Geriatric Nursing最新文献

Aims: The aims of this study were to investigate if chronic pain presence is significantly increased in older adults with heart failure (HF) compared to those without HF, and if a combination of pain and HF reduced quality of life and physical function.

Methods: Retrospective cross-sectional survey and medical record data from 41,395 participants age ≥65 in the All of Us Research Program were analyzed using linear and logistic regression.

Results: Participants with HF had a higher prevalence of chronic pain than those without HF but was not statistically significant. Having pain only, HF only, and both pain and HF were associated with reduced quality of life and physical function when compared to having no HF or pain. However, these associations were the strongest in those with both chronic pain and HF.

Conclusions: A combination of HF and chronic pain markedly worsened outcomes, underscoring the need for improved pain management.

Ageism has harmful effects on mental health of older people, leading to mental health problems, as anxiety, depression and cognitive impairment. This study aimed to investigate how ageism affects the mental health of older people living in nursing homes. A descriptive correlational study design was conducted with 60 older people from 3 geriatric homes affiliated to Damietta Governorate in Egypt. Validated tools, including the Ageism Survey, Geriatric Depression Scale, Geriatric Anxiety Inventory Scale and Mini-Mental State Examination Scale were used. Statistical analysis, including correlation and path analysis, was performed to identify direct and indirect relationships. Ageism was positively associated with older people depression (p = 0.003), anxiety (p = 0.017) and cognitive impairment (p = 0.007). Path analysis revealed that geriatric anxiety partially competitively mediated the relationship between Ageism and cognitive function status. The findings highlight the mental health challenges faced by older people study sample resident in older people homes, which are compounded by their experiences of ageism. Interventions should focus on promoting positive perceptions of aging and educating society about the challenges faced by the elderly.

Background: Despite high healthcare costs, people with dementia and their caregivers still struggle with care coordination and support. Centers for Medicare & Medicaid Services "Guiding an Improved Dementia Experience" initiative, presents an opportunity for innovative care models.

Methods: Authors piloted Geriatrics Cognitive Assessment and Resource Engagement (CARE) Day, an interdisciplinary clinic model for patients living with dementia. In a single visit, patients saw a geriatrician, social worker, occupational therapist, and Alzheimer's Association care specialist.

Results: CARE Day streamlined four different appointments into one, enhancing coordination. Geriatricians conducted cognitive assessments and care planning. Social workers connected caregivers to support groups and education. Occupational therapists addressed daily function, safety, and cognitive rehab needs. Alzheimer's Association care specialists connected families to memory-friendly programs. Follow-ups showed high patient and caregiver satisfaction, improved coordination, and fewer missed appointments.

Conclusion: Interdisciplinary clinic approach improves dementia care by streamlining multiple appointments into a single visit, enhancing efficiency and support.

This study examined barriers and facilitators reported by older adults and Physical Education professionals in a home-based exercise program with two types of supervision: video calls and text messages. A qualitative case study was conducted with 12 older adults and three professionals from a randomized controlled trial in Brazil. Interviews, which lasted between 12 and 35 min, were guided by the Theory of Planned Behavior and analyzed using thematic content analysis. Both groups identified well-being and supervision as facilitators. Barriers included scheduling conflicts and mobile device difficulties. Text message supervision led to insecurity in exercise performance, while video call supervision faced barriers like poor internet. Professionals noted older adults' technological unfamiliarity. Video call supervision facilitated social interaction, while text messages offered reduced time commitment and better accessibility. The study concluded that video call supervision supports social interaction, while text message supervision may cause insecurity due to lack of real-time guidance.

Sialorrhea, or excessive drooling, is a common yet underrecognized condition among elderly patients, particularly those with neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease. It can lead to complications, including aspiration pneumonia, skin irritation, and psychosocial distress, significantly impacting quality of life. Current nursing interventions remain fragmented, necessitating a comprehensive approach. This review applies the theory of unpleasant symptoms to identify symptom characteristics, influencing factors, and nursing interventions. A structured literature search identified 33 relevant studies, revealing that sialorrhea management involves pharmacological treatments, nonpharmacological strategies, and psychological and behavioral interventions. Additionally, emerging assistive technologies show promise but require further validation. The findings highlight the need for an integrated, evidence-based nursing framework that incorporates physiological, psychological, and environmental strategies to optimize symptom management and patient well-being. Future research should focus on standardizing nursing protocols and expanding caregiver education to enhance long-term care outcomes.

