Demandas clínicas e intervenções de enfermagem em consultas gerontológicas: Revisão integrativa / Demandas Clínicas e intervenciones de Enfermería en consultas gerontológicas: Una revisión integrativa / Clinical demands and nursing interventions in gerontological consultations: An integrative review

Resumen Introdução: A criação de guias que unificam as demandas clínicas prevalentes em consultas de enfermagem gerontológica e, das suas respectivas intervenções, se faz presente, devido a heterogeneidade das patologias emergentes no processo de envelhecimento, que irão precisar de cuidados. Objetivo: Identificar as demandas clínicas em consultas de enfermagem gerontológica e, as intervenções implementadas pelos(as) enfermeiros(as). Método: Revisão integrativa de pesquisas originais, publicadas entre 2018 e 2022, em inglês, espanhol e português, disponíveis nas bases de dados Scopus, MEDLINE/PubMed, BIREME/LILACS/BDENF/IBECS/BVS, SciELO e Google Scholar, pelos descritores DeCS/MESH: "Idoso"; "Enfermagem no Consultório"; "Enfermagem Geriátrica" e "Geriatria". O Rating System for the Hierarchy of Evidence for Intervention foi usado para determinar o nível de evidência da amostra final. Foram excluídos editoriais, estudos de revisão e artigos duplicados. A análise dos dados se deu pela leitura analítica e interpretativa, guiadas por um checklist. Resultados: Oito artigos foram selecionados e trouxeram demandas clínica tais como: o déficit no autocuidado para banho; autonegligência; fadiga; risco de integridade da pele prejudicada; desesperança; tristeza e depressão. As intervenções se relacionaram ao incentivo ao autocuidado; otimização dos medicamentos; estímulo a atividade física; cuidados com a pele; aconselhamento; musicoterapia e reabilitação psicossocial. Conclusão: Demandas clínicas atendidas nas consultas de enfermagem gerontológica possuem grande variação, com prevalência no domínio atividade/repouso, tais como intervenções voltadas para o tratamento e prevenção de doenças e ações visando a promoção da saúde, tendo o domínio comportamental mais expressivo.

Resumen Introducción: La creación de guías que unifiquen las demandas clínicas prevalentes en las consultas de enfermería gerontológica y sus respectivas intervenciones es necesaria, debido a la heterogeneidad de patologías emergentes en el proceso de envejecimiento que requerirán cuidados. Objetivo: Identificar las demandas clínicas en las consultas de enfermería gerontológica y las intervenciones implementadas por el personal de enfermería. Método: Revisión integrativa de investigaciones originales, publicadas entre 2018 y 2022, en inglés, español y portugués, en las bases de datos Scopus, MEDLINE/PubMed, BIREME/LILACS/BDENF/IBECS/BVS, SciELO y Google Scholar. Se utilizaron los descriptores DeCS/MESH: "Idoso"; "Enfermagem no Consultório"; "Enfermagem Geriátrica" e "Geriatria". Para determinar el nivel de evidencia de la muestra final, se usó el Rating System for the Hierarchy of Evidence for Intervention. Además, se excluyeron los editoriales, los estudios de revisión y los artículos duplicados. Los datos se analizaron mediante lectura analítica e interpretativa, guiada por una lista de verificación. Resultados: Se seleccionaron ocho artículos que aportaron demandas clínicas como déficit en el autocuidado para el baño, autodescuido, fatiga, riesgo integridad de la piel perjudicada; desesperanza, tristeza y depresión. Las intervenciones estaban orientadas al fomento del autocuidado, la optimización de la medicación, el fomento de la actividad física, el cuidado de la piel, el asesoramiento, la musicoterapia y la rehabilitación psicosocial. Conclusión: Las demandas clínicas atendidas en las consultas de enfermería gerontológica son muy variadas, con predominio en el dominio actividad/reposo, como intervenciones dirigidas al tratamiento y prevención de enfermedades y acciones dirigidas a la promoción de la salud, siendo más expresivo el dominio conductual.

