Estimation of sodium and potassium intakes assessed by two 24-hour urine collections in a city of Indonesia.

Intakes of excess Na and insufficient K are two major contributors of heart diseases and stroke development. However, no precise study has previously been carried out on Na and K intakes among Indonesian adults. The present study aimed to estimate the Na and K intakes using two consecutive 24-h urine collections. Participants were community-dwelling adults aged between 20 and 96 years, randomly selected from a pool of resident registration numbers. Of the 506 participants, 479 (240 men and 239 women) completed urine collections. The mean Na excretion was 102·8 and 100·6 mmol/d, while the mean K excretion was 25·0 and 23·4 mmol/d for men and women, respectively. Na and K excretions were higher in participants with a higher BMI. A higher K excretion was associated only with younger age. More than 80 % of the participants consumed more than 5 g/d of salt (the upper limit recommended by the Indonesian government), whereas none of them consumed more than 3510 mg/d of K (the lower limit). The high Na and low K intakes, especially high Na among participants with high BMI, should be considered when future intervention programmes are planned in this country.

Validity of skin blot examination for albumin and nerve growth factor ß to detect itching of the skin in Indonesian older adults.

AIM: Itching, a common skin disorder, impacts the quality of life of individuals. Itchy skin occurs more with increasing age and the prediction of itchy skin prognosis is necessary to provide good skincare. This study validated biomarkers in skin blotting to identify and measure itching sensation as well as conventional methods to measure skin barrier function. MATERIALS AND METHODS: From a cross-sectional study conducted in Long-term Care (LTC) facilities in Indonesia itching symptoms were obtained through a questionnaire. Skin conditions were assessed using photographs, stratum corneum (SC) hydration, skin pH, and skin blotting for biomarkers: albumin, interleukin 2 (IL2), nerve growth factor ß (NGFß), and thymic stromal lymphopoietin (TSLP). Association of skin measurements with the presence of skin blotting and trends analysis were conducted. RESULTS: Altogether, 564 LTC residents (average age, 70 years) participated. The SC hydration, skin pH, albumin, and NGFß were associated with the presence of itch (p value= <0.001, <0.001, <0.001, and <0.001, respectively). The signal levels of skin blotting biomarkers were higher in itch group than in the non-itch group. Additionally, the higher quantile of SC hydration was significantly associated with a lower intensity level of NGFß and TSLP (p value = 0.005, 0.003, respectively). The lower quantile of skin pH (better skin condition) was significantly associated with lower albumin, NGFß, and TSLP (p value = 0.048, 0.035, and <0.001, respectively). CONCLUSION: The albumin, NGFß, and TSLP could be a candidate for measurement of itchy skin among older adult with disrupted skin barrier function and local skin inflammation.

Homecare nurses' length of conversation and intention to remain at the workplace: A multilevel analysis.

AIMS: To examine the relationship between homecare nurses' length of conversation with nurse managers and colleagues and intention to remain at the workplace. BACKGROUND: Nurse turnover is an important issue. Previous studies focused on the perceived function of communication. However, we do not know the contribution of homecare nurses' actual conversations to nurse turnover prevention. METHODS: We conducted a cross-sectional study in 330 homecare nurse organisations in Japan. We recruited 2,315 homecare nurses and analysed the data of 608 nurses. We used a questionnaire to investigate participants' intention to remain. RESULTS: Nearly 68% had the intention to remain. The mean length of conversation was 34 min/day with the manager and 68 min/day with colleagues. Multilevel logistic regression analysis showed that long conversations with the nurse manager (20 min and more) and colleagues (40 min and more) were significantly related to the intention to remain. CONCLUSIONS: Ensuring the time of conversation with a manager and colleagues may contribute to preventing potentially avoidable nurse turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should encourage homecare nurses to have daily conversations of 20 min or more with the nurse manager and 40 min or more with colleagues to continue working at their current workplace.

Clinical practice and work-related burden among second career nurses: A cross-sectional survey.

