Health risk factors associated with presenteeism in the workplace.

OBJECTIVE: An emerging concern in the workplace is the productivity of employees who come to work instead of staying home when they are ill, also referred to as presenteeism. This study examined the health risks associated with presenteeism. METHODS: Using a cross-sectional correlational design, we used data from a 2010 self-reported wellness surveys. A negative binomial regression model was used to explore the association between employee health risks and presenteeism. RESULTS: The findings revealed that workplace stress (ß = 0.76; P < 0.001), stress at home (ß = 0.87; P < 0.001), and financial stress (ß = 0.59; P < 0.001) were related to presenteeism. Other health risks were not associated with presenteeism. CONCLUSIONS: We found that only stress was related to presenteeism, and other health risks were unrelated to presenteeism.

Nutritional screening in community dwelling older adults.

AIMS AND OBJECTIVES: The purpose of this study was to test whether a combination of validated tools, one for each of five leading nutritional risk factors, could predict unintentional weight loss in community dwelling older adults. BACKGROUND: Non-invasive, easily administered nutritional screening tools for community dwelling older adults are few and those that are available are problematic. METHOD: Convenience samples of 115 adults ≥65 were interviewed. Height, weight and measures of the five nutritional risk factors were collected at interviews 6 months apart. DESIGN: Repeated measures. RESULTS: 91 subjects completing T2 were largely white (95.6%), female (69%), well educated and in good health. Multiple regression was conducted with unintentional weight loss as the dependent variable and depression (the GDS-SF), the Lubben Social Networking Scale, food security, food intake and Independent Activities of Daily Living as the predictor variables. The regression model was statistically significant (F (5, 85) = 0.30852, P = 0.003) with an adjusted r(2) of 0.137. CONCLUSIONS: Five validated tools can be administered by nurses or non-professionals to screen for nutritional risk factors leading to unintentional weight loss. IMPLICATIONS FOR PRACTICE: Early screening has the potential to identify either nutritional risk or nutritional decline in older adults.

Relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults.

The purpose of this study was to examine the relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults in the southeastern United States. Four assessment tools were completed by 82 older adults (mean age = 74, age range = 65 to 91): the Perceived Stress Scale, the Carr Infection Symptom Checklist (SCL), the Brief Multidimensional Measurement of Religiousness/Spirituality, and a demographic form. A significant correlation was found between stress and SCL scores; however, four dimensions of religiousness/spirituality moderated the relationship between stress and infection. Older adults who were unable to forgive themselves or forgive others, or feel forgiven by God, were more likely to have had an infection in the previous month. Increased infections also occurred when older participants did not feel they had religious support from their congregations. Using these findings, gerontological nurses are well positioned to deliver tailored stress management and forgiveness interventions when older adults report increased stress.

Ready for the World: preparing nursing students for tomorrow.

In 2004, a 5-year plan of international and intercultural education was developed by the University of Tennessee, Knoxville (UTK) to help students become ready for the changing world in which they will live. This program is called "Ready for the World." The University of Tennessee College of Nursing in Knoxville has integrated many of the suggestions from this program into the undergraduate nursing curriculum to prepare students for the world by making the world their classroom. Intercultural learning includes both a solid base of knowledge obtained in the classroom and multiple experiences that involve cultural interaction. Experiences begin on UTK's diverse campus and expand to the surrounding city of Knoxville, including interactions with vulnerable populations such as the homeless or elderly persons, then to nearby Appalachian communities, and on to Central America. Many of these experiences are offered for credit in the Community Health Nursing or the Transcultural Nursing courses. The knowledge nursing students acquire and their varied experiences will help them gain cultural competence for their future nursing practice.

Screening instruments for older adult depressive disorders: updating the evidence-based toolbox.

The prevalence of clinically significant depressive disorders in persons 65 years of age or older in the United States has been estimated to be approximately 15%, increasing the risk for functional decline, morbidity, and mortality. Utilization of a well-chosen screening instrument has been shown to improve the rates of recognition of depressive disorders in older adults. This paper presents a targeted review of the most commonly accepted tools for case-finding of depressive disorders in older adults. After a review of the benefits and shortcomings of screening tools, the strengths, weaknesses, and utility of selected depression scales in geriatric clinical settings are discussed.

Screening for nutritional risk in community-dwelling old-old.

Screening tools for detecting declining nutrition in community-dwelling old-old are few and problematic. The purpose of this study was to identify the leading risk factors associated with noninvasive measures of poor nutritional status among elders aged 80 or older still living independently in the community. This cross-sectional descriptive study included 68 community-dwelling old-old (average age 85.7). Participants were recruited by parish nurses. In-home interviews were conducted. Relationships between five well-established measures of nutritional risk factors and two measures of nutritional status, body mass index (BMI) categories, and unintentional weight loss were examined. Depression and the food pyramid groups with adequate amounts eaten were predictive of unintentional weight loss in the previous 6 months (p = 0.013) but not of high or low BMI. In this sample, 25% were obese. Screening for depression and food intake may be useful in predicting nutritional decline among community-dwelling old-old and point to targeted interventions in a population who are large users of health care dollars.

Frequency of hallway ambulation by hospitalized older adults on medical units of an academic hospital.

Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to determine the frequency of hallway walking by older adults hospitalized for medical illness. The study was an observational time-sampled study, which was conducted in the hallways of 3 medical units of a 485-bed academic health care center. Each unit was observed weekdays for eight 3-hour intervals covering 8 AM to 8 PM. Before each observation, nursing staff were questioned about walking abilities of patients aged

Admission and discharge mobility of frail hospitalized older adults.

Functional decline during hospitalization is an important clinical problem with potential longlasting undesirable outcomes in frail elders. However, little is known about the change in mobility during hospitalization and the association with discharge status. A Mobility Classification Tool has been developed that categorizes progression of patients' in-hospital mobility using a 5-point scale. The validity and clinical usefulness of this tool was evaluated in a sample of 60 frail older adults hospitalized for medical illness. The tool allows nurses to assess, quantify, and communicate mobility levels and changes in mobility more accurately.

Views of community-dwelling, old-old people on barriers and aids to nutritional health.

PURPOSE: To examine barriers and aids to maintaining the nutritional health of community-dwelling old-old residents from their perspectives. DESIGN: Cross-sectional exploratory study completed in March 2002 of old-old people living independently in one county in the Midwestern United States (US). METHODS: Sixty-eight in-home interviews were conducted with community-dwelling people aged 80 or older. Content analysis was done to examine answers to two open-ended questions about barriers and helps to nutritional health. FINDINGS: These old-old people believed they were doing well nutritionally despite reduced independence and physical limitations. They were positive about their lives and creative in problem solving to remain independent. Social connectedness was the major factor for maintaining independence into old age. The leading barrier to maintaining nutritional health was health problems. Those with more barriers were more likely to be depressed. CONCLUSIONS: Knowledge of aids and barriers to nutritional health, from a personal perspective, gives an understanding of the issues and concerns of old-old people.