Abstract Introduction: The creation of guidelines that unify the prevalent clinical demands from gerontological nursing consultations and their corresponding interventions are necessary due to the heterogeneity of emerging pathologies in the aging process that will require nursing care. Objective: To identify clinical demands in gerontological nursing consultations and the interventions implemented by nurses. Method: An integrative review of original research published from 2018 and 2022, in English, Spanish, and Portuguese, in Scopus, MEDLINE/PubMed, BIREME/lilacs/BDENF/IBECS/VHL, SciELO, and Google Scholar databases, using the DeCS/MESH descriptors: "Elderly", "Nursing in the Office", "Geriatric Nursing", and "Geriatrics". The Rating System for the Hierarchy of Evidence for Intervention was used to determine the level of evidence of the final sample. Editorials, review studies, and duplicate articles were excluded. The data were analyzed by analytical and interpretative reading, guided by a checklist. Results: Eight articles were selected that showed clinical demands such as deficits in self-care for bathing, self-negligence, fatigue, risk of damaged skin integrity, hopelessness, sadness, and depression. Interventions were related to encouraging self-care, medication optimization, encouragement of exercise, skin care, counseling, music therapy, and psychosocial rehabilitation. Conclusion: There are many different clinical demands in gerontological nursing consultations, especially associated with the domain of activity/rest. These include interventions to treat and prevent diseases, and actions aimed at health promotion, in most cases associated with the behavioral domain.

Characteristics Associated with Relationship-Centred and Task-Focused Mealtime Practices in Older Adult Care Settings.

Purpose: To assess care home and staff characteristics associated with task-focused (TF) and relationship-centred care (RCC) mealtime practices prior to the COVID-19 pandemic.Methods: Staff working in Canadian and American care homes were invited to complete a 23-item online survey assessing their perceptions of mealtime care, with one item assessing 26 potential care practices from the Mealtime Relational Care Checklist (relationship-centred = 15; task-focused = 11) reported to occur in the home prior to the pandemic. Multivariate linear regression evaluated staff and care home characteristics associated with mealtime practices.Results: Six hundred and eighty-six respondents completed all questions used in this analysis. Mean TF and RCC mealtime practices were 4.89 ± 1.99 and 9.69 ± 2.96, respectively. Staff age was associated with TF and RCC practices with those 40-55 years reporting fewer TF and those 18-39 years reporting fewer RCC practices. Those providing direct care were more likely to report TF practices. Dissatisfaction with mealtimes was associated with more TF and fewer RCC practices. Homes that were not making changes to promote RCC pre-pandemic had more TF and fewer RCC practices. Newer care homes were associated with more RCC, while small homes (≤49 beds) had more TF practices.Conclusions: Mealtime practices are associated with staff and home factors. These factors should be considered in efforts to improve RCC practices in Canadian homes.

Development and validation of machine learning models to predict frailty risk for elderly.

AIMS: Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly. DESIGN: A prospective cohort study. METHODS: We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6-7 surveys (2011-2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2-8) in 2000-2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6-7). Model performance was assessed by receiver operating curve and F2-score. RESULTS: Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%). CONCLUSION: Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly. IMPACT: The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life. REPORTING METHOD: The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The global prevalence of and risk factors for fear of falling among older adults: a systematic review and meta-analysis.

BACKGROUND: As a common psychological problem among older adults, fear of falling was found to have a wide range prevalence in different studies. However, the global prevalence of it was unknown and a lack of the large sample confirmed its risk factors. OBJECTIVES: To report the global prevalence of fear of falling and to explore its risk factors among older adults for further developing precise interventions to systematically manage FOF. DESIGN: A systematic review and meta-analysis was conducted by PRISMA guidelines. METHODS: Searches were conducted in PubMed, Web of Science, EMBASE, the Cochrane Library and the manual search in August 20, 2022, updated to September 2, 2023. Observational studies published in English were included and two researchers independently screened and extracted the data. Fixed or random effects mode was used to estimate the pooled prevalence of and risk factors for fear of falling. Heterogeneity resources were analyzed by subgroup and sensitivity analysis. Publication bias was assessed through funnel plots, Egger's test and Begg's test. RESULTS: A total of the 153 studies with 200,033 participants from 38 countries worldwide were identified. The global prevalence of fear of falling was 49.60%, ranging from 6.96-90.34%. Subgroup analysis found the estimates pooled prevalence of it was higher in developing countries (53.40%) than in developed countries (46.7%), and higher in patients (52.20%) than in community residents (48.40%). In addition, twenty-eight risk factors were found a significant associations with fear of falling, mainly including demographic characteristics, physical function, chronic diseases and mental problems. CONCLUSION: The global prevalence of FOF was high, especially in developing countries and in patients. Demographic characteristics, Physical function, chronic diseases and mental problems were a significant association with FOF. Policy-makers, health care providers and government officials should comprehensively evaluate these risk factors and formulate precise intervention measures to reduce FOF. TRIAL REGISTRATION: The study was registered in the International Database of Prospectively Registered Systematic Reviews (PROSPERO): CRD42022358031.