AIMS AND OBJECTIVES: To explore the differences in clinical practice activities and work-related burden between nurses with past work experience other than nursing (second career nurses: SCNs) and nurses without any past work experience (nonsecond career nurses: NSCNs). BACKGROUND: The number of SCNs is increasing. Some studies note that SCNs must perform additional clinical practice activities and experience more work-related burden than NSCNs. However, there are no quantitative studies exploring SCNs' clinical practice and work-related burden. DESIGN: A cross-sectional survey. METHODS: Research was conducted according to the STROBE statement. Participants were 2,013 nurses working at 56 hospitals in Japan. A 30-item questionnaire was developed to capture clinical practice activities using clinical ladders, asking about the types of clinical practice activities participants had practiced. Every practiced activity received a score of 1. The total count of each clinical practice activity was then summed. The quantitative workload (QW) scale score was used to investigate levels of QW. Higher QW scores indicated higher levels of work-related burden. These variables were then compared between SCNs and NSCNs, and the factors that were associated with high QW among SCNs were examined. RESULTS: Altogether, 961 participants (328 SCNs and 633 NSCNs) were included in the analyses. No significant differences were shown in clinical practice activities between the groups; however, SCNs' QW was significantly higher than was NSCNs' after controlling for demographic variables. SCNs' high QW was associated with the following variables: unmarried marital status, not having role model nurses and previous employment as a care worker. CONCLUSIONS: Quantitative workload was significantly higher among SCNs than among NSCNs. Tailored support for SCNs' high QW based on their specific needs should be considered. RELEVANCE TO CLINICAL PRACTICE: These results can help nurse managers reduce SCNs' work-related burden and illustrate future research directions for this minority group.

The Experience of Persons With Hematological Malignancy When Communicating With Health Care Professionals.

This study aimed to elucidate the experiences of Japanese persons with hematological malignancy (PHMs) in communicating with health care professionals (HCPs), from diagnosis to the end of life, as recalled by their families. We interviewed 14 bereaved families and analyzed the data using the basic techniques of grounded theory. We found that PHMs lived to the fullest possible when they experienced ownership of their illness process despite their disease. The ownership was made possible by active communication from HCPs: first, acknowledging the PHM's way of life, including reaching out from the HCPs and appreciating sincerely PHMs' hopes and will; and second, paving the way ahead, including giving prospects and offering choices. The study underlines that rather than just providing information about the disease, HCPs need to actively ask about and show respect for the PHM's way of life. Only after achieving this can HCPs communicate possible future pathways with PHMs.

Work values and their association with burnout/work engagement among nurses in long-term care hospitals.

AIMS: To examine burnout and work engagement among nurses in Japanese long-term care hospitals and their relation to nurses' and organisational work values, and nurse-organisation congruence of such values. BACKGROUND: Nursing managers must help improve nurses' well-being; however, no research has considered strategies to improve staff outcomes in long-term care hospitals. We propose that individual nurse's work values and the congruence of these values with those of their organisations may influence burnout and work engagement. METHODS: We conducted a cross-sectional survey of nurses in long-term care hospitals. Multiple regression analyses were conducted to examine the effects of nurses' work values and nurse-organisation congruence in these values on burnout and work engagement. RESULTS: Higher individual intrinsic and altruistic work values were associated with improvements in nurses' burnout and work engagement. Nurse-organisation non-congruence in altruistic values was associated with lower work engagement, whereas that of intrinsic work values was not associated with either outcome variable. CONCLUSION: Promoting intrinsic and altruistic work values among nurses could be effective for improving both burnout and work engagement. IMPLICATIONS FOR NURSING MANAGEMENT: Opportunities such as case conferences could foster intrinsic and altruistic work values through the review of good care practices and communication between managers/colleagues about feelings and thoughts.

A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families.

Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

Workplace bullying among nurses and their related factors in Japan: a cross-sectional survey.

