Pub Date : 2026-04-01Epub Date: 2026-01-21DOI: 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.
{"title":"Healthcare workers’ perspectives on evidence-based infection control in South Korean nursing homes: A qualitative study","authors":"Yu Mi Yi PhD , Soo Min Lee PhD , Eun-Young Noh PhD , Yeon-Hwan Park PhD","doi":"10.1016/j.gerinurse.2026.103874","DOIUrl":"10.1016/j.gerinurse.2026.103874","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103874"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-23DOI: 10.1016/j.gerinurse.2026.103853
Elena Casabona PhD , Jessica Cusato PhD , Marco Clari PhD , Beatrice Albanesi PhD , Dario Cattaneo PhD , Paola Di Giulio MScN , Valerio Dimonte MScN
This study examined the association between medications with anticholinergic (ACh) activity and the risk of falls in community-dwelling older adults enrolled in a home monitoring service. A cross-sectional design was applied, and logistic regression analyses were adjusted for age, sex, comorbidities, and functional status. The sample included 84 participants who had experienced at least one fall, of whom 72.6% were single fallers and 27.4% recurrent fallers (≥2 falls in 12-months of observation). Participants were divided into two groups: those taking medications (n = 55) and those not on medication (n = 29). A total of 126 falls were reported, with no significant difference in the number of falls between the two groups.
The prevalence of ACh burden, assessed using ten different scales, ranged from 5.4% to 30.9% among fallers. Within the medication group, no significant differences were observed in the presence of ACh burden (≥1) between single and recurrent fallers. However, recurrent fallers in this group (n = 15) had higher scores on some scales compared with single fallers. Despite this, the discriminative ability of the ACh burden scales for identifying recurrent fallers were limited, with several, particularly the ALS and CrAS scales, failing to reach acceptable thresholds. After adjustment, the AAS scale suggested that older adults were over nine times more likely to experience recurrent falls compared with a single fall (OR=9.24; 95% CI 1.02–77.49; p = 0.004).
Overall, these findings highlight the limited clinical utility of current ACh burden scales in supporting medication review as part of fall prevention strategies for older adults.
本研究考察了抗胆碱能（ACh）活性药物与参加家庭监测服务的社区居住老年人跌倒风险之间的关系。采用横断面设计，并根据年龄、性别、合并症和功能状态调整逻辑回归分析。样本包括84名至少经历过一次跌倒的参与者，其中72.6%为单次跌倒者，27.4%为复发性跌倒者（12个月内观察≥2次跌倒）。参与者被分为两组：服药组（n = 55）和非服药组（n = 29）。共报告了126例跌倒，两组之间的跌倒次数没有显著差异。使用10种不同的量表评估的乙酰氨基酚负担患病率在跌倒者中从5.4%到30.9%不等。在给药组内，单次跌倒者和复发跌倒者之间乙酰胆碱负荷（≥1）的存在无显著差异。然而，该组中复发性跌倒者（n = 15）在某些量表上的得分高于单一跌倒者。尽管如此，乙酰胆碱负担量表鉴别复发性跌倒者的能力有限，有几个，特别是ALS和CrAS量表，未能达到可接受的阈值。调整后，AAS量表显示老年人复发性跌倒的可能性是单次跌倒的9倍以上（OR=9.24; 95% CI 1.02-77.49; p = 0.004）。总的来说，这些发现强调了当前乙酰胆碱负担量表在支持药物审查作为老年人跌倒预防策略的一部分方面的有限临床效用。
{"title":"Association between anticholinergic burden scales and recurrent falls in independently living older adults: a cross-sectional study.","authors":"Elena Casabona PhD , Jessica Cusato PhD , Marco Clari PhD , Beatrice Albanesi PhD , Dario Cattaneo PhD , Paola Di Giulio MScN , Valerio Dimonte MScN","doi":"10.1016/j.gerinurse.2026.103853","DOIUrl":"10.1016/j.gerinurse.2026.103853","url":null,"abstract":"<div><div>This study examined the association between medications with anticholinergic (ACh) activity and the risk of falls in community-dwelling older adults enrolled in a home monitoring service. A cross-sectional design was applied, and logistic regression analyses were adjusted for age, sex, comorbidities, and functional status. The sample included 84 participants who had experienced at least one fall, of whom 72.6% were single fallers and 27.4% recurrent fallers (≥2 falls in 12-months of observation). Participants were divided into two groups: those taking medications (<em>n</em> = 55) and those not on medication (<em>n</em> = 29). A total of 126 falls were reported, with no significant difference in the number of falls between the two groups.</div><div>The prevalence of ACh burden, assessed using ten different scales, ranged from 5.4% to 30.9% among fallers. Within the medication group, no significant differences were observed in the presence of ACh burden (≥1) between single and recurrent fallers. However, recurrent fallers in this group (<em>n</em> = 15) had higher scores on some scales compared with single fallers. Despite this, the discriminative ability of the ACh burden scales for identifying recurrent fallers were limited, with several, particularly the ALS and CrAS scales, failing to reach acceptable thresholds. After adjustment, the AAS scale suggested that older adults were over nine times more likely to experience recurrent falls compared with a single fall (OR=9.24; 95% CI 1.02–77.49; <em>p</em> = 0.004).</div><div>Overall, these findings highlight the limited clinical utility of current ACh burden scales in supporting medication review as part of fall prevention strategies for older adults.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103853"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-24DOI: 10.1016/j.gerinurse.2026.103890