Adaptation of the Australian National University Alzheimer's Disease Risk Index-Short Form (ANU-ADRI-SF) into Turkish.

BACKGROUND: The 'Australian National University Alzheimer's Disease Risk Index' (ANU-ADRI) assesses the risk of developing Alzheimer's disease (AD) and is a potential tool for its prevention. OBJECTIVES: The aim of this study is to adapt the ANU-ADRI-SF (the short version of ANU-ADRI) into the Turkish language and Turkish cultural context. METHODS: The study was methodological and involved the translation and intercultural adaptation of the ANU-ADRI-SF into the Turkish language. The study included 384 community-based participants from a province in the Western Black Sea Region of Türkiye. Data was collected via an online form prepared using Google Forms. RESULTS: The index was translated from its original language, English, into Turkish and then retranslated to English by bilingual translators. It was then reviewed and evaluated for possible issues related to translation and degrees of equivalence. When TR-ANU-ADRI-SF levels were compared according to sex, the mean risk scores were found to be 11.25 ± 7.02 for males and 11.69 ± 7.99 for females. After cross-cultural adaptation, the TR-ANU-ADRI-SF was conceptually intelligible to Turkish adults. CONCLUSIONS: The TR-ANU-ADRI-SF is a valid and reliable AD risk assessment tool. IMPLICATIONS FOR PRACTICE: Given the increase in AD and its impact on people's health, there is a great need for strategies to be implemented by health professionals to improve the lifestyle of the adult population. For use in conjunction with these strategies, a localised AD risk assessment tool that can be applied by clinicians or by individual patients has been adapted and introduced to the Turkish literature.

Cross-Cultural Adaptation of the Scale of the Nursing Work Index With Nurses From Seven Countries.

Background and Purpose: The aims of this study are as follows: to adapt and validate the psychometric properties of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) adapted to the nursing home environment across seven Spanish-speaking countries and to cross-culturally adapt the Scale of the Nursing Work Index with nurses from seven countries. Methods: Adaptation process and psychometric validation of the instrument included translation and back-translation, content validity, test-retest reliability, internal consistency, and construct validity. Results: A total of 134 nursing homes belonging to the same religious order were randomly selected from seven Spanish-speaking countries with a sample of 378 nurses. The exploratory factor analysis explained a five-factor structure (56% of the explained variance) with adequate goodness-of-fit indices in the final factor solution. Conclusions: The validation process indicates that the Spanish language version of the PES-NWI with five factors and 31 items, for long-term care facilities for the elderly, is valid and reliable in its current version and can be used to measure the environment of nurses working in clinical practice in Spanish-speaking nursing homes.

Nursing standards, language and age as variables associated with clinical competence for nurses in long-term care facilities: A cross-sectional study.

AIM: To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long-term care facilities (LTCF) for older adults. DESIGN AND METHODS: This was a cross-sectional study. The competence test, 'the Ms. Olsen test', was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non-experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables. RESULTS: The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff. CONCLUSION: This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish-speaking RNs working in institutional care homes caring for patients according to national practice standards. IMPLICATIONS: These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings. IMPACT: Caring according to national practice standards and caring for severely ill patients are associated with clinical competence. REPORTING METHOD: The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Registered and PNs completed a questionnaire for the data collection.

Developing geriatric nursing micro-credentials for undergraduate nursing students based on training objectives: A modified Delphi study.