AIMS AND OBJECTIVES: To explore the association between workplace bullying and workplace environment factors among nurses in Japan. BACKGROUND: Workplace bullying among nurses is increasing globally and occurs more frequently than among other professions. However, there is little information on the impact of workplace environment factors on nurse bullying in Japan. DESIGN: A cross-sectional survey using a self-administered questionnaire. METHODS: Participants were 1152 nurses recruited at seminars or training courses outside of their workplaces in Tokyo. Workplace bullying was measured using the Negative Acts Questionnaire-Revised. Participants were considered to have been 'bullied' if they reported experiencing at least one negative act on a daily or weekly basis. Workplace environment factors were measured using the Practice Environment Scale of the Nursing Work Index, which comprises five domains: nurse participation in hospital affairs; nursing foundations for quality of care; nurse manager ability, leadership and support of nurses; staffing and resource adequacy; and collegial nurse-physician relationships. RESULTS: A total of 898 (78·0%) questionnaires were returned, of which 825 (71·6%) were analysed. Altogether, 153 (18·5%) nurses were considered 'bullied.' The three most frequent negative acts reported as occurring on a weekly or daily basis were 'someone withholding information which affects your performance' (6·7%), 'being exposed to an unmanageable workload' (4·4%) and 'being shouted at or being the target of spontaneous anger (or rage)' (3·6%). Logistic regression analysis indicated that 'bullied' were associated with low scores on two work environment domains: nurse manager ability, leadership and support of nurses and staffing and resource adequacy. CONCLUSIONS: Effective nurse manager leadership and support as well as appropriate staffing management may positively influence workplace bullying among nurses in Japan. Authentic leadership styles and allowing nurses to easily request days off might also be important. RELEVANCE TO CLINICAL PRACTICE: Nurse managers' leadership may influence nurses' workplace bullying.

How does collegial support increase retention of registered nurses in homecare nursing agencies? a qualitative study.

BACKGROUND: Collegial workplace support has been linked to higher registered nurse (RN) retention in various clinical settings. In Japan, homecare agencies experience high RN turnover. The purpose of this study was to develop a conceptual framework to describe how perceived support from colleagues affects RNs' decision to remain in an agency. METHODS: A qualitative research method based on grounded theory was used. Participants were RNs with at least 4 years of experience at the same homecare agency. Participants were theoretically sampled via managers of 12 homecare nursing agencies. Semi-structured interviews and supplementary participant observations were conducted. Data were analyzed using a constant comparative technique, and the process of how workplace support affected participants' decision to remain at their agency was clarified. RESULTS: In total, 26 RNs were interviewed, 23 of whom were observed in their practice setting. Participants' perception of support from colleagues was framed as being "encouraged to grow in one's own way", which comprised practicing with protected autonomy in an insight-producing environment. Participants reported that they were able to practice with protected autonomy, receiving 1) mindful monitoring, 2) semi-independent responsibility, 3) help as needed, and 4) collegial empathy and validation. RNs also felt supported in an insight-producing environment by 1) enlightening dialogue, 2) being set for one's next challenges, and 3) being able to grow at one's own pace. Reportedly, these were defining characteristics in their decision to continue working in their agencies. CONCLUSIONS: For RNs to willingly stay at a homecare nursing agency, it is essential that they are able to practice with protected autonomy in an insight-producing environment that encourages them to grow in their own way. Further research is needed to explore ways to create and enhance such environments to lower RN turnover.

Factors of Good Collaboration in Home-Based End-of-Life Care: A Questionnaire Survey of Japanese Home Care Nurses, Home Helpers, and Care Managers.

Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of "good collaboration," as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 HHs, and 476 CMs, and data were collected on 177 EOL cases from HNs, 84 cases from HHs, and 123 cases from CMs. Evaluation of good collaboration by HNs was associated with working with a CM with whom they had multiple collaborative experiences, the client being independent for their toileting until just before dying, and sharing information regarding the client's EOL decision with an HH 1 month before dying. Evaluation of good collaboration by HHs was associated with working at an agency that collaborated with fewer CM agencies and working at an agency that allowed staff to visit dying clients. Evaluation of good collaboration by CMs was associated only with the client being dependent for toileting. Our results highlighted the characteristics of how each professional seeks to collaborate depending on their preparedness, contexts, and resultant expectations toward other professionals when entering the IPW for home-based EOL care. To promote good IPW for home-based EOL care further, professionals need to understand these differences among ourselves and try to meet others' expectations.

Patterns of long-term care service use and multimorbidity in older Japanese adults: A cross-sectional study of claim data.

