Nursing undergraduates' ageism and attitudes toward dementia: Serial multiple mediating effects of person-centered care and compassion - A cross-sectional survey.

Background: Although ageism has a strong relationship with attitudes toward dementia, no study has confirmed how person-centered care and compassion mediate the relationship between nursing students' ageism and attitudes toward dementia. Objectives: This study aimed to examine the mediating effects of person-centered care competency and compassion competency on ageism and attitudes toward dementia among nursing undergraduates. Participants: Participants were 295 undergraduate nursing students from four universities. Methods: A descriptive cross-sectional electronic survey was conducted, involving the selection of four Korean nursing schools for the study. Data was obtained via an online survey conducted from March to July 2022. Data were analyzed with Pearson's correlations, and multi-mediating effects using the PROCESS Macro for software, utilizing bootstrap techniques. Results: Attitudes toward dementia was correlated with ageism (r = -0.386, p < 0.001), person-centered care (r = 0.422, p < 0.001), and compassion competency (r = 0.457, p < 0.001). The total effect (ß = -0.326, p < 0.001) and direct effect (ß = -0.243, p < 0.001) of ageism on attitudes toward dementia were significant. Ageism does not have a direct effect on compassion competency (Std. estimate = -0.0213, CI: -0.0518∼0.0048). However, person-centered care and compassion competency had multiple serial mediating effects on the relationship between ageism and attitudes toward dementia (Std. estimate = -0.0357, CI: -0.0624∼-0.0145). Conclusions: Person-centered care and compassion competency may mediate the association between ageism and attitudes toward dementia. Ageism was negatively associated with person-centered care and compassion competency, which in turn positively contributed to attitudes toward dementia. Therefore, an educational program that considers the interaction between generations and the context of older people must be applied to increase person-centered care and compassion competency.

Mixed Method Evaluation of ACTS: Advancing Connection Through Storytelling-A Novel Approach to Improve Older Adult Engagement and Staff Interactions in Korean Nursing Homes.

BACKGROUND: A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes. OBJECTIVES: To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care. METHODS: This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years). Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys. Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program's outcomes. RESULTS: The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention. Analysis of the residents' stories identified 5 themes. The staff focus group interviews identified 2 themes and 7 subthemes. Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities. CONCLUSIONS: The storytelling program was useful in reducing older adults' negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction. These effects could help foster relationship- and communication-centered facility cultures.

Digital Storytelling as an Intervention for Older Adults: A Scoping Review.

The population of older adults is rapidly increasing worldwide. Owing to fewer interactions between generations, older adults experience ageism and various psychological issues, such as depression and loneliness. Digital storytelling (DST) has the potential to share vivid lived experiences, support the forming of social relationships, and lead to improved well-being. This scoping review examines the potential psychosocial benefits of individual DST interventions for older adults and people with dementia. We adopted the methodological framework for scoping reviews outlined in the Joanna Briggs Institute's (JBI) manual. A scoping review was performed using the following bibliographic databases: Web of Science, PubMed, Cochrane Library, CINAHL, Research Information Sharing Service, and National Assembly Library. There were 395 references retrieved, of which 19 articles were selected after applying inclusion and exclusion criteria. Our findings revealed that the most common effects of DST on older adults included the promotion of mental health, an increased amount of meaningful community connections, greater digital literacy, the mitigation of negative ageism, and enhanced intellectual ability. We suggest randomized controlled trials are conducted to confirm the efficacy of intergenerational DST intervention and the effects of DST interventions at multilevel outcomes, including the community level.

A Concept Analysis of Illness Intrusiveness in Chronic Disease: Application of the Hybrid Model Method.

This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients.