Impact of caregiver relationship on self-care in patients with Parkinson's disease: A cross-sectional study using Riegel's theory of self-care of chronic illness.

AIMS: To explore how the characteristics of patients and caregivers affect self-care in patients with Parkinson's disease (PD). DESIGN: A multicentre cross-sectional study. METHOD: We followed the STROBE checklist. Parkinson's disease patients aged 50 years and older and their caregivers were recruited from two tertiary hospitals and the Korean Parkinson's Disease Association website. Patient characteristics, including social support, relationship quality with caregivers, self-care efficacy and self-care, were analysed. Caregiver characteristics were also evaluated, including caregiving duration, social support, relationship quality with patients, contribution to patients' self-care efficacy and contribution to patients' self-care. RESULTS: The characteristics of patients and caregivers (103 pairs) were hierarchically regressed into patient self-care domains (maintenance, monitoring and management). Most patients and caregivers gave a self-care efficacy and self-care management rating of moderate. In three regression models, patient self-care efficacy was positively related to three domains of patient self-care. Self-care maintenance decreased as patients' disease duration increased. Self-care monitoring was positively related to the education level of patients and caregiving duration. Self-care management showed an inverse relationship with caregiving duration and a positive relationship with caregiver contribution. CONCLUSION: Self-care efficacy was important in promoting PD patients' self-care maintenance, monitoring and management. The contributions of caregivers were also critical in increasing PD patients' self-care management. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: To increase patients' self-care efficacy and self-care, educational interventions containing information about the disease, symptom management, and problem-solving should be implemented. Since caregivers are deeply involved in patients' self-care, educational interventions for caregivers should also be provided. IMPACT: This study closed the literature gap by examining the self-care efficacy and self-care of Korean PD patients. Findings demonstrated the importance of caregiver roles on patients' self-care and health. PATIENT OR PUBLIC CONTRIBUTION: Two tertiary hospitals and the Korean Parkinson's Disease Association assisted during the recruitment process.

Use of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review.

AIM: To understand how researchers applied the Tilburg Frailty Indicator (TFI) to older adults. The use of the TFI was examined based on the Integral Conceptual Model of Frailty (ICMF). DESIGN: A scoping review. DATA SOURCES: A database search was conducted without a time limit in PubMed, CINAHL, Embase and the Cochrane library. A hand search was also conducted. REVIEW METHODS: Research questions were developed based on the population-concept-context framework suggested by the Joanna Briggs Institute (2017). Studies were included if topics were related to the use of the TFI or ICMF and designs were longitudinal studies. RESULTS: A total of 37 studies met the inclusion criteria. Studies were reviewed according to the tested pathways of the ICMF: determinants of frailty or adverse outcomes, adverse outcomes of frailty and comparison of predictive power between frailty measures. CONCLUSION: The TFI is a useful tool to screen for frailty and predict health outcomes in older adults. Among the pathways of the ICMF, relationships between social factors and frailty were reported in several studies. Despite this relationship, social factors were considered as items to assess the social domain of frailty rather than determinants of frailty. The predictive power of the TFI was not superior to other frailty measures, but it had a high sensitivity. IMPACT: This study demonstrates the usability of the TFI in older adults living in various conditions. Further studies are required to identify more effective ways to screen frailty using the TFI. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement in this study.

Experiences of Older Adults During COVID-19: Loss, Boredom, Uncertainty, Worry, and Resilience.

The coronavirus disease 2019 (COVID-19) pandemic and resulting instructions to stay home and social distance enhanced concerns of the impact of social isolation on the physical and mental well-being of older adults. Eighteen community-dwelling older adults participated in interviews describing their experiences early in the COVID-19 pandemic. Participants experienced loss of activities, routines, and social connection, and feelings of worry and uncertainty. Nevertheless, participants were hopeful about the future and demonstrated resilience in overcoming boredom as they became intentional in finding new activities and using technology to maintain connection with others. Older adults may need support in such situations to manage boredom and uncertainty and avoid social isolation. [Journal of Gerontological Nursing, 49(6), 27-32.].

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications.

Adverse childhood experiences (ACEs) are linked with negatively impacting child and adult health outcomes. Clinicians are integral in identifying childhood adversities and offering supportive measures to minimize negative effects. This systematic literature review included 13 ACE studies that examined the acceptability, feasibility, and implementation of ACE screenings from the perspectives of clinicians and patients. The findings of this review can assist clinicians in considering the appropriateness of ACE screenings for their patients and the ethical and practical issues that must be addressed for effective screening implementation.

The psychological effects of water-based exercise in older adults: An integrative review.

