Geriatric Nursing最新文献

Objective: To estimate the importance of risk factors on overweight/obesity among older adults by comparing different predictive model.

Methods: Survey data from 400 older individuals in China was employed to assess the impacts of four domains of risk factors (demographic, health status, physical activity and neighborhood environment) on overweight/obesity. Six machine learning algorithms were utilized for prediction, and SHapley Additive exPlanations (SHAP) was employed for model interpretation.

Results: The CatBoost model demonstrated the highest performance among the prediction models for overweight/obesity. Gender, transportation-related physical activity and road network density were top three important features. Other significant factors included falls, cardiovascular conditions, distance to the nearest bus stop and land use mixture.

Conclusion: Insufficient physical activity, denser road network and incidents of falls increased the likelihood of older adults being overweight/obese. Strategies for preventing overweight/obesity should target transportation-related physical activity, neighborhood environments, and fall prevention specifically.

Objective: To explore the perspectives and perceptions of persons with mild cognitive impairment (MCI), their caregivers, and healthcare professionals on computerized cognitive training (CCT).

Material and methods: Utilizing phenomenological research methods, 12 MCI patients, 11 caregivers, and 15 healthcare professionals were recruited. Data were collected through four focus group interviews and six semi-structured in-depth interviews conducted between March 2023 and June 2023. Colaizzi's analysis method was used to analyze the transcribed interviews.

Results: The study identified three main themes: (1) perception of CCT treatment, (2) emotional experiences with CCT, and (3) coping strategies. These themes highlighted various barriers and facilitators to CCT acceptance and implementation.

Conclusions: Emphasizing the popularization of CCT for MCI treatment is crucial. The study underscores the importance of addressing patients' emotional needs, providing psychological and social support, and offering personalized, multidomain non-pharmacological guidance to maximize CCT's effectiveness.

Background: Aging is a critical phase of human, necessitating focused attention on the unique issues, needs, and diseases that older adults face. Self-efficacy has been recognized as a fundamental prerequisite for behavior change in health promotion and health education. Therefore, the present study was aimed to empower older people to improve their self-efficacy based on Pender's health promotion model.

Methods: His randomized clinical trial was conducted with 64 older adults (32 in the intervention group and 32 in the control group) who were referred to health centers in Kermanshah and selected by cluster sampling. Empowerment interventions were implemented over six sessions, each lasting 60 minutes, for the older adults, along with two additional sessions for their families. Training was conducted using various strategies aligned with the constructs of Pender's Health Promotion Model, including perceived barriers, perceived benefits, self-efficacy, activity-related affect, interpersonal influences, and situational influences. Data were collected at two time points: prior to the intervention and four weeks post-intervention, utilizing Sherer's General Self-Efficacy Scale and a demographic checklist. The data were analyzed using SPSS version 22.

Results: The mean age of the older adults in the intervention group was 66.63±6.84 years, while in the control group, it was 65.25±7.07 years. Before the intervention, there was no significant difference in self-efficacy score between the groups (intervention: 53.09±16.18; control: 55.59±7.33; P>0.01). After the intervention, the intervention group's the self-efficacy score of the intervention group (68.87±10.27) was significantly higher than that of the control group (54.96±5.67; (P˂0.01).

Conclusion: Empowerment interventions based on the Pender's health promotion model significantly increased self-efficacy among older adults. Given the importance of self-efficacy in lifestyle changes, implementing these interventions in health centers, clinics, and nursing homes can effectively prevent future issues faced by older adults.

Objective: This study aimed to assess the influence of sarcopenia on mild cognitive impairment (MCI) through a nationally representative survey.

Method: Participants in this nested case-control study were from the China Health and Retirement Longitudinal Study (CHARLS) cohort. In 2015, 3222 participants were included, with 2304 participants were followed up in 2018. Propensity score matching (PSM) was utilized to equalize the distribution of covariates between the two groups.

Results: MCI was observed in 268 participants. After PSM, 263 participants with MCI were compared with 1052 participants without MCI. The study revealed that participants with sarcopenia had a 1.625 (p = 0.002) times higher risk of MCI.

Conclusion: The study determined a causal link between sarcopenia and the onset of MCI, with sarcopenia identified as an independent risk factor for MCI development. It is recommended that healthcare providers incorporate muscle training into the care and health education for individuals with MCI.

This study aimed to explore the relationship between perceived stress and presenteeism among geriatric caregivers in long-term care facilities (LTCFs), as well as to examine the mediating role of job burnout. A total of 272 geriatric caregivers in LTCFs were recruited. A cross-sectional survey was conducted using Perceived Stress Scale-10 (PSS-10), Maslach Burnout Inventory-General Survey (MBI-GS) and the Stanford Presenteeism Scale-6 (SPS-6). The mediating effect of job burnout between perceived stress and presenteeism was tested using the PROCESS macro model 4. The results indicated that job burnout partially mediated the relationship between perceived stress and presenteeism (B = 0.280, 95 %CI: [0.108, 0.186]), accounting for 39.05 % of the total effect. The findings suggest that LTCF managers should take proactive measures to reduce work-related stress of geriatric caregivers, improve their job burnout, and consequently reduce the occurrence of presenteeism.