Chia-Chen Chang PhD , Chen-Yin Tung PhD
Background
With rising global demand for long-term care, understanding nurse-aide students’ psychological and professional readiness is vital for effective training.
Purpose
This study explored coping strategies, psychological resilience, and professional commitment among senior nurse-aide students in Taiwan, assessing links to experiential factors to guide educational strategies.
Methods
A cross-sectional survey of 158 randomly selected senior students from Taiwan’s long-term care programs used validated tools to measure coping, resilience, and commitment. Data were analyzed with Pearson correlations, t-tests, ANOVA, and regression.
Results
Professional commitment varied significantly across professional-related training backgrounds. Students who had completed a nurse-aide internship or obtained a nurse-aide certificate demonstrated higher levels of commitment than those with no formal training. Similarly, students with long-term care work experience showed greater commitment than those without such experience. Both coping strategies and psychological resilience were positively associated with professional commitment, and together these psychological and experiential factors explained 35.1% of its variance.
Conclusions
Coping, resilience, and practical training reinforce professional commitment. Embedding these elements in long-term care education can enhance caregiving readiness and workforce sustainability in the context of global aging.
{"title":"Coping strategies, psychological resilience, and professional commitment among nurse-aide students in Taiwan: A cross-sectional study","authors":"Chia-Chen Chang PhD , Chen-Yin Tung PhD","doi":"10.1016/j.gerinurse.2026.103890","DOIUrl":"10.1016/j.gerinurse.2026.103890","url":null,"abstract":"<div><h3>Background</h3><div>With rising global demand for long-term care, understanding nurse-aide students’ psychological and professional readiness is vital for effective training.</div></div><div><h3>Purpose</h3><div>This study explored coping strategies, psychological resilience, and professional commitment among senior nurse-aide students in Taiwan, assessing links to experiential factors to guide educational strategies.</div></div><div><h3>Methods</h3><div>A cross-sectional survey of 158 randomly selected senior students from Taiwan’s long-term care programs used validated tools to measure coping, resilience, and commitment. Data were analyzed with Pearson correlations, t-tests, ANOVA, and regression.</div></div><div><h3>Results</h3><div>Professional commitment varied significantly across professional-related training backgrounds. Students who had completed a nurse-aide internship or obtained a nurse-aide certificate demonstrated higher levels of commitment than those with no formal training. Similarly, students with long-term care work experience showed greater commitment than those without such experience. Both coping strategies and psychological resilience were positively associated with professional commitment, and together these psychological and experiential factors explained 35.1% of its variance.</div></div><div><h3>Conclusions</h3><div>Coping, resilience, and practical training reinforce professional commitment. Embedding these elements in long-term care education can enhance caregiving readiness and workforce sustainability in the context of global aging.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103890"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-24DOI: 10.1016/j.gerinurse.2026.103835
Yufeng Li MSc , Yun Li BSc , Shengying Wang BSc , Wenjiao Li MSc , Li Feng BSc , Zhibin Liu BSc , Yang Zhou MSc , Xiujie Sun MSc
Objectives
To identify factors affecting readiness of hospital discharge (RHD) among Chinese elderly patients after hip or knee arthroplasty under Enhanced Recovery After Surgery (ERAS).