BACKGROUND: China's population has begun to age rapidly in the past several years and this trend is predicted to continue. In the face of this growing older population, the existing number of aged care personnel, especially medical care professionals, can hardly meet the demand for aged care services. AIM: To develop geriatric nursing micro-credentials (MCs) for undergraduate nursing students based on standardized training objectives and to specify the learning goals and course modules that correspond to each specific MC. DESIGN: Modified Delphi study. METHODS: An initial set of geriatric nursing MCs were developed based on the training objectives. Expert group discussion (n=13) reviewed the clarity and intelligibility of the statements' wording and supplemented the framework. A three-round Delphi survey (n=15) was then employed to obtain a consensus on the learning goals and course modules via an online questionnaire. Descriptive statistics were used to analyze the data. RESULTS: The final geriatric nursing MCs consisted of six courses, namely fundamentals of geriatric nursing (8 modules), geriatric sociology (6 modules), geriatric clinical nursing (3 modules), geriatric psychological nursing (8 modules), geriatric rehabilitation nursing (8 modules) and geriatric hospice care (10 modules). CONCLUSION: Nursing faculty can use the geriatric nursing MCs developed in this study to train current undergraduate nursing students to become backups for current, fully credentialed geriatric caregivers.

Intrinsic capacity trajectories, predictors and associations with care dependence in community-dwelling older adults: A social determinant of health perspective.

AIMS: To identify intrinsic capacity trajectories, predictors of intrinsic capacity trajectories and associations between intrinsic capacity trajectories and care dependence in community-dwelling older adults in China. METHODS: A retrospective longitudinal study was conducted, and the data were obtained from a five-year national longitudinal cohort study of older adults in China between 2011 and 2015. The social determinants of health framework informed the data analysis and interpretation. RESULTS: A total of 3893 older adults met the selection criteria and were included in the study. Three intrinsic capacity trajectories were identified: high trajectory (15.7 %), stable trajectory (52.7 %) and declining trajectory (31.6 %). Social determinants contribute to intrinsic capacity decline in older adults. Decreased cognitive function, psychological status, and locomotion at baseline were associated with care dependence. CONCLUSION: Approximately thirty percent of the older adults in this cohort study experienced a decline in intrinsic capacity within a 5-year period. Social determinants contributed to this decline in older adults.

Influencias del mundo y el cuerpo en la sexualidad del adulto mayor / Influences exerted by the world and the body on older adults' sexuality

Introducción: La sexualidad es una dimensión humana poco atendida por las ciencias de la salud pese a la necesidad de cuidado expresada por los adultos mayores. Objetivo: Describir el significado de la sexualidad del adulto mayor desde la influencia del mundo y el cuerpo. Método: Estudio fenomenológico guiado por los conceptos de la Fenomenología de la percepción de Merleau Ponty, realizado en una ciudad del centro de México en grupos de adultos mayores. Muestreo intencional con criterios de selección: adulto mayor con capacidad de comunicación verbal conservada, sin deterioro cognitivo (≥24 puntos en Mini Examen del Estado Mental) y con capacidad de decisión jurídica, participaron 16 adultos mayores, considerando criterio de saturación de información. Se realizaron entrevistas fenomenológicas virtuales analizadas con el método fenomenológico de Giorgi. Se respetaron los criterios éticos y de rigor cualitativo. Resultados: A partir de las unidades de significado identificadas surgieron tres temas: 1) Mundo vivido del adulto mayor; 2) Posibilidades del cuerpo actual; 3) Estereotipos y prejuicios sobre la sexualidad del adulto mayor. Conclusiones: La sexualidad del adulto mayor está influida por el contexto donde se desenvuelve y por las experiencias vividas al respecto a lo largo de toda su vida. Las enfermedades y limitaciones físicas afectan la sexualidad del adulto mayor y dificultan su expresión, en este mismo sentido. Los estereotipos y prejuicios que existen sobre la sexualidad en la sociedad y en la familia condicionan la expresión sexual y obliga a la represión de la sexualidad por el mismo adulto mayor (AU)

