Engaging With Aging: A Framework for Managing Daily Living.

Older adults live with the constant reality of having to manage their daily living with the emergence and progression of normal age-related changes that alter their usual capacities and resource needs. Although literature addresses successful aging, gaps exist in our understanding about how older adults manage daily living tasks, particularly from their viewpoint. To address this, the current authors propose Engaging with Aging (EWA), a perspective and set of processes older adults can use to approach daily living in a reasoned, purposeful manner that has similarities with clinical reasoning. EWA, a person-centered approach, can be considered citizen science in that it was developed by a nonagenarian based on personal experiences. Research using the EWA framework has the potential to advance the science of how older adults can manage and adapt to the impact of age-related changes to maintain independence and life satisfaction, and ultimately contribute to the development of care strategies. [Journal of Gerontological Nursing, 45(12), 13-20.].

"It May Be a Bit Uncertain But It's Never Boring": Thematic Analysis of a Blog About Engaging With Aging.

Online blogs about healthy aging written by health care professionals and others are increasing. The purpose of the current study was to analyze a first-person narrative blog about engaging with aging (EWA), with a goal of better understanding the process used to manage daily life and inform healthy aging for older adults. Using a thematic analysis approach, 67 blog posts written by a nonagenarian, retired nursing professor were analyzed. Emergent themes revealed the identification of age-related changes (e.g., physical, cognitive, functional, social, societal, psychological), characteristics of the age-related changes process, responses to age-related changes (e.g., feelings, attitudes), approaches and strategies to addressing age-related changes (i.e., the use of internal and external resources), and the outcomes of the approaches. The EWA blog posts help understand the aging experience from the perspective of an older adult, especially functional changes and how they affect daily life, as well as strategies used to adapt to changes. [Journal of Gerontological Nursing, 45(12), 21-27.].

Community Health Needs Assessments: Expanding the Boundaries of Nursing Education in Population Health.

BACKGROUND: Conducting federally mandated community health needs assessments through academic-practice partnerships provides new opportunities for developing population health nursing competencies. OBJECTIVES: The purpose of this article was to describe how a baccalaureate practicum experience within such an assessment process, involving health care system partners, re-affirms the importance of community and population health assessment in the development of future nursing leaders. RESULTS: Student evaluations indicated an emerging appreciation for the social determinants of health, the power of partnerships, and the importance of diversity. Integrating health care and public health system perspectives on assessment meets both public health and nursing accreditation standards and extends student leadership experiences. Such integration also improves regional capacity for improving population health. CONCLUSIONS: Federal mandates for community health needs assessments provide opportunities to advance leadership roles for nursing graduates throughout the health care system, and for confirming the importance of community assessment as an essential nursing competency.

Changes in political astuteness following nurse legislative day.

Political astuteness, including awareness, knowledge, and involvement, is necessary if nurses are to engage in policy advocacy-a vital aspect of the nursing profession. However, little is known about the effects of learning activities, such as legislative days, on political astuteness. The purpose of this research was to determine if political astuteness changed after participants attended a state nurse legislative day. Pre and post data were collected from participants in two studies (N = 80 and N = 34) using the Political Astuteness Inventory (PAI). Political astuteness scores were significantly higher after participants attended legislative day as compared to before. Age and educational rank were positively correlated with political astuteness. Experiential activities such as attending nurse legislative days that offer opportunities to learn policy advocacy skills can enhance knowledge of and participation in the policy process.

Engaging With Aging: A Qualitative Study of Age-Related Changes and Adaptations.

Background and Objectives: In the context of global aging, there is a need to better understand how older adults adapt to their changing health status. Engaging with aging (EWA) is an emerging framework proposed by Carnevali, which provides a new lens to understand an active, conscious daily-living process of managing age-related changes (ARCs) taken on by older adults. Study aims were to (a) describe the ARCs experienced by community-dwelling older adults and (b) identify the strategies and resources used by older adults to accommodate the daily-living challenges caused by the associated ARCs. Research Design and Methods: We conducted semistructured interviews using a virtual card sort to gather qualitative data about ARCs and strategies to manage ARCs. Interviews were conducted virtually due to coronavirus disease 2019 (COVID-19) restrictions. Results: Participants included 19 females and 10 males. The mean age was 77.45 years old (range from 64 to 98). Sixteen ARCs (e.g., changes in hearing, changes in stability, changes in sleep, etc.) were mentioned by participants, and their corresponding adaptations were discussed. Participants linked their adaptations to their ARCs based on their changing capacities and needs. Examples of commonly used adaptations included, for example, conserving energy, utilizing tools or technology, and being more conscious before and while taking actions. The challenges caused by COVID-19 in implementing the adaptations were also discussed. Discussion and Implications: Findings from this study demonstrate how older adults explore, generate, and utilize adaptive behaviors to address their ARCS. This study substantiates the EWA framework by showing common patterns among older adults in linking ARCs with adaptations. Implications for clinicians include using EWA to help older adults identify personalized health solutions that fit their capacities. Researchers may use EWA to design and test interventions by considering the specific ARCs older adults encounter and the attitudes they hold towards the ARCs.