AIM: The long-term care (LTC) insurance system provides a combination of several services in Japan; therefore, it is important to clarify service utilization. Furthermore, it is important to consider multimorbidity among older adults, who frequently present several diseases. This study aimed to clarify LTC service utilization patterns, including those for newly added multifunctional services, and to describe the basic characteristics, including multimorbidity, of these patterns. METHODS: We included 37 419 older adults in care need levels 1-5, living at home, who used LTC services in October 2017. We used LTC and medical claims data that were linked using unique identifiers from the National Health Insurance, Advanced Elderly Medical Insurance, and LTC Insurance of Shizuoka Prefecture in Japan. LTC service utilization patterns were identified using cluster analysis based on service fees. Multimorbidity was analyzed using the Charlson Comorbidity Index (CCI) and compared characteristics in these patterns. RESULTS: Six LTC service utilization patterns were identified: light use (51.0%), intensive use of day care (33.7%), intensive use of short stay (6.3%), intensive use of home help (5.1%), multifunctional LTC in small-group homes (MLS) use (3.7%), and MLS and home-visiting nurses (MLSH) use (0.2%). MLSH use had the highest CCI (3.6 ± 2.3). Intensive use of day care and short stay had the lowest CCI (2.6 ± 1.9). CONCLUSIONS: The characteristics of multimorbidity differed by LTC service utilization patterns. Our findings are useful for considering service utilization that takes into account the characteristics of older adults. Geriatr Gerontol Int 2024; 24: 283-289.

Physical function decline predictors in nursing home residents using new national quality indicators.

AIM: To determine the predictors of physical function (PF) decline among nursing home residents using items from the Long-term care Information system For Evidence (LIFE), a system launched in 2021 to ensure the quality of long-term care. METHODS: The LIFE data of 1648 residents from 45 nursing homes in Japan were retrospectively collected in July 2021 (T0) and January 2022 (T1), including demographics, PF assessed by the Barthel index (BI), nutrition and oral health, and cognitive function. The Dementia Behavior Disturbance scale was used to assess the frequency of certain behaviors, such as "waking at midnight." The predictors of PF decline, defined as a decrease ≥5 in the BI score at T1 compared with that at T0, were determined using mixed-effects logistic regression analyses. PF at T0 was classified into high (>60 BI) and low (≤60 BI) groups. RESULTS: The participants' mean age was 87.2 ± 7.1 years, and 45.3% experienced PF decline. The significant predictors of PF decline were age ≥ 90 years, body mass index <18.5 kg/m2 , dementia diagnosis, moderate and severe cognitive impairments, not vocalizing reciprocal exchanges at will, always "waking at midnight," and high PF at T0. CONCLUSIONS: The LIFE items predicted PF decline among nursing home residents, suggesting that LIFE data can be used to ensure the quality of long-term care. Geriatr Gerontol Int 2024; 24: 123-132.

The Perceptions and Experiences of Older People Living in the Aftermath of Lombok Earthquakes, Indonesia: A Qualitative Study.

INTRODUCTION: Despite the growing knowledge of people's vulnerability following natural disasters, the perspective of older people has received limited attention. This study aimed to explore the perceptions and experiences of older people encountering the 2018 Lombok earthquakes. METHODS: This exploratory qualitative study involved 16 older people living in one of the villages most affected by the 2018 earthquakes in Lombok Island, Nusa Tenggara Barat, Indonesia. The data were collected in June 2019 using semi-structured interviews. Participants' responses were digitally recorded and transcribed verbatim for analysis. The data were analysed using qualitative content analysis managed in NVivo. RESULTS: From older people's perspectives, three themes were generated: surviving the disaster, dealing with life changes and navigating through challenges and hope. Each theme comprised two categories, which reflected the journey of older people from the early to the later phase of the disaster. CONCLUSIONS: Older people experienced critical conditions and difficulties both physically and mentally. They also experienced various emotional responses before accepting living situations following a disaster. Nurses should play a role in fulfilling the physical and mental health needs of older people in post-disaster conditions. IMPLICATIONS FOR PRACTICE: This study can inform nurses and other key stakeholders about the needs of older people during and after natural disasters. Nurses need to be equipped with the skills and abilities to identify and meet the needs of older people in difficult situations and with limited resources.

The Process of Home-Visiting Nurses Supporting People with Mental Disorders.