Introduction: Despite the care need expressed by older adults, sexuality is a human dimension that is hardly addressed by Health Sciences. Objective: To describe the meaning of older adults' sexuality based on the influence exerted by the world and the body. Method: A phenomenological study guided by the concepts of Merleau Ponty's Phenomenology of Perception, conducted in a city from central Mexico with groups of older adults. Intentional sampling with the following selection criteria: older adults with preserved verbal communication ability, with no cognitive decline (≥24 points in the Mini-Mental State Examination), and with legal decision capacity; the participants were 16 older adults, considering the data saturation criterion. Virtual phenomenological interviews were conducted, analyzed according to Giorgi's phenomenological method. The ethical and qualitative rigor criteria were respected. Results: Three topics emerged from the units of meaning identified, namely: 1) The world as experienced by older adults; 2) Possibilities of the current body; and 3) Stereotypes and preconceptions about older adults' sexuality. Conclusions: Older adults' sexuality is influenced by the context where they interact and by the experiences underwent in this aspect throughout their lives. Diseases and physical limitations affect aged people's sexuality and hinder its expression; in this same sense, the stereotypes and preconceptions about sexuality existing in society and in the family condition sexual expression and force older adults themselves to repress their sexuality (AU)

A qualitative study on the willingness and influencing factors of master of geriatric nursing specialist postgraduates to volunteer for home respite care for disabled elderly families.

BACKGROUND: As China's population ages, the demand for care for the disabled elderly is increasing, and family caregivers find it challenging to meet the comprehensive care needs of the disabled elderly. Through home respite services, families of the disabled elderly can receive help and support from specialized nursing professionals to ease the burden on family caregivers and provide high-quality services. This study explores the willingness and influencing factors of Master of Geriatric Nursing Specialist postgraduates in China to volunteer to provide home respite services for disabled elderly individuals. METHODS: A qualitative study based on Grounded Theory used Strauss and Corbin's programmatic version. A purposive sampling method was employed to conduct semi-structured interviews with 12 Master of Geriatric Nursing Specialist postgraduates from a tertiary hospital in Changsha, Hunan Province, China. RESULTS: The willingness of Master of Geriatric Nursing Specialist postgraduates to volunteer to provide home respite services for the disabled elderly was established as a core category, which was influenced by three main categories: personal factors, service object factors, and social factors, and nine categories formed from 39 initial concepts were included under the main category. CONCLUSIONS: Influenced by China's traditional cultural background, Master of Geriatric Nursing Specialist postgraduates in China have shown high motivation in volunteering to provide home respite services for the families of the disabled elderly but have been challenged by several challenges from China's healthcare environment and education system. Relevant departments need to adopt a series of policies and measures to increase volunteers' willingness to participate in respite care and promote its development.

Percepção sobre abandono afetivo em idoso institucionalizado / Perception of emotional neglect in institutionalized elderly / Percepción del abandono afectivo en adultos mayores institucionalizado

Objetivo: Compreender a percepção dos idosos institucionalizados quanto ao abandono afetivo por parte de seus familiares.Método: Trata-se de um estudo exploratório, comabordagemqualitativa. Conduzido por meio de entrevistas semiestruturadas. A organização e análise dos dados foram baseadas na técnica de Minayo. O estudo foi realizado em uma Instituição de Longa Permanência para Idosos, localizada em uma cidade do nordeste de Santa Catarina.Resultados: Participaram do estudo nove idosos, com idades entre 60 e 89 anos, com diferentes estados civis (viúvos, casados e divorciados), variando sua escolaridade do nível básico ao superior, além de serem aposentados ou pensionistas. Foram identificadas quatro categorias analíticas: (1) vivência na instituição, (2) motivos para a institucionalização, (3) relacionamento familiar e (4) percepção do abandono familiar.Conclusão: alguns idosos enfatizaram sentir-se esquecidos na instituição, o que os deixa tristes e deprimidos. É crucial para a prática de a enfermagem compreender a realidade dos idosos nas Instituições de Longa Permanência, pois essa compreensão está diretamente ligada à prestação de cuidados em todos os níveis de assistência à saúde

