期护理（RLTC）中很普遍，增加了药物相关问题的风险。作为国家卫生保健质量指标（QI）倡议的一部分，瑞士的RLTC机构必须报告多种药物（定义为≥9种活性物质）。这项顺序解释性混合方法研究评估了收集的数据的质量，以计算瑞士德语区14家RLTC机构的多药QI，旨在提出改进建议。验证研究评估了评分者之间的信度，随后，与RLTC工作人员讨论了不同药物计数的个体患者的药物清单，以探讨影响这些计算的问题。机构和研究人员计算了580名被评估居民中65.3%的活性物质的不同数量，并记录了综合用药的总体患病率分别为45.5%和47.4%。可靠的主数据、明确的计数规则和电子算法是计算可靠的多药QIs所必需的。其他措施，如药物审查，可能有助于区分适当和不适当的多种用药。

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引用次数: 0

Kinesiophobia, Exercise Self-Efficacy, and Physical Activity in Patients with Permanent Pacemaker Implantation: A Latent Profile and Mediation Analysis 永久性起搏器植入患者的运动恐惧症、运动自我效能和身体活动：潜在特征和中介分析。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103828

Jiali Yu MM, RN , Fan Chen MSN, RN , Yaxin Ren MSN, RN , Jialin Zeng SN, RN

引用次数: 0

What have nursing home staff learned from the COVID-19 pandemic about managing pandemic infectious diseases? A qualitative study 养老院工作人员从COVID-19大流行中学到了什么关于管理大流行性传染病的知识？定性研究。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103850

Anita Nilsen MSc , Bjørn Lichtwarck MD, PhD , Siren Eriksen PhD , Anne Marie Mork Rokstad PhD

Aim

The aim of this study is to explore the lessons that nursing home staff learned from the COVID-19 pandemic related to the management of pandemic infectious diseases.

Methods

Four focus groups were conducted with nursing home staff who had experienced COVID-19 infections at the nursing home where they were employed. The focus groups, conducted during September and October 2023 at the respective nursing homes, were audio recorded and transcribed verbatim. Data were analyzed using reflexive thematic analysis as described by Braun and Clarke (2022).

Findings

The analysis resulted in three themes: 1) organization of infection control measures, 2) framework for training in infection control routines, and 3) clinical assessments and measures when suspecting infection. The participants experienced challenges regarding access to personal protective equipment, a lack of knowledge about infection control routines, and the difficulty of limiting infection given the building layout. Using clinical tools or assessments to detect signs of infection in nursing home residents improved nursing home staff’s ability to detect symptoms of contagious infections.

Conclusion

For nursing homes to be more prepared and resilient in the event of a new pandemic, overall planning of nursing homes’ needs should take place at both the national and municipal levels, as well as at the management level within each nursing home. This planning must ensure sufficient staffing, access to infection control equipment, and the updating of employees’ professional and clinical knowledge.

目的：本研究旨在探讨养老院工作人员从COVID-19大流行中汲取的与大流行性传染病管理相关的经验教训。方法：采用4个焦点小组对在所在养老院感染COVID-19的养老院工作人员进行调查。焦点小组于2023年9月至10月在各自的养老院进行，录音并逐字转录。数据分析使用Braun和Clarke（2022）所描述的反身主题分析。结果：分析得出三个主题：1)感染控制措施的组织，2)感染控制常规培训框架，3)怀疑感染时的临床评估和措施。参与者在获得个人防护装备、缺乏感染控制常规知识以及在建筑布局下难以限制感染方面遇到了挑战。使用临床工具或评估来检测养老院居民的感染迹象，可以提高养老院工作人员检测传染性感染症状的能力。结论：为了使养老院在新的大流行事件中做好更充分的准备和抵御能力，应在国家和城市两级以及每个养老院的管理层对养老院的需求进行总体规划。这一计划必须确保足够的人员配备，获得感染控制设备，并更新员工的专业和临床知识。

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引用次数: 0

A cross-sectional study of olfactory stimulation on retrieval of the Who, Where and When information in Alzheimer’s disease 嗅觉刺激对阿尔茨海默病Who， Where and When信息检索的横断面研究。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103857

