A spark of change: developing an innovative gerontological nursing intervention mapping initiative for training and education (IGNITE).

BACKGROUND: With an aging global population and advancements in medical technology, there is an urgent need for innovative gerontological nursing education programs. This study aimed to develop and evaluate the Innovative Gerontological Nursing Intervention Mapping Initiative for Training and Education (IGNITE) program. This program is a digital platform-based postgraduate nursing curriculum that employs the Intervention Mapping Approach (IMA) and Transformative Learning Theory to address the evolving needs of gerontological nursing. METHODS: The IGNITE program's development process encompassed a comprehensive approach, including needs assessment, mapping of course objectives, integration of theory-based methods and strategies, course design, implementation, and rigorous evaluation. The pilot evaluation study involved pre- and post-tests focused on ageism, attitudes towards elder care, knowledge about older adults, transformative behavior change, and program satisfaction. The findings revealed significant improvements across all these dimensions, affirming the effectiveness of the program. RESULTS: The program leveraged experiential learning, critical reflection, and rational discourse to facilitate transformative educational experiences. Notably, pre- and post-test comparisons showed marked improvements in attitudes towards older adult care and dementia care knowledge. Participants expressed high satisfaction with the program, with significant reported changes in transformative behaviors. The study also illuminated the initial negative attitudes of clinical nurses towards older adults and underscored the importance of transformative learning experiences in fostering empathy and understanding. CONCLUSIONS: The IGNITE program lays a foundational framework for developing educational materials that promote transformative learning and self-reflection among healthcare professionals. This approach can lead to innovative nursing practices and personal growth. The application of the IMA and Transformative Learning Theory in gerontological nursing education shows significant promise. Future research should focus on exploring the long-term impacts of such programs and their applicability in diverse healthcare settings.

Academic-Practice Partnership to Strengthen Nursing Care of Older Adults.

A long-standing academic-practice partnership was leveraged to facilitate student learning opportunities pertaining to care provision for older adults living with multiple chronic conditions and complex medical problems. Students from a gerontological nursing course in an accelerated baccalaureate nursing program were partnered with gerontology-educated population health nurses in primary care settings. Students observed how population health nurses integrated the Institute for Healthcare Improvement Age-Friendly 4Ms framework into clinical practice as they performed behavioral, psychosocial, and biometric health risks assessments for older adults during their Medicare annual wellness visit. The population health nurses served as role models for professional delivery of age-friendly care including preventative health and wellness care. Student confidence and perception of their understanding of age-friendly and gerontological nursing care improved. Post clinical experience debrief sessions and clinical reflection assignments demonstrated students' admiration of the expansive role and person-centered approach that population health nurses undertake to ensure comprehensive assessment and wellness promotion. Students appreciated the fluidity of population health nurses' conversation regarding the things that matter most to older adults with complex medical conditions.

The effect of an escape room game on college nursing students' learning attitude and game flow experiences in teaching safe medication care for the elderly: an intervention educational study.

BACKGROUND: In the context of an aging population, the Gerontological Nursing course is becoming more and more important. Escape room games have been shown to have a positive effect on nursing education, but they have not been applied in the Gerontological Nursing course. The purpose of this study was to investigate the effects of adding an escape room game-based learning activity at the end of classroom teaching in a Gerontological Nursing course on nursing students' learning attitude and game flow experience. METHODS: In April 2023, a total of 84 nursing students from two classes at a medical school in Northeast China were selected for the study, and the classes were divided into a test group (n = 41) and a control group (n = 43). Both groups received regular classroom teaching on "Safe Medication Care for the Elderly", and the test group participated in an escape room game at the end of the classroom teaching. General information about the nursing students in both groups was collected prior to participation; learning attitude were measured before and after participation; and game flow experience was measured before and after participation in the test group. Data were analyzed using independent samples t-tests and paired samples t-tests. RESULTS: There was no statistically significant difference in the general information and learning attitude of nursing students between the two groups before participation. After participation, the total learning attitude score of nursing students in the test group was (73.17 ± 1.67) and that of the control group was (61.63 ± 2.66), and the difference was statistically significant (p < 0.001, Cohen's d = 5.196). The game flow experience of nursing students in the test group before and after participation was (63.27 ± 2.48) and (81.29 ± 2.49), respectively, and the difference between before and after was statistically significant (p < 0.001, Cohen's d = 5.253). CONCLUSIONS: During the teaching process of the Gerontological Nursing course, an escape room game added at the end of classroom teaching can improve nursing students' learning attitude and also help them to have a good game flow experience. These findings suggest that teaching activities based on the escape room game have considerable practical application value.