Objective: To understand the perception of institutionalized elderly individuals regarding the emotional abandonment by their family members.Methodology: This is an exploratory study, using qualitative methods. Conducted through semi-structured interviews. Data organization and analysis were based on Minayo's technique. The study was conducted at a Long-Term Care Institution for the Elderly located in a city in northeastern Santa Catarina.Results: Nine elderly individuals participated in the study, ranging in age from 60 to 89 years old, with different marital statuses (widowed, married, and divorced), ranging in education from basic to higher levels, and being retirees or pensioners. Four analytical categories were identified: (1) experience in the institution, (2) reasons for institutionalization, (3) family relationships, and (4) perception of family abandonment.Conclusion: Some elderly individuals emphasized feeling forgotten in the institution, which makes them feel sad and depressed. Understanding the reality of the elderly in Long-Term Care Institutions is crucial for nursing practice, as this understanding is directly linked to providing care at all levels of healthcare assistance in the Health Care Network

Objetivo: Comprender la percepción de las personas mayores institucionalizadas con respecto al abandono afectivo por parte de sus familiares. Metodología:Se trata de un estudio exploratorio, utilizando métodos cualitativos. Realizado a través de entrevistas semiestructuradas. La organización y análisis de los datos se basaron en la técnica de Minayo. El estudio se llevó a cabo en una Institución de Larga Estadía para Personas Mayores lubicada en una ciudad del noreste de Santa Catarina. Resultados:Nueve personas mayores participaron en el estudio, con edades comprendidas entre 60 y 89 años, con diferentes estados civiles (viudos, casados y divorciados), variando en educación desde niveles básicos hasta superiores, y siendo jubilados o pensionistas. Se identificaron cuatro categorías analíticas: (1) experiencia en la institución, (2) motivos para la institucionalización, (3) relaciones familiares y (4) percepción del abandono familiar. Conclusión:Algunas personas mayores enfatizaron sentirse olvidadas en la institución, lo que los hace sentir tristes y deprimidas. Es crucial para la práctica de enfermería comprender la realidad de los adultos mayores en las Instituciones de Larga Estancia, ya que esta comprensión está directamente vinculada con la prestación de cuidados en todos los niveles de asistencia sanitaria en la Red de Atención a la Salud.

Clarity and adaptability of instructions preventing the spread of the COVID-19 virus and its association with individual and organisational factors regarding the psychosocial work environment: a cross-sectional study.

BACKGROUND: In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff's perceptions of the clarity of instructions and the ability to follow them. METHODS: A cross-sectional study design was employed using a web survey. The staff's perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff's ability to follow them, were assessed using multivariate (ordinal) regression analysis. RESULTS: The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability. CONCLUSIONS: High job demands and individual learning demands were demonstrated to decrease the staff's understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.

Status and influencing factors of elder neglect by geriatric nursing assistants in Chinese nursing homes: a cross-sectional survey.

Background: In nursing homes, elder neglect has come to the forefront. Currently, few studies have examined the impact of personal and organizational factors of geriatric nursing assistants on elder neglect. From the perspective of geriatric nursing assistants, this study aims to explore the current situation and influencing factors of elder neglect in Chinese nursing homes. Methods: A convenience sampling method was used to recruit 412 geriatric nursing assistants from 50 nursing homes in China. Participants were surveyed using a demographic questionnaire, the Elder Neglect Scale for Geriatric Nursing Assistants, the General Self-Efficacy Scale (GSES), and the Proactive Personality Scale (PPS). Spearman correlation analysis and multiple linear regression were used to analyze the factors influencing elder neglect. Results: Geriatric nursing assistants scored a median of 74 out of 85 on the Elder Neglect Scale. Multiple linear regression analyses showed that the main personal factors influencing geriatric nursing assistants' elder neglect were general self-efficacy (ß = 0.312), proactive personality (ß = 0.180), and advanced qualification (ß = 0.084), while the main organizational factors included monthly salary ≤ 1,900 RMB (ß = -0.256), no regular training after induction (ß = -0.253), and the number of days off per month (3-4 days off ß = 0.192, ≥ 5 days off ß = 0.101). Conclusion: Although geriatric nursing assistants are at low levels of elder neglect, it remains a cause for concern. Among the personal factors, geriatric nursing assistants who possessed proactive personalities, high self-efficacy and advanced qualifications, exhibited low levels of elder neglect. Among the organizational factors, those who possessed a high number of days off per month portrayed low levels of elder neglect. Conversely, those who received low monthly salaries and no regular training after induction portrayed high levels of elder neglect. To reduce the risk of elder neglect, nursing homes should give due consideration to candidates' self-efficacy and proactive personality traits when recruiting, and focus on fostering these personality traits in their employees during their work. In addition, strengthening regular training for geriatric nursing assistants, optimizing the salary structure, and arranging rest days in a reasonable manner are also necessary measures.