Associations between asthma emergency visits and particulate matter sources, including diesel emissions from stationary generators in Tacoma, Washington.

The objective of this research was to evaluate the effect of particulate matter air pollution, including emissions from diesel generators, on visits to emergency departments for asthma. Daily asthma case data from participating hospitals in the greater Tacoma, Washington area were obtained. Daily asthma emergency room visit data were available from six Tacoma hospitals from January 3, 1998 to May 30, 2002. Only emergency visits where the primary discharge diagnosis was asthma were included in the analysis. Air pollution, daily temperature and relative humidity data were obtained from the Puget Sound Clean Air Agency. An association between daily PM2.5 and emergency department (ED) visits for asthma at lag days 2 and 3 was observed. The relative risk for lag day 2 was 1.04 (95% confidence interval[CI]: 1.01, 1.07) and for lag day 3 was 1.03 (1.0, 1.06). A significant association between ED visits for asthma and increased use of diesel generators was not detected. The use of low-sulfur diesel oil may have mitigated potential adverse health effects. These data indicate that air pollution in a medium-sized coastal city may be sufficient to have a public health impact on asthma.

Changes in political astuteness after a health systems and policy course.

Political advocacy, an integral part of the nursing role, requires knowledge of the policy process and skills. Few studies describe the influence of nursing education on political competence. This study examined political astuteness in graduate students before and after a required course in health policy. Students reported significantly higher political astuteness scores after the course. Academic preparation in health policy can increase the knowledge and skills that nurses need to effectively advocate for healthcare change.

Outcomes of scholarly inquiry: an analysis of Master's of Nursing students' projects/theses.

This study examined the first scholarly projects/theses of 112 graduates of a newly formed Master of Nursing (MN) program. The purpose of the analysis was to determine whether MN graduates' scholarly projects/theses addressed the American Association Colleges of Nursing's (1996) Essentials of Master's Education for Advanced Practice Nursing, met program outcomes, and adhered to campus and program values. Other specific questions were formulated to ascertain the method of inquiry most used, the population group most examined, and the outcomes of the inquiry. The sample of 106 scholarly projects and six theses were categorized according to method of inquiry, population group, population type, and scholarly outcomes and then entered into a database software program. The findings showed the method of inquiry most used was literature review, followed by program critique, community assessment, and secondary analysis. The community was the most frequently examined population group, with patient, children, provider, minority, and elderly the most used population type. The most frequent scholarly outcomes were recommendations, study reports, educational materials, and program development. Findings supported the campus's and program's mission statement that values community partnership and diversity, improved health care outcomes, as well as an outcome objective of master's-level proficiencies in research competencies.

A comparative analysis of master of nursing students' scholarly inquiry.

Although graduates of master's of nursing programs are expected to demonstrate competence in systematic inquiry, few reports describe how students obtain this skill. We conducted a comparative analysis of 118 scholarly projects from 2004 to 2009 with an earlier sample of 112 projects from 1996 to 2003. We examined changes in the method of scholarly inquiry, population type examined, and outcomes or products of inquiry. Data from a scholarly inquiry evaluation checklist were transcribed and analyzed. Literature review continued to be the most frequent method of scholarly inquiry, with few group differences noted between the time periods. Evidence-based clinical or practice projects increased as an inquiry method, as did health care providers as the population type. Papers of publishable quality and educational materials increased as outcomes of scholarly inquiry. Although this analysis is limited by incomplete data and a need to clarify checklist categories, the increased number of clinical-based projects supports a shift to evidence-based practice outcomes. The expansion in the number of educational scholarly projects is attributed to increasing enrollment in the nurse educator option. With new Essentials of Master's Education in Nursing and the transition of specialty preparation to the doctoral level, revisiting scholarly outcomes for master's degree students is recommended.

Evaluation of a community-based outreach worker program for children with asthma.

OBJECTIVE: An asthma outreach worker (AOW) can provide home-based education about asthma management and methods to minimize home environmental asthma triggers. A theory-based AOW program was implemented by a community partnership and its effectiveness was evaluated. DESIGN: Baseline and follow-up surveys were used to evaluate the effectiveness of the AOW. SAMPLE: The convenience sample consisted of 60 caregivers whose children received AOW services. MEASURES: Quality of life, use of asthma management plans, medication use, health care utilization, home environmental behavior changes to reduce triggers, and satisfaction with AOW services were self-reported by caregivers. RESULTS: Caregivers reported significantly higher quality of life at follow-up than at baseline. At follow-up, 93% of the children had asthma management plans as compared with 31% at baseline. Self-reported hospitalizations were significantly reduced. All of the families made changes to minimize household asthma triggers. Caregivers reported high satisfaction with the AOW and 90% of them felt that the home environmental assessment conducted by the AOW helped improve their child's asthma. CONCLUSION: Short-term community-based AOW services for children can be effective in enhancing self-management capabilities, improving the quality of life, increasing the use of asthma management plans, and helping families reduce asthma triggers in the home environment.