The number of people with mental disorders (PMD) living in the community is increasing; however, it is unclear how home-visiting nurses (HVNs) supporting them in the community acquire their support skills. This study aimed to reveal the process of how HVNs learn support skills for PMD. Semi-structured interviews were conducted with 14 HVNs supporting PMD living in the community. The grounded theory approach was used for data analysis. As a result, two stages were present: "Explore the personal recovery of PMD" and "Believe in the potential of PMD and accompanying them". The first stage is further divided into two themes: "Overlapping the worlds of PMD and HVNs", and "Easing difficulty in living for PMD". In the first stage, HVNs gained a better understanding of PMD and obtained insight into the support they needed in their daily lives. In the second stage, HVNs became to provide the support that PMD truly needed. HVNs gained a deeper understanding of the reality of PMD through their support. After HVNs found the support PMD required, they sought to provide it, ultimately resulting in finding ways to facilitate the personal recovery of PMD.

Unplanned Hospital Visits and Poor Oral Health With Undernutrition in Nursing Home Residents.

OBJECTIVES: In 2021, the Japanese government began operating a long-term care (LTC) database called the Long-Term Care Information System for Evidence (LIFE). However, its utility has not been verified. Regarding unplanned hospital visits of nursing home residents, one of the challenges in LTC is that poor oral health with undernutrition could indicate high-risk residents. Therefore, this study examined the association between poor oral health with undernutrition assessed using the LIFE data and unplanned hospital visits of nursing home residents. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: The participants were 237 residents aged ≥65 years in 4 nursing homes in Japan. The analyses included 1041 LIFE data entries repeatedly measured for the participants every month and unplanned hospital visit data during the observation period. METHODS: The participants' LIFE and unplanned hospital visit data were obtained from the nursing home providers. Poor oral health was defined using oral items included in the LIFE data and body mass index. Using the LIFE data, the association between poor oral health and unplanned hospital visits within 1 month after LIFE assessment entries was analyzed. The odds ratios (ORs) and 95% CIs were calculated using a generalized linear mixed model. RESULTS: In total, 59 of 1041 LIFE data (5.7%) entries were unplanned hospital visits within 1 month after LIFE assessment. Among patient characteristics, significant differences were noted in dementia diagnosis [OR (95% CI): 2.66 (1.26-5.63)], although no significant differences were observed in other characteristics. Multivariate analysis using participant identification as a random effect confirmed that poor oral health was associated with unplanned hospital visits within 1 month [adjusted OR (95% CI): 2.63 (1.05-6.61)]. CONCLUSIONS AND IMPLICATIONS: Poor oral health assessed using the LIFE data could be used as an indicator to identify nursing home residents at high risk for unplanned hospital visits.

Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan.

INTRODUCTION: Care quality in Japan's long-term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal. OBJECTIVES: To describe the development of quality indicators for LTC (QIs-LTC) in Japan. METHODS: QIs-LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2-year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122). RESULTS: Across eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well-being), 24 care quality objectives were set with 24 outcome QIs-LTC and 144 process QIs-LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care. CONCLUSIONS: The QIs-LTC developed in the current study are generic and client- and family-centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383-394.

Dietary Patterns of 479 Indonesian Adults and Their Associations with Sodium and Potassium Intakes Estimated by Two 24-h Urine Collections.

The excess sodium (Na) intake and insufficient potassium (K) intake are frequently observed all over the world, including Indonesia. This study explored the dietary patterns of Indonesian people and evaluated their associations with Na and K intakes. Na and K intakes were assessed by repeated 24-h urine collection. The dietary patterns of the previous month were extracted by factor analysis using the Indonesian Food Frequency Questionnaire. The participants were community-dwelling Indonesian men and women (n = 479) aged 20 years and over. We identified four dietary patterns in each sex. After controlling for confounding factors, the high quantile of 'Noodle, oil, and salty sea products' pattern was associated with the high Na intake in both men and women (p = 0.02 and <0.001, respectively). The 'Meat, vegetable, oil, and fruit' pattern statistically significantly contributed to the high K intake in men (p = 0.04), but not in women (p = 0.26). The 'Vegetable, non-oil, and milk' pattern in men and 'Meat, vegetable, and fruit' pattern in women were associated with low Na:K ratios (p = 0.03 and 0.01, respectively). Neither 'bread' nor 'fish' appeared as a major determinant of any dietary patterns in this population. The 'Noodle, oil, and salty sea products' pattern should be avoided to reduce sodium intake.

Association between participation in hospital-led community activities and sense of security in continued community living among older adults in a rural district of Japan: A cross-sectional study.