The Status of Geriatric In-Hospital Nursing Care from the Perspective of Nurses Working in the Emergency Department of Hospitals in the Northwest of Iran in 2020.

Background: The evaluation of geriatric care in the emergency departments is necessary to improve the quality of care. This study aimed to determine the status of geriatric nursing care from the perspective of nurses working in the emergency department of hospitals. Materials and Methods: This study was a cross-sectional research study. Through census sampling, 252 nurses working in the emergency departments of hospitals of Ardabil Province were selected. The status of elderly care was assessed using the Geriatric In-Hospital Nursing Care Questionnaire. Data were analyzed using independent and one-sample t-tests and analysis of variance. Results: The mean (GerINCQ) score of the participants [mean (SD): 237.30 (75.30)] was significantly higher than the criterion score (201) (p = 0.001). The scores of the sub-scales of perception of elderly care [mean (SD): 45.42 (7.53)], aging-sensitive care delivery [mean (SD): 41.55 (10.25)], professional responsibility [mean (SD): 39.62 (9.86)], and attitude toward caring for elderly [mean (SD): 56.14 (12.53)] were significantly higher than the standard score (p = 0.001). However, the score of performed intervention [mean (SD): 38.36 (8.42)] was significantly (p = 0.02) lower than the criterion score (39). The score of professional responsibility and attitude toward elderly care was higher in women than men, and this difference was statistically significant (p < 0.05). Conclusions: The results showed that aging-coordinated care delivery, professional responsibility, and attitudes and perceptions of nurses toward elderly care were satisfactory, but performed intervention was unfavorable. According to the results of this study, nursing service managers can improve the quality of elderly nursing care through appropriate policies, fixing the workforce shortage, and closely monitoring elderly care in the emergency departments.

Nursing students' knowledge and attitudes toward older adults.

Nursing students, as the future healthcare workforce, hold immense potential in providing quality care to older adults and becoming advocates for promoting aging and public health, thus contributing significantly to addressing the multifaceted challenges of our aging society. Nurses' knowledge and attitudes about aging affect health care quality. Negative and unattractive representations of the social problems associated with aging contaminate nursing students' attitudes. Nursing schools are challenged to develop new curricula to prepare future nurses for the inherent complexity of an aging society. This study aims to assess the knowledge and attitudes of nursing students toward older adults and identify the variables that can influence these attitudes. Quantitative research was carried out through the application of an online survey using a cross-sectional descriptive research design. A total of 182 nursing students completed the online survey. Progression in the nursing course was statistically significant; the more students advanced, the more positive attitudes and knowledge they revealed about aging; 39% of students have daily contact with their grandparents; however, only 14.8% would like to work with older adults. Multiple linear regression revealed that the most important factor for positive attitudes and knowledge about aging was regular contact with grandparents, followed by progression in the nursing course. The students' age was not a significant factor in improving attitudes or expanding knowledge regarding older adults. In a multidimensional logic, the deepening of knowledge about aging and the socialization of students with older adults are central factors that should reinforce curricula in nursing education.

Nursing-sensitive quality indicators for quality improvement in Norwegian nursing homes - a modified Delphi study.