Design
This study followed the cross-sectional descriptive design and the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guideline.
Methods
Data from 511 elderly patients who underwent hip or knee arthroplasty in a tertiary hospital (October 2021 to August 2023) were analyzed. Participants completed demographic, the Blaylock Risk Assessment Screening Score (BRASS), the Activities of Daily Living (ADL) score, and the Readiness for Hospital Discharge Scale (RHDS) before discharge. Correlations and multiple linear regression identified factors associated with RHD.
Results
The mean RHDS score was 100.45 ± 12.44, indicating moderate to high readiness. RHDS correlated positively with ADL (r = 0.586, p < 0.001) and negatively with BRASS (r = –0.501, p < 0.001). Regression showed that ADL, BRASS, gender, age, admission form, and surgical type were independent predictors (Adjusted R² = 0.414, p < 0.001).
Conclusion/Relevance to clinical practice
Elderly patients showed moderate to high RHD, which still requires improvement. Early evaluation, tailored discharge education, and follow-up nursing interventions can enhance recovery and reduce readmission. These findings underscore the importance of strengthening discharge readiness education in geriatric nursing practice.
目的：确定影响中国老年髋关节或膝关节置换术后增强康复（ERAS）患者出院准备度（RHD）的因素。设计：本研究遵循横断面描述性设计和加强流行病学观察性研究报告（STROBE）指南。方法：对2021年10月至2023年8月在某三级医院行髋关节或膝关节置换术的511例老年患者的数据进行分析。参与者在出院前完成人口统计、Blaylock风险评估筛选评分（BRASS）、日常生活活动（ADL）评分和出院准备量表（RHDS）。相关性和多元线性回归确定了与RHD相关的因素。结果：RHDS平均评分为100.45±12.44，为中度至高度准备。RHDS与ADL呈正相关（r = 0.586, p < 0.001），与BRASS呈负相关（r = -0.501, p < 0.001）。回归分析显示，ADL、BRASS、性别、年龄、入院方式、手术类型是独立预测因素（调整后R²= 0.414,p < 0.001）。结论/与临床实践的相关性：老年患者表现为中高RHD，仍需改善。早期评估，有针对性的出院教育和后续护理干预可以提高康复和减少再入院。这些发现强调了在老年护理实践中加强出院准备教育的重要性。
{"title":"Current status and factors influencing analysis on readiness of hospital discharge among elderly patients following hip and knee arthroplasty under the concept of enhanced recovery after surgery: A cross-sectional study","authors":"Yufeng Li MSc , Yun Li BSc , Shengying Wang BSc , Wenjiao Li MSc , Li Feng BSc , Zhibin Liu BSc , Yang Zhou MSc , Xiujie Sun MSc","doi":"10.1016/j.gerinurse.2026.103835","DOIUrl":"10.1016/j.gerinurse.2026.103835","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify factors affecting readiness of hospital discharge (RHD) among Chinese elderly patients after hip or knee arthroplasty under Enhanced Recovery After Surgery (ERAS).</div></div><div><h3>Design</h3><div>This study followed the cross-sectional descriptive design and the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guideline.</div></div><div><h3>Methods</h3><div>Data from 511 elderly patients who underwent hip or knee arthroplasty in a tertiary hospital (October 2021 to August 2023) were analyzed. Participants completed demographic, the Blaylock Risk Assessment Screening Score (BRASS), the Activities of Daily Living (ADL) score, and the Readiness for Hospital Discharge Scale (RHDS) before discharge. Correlations and multiple linear regression identified factors associated with RHD.</div></div><div><h3>Results</h3><div>The mean RHDS score was 100.45 ± 12.44, indicating moderate to high readiness. RHDS correlated positively with ADL (<em>r</em> = 0.586, <em>p</em> < 0.001) and negatively with BRASS (<em>r</em> = –0.501, <em>p</em> < 0.001). Regression showed that ADL, BRASS, gender, age, admission form, and surgical type were independent predictors (Adjusted <em>R</em>² = 0.414, <em>p</em> < 0.001).</div></div><div><h3>Conclusion/Relevance to clinical practice</h3><div>Elderly patients showed moderate to high RHD, which still requires improvement. Early evaluation, tailored discharge education, and follow-up nursing interventions can enhance recovery and reduce readmission. These findings underscore the importance of strengthening discharge readiness education in geriatric nursing practice.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103835"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-18DOI: 10.1016/j.gerinurse.2026.103901
April Morris DNP , Melissa Kalarchian PhD , Angela Allen PhD
Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among residents in long-term care (LTC) and contribute to poor quality of life and increased caregiver burden. Non-pharmacological interventions (NPIs) are recommended as first-line approaches, but their implementation is often limited by workforce shortages, inconsistent protocols, and lack of staff preparation. This scoping review mapped NPI characteristics, reported outcomes, and key implementation challenges used to address BPSD in LTC. Thirty-two studies met criteria and were included, encompassing music therapy, reminiscence therapy, exercise programs, assistive technology, multimodal interventions, and emerging therapies. Intervention characteristics such as personalization and cultural tailoring were associated with improved engagement and emotional responsiveness. Outcomes included reductions in agitation, anxiety, and mood disturbances, though effects varied across settings and modalities. Common challenges included staffing limitations, lack of standardized protocols, and ethical considerations. These findings point to opportunities for more structured, scalable NPI models and highlight the need for future research that incorporates resident and staff perspectives to support sustainable dementia care practices.