Gait and/or balance disturbances associated with Alzheimer's dementia among older adults with amnestic mild cognitive impairment: A longitudinal observational study.

AIMS: To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI). DESIGN: This study employed a longitudinal retrospective cohort design. METHODS: We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years. RESULTS: Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants. CONCLUSION: Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex. IMPACT: Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline. NO PATIENT OR PUBLIC CONTRIBUTION: Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study.

Measuring gerontological nursing competencies among aged care nurses: Cultural adaptation and psychometric validation.

BACKGROUND: Existing gerontological nursing competencies include the requisite knowledge and skills required for aged care nursing. What were not previously considered were legal and ethical aspects and access to technology, e-health and social media. OBJECTIVES: This study aimed to validate an Australian gerontological nursing competencies scale and assess the factors associated with for aged care nurses in Taiwan. METHODS: A methodological study design was used to validate the scale with a sample of 369 aged care nurses from aged care settings including nursing homes, long-term care facilities and aged care wards in Taiwan. The cultural adaptation and psychometric validation were evaluated. The content validity, construct validity through exploratory factor analysis and the internal consistency of the scale were assessed. RESULTS: The exploratory factor analysis extracted two levels of gerontological nursing practice, 'essential' and 'enhanced', which accounted for 80.8% of the total variance. The internal consistency, split-half reliability and test-retest reliability were excellent. Aged care nurses with higher levels of education, aged care education as their highest degree and continued education within 6 months, and certified long-term care education had higher gerontological nursing competencies scores than those who did not. CONCLUSIONS: This validated gerontological nursing competencies scale is a reliable and valid tool that can be implemented in future workforce planning, research and postgraduate and undergraduate curriculum and education in Taiwan and other Mandarin-speaking locales. IMPLICATIONS FOR PRACTICE: Using validated gerontological nursing competencies scales to explain different levels of specialist practice is crucial for addressing negative views about aged nursing and explicitly demonstrate the possibilities for career pathways in gerontological nursing.

Understanding the Significance of Listening to Older People's Life Stories in Whole Person Care-An Interview Study of Nurses in Gerontology.

Aim: The purpose of this study was to explore the significance of performing a life story interview for gerontological nursing students. Method: The study had a qualitative exploratory design, focusing on hermeneutical understanding using thematic analysis. Seven nurses in older people nursing were interviewed. Findings: Two main themes emerged from the analysis: "Engaging fellowship" and "Understanding the importance of life stories." The participants experienced increased engagement and fellowship with their patients after the life story interview; the change in their perspective was characterized by renewed interest, connection, and recognition of the individual person. The participants also gained a deeper understanding of the significance of listening to an older person's life story narrative, and this was expressed through them gaining an understanding of people's actions, achieving an altered mindset, gaining a greater generational understanding, and integrating a life story focus in their everyday professional life. Conclusion: Knowledge of human life and stories makes older people's situations easier to understand; this insight affects how we as nurses think about others. Seeing each patient as an individual and unique person and being aware of this in daily care is essential for nursing.

Evaluation of the feasibility of an Education-Career pathway in Healthcare for Older People (ECHO) for early career nurses.

