Multidimensional Frailty, Quality of Life and Self-Management in Aging Hispanics Living With HIV.

An observational cross-sectional study was conducted to examine multidimensional frailty and its potential impact on quality of life (QOL) in aging Hispanic people living with HIV (PLWH) and assess the extent to which HIV self-management moderates this association. The sample included 120 Hispanic PLWH aged 50 years and older (M = 59.11; SD = 7.04). The structural equation modeling analyses demonstrated that multidimensional frailty was significantly related to QOL in its two dimensions, physical and mental (p < .001). The relationship between multidimensional frailty and mental and physical QOL remained significant even after controlling for confounders (age and gender). The moderator analyses indicated no statistically significant moderator effect of HIV self-management on multidimensional frailty and mental or physical QOL. These study results have practical implications that highlight the need for early screening for frailty with a multidimensional focus. Age-appropriate and culturally tailored interventions to prevent or mitigate multidimensional frailty may improve QOL.

Feasibility and acceptability of SEPA+PrEP: An HIV prevention intervention to increase PrEP knowledge, initiation, and persistence among cisgender heterosexual Hispanic women.

The HIV epidemic disproportionately affects Hispanics in the U.S., with Hispanic women (HW) accounting for 18% of new HIV diagnoses in 2019 despite comprising only 16% of the female population. The imbalance of power related to cultural values and HW's lack of knowledge and low perception of risk for HIV interferes with prevention efforts (e.g., condom use, HIV testing, and Pre-Exposure Prophylaxis [PrEP]). It is estimated that in 2019, only 10% of women in the U.S. who could benefit from PrEP were given prescriptions for it. This number is estimated to be significantly lower among HW. PrEP is highly effective for preventing HIV, reducing the risk of acquiring HIV from sexual activity by about 99%. To respond to this need, we developed SEPA+PrEP, a biobehavioral HIV prevention intervention that adapted and integrated SEPA (Salud/Health, Educación/Education, Prevención/Prevention, Autocuidado/Self-Care), an empirically validated behavioral HIV prevention intervention, with the evidence-based biomedical strategy of PrEP. This study aimed to investigate the feasibility and acceptability of SEPA+PrEP among cisgender heterosexual Hispanic women (HW). We used a mixed methods approach to gather data from 44 HW living in the City of Homestead and its surrounding communities in Miami-Dade County, Florida. None of the participants knew about PrEP prior to participating in the study, and the majority (70.5%, n = 23) had not used condoms when engaging in vaginal sex during the previous three months. Overall, study results suggest that SEPA+PrEP is an acceptable and feasible intervention to prevent HIV among HW, with a focus on PrEP knowledge, initiation, and maintenance.

Walking to Prevent Fear of Falling Among Community-Dwelling Older Adults: A Scoping Review.

The current review sought to identify and synthesize the evidence on available interventions that include walking and their impact on fear of falling (FOF) among community-dwelling older adults without cognitive impairment. A 10-year search was conducted (January 2012 to January 2022) in two peer-reviewed databases. A total of 116 articles were identified, and 22 articles were reviewed. Most studies included multicomponent walking interventions, such as walking and another type of intervention or exercise. Among the different questionnaires to assess FOF, the Falls Efficacy Scale-International was the most used in 77.3% (n = 17) of studies. In addition to walking, interventions to reduce FOF mainly included balance training, lower extremity strengthening, cardio or aerobic exercises, or a combination of these exercises. Further research is needed to evaluate the impact of unidimensional walking interventions, as well as those that incorporate psychological and technological elements targeted to FOF prevention and management. [Journal of Gerontological Nursing, 50(1), 15-21.].

Factors Related to the Need for Informal Care Among Community-Dwelling Older Adults in Chile.

PURPOSE: To identify factors contributing to the need for informal care among community-dwelling older adults with functional impairment in Chile. METHOD: A secondary data analysis was conducted using cross-sectional data from 540 Chilean older adults aged ≥60 years (mean age = 72.2 years, SD = 6.22 years). RESULTS: Informal care need was reported by 24.3% (n = 131) of participants. Among the variables that most influenced the need for informal care among older adults were hospitalization in the past 1 year, functionality, comorbidities, and multidimensional frailty (all p < 0.05). CONCLUSION: This study identified factors that clinicians and nurses should be aware of when caring for this population to prevent or manage the need for informal care. [Journal of Gerontological Nursing, 50(2), 43-52.].

Sources of Well-Being for Hispanic Women Who Have Experienced Intimate Partner Violence: A Scoping Review.