{"title":"Implementing Non-Pharmacological interventions for dementia in long-term care: A scoping review","authors":"April Morris DNP , Melissa Kalarchian PhD , Angela Allen PhD","doi":"10.1016/j.gerinurse.2026.103901","DOIUrl":"10.1016/j.gerinurse.2026.103901","url":null,"abstract":"<div><div>Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among residents in long-term care (LTC) and contribute to poor quality of life and increased caregiver burden. Non-pharmacological interventions (NPIs) are recommended as first-line approaches, but their implementation is often limited by workforce shortages, inconsistent protocols, and lack of staff preparation. This scoping review mapped NPI characteristics, reported outcomes, and key implementation challenges used to address BPSD in LTC. Thirty-two studies met criteria and were included, encompassing music therapy, reminiscence therapy, exercise programs, assistive technology, multimodal interventions, and emerging therapies. Intervention characteristics such as personalization and cultural tailoring were associated with improved engagement and emotional responsiveness. Outcomes included reductions in agitation, anxiety, and mood disturbances, though effects varied across settings and modalities. Common challenges included staffing limitations, lack of standardized protocols, and ethical considerations. These findings point to opportunities for more structured, scalable NPI models and highlight the need for future research that incorporates resident and staff perspectives to support sustainable dementia care practices.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103901"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Geriatrics cognitive assessment and resource engagement day: Piloting an interdisciplinary outpatient cognitive care model","authors":"Kanishk D. Sharma MD , Gaby Naranjo LMSW , Amy Harper OTD, OTR/L, CHT","doi":"10.1016/j.gerinurse.2026.103923","DOIUrl":"10.1016/j.gerinurse.2026.103923","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Interdisciplinary clinic approach improves dementia care by streamlining multiple appointments into a single visit, enhancing efficiency and support.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103923"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-23DOI: 10.1016/j.gerinurse.2026.103806
Yunfei Sun MSN , Robert Jiqi Zhang PhD , Chuqian Chen PhD
This study assessed cross-sectional end-of-life care (EoLC) knowledge among 650 adults aged 60 and above across 26 provincial-level regions in China and examined the influence of individual- and provincial-level predictors. Using repeated measures ANOVA, familiarity with 15 EoLC-related concepts was compared. Hierarchical linear regression analyzed predictors of total knowledge scores, incorporating provincial-level health and standard of living indices alongside individual factors. The average knowledge score was relatively high (42.04/60), with participants more familiar with general concepts than specific medical terms. Higher knowledge scores were associated with having an urban Hukou, working in agriculture, forestry, animal husbandry, or fishery sectors as opposed to factories before retirement, having pension insurance, better self-rated health, and caregiving experience. Provincial-level health and living standards did not significantly enhance explanatory power for cross-regional differences. The findings highlight that while participants had relatively high EoLC knowledge, individual resources and experiences were pivotal in shaping their understanding.