BACKGROUND: Rapid population ageing is driving demand for qualified gerontological nurses. Yet, early career nurse attrition and limited focus on retention in the speciality limits supply. OBJECTIVES: To test the feasibility and acceptability of an Education-Career pathway in Healthcare for Older People (ECHO) intervention for early career nurses to improve retention and capability in gerontological nursing. ECHO is a multicomponent intervention with integrated education, career planning and coaching components, tested over two 6-month cycles. METHODS: A feasibility study with a pre-post design using a multi-methods evaluation. Twenty-nine early career nurse participants were recruited from eight NHS acute and community care Trusts in England. ECHO participants completed online questionnaires at baseline (Time 1), 6-month (T2, end of intervention) and follow-up at 18 months from baseline (T3). Outcome measures were career intention, self-reported knowledge, career planning confidence, and burnout using the Maslach Burnout Inventory. Qualitative interviews were undertaken with participants (n = 23) and organizational stakeholders (n = 16) who facilitated ECHO. Data analysis used descriptive statistics and non-parametric tests for paired data and thematic analysis for qualitative data. RESULTS: Overall, 19 of 29 participants (65%) completed all aspects of the intervention. The evaluation was completed by 23 participants. ECHO was well received by participants and stakeholders. At T3, the 23 participants were working in the speciality, though two had changed organizations. There was a significant improvement in self-reported gerontological knowledge, pre 87 (IQR 81-102), post 107 (IQR 98-112) p = 0.006, but no significant changes in other outcomes. In qualitative data, participants and organizational stakeholders held similar views, presented under four main themes: intended outcomes (personal and professional development, raise gerontological profile, expand horizons); nurse retention-a double-edged sword, ECHO logistics, and sustainability. CONCLUSION: Education-Career pathway in Healthcare for Older People was feasible and may positively impact early career nurse retention, capability and socialization into gerontological nursing. ECHO requires further refinement and piloting, but learning can contribute to retention strategies. IMPLICATIONS FOR PRACTICE: Attracting and retaining early-career nurses to the gerontological speciality requires greater innovation, organizational and senior nurse leadership.

Does telehealth influence the decision to transfer residents of residential aged care facilities to emergency departments? A scoping review.

BACKGROUND: Emergency Departments (ED) can be crowded places and not ideal environments for Residential Aged Care Facilities (RACF) residents awaiting assessment. Assessment and care planning may be made available via telehealth thereby avoiding unnecessary transfer to ED, without compromising the quality of care for the older person. Telehealth is attractive addition to improving healthcare decision-making in RACFs. OBJECTIVES: The aim of this scoping review is to explore the evidence around the use of telehealth and whether it influences the decision to transfer residents of RACF to ED. METHODS: All peer reviewed literature that focused on RACFs, decision-making and assessment of residents using telehealth in real time, was included. All study designs, pilot studies and some systematic reviews were considered. Databases Medline, Embase and CINAHL were used in this search in June 2022. Search terms were a combination of the population: RACF residents, decision-making and assessments using telehealth, and or transfer to the ED. The search was assisted by a senior university research academic librarian/information specialist and reviewed by senior researchers. The PRISMA-ScR guidelines were used to report this study. RESULTS: Of the 124 articles initially identified, 31 were eligible for inclusion for synthesis. The date range of the included studies was 2001 to 2022, with 15 published in the last five years. Critical appraisal was conducted using the Mixed Methods Appraisal Tool. CONCLUSION: This scoping review has mapped evidence that telehealth has been widely used in multiple settings. The association between the use of telehealth with improved clinical outcomes highlights its potential utility in enhancing care delivery for an older population in RACFs. Telehealth has shown that it can improve the decision-making for residents in RACFS, but more robust research designs are needed. IMPLICATIONS FOR PRACTICE: Using video/telehealth appears to improve RACF staff access to expert clinicians who can then assess and jointly plan care/management that can be provided in the resident's home. Knowledge and skills of RACF staff appear to be improved through joint assessment and decision-making with the use of video/telehealth access to expert clinicians.

Cuidados de enfermagem em instituição de longa permanência para pessoas idosas no contexto da covid-19: revisão de escopo / Nursing care in a long-term care facility for older people in the context of COVID-19: scoping review

Resumo Objetivo Identificar as evidências científicas sobre os cuidados de enfermagem à pessoa idosa em instituição de longa permanência no contexto da pandemia covid-19. Método Trata-se de revisão de escopo baseada nas orientações do Manual para Revisões do Joanna Briggs Institute (JBI). A formulação da questão ocorreu a partir do acrônimo PCC, em que o "P" correspondeu a "pessoa idosa", o "C" a "cuidados de enfermagem" e o "C" a "covid-19". A busca das evidências cientificas foi realizada nas bases de dados LILACS, MEDLINE®, CINAHL® e Web of ScienceTM. Foram analisados artigos recuperados ao se empregar os descritores controlados e não controlados, e aqueles provenientes da literatura cinzenta, sites e repositórios. A análise deu-se por estatística descritiva e crítica dos estudos. Resultados A amostra final do estudo foi composta por 14 evidências cientificas. Verificou-se que a maioria das produções pertenciam a modalidade relatório técnico (35,7%) publicadas no Brasil (64,28%). Os cuidados de enfermagem foram organizados em: intervenções gerenciais; intervenções educacionais; intervenções assistenciais em especial aquelas voltadas à prevenção e controle da disseminação do SARS-CoV-2, residentes com quadro suspeito ou confirmado de covid-19 e ao corpo em caso de óbito; intervenções voltadas a facilitar a comunicação entre os residentes e seus familiares/amigos e entre esses e o enfermeiro; além de intervenções de apoio emocional aos profissionais/cuidadores e aos residentes. Conclusão Diante da pandemia covid-19, os cuidados de enfermagem são imprescindíveis para prevenir e controlar a disseminação do SARS-CoV-2.