Purpose: This review sought to identify and integrate available evidence on various sources of Hispanic women's well-being following intimate partner violence (IPV). Methods: The review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four peer-reviewed databases were reviewed for studies published between 2007 and 2022. The inclusion criteria include being an original research, quantitative and/or qualitative data, Hispanic women as a separate group for analysis, well-being as an outcome variable (quantitative) or phenomenon of interest (qualitative), and published in English or Spanish. Results: A total of 2,292 records were identified, and nine articles were included in the final review. Findings revealed that ensuring safety and opportunities for women's children, separating from violent partners, and obtaining a job were related to increased well-being. Other findings revealed that peer support, self-empowerment, and leadership skills were associated with interpersonal, psychological, and community well-being, respectively. Economic and occupational well-being was linked to education and financial independence. Conclusions: This scoping review advances the exploration of well-being among Hispanic women who have experienced IPV. This knowledge can be used to inform post-IPV support for Hispanic women and highlight areas for intervention development to promote well-being.

HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV.

Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.

Multidimensional Frailty and Traumatic Brain Injury among Older Adults: A Literature Review / Fragilidad multidimensional y lesión cerebral traumática en adultos mayores: Una revisión de la literature / Fragilidade multidimensional e traumatismo cranioencefálico em idosos: uma revisão da literatura

Background. Numerous health conditions in the older adult population can be attributed to falls, including traumatic brain injury (TBI), which can lead to devastating short and long-term sequelae. Older adults are also more likely to experience frailty, which encompasses physical, psychological, and social deficits that may lead to adverse health outcomes. Our literature review synthesizes current evidence for understanding frailty in the context of TBI among older adults using the Integral Model of Frailty as a framework. Content synthesis. A total of 32 articles were identified, and 9 articles were included. The results of this review indicate that outcomes resulting from TBI are closely linked to the physical, psychological, and social domains of frailty. Conclusions. A small amount of literature currently examines frailty in the context of TBI among older adults. Using the Integral Model of Frailty to Invest Educ Enferm. 2023; 41(2): e02Multidimensional Frailty and Traumatic Brain Injury among Older Adults:A Literature Reviewunderstand frailty in the context of TBI can help clinicians anticipate patient outcomes and improve care plans. We emphasize the need for a greater understanding of TBI concerning frailty to improve health outcomes among older adult patients.

Antecedentes. Numerosos trastornos de salud en la población de adultos mayores pueden atribuirse a las caídas, incluida la lesión cerebral traumática (LCT), que puede provocar secuelas devastadoras a corto y largo plazo. Los adultos mayores también son más propensos a experimentar fragilidad, que abarca déficits físicos, psicológicos y sociales que pueden conducir a resultados adversos para la salud. Nuestra revisión de la literatura sintetiza la evidencia actual para la comprensión de la fragilidad en el contexto de la LCT entre los adultos mayores utilizando el Modelo Integral de Fragilidad como marco. Síntesis del contenido. Un total de 32 artículos fueron identificados, y 9 artículos fueron incluidos. Los hallazgos de esta revisión indican que los resultados de la LCT están estrechamente relacionados con los dominios físico, psicológico y social de la fragilidad. Conclusión. Una pequeña cantidad de literatura examina actualmente la fragilidad en el contexto de la LCT entre los adultos mayores. Usar el Modelo Integral de Fragilidad para entender la fragilidad en el contexto de la LCT puede ayudar a los clínicos a anticipar los resultados de los pacientes y mejorar los planes de cuidados. Enfatizamos la necesidad de una mayor comprensión de la LCT en relación con la fragilidad para mejorar los resultados de salud entre los pacientes adultos mayores.

Antecedentes. Numerosos distúrbios de saúde na população idosa podem ser atribuídos a quedas, incluindo traumatismo cranioencefálico (TCE), que pode causar sequelas devastadoras a curto e longo prazo. Os idosos também são mais propensos a experimentar fragilidade, que engloba déficits físicos, psicológicos e sociais que podem levar a resultados adversos à saúde. Nossa revisão da literatura sintetiza as evidências atuais para entender a fragilidade no contexto do TCE entre idosos usando o Modelo Abrangente de Fragilidade como estrutura. Síntese de conteúdo. Um total de 32 artigos foram identificados e 9 artigos foram incluídos. As descobertas desta revisão indicam que os resultados do TCE estão intimamente relacionados aos domínios físico, psicológico e social da fragilidade. Conclusão.Um pequeno corpo de literatura atualmente examina a fragilidade no contexto do TCE entre adultos mais velhos. Usar o Modelo Abrangente de Fragilidade para entender a fragilidade no contexto do TCE pode ajudar os médicos a antecipar os resultados do paciente e melhorar os planos de tratamento. Enfatizamos a necessidade de uma maior compreensão do TCE em relação à fragilidade para melhorar os resultados de saúde entre pacientes idosos