{"title":"End-of-life care knowledge among chinese older adults: current status and influencing factors","authors":"Yunfei Sun MSN , Robert Jiqi Zhang PhD , Chuqian Chen PhD","doi":"10.1016/j.gerinurse.2026.103806","DOIUrl":"10.1016/j.gerinurse.2026.103806","url":null,"abstract":"<div><div>This study assessed cross-sectional end-of-life care (EoLC) knowledge among 650 adults aged 60 and above across 26 provincial-level regions in China and examined the influence of individual- and provincial-level predictors. Using repeated measures ANOVA, familiarity with 15 EoLC-related concepts was compared. Hierarchical linear regression analyzed predictors of total knowledge scores, incorporating provincial-level health and standard of living indices alongside individual factors. The average knowledge score was relatively high (42.04/60), with participants more familiar with general concepts than specific medical terms. Higher knowledge scores were associated with having an urban Hukou, working in agriculture, forestry, animal husbandry, or fishery sectors as opposed to factories before retirement, having pension insurance, better self-rated health, and caregiving experience. Provincial-level health and living standards did not significantly enhance explanatory power for cross-regional differences. The findings highlight that while participants had relatively high EoLC knowledge, individual resources and experiences were pivotal in shaping their understanding.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103806"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-20DOI: 10.1016/j.gerinurse.2026.103810
Michelle Kabakibi PhD, DNP, FNP-C, AGNP-C
Purpose
To explore the critical attributes of the concept of caregiver information needs in the context of dementia.
Background
Informal caregivers of patients with dementia need information in the postdiagnosis period; however, due to a lack of high-quality and available information, education, and support services, it is not really known what information needs are required specifically for caregivers to be successful.
Methods
The eight-step concept analysis method of Walker and Avant was used to analyze this concept. Uses of the concept, defining attributes, antecedents, consequences, and empirical referents are presented. Case samples are provided to assist in understanding the defining attributes.
Results
Caregiver information needs in the context of dementia are defined as the dynamicity of facts that apply to the disease process of dementia and that replace the lack of something requisite with adequate and useable knowledge. Identified attributes were lack of something requisite and dynamicity. Access to knowledgeable providers, motivation to be a caregiver, and the ability to coordinate care are the antecedents to caregiver information needs. Consequences included caregiver burnout, quality of life, internal locus of control, and maintaining patients in their homes.
Conclusion
Family caregivers need early, continuous, and stage-specific information that is usable to aid in their care abilities.
Implications
Education and the timing of information must be tailored to meet families' unique needs rather than a “one size fits all” approach. This, coupled with continuity of care, can empower caregivers and persons with dementia to advocate for their changing needs.
{"title":"Caregiver information needs in the context of dementia: A concept analysis","authors":"Michelle Kabakibi PhD, DNP, FNP-C, AGNP-C","doi":"10.1016/j.gerinurse.2026.103810","DOIUrl":"10.1016/j.gerinurse.2026.103810","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the critical attributes of the concept of caregiver information needs in the context of dementia.</div></div><div><h3>Background</h3><div>Informal caregivers of patients with dementia need information in the postdiagnosis period; however, due to a lack of high-quality and available information, education, and support services, it is not really known what information needs are required specifically for caregivers to be successful.</div></div><div><h3>Methods</h3><div>The eight-step concept analysis method of Walker and Avant was used to analyze this concept. Uses of the concept, defining attributes, antecedents, consequences, and empirical referents are presented. Case samples are provided to assist in understanding the defining attributes.</div></div><div><h3>Results</h3><div>Caregiver information needs in the context of dementia are defined as the dynamicity of facts that apply to the disease process of dementia and that replace the lack of something requisite with adequate and useable knowledge. Identified attributes were <em>lack of something requisite</em> and <em>dynamicity</em>. Access to knowledgeable providers, motivation to be a caregiver, and the ability to coordinate care are the antecedents to caregiver information needs. Consequences included caregiver burnout, quality of life, internal locus of control, and maintaining patients in their homes.</div></div><div><h3>Conclusion</h3><div>Family caregivers need early, continuous, and stage-specific information that is usable to aid in their care abilities.</div></div><div><h3>Implications</h3><div>Education and the timing of information must be tailored to meet families' unique needs rather than a “one size fits all” approach. This, coupled with continuity of care, can empower caregivers and persons with dementia to advocate for their changing needs.</div><div>No patient or public contribution</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103810"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-20DOI: 10.1016/j.gerinurse.2026.103885
Lin Guo MD , Qun Wang MD
Background
Frailty and dysregulated inflammation are prevalent among cancer survivors. The Dietary Inflammatory Index (DII) reflects dietary inflammation and may influence systemic inflammation, but its association with frailty remains unclear. This study investigates the relationship between DII and frailty in middle-aged and older cancer survivors.