For older adults to continue living in a community, they need to have a certain sense of security, especially in terms of the availability of healthcare in the community. The aim of this cross-sectional study was to explore important factors of the sense of security among older adults in their continued community living, with particular attention to hospital-led community activities. The participants comprised 252 randomly sampled older adults aged 65 years or older, living in a local community in western Japan, and ranging from being independent to physically and cognitively frail. Participants' sense of security in continued community living was assessed using a modified scale from past research on cancer care. Activities provided by local community organisations and hospitals were examined. The participants' mean age was 75.0 years, 144 (57.8%) were female and 32 (13.3%) were frail. Hospital-led groups (e.g. health lectures) and individual (e.g. health counselling) activities were used by 73 (30.5%) and 76 (31.9%) participants respectively. Among participants, 174 (73.4%) had participated in activities run by the local community, such as senior day celebrations or senior centre activities. A stronger sense of security was associated with participation in hospital-led individual activities (ß = 0.171, p = .036), being a member of a neighbourhood association (ß = 0.156, p = .020), frequency of contact with family members (ß = 0.145, p = .034) and lower depression (ß = -0.269, p < .001). Participation in community hospital-led individual activities may provide older adults opportunities to discuss their health-related concerns in a community setting, and thus might enhance their sense of security. In the aged society, the role of healthcare facilities may need to be expanded to facilitate outreach for older adults in the community to enhance their sense of security and actualise ageing in place.

Family-oriented interventions in long-term care residential facilities for older people: A scoping review of the characteristics and outcomes.

INTRODUCTION: Family-oriented interventions in long-term care (LTC) residential facilities are heterogenous in design, characteristics, and outcomes. OBJECTIVES: To synthesize characteristics (e.g., type, provider, and duration) and outcomes of family-oriented interventions in LTC residential facilities. METHODS: We followed the JBI methodology and searched seven databases for quantitative, qualitative, and mixed method studies that reported family-oriented interventions in LTC residential settings for older people; defined in this review as ≥60 years. Interventions that included residents, resident families, health professionals, or any combinations of these three were included if the study reported post-intervention assessment of at least one family-related outcome. RESULTS: Thirteen studies met the inclusion criteria. Interventions were found to be multifaceted, and education was the most common element. Nurses were the most common intervenors, and most interventions had more than one target (residents, resident families, or staff). Most outcomes were related to family involvement, satisfaction with care, quality of life, communication, symptom management, and shared decision making, and none of the studies reported a negative impact. CONCLUSIONS: Family-oriented interventions were associated with high care quality and better resident-staff-family partnership. Staff education and staff-family conversation are relatively cheap interventions to help family involvement, facilitate shared decision-making, and improve family satisfaction.

Home-care nurses' community involvement activities and preference regarding the place for end-of-life period among single older adults: A cross-sectional study in Japan.

Older adults' preference regarding where they want to spend their end-of-life (EOL) has been reported to be a significant predictor of the actual EOL location. Home-care nurses have often been reported to try involving single older adults' neighbours in the support network of the older adults (community involvement activities) to allow them to stay at home. Hence, nurses' community involvement activities may be among the significant factors of older adults' preference to stay at home during EOL. Therefore, this study explored home-care nurses' community involvement activities and its association with single older adults' EOL preference. A cross-sectional questionnaire survey was conducted with older adults (aged 65 years or older) who lived alone and used home-care nursing services for more than 6 months, their home-care nurses, and managers of their home-care nursing agencies. Questions included participants' characteristics, nurses' community involvement activities and older adults' preference to remain at home during EOL. We conducted multiple logistic regression analyses to explore the relationship between nurses' community involvement activities and older adults' preference to remain at home during EOL while controlling for their demographic variables. In total, 103 pairs of home-care nurses and single older adults from 27 home-care nursing agencies participated. Approximately 70% of older adults preferred to remain at home during EOL, and 50% of nurses implemented community involvement activities. Older adults' preference to remain at home during EOL was associated with implementation of community involvement activities (Odds Ratio [OR]: 3.4; 95% Confidence Interval [95%CI]:1.1-9.8), home-care nurses' higher practical clinical ability (OR: 1.4, 95%CI:1.0-1.8), and older adult's longer use of home-care nursing service (OR: 2.2, 95%CI:1.2-4.1). Community involvement activities may be essential in helping single older adults to stay at home as per their preference for EOL.