Multilevel Self-Management in Nursing Research: An Approach to Decrease Health Disparities in Chronic Diseases / Intervenciones de autogestión multinivel en la investigación en enfermería: Un enfoque para disminuir las disparidades de salud en enfermedades crónicas / Intervenções multiníveis de autogerenciamento na pesquisa em enfermagem: uma abordagem para reduzir as disparidades de saúde em doenças crônicas

Objective. To discuss multilevel self-management intervention research in nursing to decrease health disparities among people living with chronic diseases. Content synthesis. Multilevel interventions have become the core of nursing research in the last decade. However, a critical limitation of existing interventions targeting health disparities among those living with chronic diseases is the tendency to address single or individual-level factors solely. Conclusions. Nursing research is creating knowledge that may be translated into clinical practice and promoting evidence-based and innovative self-management practices to decrease health disparities and promote health equity among people living with chronic diseases.

Objetivo. Analizar la investigación realizada por enfermería en intervenciones multinivel de automanejo con el fin de disminuir las disparidades de salud entre las personas que viven con enfermedades crónicas. Síntesis de contenido.Las intervenciones multinivel se han convertido en el núcleo de la investigación en enfermería en la última década. Sin embargo, una limitación crítica de las intervenciones existentes que se enfocan en las disparidades de salud entre quienes viven con enfermedades crónicas es la tendencia a abordar factores individuales o de nivel individual únicamente. Conclusiones. La investigación en enfermería está creando conocimiento que puede traducirse en la práctica clínica y promueve prácticas de autocuidado innovadoras y basadas en evidencia para disminuir las disparidades en la salud y promover la equidad en la salud entre las personas que viven con enfermedades crónicas.

Objetivo. Analisar a pesquisa realizada pela enfermagem em intervenções multiníveis de autogestão para reduzir as disparidades de saúde entre pessoas que vivem com doenças crônicas. Síntese de conteúdo. As intervenções multiníveis tornaram-se o núcleo da pesquisa em enfermagem na última década. No entanto, uma limitação crítica das intervenções existentes que visam as disparidades de saúde entre aqueles que vivem com doenças crônicas é a tendência de abordar apenas fatores individuais ou de nível individual. Conclusões.A pesquisa em enfermagem está criando conhecimento que pode ser traduzido para a prática clínica e promovendo práticas de autocuidado inovadoras e baseadas em evidências para diminuir as disparidades de saúde e promover a equidade na saúde entre pessoas que vivem com doenças crônicas.

"ActuaYa": A Preliminary Efficacy Study of a Chronic Disease Prevention and Health Promotion Intervention for Older Hispanic Women.

Chronic diseases (CDs) are increasingly common among the aging population. Some evidence suggests that older Hispanic women ages 50 years and older (OHW) are at an increased risk for CDs and poorer outcomes than other groups. This study investigated the preliminary efficacy of ActuaYa, a culturally tailored CD prevention and health promotion intervention for OHW. A prospective, single-group, repeated measures study (n = 50) was conducted in Florida. Clinical measures and surveys were collected at baseline and post-intervention at 3- and 6-month follow-up. Descriptive statistics, paired-sample t-tests, and McNemar tests were used for analysis. At baseline, more than half of the participants had a CD. Post-intervention results showed a significant decrease in participants' MAP, BMI, and A1C, and a significant increase in self-efficacy for exercise and HIV knowledge compared to baseline measures. The results of this study support the preliminary efficacy of ActuaYa in preventing CDs and increasing health promotion among OHW.

Biopsychosocial Factors of Depression Among Hispanic Women Aged ≥50 Years.

The purpose of the current study was to identify biopsychosocial factors associated with depressive symptoms among Hispanic women aged ≥50 years. Cross-sectional data related to 10 biological, psychological, and social factors were analyzed. Center for Epidemiologic Studies Depression Scale scores suggested that 32% of the sample had depressive symptoms. Self-esteem, self-perception of health status, income, and chronic pain had statistically significant associations with depressive symptoms. A logistic regression analysis showed that increasing self-esteem scores were associated with decreases in the likelihood of having depressive symptoms. Findings underscore that depression is associated with biological, psychological, and social factors. Culturally tailored interventions that aim at targeting these factors may have an impact on Hispanic women's depression and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 32-42.].