Methods
Dietary inflammation was calculated from two 24-hour dietary recall interviews using a validated literature-derived scoring algorithm. Frailty was assessed using a 49-item frailty index integrating deficits across physical, cognitive, and clinical domains. We used weighted multivariable logistic regression and subgroup analyses to examine the DII-frailty link. Generalized Additive Models identified nonlinear associations, and a segmented linear regression model determined the inflection point.
Results
Among 2,671 U.S. participants, the adjusted odds ratio (OR) for DII and frailty was 1.09 (95% CI: 1.02, 1.17). A J-shaped relationship was observed, with an inflection point at 0.12; beyond this, the OR increased to 1.21 (95% CI: 1.09, 1.34). Subgroup analyses supported these findings.
Conclusion
DII exhibits a J-shaped association with frailty in middle-aged and older U.S. cancer survivors, highlighting the importance of dietary inflammation in frailty risk.
{"title":"A J-shaped relationship between Dietary Inflammatory Index and frailty risk among middle and old aged US cancer survivors","authors":"Lin Guo MD , Qun Wang MD","doi":"10.1016/j.gerinurse.2026.103885","DOIUrl":"10.1016/j.gerinurse.2026.103885","url":null,"abstract":"<div><h3>Background</h3><div>Frailty and dysregulated inflammation are prevalent among cancer survivors. The Dietary Inflammatory Index (DII) reflects dietary inflammation and may influence systemic inflammation, but its association with frailty remains unclear. This study investigates the relationship between DII and frailty in middle-aged and older cancer survivors.</div></div><div><h3>Methods</h3><div>Dietary inflammation was calculated from two 24-hour dietary recall interviews using a validated literature-derived scoring algorithm. Frailty was assessed using a 49-item frailty index integrating deficits across physical, cognitive, and clinical domains. We used weighted multivariable logistic regression and subgroup analyses to examine the DII-frailty link. Generalized Additive Models identified nonlinear associations, and a segmented linear regression model determined the inflection point.</div></div><div><h3>Results</h3><div>Among 2,671 U.S. participants, the adjusted odds ratio (OR) for DII and frailty was 1.09 (95% CI: 1.02, 1.17). A J-shaped relationship was observed, with an inflection point at 0.12; beyond this, the OR increased to 1.21 (95% CI: 1.09, 1.34). Subgroup analyses supported these findings.</div></div><div><h3>Conclusion</h3><div>DII exhibits a J-shaped association with frailty in middle-aged and older U.S. cancer survivors, highlighting the importance of dietary inflammation in frailty risk.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103885"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-20DOI: 10.1016/j.gerinurse.2026.103842
Peng Bai PhD , Qiang Xiong PhD , Tao Wu PhD
Objective
This study systematically evaluated the effects of both overall and modality-specific exercise doses on lower-limb functional mobility in middle-aged and older adults with stroke, and identified optimal dose–response relationships using Bayesian non-linear modeling.
Methods
Twenty-five randomized controlled trials involving 788 stroke patients aged ≥45 years were included. Lower-limb function was assessed using the Timed Up and Go test. Exercise dose was standardized as MET·min/week, incorporating frequency, duration, and intensity. Bayesian model-based network meta-analysis was used to estimate non-linear dose-response curves across six intervention modalities: gait training, motor control training, resistance training, integrated aerobic training, combined cognitive-exercise training, and virtual reality training.
Results
A non-linear association was observed between overall exercise dose and functional mobility improvement, with a peak effect (SMD ≈ 0.45) at approximately 1400 MET·min/week. Optimal dose zones varied across modalities: resistance and gait training showed strong effects at low doses (∼560 MET·min/week), integrated aerobic and combined cognitive-exercise training peaked at higher doses (∼1700–1800 MET·min/week), while motor control training achieved significant effects (∼SMD 0.50) at moderate doses (∼890 MET·min/week). Virtual reality training exhibited wide credible intervals and non-significant effects.