The NICHE GRN model and program have enjoyed broad implementation over more than three decades and align well with various care settings, subspecialties, and geriatric excellence programs. As NICHE continues to grow and amplify its impact on clinical nursing excellence in the care of older adults, it focuses on adapting and aligning program implementation efforts to amplify the impact of complementary geriatric quality programs and expand to new care settings.

Introduction: Low back pain (LBP) is a well-recognized and major cause of disability worldwide. This study aimed to compare the effects of dynamic neuromuscular stabilization (DNS) exercises with and without the Feldenkrais method (FM) on pain, balance, and hip muscle strength in elderly women with chronic non-specific LBP (CNLBP).

Method: In this randomized controlled trial, 40 women aged 60-80 years with CNLBP were randomly allocated to either the DNS exercise (DNSE) group or the combined DNS and Feldenkrais method exercise (DNS-FME) group for an 8-week intervention. Three participants dropped out, leaving 37 completers (18 in the DNSE group and 19 in the DNS-FME group). Baseline and post-intervention assessments were conducted 1-3 days before the first session and 1-3 days after the final session, respectively. Outcome measures included pain intensity, Berg Balance Scale score, and hip muscle strength. Data were analyzed using repeated-measures ANOVA, with statistical significance set (p < 0.05).

Results: After the 8-week intervention, significant group-by-time interactions were observed for all outcome variables (p < 0.05). Post-hoc analysis with Bonferroni correction revealed that the DNS-FME group exhibited significantly greater reductions in pain intensity (p < 0.001) as well as significantly greater improvements in hip adductor strength (p < 0.001) and hip abductor strength (p < 0.001) compared to the DNSE group. Although balance improvements were noted in both groups, the between-group difference did not reach statistical significance.

Conclusion: The addition of the Feldenkrais method to dynamic neuromuscular stabilization exercises provides superior benefits in pain reduction and hip muscle strengthening in elderly women with chronic non-specific low back pain. Both interventions improve balance, but combined training may offer greater clinical advantages. These findings support integrating sensorimotor awareness techniques into rehabilitation programs for older adults with low back pain.

Aim: This study aims to cluster communication types in older adults with BPH mainly based on differences in their characteristics (cognitive function and adaptive level).

Methods: The study included 208 patients with benign prostatic hyperplasia aged 60 years or older. Cognitive function and adaptive level were used as sub-variables to cluster the communication behaviors of these patients. SPSS 24.0 was used to analyse the data, including descriptive statistics, k-means clustering analysis, analysis of variance and chi-square test.

Results: Analysis revealed four clusters: named as 'adaptive support type', 'mixed communication type', 'high-quality communication type', and 'cognitive compensation type'. Besides differences in cognitive function and adaptive level, the clusters differed on education level, residence registration, monthly income, work status, and participate Intellectual activity.

Conclusions: Healthcare providers can use the results of cluster analysis to improve their knowledge of communication types and tailor communication strategies for older BPH surgery patients.

People living with dementia (PLWD) are vulnerable to safety events during hospitalization but the role of family caregivers in their safety is understudied. We analyzed N = 1276 dementia-related safety event reports occurring between January 2018 and July 2023. A family caregiver was mentioned in 31.2 % of dementia-related safety event reports. Caregiver presence was associated with level of harm (X²= 39.68, p < 0.0001), with no-harm events more likely to be reported when a caregiver was present. Caregiver presence was associated with the contributing factors to safety events (X²= 17.88, p = < 0.01), and provider response to dementia-related safety events (X²= 6.09, p = < 0.05). Overall, caregiver presence was associated with less harm, fewer active failures, and more comprehensive provider responses to dementia-related safety events. Findings can inform the design of interventions to reduce the risk of dementia-related safety events during hospitalization.

We estimated the association between the depressed frail phenotype and fall prevalence in older adults in the Totos district, Cangallo, Ayacucho, Peru during 2022. A secondary analysis was conducted using data from a cross-sectional study involving older adults aged 60 and over. Frailty was defined by three or more Fried phenotype criteria, depressive symptoms by two or more points on the Geriatric Depression Scale, and the depressed frail phenotype by the presence of both conditions. Falls were assessed with the SARC-F questionnaire. Sociodemographic characteristics, comorbidities, harmful habits, functional status, and social support were included. Among 272 participants (mean age 75±8.6 years), 14.3% had the depressed frail phenotype, and 48.2% had experienced falls in the past year. Adjusted Poisson regression showed a 41% higher fall prevalence among those with the depressed frail phenotype (aPR=1.41; 95% CI: 1.08-1.85). This phenotype was associated with a higher fall prevalence in older adults at high altitude.