Providing Care During the COVID-19 Pandemic: The Experience of Formal Caregivers in Long-Term Care Facilities in Chile.

The current study aimed to identify the main challenges to formal caregivers from different long-term care facilities (LTCFs) that care for older adults (aged ≥60 years) in Chile during the coronavirus disease 2019 pandemic. Chile's national LTCF governing body (SENAMA) sent a survey to 1,190 LTCFs, receiving 996 responses. LTCF characteristics were number of residents, certification with SENAMA, licensure, geographic zone, and poverty level. Four dimensions were assessed: (a) concerns, (b) challenges, (c) needs, and (d) opportunities for improvement. The majority of respondents replied negatively to these four dimensions. Among those who responded positively, the fear of infecting a loved one, staff shortages and overwork, the need for access to psychological support, and improving payments were among formal caregivers' primary concerns. Targeting supportive interventions for formal caregivers, clinically and psychologically, is essential to preserve caregivers' health. [Journal of Gerontological Nursing, 49(5), 39-44.].

Disparities in Resource Availability, Psychological Intimate Partner Violence, and Depression Among Hispanic Women.

This study aims to analyze the relationship between the availability of resources, exposure to psychological intimate partner violence (P-IPV), and depression in Hispanic women in South Florida. This secondary data analysis used cross-sectional baseline data from SEPA (Salud, Educación, Prevención y Autocuidado) III. SEPA III was a randomized controlled trial that tested the SEPA intervention with 320 cisgender, sexually active Hispanic women. Descriptive analysis, logistic, and multiple regressions were conducted. Lower sexual relationship power and attending religious services were associated with higher odds of P-IPV. Reporting a history of P-IPV in the last 3 months predicted depression scores and higher depression scores were associated with higher odds of experiencing P-IPV. Participants with higher depressive scores reported less education, increased emergency room utilization, and less sexual relationship power. P-IPV is highly prevalent among Hispanic women living in South Florida. The availability of personal and community resources can buffer the risk of P-IPV and its mental health consequences. Nurses can strengthen women's resources to prevent Hispanic women from exposure to P-IPV.

The Impact of COVID-19 Household Isolation on Conflict and Cohesion in One-, Two-, and Three-Generation Households With Older Adults.

The current cross-sectional study examined the effect of coronavirus disease 2019 (COVID-19) household isolation on household conflict and cohesion in one-, two-, and three-generation households with older adults (aged ≥65 years). Participants were 757 adults (aged ≥18 years) with at least one older adult in their household. Respondents were from 51 countries. Study variables were measured with the COVID-19 Household Environmental Scale. Non-parametric tests were used to assess differences between groups. Most participants (n = 437, 57.7%) lived in three-generation homes. Three-generation homes reported greater increases in conflict (p < 0.001) and cohesion (p < 0.001) during household isolation compared to oneand two-generation homes. Findings suggest that older adults living in multigenerational households experienced more cohesive and conflictive household environments as a function of the COVID-19 pandemic. Further research should explore how family or health care interventions could better support older adults and families as a unit of care to avoid adverse outcomes and boost resilience. [Journal of Gerontological Nursing, 49(4), 47-56.].

Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study.

ABSTRACT: Among Hispanics, frailty has been extensively studied as a physical syndrome associated with an increased risk for adverse outcomes. Because of additional barriers to accessing care, the impact of frailty may be even more significant for people living with HIV (PLWH). Multidimensional frailty among Hispanic PLWH has not been studied. This study aimed to examine the factors related to multidimensional frailty among Hispanic PLWH aged 50 years and above. A cross-sectional design with 120 participants was used. Hypothesized factors related to multidimensional frailty were sociodemographic and psychosocial variables. Multidimensional frailty was measured with the Tilburg Frailty Indicator. We found that 45.83% of the participants were frail ( n = 55), and multidimensional frailty was significantly associated with higher depressive symptoms ( b = .26, p < .001) and a higher number of comorbidities ( b = .71, p < .001). This study identified factors that clinicians should be aware of when caring for Hispanic PLWH to prevent or manage frailty-related complications.

Understanding the student's experience of community health nursing simulations.

OBJECTIVES: The purpose of this study was to explore nursing students' experiences after completing community health nursing simulation encounters. METHODS: The study used a descriptive qualitative design. Through conventional content analysis, the research team analyzed the experiences of 73 nursing students after participating in community health nursing simulation encounters. The data come from nursing students' responses to three post-simulation qualitative questions. RESULTS: Nursing students identified both positive aspects (simulation as a great learning method, useful in understanding community health nurses' roles, faculty's role in facilitating an effective learning environment) and opportunities for improvement (needing for clear objectives, expectations, and roles). CONCLUSIONS: Community health nursing simulation encounters can be a powerful educational method to help students experience and understand the roles of community health nurses. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Augmentation of the pre-brief component will further improve students' simulation experiences.