Although many review studies have been conducted on the physical benefits of water-based exercise, review studies on its psychological benefits are scarce. Thus, the aim of this integrative review was to explore the psychological effects of water-based exercise in older adults. Studies were included if they examined the psychological effects of water-based exercise in individuals aged 60 or older. The initial database search yielded 3861 studies. Duplicates and irrelevant studies were excluded by assessing titles and abstracts. Two additional studies were identified through ancestry searches. A total of 18 studies met the criteria. This review's findings suggest that water-based exercise can effectively improve individuals' quality of life, mood, depression, anxiety, tension, and fall efficacy. In addition, findings show that water-based exercise is feasible for both healthy older adults and those with chronic disease.

Association Between Lifestyle Behaviors and Obesity Among Stroke Survivors.

AIM: The aim was to investigate factors influencing obesity among stroke survivors based on demographics and lifestyle behaviors. BACKGROUND: Stroke survivors are more likely to experience stroke recurrence within a few years. As obesity is a traditional risk factor for stroke, obesity should be managed in stroke survivors to prevent stroke recurrence. METHODS: A cross-sectional secondary data analysis analyzed data from the 2017 United States Behavioral Risk Factor Surveillance System (BRFSS) survey. Demographics, frequency of vegetable and fruit intake, smoking, alcohol use, physical activity, and sleep were examined. RESULTS: Among 1032 stroke survivors, 57.8% were obese. Advanced age, female sex, veteran status, at least once-daily fruit intake, current smoking, and lack of physical activity were associated with obesity. CONCLUSION: Stroke survivors should be encouraged to pursue healthy behaviors to manage obesity. Appropriate transitional care, including diet education and tailored exercise, can be an effective strategy.

Effects of Manikin Fidelity on Simulation-Based Nursing Education: A Systematic Review and Meta-Analysis.

BACKGROUND: Few studies have examined whether higher-fidelity manikins are superior to lower-fidelity manikins in nursing simulation-based education. METHOD: A database search initially yielded 2,656 studies written in English or Korean. Duplicates and irrelevant studies were excluded. Ancestry searches generated 3 additional studies, and 15 studies met the criteria. RESULTS: Higher-fidelity manikins were more effective than lower-fidelity manikins in improving skill performance/clinical competence and perception of nursing students and nurses. In terms of learners' knowledge, satisfaction, and self-confidence, both higher- and lower-fidelity manikins were similarly effective for nursing students. CONCLUSION: This article provides evidence that higher-fidelity manikins do not always ensure a superior educational effect compared with lower-fidelity manikins. [J Nurs Educ. 2022;61(2):67-72.].

Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review.

The relationship between adverse childhood experiences (ACEs) and risky behavior, chronic illness, and premature mortality is well documented. Despite this evidence, screening for ACEs in primary care settings remains limited. Objections to widespread screening include concerns that the original ACE screening tool limited childhood adversities to family and household dysfunction. The purpose of this scoping review is to describe current knowledge for expanding ACEs categories and revising the formatting and scoring of the screening tool. With the assistance of a medical librarian, we used a two-step process to conduct a systematic search in three databases (CINAHL, OVID Medline, PsycINFO). Our aim was to focus on articles that expanded ACE categories and/or revised the scoring or formatting of the ACE tool. Eighteen articles (reporting 19 studies) met criteria. A minimum of two authors extracted the relevant characteristics of the studies independently and conferred to reach agreement. The majority of studies broadened ACEs to include community and systemic categories; three studies revised the formatting or scoring of the ACE tool. Exposure to community violence (ECV) was the most frequently added category (15), followed by economic hardship in childhood (EHC) (13); bullying (10); absence/death of parent or significant others (9); and discrimination (7). This evidence supports the expansion of ACE screening tools for assessment of childhood trauma and timely treatment.

The utilization of debriefing for simulation in healthcare: A literature review.

The aim of this review was to examine how debriefings have been conducted in healthcare simulations. Using keywords, our search yielded 962 studies through databases. After removing duplicates, we found 20 studies that met inclusion and exclusion criteria. Through ancestry searches, we found two more studies. A total of 22 studies were reviewed. From each study, detailed information about debriefing was extracted based on six criteria, namely, timing, facilitator, place of occurrence, method, length, and structure. Various types of debriefings were available according to learning objectives, learners' abilities, availability of resources, and context of simulations. We found that peer-led debriefing might be more appropriate for experienced healthcare professionals than unlicensed students due to a gap in knowledge and problem-solving skills between them. In addition, we found that tele-debriefing was feasible in some studies. Although types of individual debriefing varied across the studies, a substantial number of debriefings closely aligned to the standards for high-quality debriefing.