Karim Gallouj MD, PhD , Pascal Antoine PhD , Guillaume Chapelet MD, PhD , Mohamad El Haj PhD

We investigated whether olfactory stimulation can enhance the retrieval of contextual details—“who/where/when”—during autobiographical memory recall in patients with Alzheimer’s-disease (AD). Previous research has shown that odors can trigger vivid autobiographical memories in healthy-adults, but evidence in AD is limited, and most studies have focused on general memory recall rather than specific contextual information. Given that a key feature of autobiographical decline in AD is difficulty retrieving contextual details, it remains unclear whether olfactory cues can selectively improve recall of “who,” “where,” and “when” information. In this cross-sectional study, 33 patients with AD and 35 healthy controls retrieved autobiographical events with and without odor exposure. Analyses revealed that odor exposure increased the number of “who,” “where,” and “when” details in both groups. These findings address a critical gap in the literature, demonstrating that olfactory stimulation can specifically support contextual memory retrieval in AD, offering a non-invasive-tool to mitigate autobiographical memory deficits.

我们研究了嗅觉刺激是否可以增强阿尔茨海默病（AD）患者自传式记忆回忆过程中上下文细节的检索-“谁/在哪里/何时”。先前的研究表明，气味可以激发健康成年人生动的自传式记忆，但在阿尔茨海默氏症方面的证据有限，而且大多数研究都集中在一般记忆的回忆上，而不是具体的背景信息。鉴于阿尔茨海默氏症自传式衰退的一个关键特征是难以检索上下文细节，嗅觉线索是否能选择性地提高对“何人”、“何地”和“何时”信息的回忆尚不清楚。在这项横断面研究中，33名AD患者和35名健康对照者在有或没有气味暴露的情况下检索了自传体事件。分析显示，气味暴露增加了两组人“谁”、“在哪里”和“何时”等细节的数量。这些发现填补了文献中的一个关键空白，表明嗅觉刺激可以特别支持AD患者的情境记忆检索，为减轻自传式记忆缺陷提供了一种非侵入性工具。

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引用次数: 0

Advance directive preferences of community-dwelling adults: Comparing medical-social-emotional vs. medical-based approaches 社区居住成人的预先指示偏好：比较医学-社会-情感与医学为基础的方法。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103849

Ashley Shayya MPH , Yuchi Young DrPH , Yufang Tu MS , Wan-Yu Chiu PhD , Taylor Perre MPH, MSW

Purpose

This study explores adults’ preferences for and recommendations to improve medical-based (Portable Medical Orders [POLST]/Medical Orders for Life-Sustaining Treatment [MOLST]) and medical-social-emotional-based (Five Wishes) advance directives, with a focus on age-related differences.

Methods

US community-dwelling adults completed a survey on advance directives. Univariate analyses were used to assess advance directive type preferences, bivariate analyses evaluated age differences, and a thematic analysis identified recommendations for improvement.

Results

Participants, particularly young adults, preferred the Five Wishes form over the POLST/MOLST. Three key themes emerged from participants’ recommendations for improving the advance directives: content, formatting, and no recommendations.

Conclusion

Preferences for medical-social-emotional-based and medical-based advance directives should be considered by medical practitioners, policymakers, and public health professionals when promoting advance directives, especially among young adults.

目的：本研究探讨成人对基于医疗（便携式医疗医嘱[POLST]/维持生命治疗医嘱[MOLST]）和基于医疗-社会-情感（五个愿望）的预嘱的偏好和建议，并重点研究年龄相关差异。方法：美国社区居住的成年人完成了一项关于预先指示的调查。单变量分析用于评估预先指示类型偏好，双变量分析评估年龄差异，主题分析确定改进建议。结果：参与者，尤其是年轻人，比POLST/MOLST更喜欢“五个愿望”表格。与会者提出了改善预先指示的三个关键主题：内容、格式和不建议。结论：医疗从业人员、政策制定者和公共卫生专业人员在推广临终关怀指示时应考虑对医疗社会情感型和医疗型临终关怀指示的偏好，尤其是在年轻人中。