Aim: Aim of the paper is to determine the relationship between patients' perceived risk of falling and their fall-risk assessment ranking.

Design: A cross-sectional correlational design.

Methods: Four questionnaires: confidence, fear, consequence and intention related to falls were administered to 54 hospitalized older adults. Fall-ranking scores were also collected on each participant as well as demographic information.

Results: There was no significant relationship between fall assessment ranking and patients' perceived risk of falling. Significant relationships were observed between the patient's perceptions of fall risk scales: fear of falling, confidence, consequences, and intention. Intention to ask for help is higher in those with no prior falls. Age and Sex were not significant related to patient perceptions and did not interact with perceived risk in predicting fall assessment ranking.

Conclusion: Hospitalized older adults identified as a high fall risk were not more likely to view themselves as being at higher risk for falls. Those with a history of having fallen had lower intention to ask for help when getting up, which is the opposite of what might be expected. This highlights the need to better align patient perceptions related to their fall potential while hospitalized.

Implications: Falls in older adults remains a top public health issue, and this study reinforces the disconnect between self-perceived fall risk and nurse ratings of fall risk. There also remains few relationships between actual history of falls and self-perceived risk of falling except those with a history of falling have lower intentions for asking for help. To prevent patient falls, we must develop customized interventions to help patients better understand their risk of falling and how to prevent them.

Objective: This longitudinal study aimed to identify the impact of high health literacy (HL) and participation in more social activities (SA) on preventing the risk of disability among community-dwelling older adults.

Methods: Participants were 3,486 community-dwelling older adults who underwent functional health examinations. Participants were classified into four groups based on High (Low) HL and High (Low) SA. A Cox proportional hazards model was used to assess the risk of disability over five years among the four groups.

Results: During follow-up, 339 patients with disabilities were observed. In the Cox proportional hazards analysis, only High HL and High SA groups were significantly associated with a lower hazard ratio (HR) for disability onset (HR = 0.71, 95% confidence interval = 0.51-0.99).

Conclusions: In community-dwelling older adults, high HL and increased SA effectively reduced the risk of disability compared to low HL and low SA.

Objective: To evaluate the feasibility and effect of nurse-led cognitive-motor dual-task training based on mobile health technology in people with cognitive frailty and investigate its potential for transforming practice in this population.

Methods: From September 2021 to May 2022, a total of 74 older adults with cognitive frailty were screened at a Cognitive Memory Clinic of a tertiary hospital in Beijing. The control and intervention groups received health education related to cognitive frailty; additionally the intervention group received cognitive-motor dual-task training based on mobile health technology at home for 12 weeks, three times a week. At baseline (T₀), post-intervention (T₁) and one-year follow-up (T₂), Montreal Cognitive Assessment-Peking version (MoCA-P), Fried Frailty phenotype (FP), Short Physical Performance Battery (SPPB), and Modified Fall Efficacy Scale (MFES) were employed to evaluate cognitive function, frailty, physical function, and fear of falling, and to assess the impact of cognitive-motor dual-task training on these measures.

Results: The data collected for 65 out of 74 participants enrolled for the study was completed after 12 weeks intervention, including 34 participants in the control group and 31 participants in the intervention group. During the intervention, the majority (83.8 %) of the participants in the intervention group were able to complete the recommended intervention dose for 12 weeks under the guidance of nurses and the presence of caregivers. At the end of the 12-week intervention, the intervention group showed statistically significant improvements compared to the control in scores of MoCA-P (t=4.017, p<0.001), FP (t=3.739, p<0.001), MFES (t=4.283, p<0.001) and SPPB (t=3.548, p<0.001). At after one-year follow-up, the scores of MoCA-P (t=3.237, p<0.05), FP(t=3.725, p<0.001), and MFES (t=4.473, p<0.001) in the two groups remained statistically significant. Cognition, frailty and fear of falling were significantly affected by intergroup effects (P_group<0.05), time effects (P_time<0.05) and interaction effects (P_group*time<0.001).

Conclusions: The cognitive-motor dual-task training program based on mobile health technology developed by nurses exhibited high feasibility and acceptability in older people with cognitive frailty. The intervention was found to significantly improve cognitive function, frailty, physical function, and fear of falling in older individuals with cognitive frailty, and showed a specific long-term maintenance effect. This study provides evidence for the promotion and application of mobile health technology, and serves as a practical basis for home health intervention for older individuals in the post-pandemic era.

Purpose: The study aimed to determine the test-retest, interrater, and minimum detectable change, concurrent and known-groups validity in older adults with mild cognitive impairment. Minimal detectable change values are the degree of change needed to exceed a measurement's error within a confidence limit.

Methods: A total of 46 older adults with mild cognitive impairment and 34 healthy controls were included. The Four Square Step Test was used together with the Timed Up and Go Test, Berg Balance Scale, Functional Reach Test, and One-Leg Stand Test.

Results: The Four Square Step Test revealed high interrater and test-retest reliability (ICC = 0.963-0.986 and 0.937-0.956, respectively). The cut-off times of 15.11 s best distinguished older adults as fallers from non-fallers with mild cognitive impairment.

Conclusions: The Four Square Step Test is a valid, reliable, applicable, and safe dynamic balance evaluation to identify subtle changes to dynamic balance in mild cognitive impairment patients.