Conclusion
This study demonstrates that lower-limb functional mobility in stroke patients follows a clear moderate-dose optimal pattern, with improvements peaking at around 1400 MET·min/week. Modality-specific analyses show that exercise approaches do not differ in inherent superiority but instead present distinct dose-response profiles. Evidence for virtual reality training remains inconclusive due to wide credible intervals. These findings provide quantitative guidance for dose-informed, individualized exercise prescriptions in neurorehabilitation.
目的：本研究系统评估了整体运动剂量和特定运动方式的运动剂量对中老年脑卒中患者下肢功能活动能力的影响，并利用贝叶斯非线性模型确定了最佳剂量-反应关系。方法：纳入25项随机对照试验，788例年龄≥45岁的脑卒中患者。采用Timed Up and Go测试评估下肢功能。运动剂量标准化为MET·min/周，包括频率、持续时间和强度。采用基于贝叶斯模型的网络元分析来估计六种干预方式的非线性剂量-反应曲线：步态训练、运动控制训练、阻力训练、综合有氧训练、认知-运动联合训练和虚拟现实训练。结果：总体运动剂量与功能活动能力改善之间存在非线性关联，在约1400 MET·min/week时达到峰值效应（SMD≈0.45）。最佳剂量区域因模式而异：阻力和步态训练在低剂量（~ 560 MET·min/周）表现出强烈的效果，综合有氧和联合认知运动训练在高剂量（~ 1700-1800 MET·min/周）达到峰值，而运动控制训练在中等剂量（~ 890 MET·min/周）达到显著效果（~ SMD 0.50）。虚拟现实训练具有较宽的可信区间和不显著的效果。结论：本研究表明，脑卒中患者的下肢功能活动性遵循一个明确的中剂量最佳模式，在1400 MET·min/周左右达到改善的峰值。模式特异性分析表明，运动方法在固有优势上没有差异，而是呈现出不同的剂量-反应谱。由于可信间隔较宽，虚拟现实训练的证据仍然不确定。这些发现为神经康复中剂量知情的个体化运动处方提供了定量指导。
{"title":"Effects of overall and modality-specific exercise dose on lower-limb functional mobility in middle-aged and older adults with stroke: A systematic review and bayesian dose-response meta-analysis","authors":"Peng Bai PhD , Qiang Xiong PhD , Tao Wu PhD","doi":"10.1016/j.gerinurse.2026.103842","DOIUrl":"10.1016/j.gerinurse.2026.103842","url":null,"abstract":"<div><h3>Objective</h3><div>This study systematically evaluated the effects of both overall and modality-specific exercise doses on lower-limb functional mobility in middle-aged and older adults with stroke, and identified optimal dose–response relationships using Bayesian non-linear modeling.</div></div><div><h3>Methods</h3><div>Twenty-five randomized controlled trials involving 788 stroke patients aged ≥45 years were included. Lower-limb function was assessed using the Timed Up and Go test. Exercise dose was standardized as MET·min/week, incorporating frequency, duration, and intensity. Bayesian model-based network meta-analysis was used to estimate non-linear dose-response curves across six intervention modalities: gait training, motor control training, resistance training, integrated aerobic training, combined cognitive-exercise training, and virtual reality training.</div></div><div><h3>Results</h3><div>A non-linear association was observed between overall exercise dose and functional mobility improvement, with a peak effect (SMD ≈ 0.45) at approximately 1400 MET·min/week. Optimal dose zones varied across modalities: resistance and gait training showed strong effects at low doses (∼560 MET·min/week), integrated aerobic and combined cognitive-exercise training peaked at higher doses (∼1700–1800 MET·min/week), while motor control training achieved significant effects (∼SMD 0.50) at moderate doses (∼890 MET·min/week). Virtual reality training exhibited wide credible intervals and non-significant effects.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that lower-limb functional mobility in stroke patients follows a clear moderate-dose optimal pattern, with improvements peaking at around 1400 MET·min/week. Modality-specific analyses show that exercise approaches do not differ in inherent superiority but instead present distinct dose-response profiles. Evidence for virtual reality training remains inconclusive due to wide credible intervals. These findings provide quantitative guidance for dose-informed, individualized exercise prescriptions in neurorehabilitation.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"69 ","pages":"Article 103842"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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