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引用次数: 0

Mapping -nurses’ roles in home care for older people: a scoping review 绘制护士在老年人家庭护理中的角色：范围审查。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103871

Isabella Santomauro MSN , Erika Bassi PhD , Roberta Sturaro MSN , Ines Basso PhD , Angela Durante PhD , Erica Busca PhD , Alberto Dal Molin PhD

Introduction

Historical, geographic, and contextual variation in nursing titles and the multitude of labels for different roles have hindered the creation of a clear map outlining nursing roles in home care settings for older people.

Objective

This scoping review aimed to explore the literature on nurses’ roles in home care for older people.

Methods

A literature search was conducted using Embase, CINAHL, and Medline by two independent reviewers.

Results

Out of 1973 references, 14 studies from eight countries were included, primarily from the United Kingdom (n = 6), the United States (n = 2), and Italy (n = 2). Twelve distinct nursing roles were identified, addressing health issues such as cardiovascular disease, mental health disorders, and diabetes. The most frequent nursing activities performed were assessment-related (32%).

Conclusion

The findings indicate the presence of diverse nursing roles in home care and highlight the significant heterogeneity in nursing activities performed.

导言：历史、地理和背景的变化在护理职称和不同角色的标签的众多阻碍了创建一个清晰的地图概述护理角色在家庭护理环境中为老年人。目的：本综述旨在探讨护士在老年人家庭护理中的作用。方法：由2位独立审稿人使用Embase、CINAHL和Medline进行文献检索。结果：在1973篇文献中，纳入了来自8个国家的14篇研究，主要来自英国（n = 6）、美国（n = 2）和意大利（n = 2）。确定了12种不同的护理角色，解决诸如心血管疾病、精神健康障碍和糖尿病等健康问题。最常见的护理活动与评估相关（32%）。结论：研究结果表明，家庭护理中存在不同的护理角色，并突出了护理活动的显著异质性。

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引用次数: 0

Factors influencing healthcare professionals' attitudes toward advance care planning 影响医护人员对预先护理计划态度的因素。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103825

Beatriz Braña-Marcos MSc, PhD(c) , Lucía Fernández-Arce MHP, PhD , Estefanía Vegas-Pardavila MSc, PhD , Cristina Fernández-García BS , María Isabel Orts-Cortés PhD

Aim

To examine healthcare professionals' knowledge and attitudes regarding Advance Care Planning (ACP), advance directives, and related legislation. The study also explored how sociodemographic and professional characteristics influence these perceptions.

Methods

A cross-sectional study was conducted among healthcare professionals in Asturias, Spain, using an online questionnaire. A multiple linear regression model was employed to analyze the impact of sociodemographic and occupational characteristics on the survey outcomes.

Results

A total of 409 responses were collected. Professional category, specific training, age, and work area were found to influence the quality of ACP and attitudes towards it. A significant lack of specific training hindered the development of a proactive attitude toward ACP.

Conclusions

There is a need to promote a cultural shift in the approach to end-of-life care and ACP. Effective interventions should be developed to improve the quality of end-of-life care and fulfill patient wishes.

目的：调查医疗保健专业人员对预先护理计划（ACP）、预先指示和相关立法的知识和态度。该研究还探讨了社会人口和职业特征如何影响这些看法。方法：在西班牙阿斯图里亚斯的医疗保健专业人员中进行了一项横断面研究，使用在线问卷。采用多元线性回归模型分析社会人口学特征和职业特征对调查结果的影响。结果：共收集问卷409份。研究发现，专业类别、具体培训、年龄和工作领域影响ACP的质量和对ACP的态度。严重缺乏具体培训阻碍了对非加太的积极态度的发展。结论：有必要促进临终关怀和ACP方法的文化转变。应开发有效的干预措施，以提高临终关怀的质量和满足病人的愿望。

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引用次数: 0

Implementation of a risk factor-based pressure injury prevention protocol in a long-term care facility: a quality improvement project 在长期护理机构实施基于风险因素的压力伤害预防方案：质量改进项目。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103839

Megan Kazakoff DNP , Heeyoung Lee PhD

Background

Annually 11-20 % of older adults residing in long term care facilities (LTCF) develop a pressure injury (PI), resulting in $3.8 billion in treatment costs. Clinical trials support risk factor-based prevention strategies in hospital settings.