BACKGROUND: Use of nursing-sensitive quality indicators (QIs) is one way to monitor the quality of care in nursing homes (NHs). The aim of this study was to develop a consensus list of nursing-sensitive QIs for Norwegian NHs. METHODS: A narrative literature review followed by a non-in-person, two-round, six-step modified Delphi survey was conducted. A five-member project group was established to draw up a list of nursing-sensitive QIs from a preliminary list of 24 QIs selected from Minimum Data Set (2.0) (MDS) and the international Resident Assessment Instrument for Long-Term Care Facilities (interRAI LTCF). We included scientific experts (researchers), clinical experts (healthcare professionals in NHs), and experts of experience (next-of-kin of NH residents). The experts rated nursing-sensitive QIs in two rounds on a seven-point Likert scale. Consensus was based on median value and level of dispersion. Analyses were conducted for four groups: 1) all experts, 2) scientific experts, 3) clinical experts, and 4) experts of experience. RESULTS: The project group drew up a list of 20 nursing-sensitive QIs. Nineteen QIs were selected from MDS/interRAI LTCF and one ('systematic medication review') from the Norwegian quality assessment system IPLOS ('Statistics linked to individual needs of care'). In the first and second Delphi round, 44 experts (13 researchers, 17 healthcare professionals, 14 next-of-kin) and 28 experts (8 researchers, 10 healthcare professionals, 10 next-of-kin) participated, respectively. The final consensus list consisted of 16 nursing-sensitive QIs, which were ranked in this order by the 'all expert group': 1) systematic medication review, 2) pressure ulcers, 3) behavioral symptoms, 4) pain, 5) dehydration, 6) oral/dental health problems, 7) urinary tract infection, 8) fecal impaction, 9) depression, 10) use of aids that inhibit freedom of movement, 11) participation in activities of interest, 12) participation in social activities, 13) decline in activities of daily living, 14) weight loss, 15) falls, and 16) hearing loss without the use of hearing aids. CONCLUSIONS: Multidisciplinary experts were able to reach consensus on 16 nursing-sensitive QIs. The results from this study can be used to implement QIs in Norwegian NHs, which can improve the quality of care.

[Geriatrics and geriatric aspects in the German coalition agreement of 2021]. / Geriatrie und geriatrische Aspekte im Koalitionsvertrag 2021.

BACKGROUND: The proportion of older people in Germany is increasing. By the next federal election in 2025 the Federal Statistical Office of Germany expects that one third of the population will have reached retirement age. Older people are thus one of the largest voter groups and are particularly politically relevant. OBJECTIVE: How does the federal government support the living conditions of this voter group? What are the plans of the federal government regarding medical care of older people? METHODS: A content analysis of the coalition agreement was carried out with respect to aspects of demographic change, geriatric care and living conditions of older people. The coded text passages were categorized using a mixed inductive-deductive approach. Finally, the implementation progress of concrete projects after 1.5 years in office was evaluated. RESULTS: This study identified and categorized 23 passages with just under 620 words (about 1% of the total text) in the coalition agreement. Of the passages nine were assigned to the topic older population, six passages to medical care and eight to nursing care. Of the 23 passages 14 contained concrete plans for action or target dates. In the first 1.5 years of the federal government, partial progress could be identified in 4 of these, while no projects were realized. CONCLUSION: Overall, the coalition agreement shows an awareness for an ageing population. In view of the demographic development, however, few solutions are proposed for genuine geriatric aspects. The first year in office was strongly influenced by other topics, which resulted in unplanned laws and regulations and projects from the coalition agreement faded into the background.

Resilience in Older Adults Diagnosed With Cancer and Receiving Chemotherapy.

BACKGROUND: Resilience is the capacity for physical and emotional recovery from stressful events like cancer diagnosis and treatment. OBJECTIVES: The objectives of this study were to review existing literature to understand and illustrate ways to assess and manage resilience when providing holistic care to older adults with cancer. METHODS: A review of the literature was conducted with a focus on assessment, management, and preservation of resilience in older adults with cancer. FINDINGS: Interventions to support resilience include managing problems that occur in the areas of nutrition, exercise, social support, cognition, functional status, and emotion. Cell cycle arrest using pharmacologic agents may provide a novel proactive approach to protect resilience from deteriorating during chemotherapy to treat cancer. The oncology nurse can assess and manage resilience. which can lead to better treatment outcomes.

Resilience in Older People: A Concept Analysis.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.