Multidimensional Frailty and Traumatic Brain Injury among Older Adults: A Literature Review.

Background: Numerous health conditions in the older adult population can be attributed to falls, including traumatic brain injury (TBI), which can lead to devastating short and long-term sequelae. Older adults are also more likely to experience frailty, which encompasses physical, psychological, and social deficits that may lead to adverse health outcomes. Our literature review synthesizes current evidence for understanding frailty in the context of TBI among older adults using the Integral Model of Frailty as a framework. Content Synthesis: A total of 32 articles were identified, and 9 articles were included. The results of this review indicate that outcomes resulting from TBI are closely linked to the physical, psychological, and social domains of frailty. Conclusions: A small amount of literature currently examines frailty in the context of TBI among older adults. Using the Integral Model of Frailty to understand frailty in the context of TBI can help clinicians anticipate patient outcomes and improve care plans. We emphasize the need for a greater understanding of TBI concerning frailty to improve health outcomes among older adult patients.

Multilevel Self-Management in Nursing Research: An Approach to Decrease Health Disparities in Chronic Diseases.

Objective: To discuss multilevel self-management intervention research in nursing to decrease health disparities among people living with chronic diseases. Content synthesis: Multilevel interventions have become the core of nursing research in the last decade. However, a critical limitation of existing interventions targeting health disparities among those living with chronic diseases is the tendency to address single or individual-level factors solely. Conclusion: Nursing research is creating knowledge that may be translated into clinical practice and promoting evidence-based and innovative self-management practices to decrease health disparities and promote health equity among people living with chronic diseases.

Factors Associated With Psychosocial Illness Impact Among Black/African American and Hispanic Older Women Living With HIV.

BACKGROUND: In 2018, one in six newly diagnosed individuals with HIV in the United States were adults aged 50 years and older, 24% were women, and 60% were Black/African American and Hispanic (42% and 18%, respectively). OBJECTIVES: This study aims to examine the factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women living with HIV. METHOD: Guided by the socioecological model, a secondary data analysis design with cross-sectional data that included 138 Black/African American and Hispanic women aged 50 years and older was conducted. RESULTS: Higher levels of avoidant coping, depressive symptoms, negative self-perception of health, and decreased social support were significant factors associated with HIV psychosocial illness impact among this sample. CONCLUSIONS: Findings from this study can contribute to identifying solutions to prevent and decrease these negative factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women.

Frailty in the Context of Older People Living With HIV: A Concept Analysis.

Despite advances in knowledge about older people living with HIV infection (PLWH), frailty remains a challenge to HIV care. Numerous studies have documented its impact; however, the concept remains unclear. Concept exploration of frailty in the context of older PLWH was conducted to provide a comprehensive understanding of the concept based on the Walker and Avant method. After the literature review, a concept analysis and a definition of frailty among older PLWH emerged. Implications for further practice, education, public policy, and research are presented to use the concept consistently, develop interventions to prevent frailty, and improve health outcomes.

Hispanic Mother-Daughter Communication About the Risks of Sex, Drugs, and Alcohol: Influences and the Strategies Mothers Use.

PURPOSE: U.S. Hispanic adolescents are at risk for negative health outcomes due to risk-taking behaviors involving sex, drugs, and alcohol. Mother-daughter communication can reduce these risk-taking behaviors and reinforce parents' expectations. The purpose of this study was to explore mothers' descriptions of their communication about risk-taking behaviors with their early adolescent Hispanic daughters. DESIGN AND METHODS: This qualitative descriptive study involved focus groups with 21 Hispanic mothers of 7th grade (12-14 years old) girls. Conventional content analysis was conducted to identify the strategies they used during these conversations. RESULTS: Strategies mothers used included warning, focusing on negative consequences, creating opportunities to express maternal expectations, and stressing the importance of positive influences. Communication was also influenced by daughters' physical development and social media. CONCLUSIONS: The mothers were concerned about their daughters' exposure to risk-taking behaviors but were unsure about how to talk to their daughters about how to avoid them, particularly regarding topics related to sex. PRACTICE IMPLICATIONS: Our study results have implications on how to facilitate parent-child conversations about risk-taking behaviors and to equip mothers and parents to teach their children how to avoid engaging in these behaviors.