Abstract Objective To Identify the scientific evidence on nursing care for older people in a long-term care facility in the context of the COVID-19 pandemic. Method This scoping review was based on the Joanna Briggs Institute Reviewers' Manual guidelines. The question was formulated from the acronym PCC, in which "P" corresponded to "older people, "C" to "nursing care" and "C" to "COVID-19". The search for scientific evidence was carried out on the LILACS, MEDLINE®, CINAHL® and Web of ScienceTM databases. Articles retrieved using controlled and uncontrolled descriptors, and those from gray literature, websites and repositories were analysed. Descriptive and critical analysis of statistics from the studies was performed. Results The final study sample consisted of 14 scientific publications. Most of the output constituted technical reports (35.7%) published in Brazil (64.28%). Nursing care was categorized under: managerial interventions; educational interventions; care interventions, especially those forts preventing and controlling the spread of SARS-CoV-2, residents with suspected or confirmed COVID-19, and handling the corpse in the event of death; interventions facilitating communication between residents and their family/friends and between this group and the nurse; in addition to emotional support interventions for professionals/caregivers and residents. Conclusion Amid the COVID-19 pandemic, nursing care is essential to prevent and control the spread of SARS-CoV-2.

Developing a competence framework for gerontological nursing in China: a two-phase research design including a needs analysis and verification study.

BACKGROUND: China faces a serious shortage of competent nurses who can address the healthcare needs of older people in an ageing society. Chinese higher education institutes face serious challenges when it comes to developing new curricula that are capable of educating sufficient numbers of competent gerontological nurses. Therefore, the aim of this research study was to identify and verify competencies for gerontological nurses in China that are needed to provide nursing care for the growing number of older people in all care settings. This study takes into account the possible opportunities that trends and developments may offer in the near future. METHODS: In this study, a two-phase research design was used. The first phase concerned needs analysis, including a situational analysis, a trend analysis and a competence analysis. This process resulted in a draft competence framework. The second phase addressed the verification of the competence framework through a two-round Delphi study with a panel of Chinese and European experts. This process led to the final competence framework. RESULTS: The final competence framework for gerontological nursing in China included six competencies divided into 13 essential and five relevant learning outcomes. The competencies are: 'providing gerontological care', 'communication and collaboration', 'organization of gerontological nursing care', 'health promotion', 'evidence-based nursing and lifelong learning' and 'professional behaviour'. CONCLUSION: The framework comprehensively covers the six core competencies that nurses who care for older people should possess. These competencies are well-embedded in a Chinese context. The framework therefore offers concrete, practical suggestions for the competencies and skills that nursing graduates will need to work in current and future professions related to gerontological nursing education and practice.

[Nursing Students' Learning and Issues in Gerontological Nursing in Online Practical Training].

The aim of this research is to clarify student learning and the issues they faced in the practice of gerontological nursing that our students completed online from home during the COVID-19 pandemic. A survey was conducted involving 71 third-year students who completed practical training in October 2020, and their choice of answers regarding "students' online learning environment" and free text answers regarding "what they have learned through practical training" were investigated through e-Learning systems. A total of 68 valid responses were analyzed, and the following 5 categories regarding students' learning were extracted: 1. the pleasure of experiencing that their understanding about patients can improve the care and the pleasure experienced from interacting with the elderly; 2. the importance of verbalizing and transmitting information in a way that others can understand; 3. the reconfirmation of records to avoid mixing facts with assessment and discussion, and the development of behavioral goals for personal growth: 4. the multidisciplinary cooperation and care necessary to support the lives of patients; and 5. the importance of maintaining independence during the online practice and increasing the motivation to learn. This study revealed that the benefits of learning from on-site training could be obtained in part, by providing opportunities for students to be connected with both clinical practice instructors and patients. The results suggest the possibility that online practical training, where more time is shared among teachers and students, may help students understand the importance of learning behavior and independence generated from teacher-student interactions. It was suggested that there is a need for the improvement of the student's online learning environment and practical training goals.