Methods

A pre-post cohort design project was implemented at a suburban LTCF. Recent Braden Scale risk assessments were reviewed, and an evidenced based algorithm was used to determine prevention strategies based on a unique risk profile. After a three-month implementation period, survey data was collected from direct care staff and management to measure buy-in, sustainability, and effect on cost.

Results

Among the 71 participants (mean age 85.07) there was an 80 % reduction in PI incidence. Surveys indicated that nursing staff found the protocol effective without increasing the workload. An intervention fidelity of 92 % was observed.

Conclusions

This protocol, accepted by facility management, benefits facilities by streamlining decision making, allowing nursing staff to make informed decisions and reducing waste.

背景：每年11- 20%居住在长期护理机构（LTCF）的老年人发生压力性损伤（PI），导致38亿美元的治疗费用。临床试验支持医院环境中基于风险因素的预防策略。方法：在郊区一家长期护理中心实施岗前队列设计项目。回顾了最近的布雷登量表风险评估，并使用基于证据的算法来确定基于独特风险概况的预防策略。在三个月的执行期后，从直接护理人员和管理层收集调查数据，以衡量买入率、可持续性和对成本的影响。结果：在71名参与者中（平均年龄85.07岁），PI发生率降低了80%。调查显示，护理人员发现该方案在不增加工作量的情况下有效。观察到干预保真度为92%。结论：该方案已被医院管理层接受，通过简化决策流程，使护理人员做出明智的决策并减少浪费，使医院受益。

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引用次数: 0

Clinicians’ perspectives of pain in older adults with heart failure 临床医生对老年心力衰竭患者疼痛的看法

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103840

Youjeong Kang PhD, MPH, CCRN-K. Heart-Cert, FHFSA , Yong K Choi PhD, MPH , Julie T. Bidwell PhD, RN , Cherie Cofield PhD, MSN, RN , M. Cary Reid MD

Pain is one of the common heart failure (HF)-related symptoms and is often ignored by older adults, who consider it to be a natural process of aging. Little is known about the pain experiences and management of clinicians who are specialized in HF. We conducted semi-structured interviews to obtain qualitative data and sought to describe clinicians’ experiences with pain assessment and pain management among older patients with HF using a descriptive approach with 20 interviews. Participants’ mean age was 45 ± 10.7 years; 90% identified as White. The majority (85%) of participants had more than five years of clinical experience caring for persons with HF. Some participants expressed that pain management is not their routine even though they assess pain as part of the physical exam. Most participants highlighted the lack of specific guidelines or educational materials for managing pain in older adults with HF. Some participants stated that family caregivers could play an important role in HF patient pain assessment and management. Our findings show that non-pharmacologic treatments play a pivotal role in improving care for individuals with HF and pain symptoms.

疼痛是心力衰竭（HF）常见的相关症状之一，但往往被老年人忽视，他们认为这是衰老的自然过程。对于心衰专业临床医生的疼痛经历和治疗，我们所知甚少。我们进行了半结构化访谈，以获得定性数据，并试图通过20次访谈描述临床医生在老年HF患者疼痛评估和疼痛管理方面的经验。参与者平均年龄45±10.7岁；90%为白人。大多数（85%）参与者有5年以上的心衰患者护理临床经验。一些参与者表示，即使他们将疼痛评估作为身体检查的一部分，疼痛管理也不是他们的日常工作。大多数参与者强调缺乏针对老年心衰患者疼痛管理的具体指南或教育材料。一些与会者表示，家庭照顾者可以在心衰患者疼痛评估和管理中发挥重要作用。我们的研究结果表明，非药物治疗在改善心衰和疼痛症状患者的护理方面起着关键作用。

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引用次数: 0