The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study.

BACKGROUND: Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing. METHOD: This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software. RESULTS: The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement. CONCLUSION: There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

The Effect of Integrating Service-Learning and Learning Portfolio Construction into the Curriculum of Gerontological Nursing.

BACKGROUND: With the rapid increase in the aging population, a greater number of older individuals will require nursing care in the future. Therefore, it is important for nurses to be willing to engage in gerontological nursing. Nursing students must increase their experience in providing care to older people during their education and must receive education that improves their attitudes toward aging; this will help provide care to the older people, develop positive attitudes toward aging, and increase their empathy and willingness to provide care to older people after graduation. Hence, studies focused on improving the attitude of nursing students toward aging are urgently required. METHODS: In this mixed-method experimental study, participants were interviewed individually and observed to better understand the connection between quantitative and qualitative data. Service learning and learning portfolio constructions were integrated in the gerontological nursing curriculum of an experimental group, whereas traditional gerontological nursing curriculum was provided to a control group. Quantitative data on the nursing students were collected using the attitudes toward aging scale (ATAS) and older people behavioral intention scale (OBIS) and analyzed using descriptive and inferential statistics. RESULT: From the pre- to the post-test, the average ATAS and OBIS scores of the experimental group increased significantly, reaching a statistically significant level. However, the results of the control group indicated that the educational intervention does affect the attitudes toward aging and older people behaviors. A qualitative analysis revealed that educational intervention can improve the students' attitudes toward aging and older people behavioral intention. CONCLUSION: Our study results showed that integrating community older people service and learning portfolio construction into the curriculum can effectively improve the attitudes of nursing students toward aging and older people's behaviors, thus providing substantial assistance to students intending to care for the older people in the future.

Relatives' experiences of the hospitalisation of older people with COVID-19: A qualitative interview study.

BACKGROUND: During the COVID-19 pandemic, visitors were restricted from hospitals, separating them from hospitalised friends and family to reduce the infection risk. OBJECTIVES: The objective was to explore how relatives of older people acutely admitted to hospital with COVID-19 experienced being a relative, and how they felt about their contact with health care professionals (HCPs) when visitor restrictions prevented their physical presence in the ward. METHOD: This study employed a qualitative design. We used individual qualitative semi-structured interviews and the participants were relatives of acutely admitted older people from three COVID-19 wards in Denmark. A total of 18 relatives participated, 14 female and 4 male, aged between 45 and 83 years. The analysis was guided by Graneheim and Lundman's qualitative content analysis. RESULTS: The analysis derived the following three themes: (1) the importance of trust in a period of uncertainty; (2) the meaning of contact with HCPs, and (3) active but at a distance-a balancing act. The participants' feelings of uncertainty were prominent. The unknown nature of the disease and the unusual situation challenged relatives' trust in HCPs and the health care system. CONCLUSIONS AND RELEVANCE TO PRACTICE: The findings highlight relatives' stress when the possibilities for visiting are restricted and the importance of trust in, and the relationship with HCPs. This study can strengthen HCPs' understanding of relatives' situation when older people are hospitalised during and after the COVID-19 pandemic.

Teaching Gerontology in Transcultural Academics: A Phenomenographic Study of Thai and Swedish Nurse Educators' Conceptions of Gerontological Nursing.

INTRODUCTION: There is an urgent need for registered nurses with gerontological competence within long-term care (LTC) of older adults. Despite increases of life expectancy, LTC for older adults is not emphasized in nursing curricula in neither Sweden nor Thailand. Thus, the aim was to explore conceptions on gerontological nursing (GN) among Swedish and Thai nurse educators. METHOD: A qualitative phenomenographic method, based on open-ended interviews with five Thai and nine Swedish nurse educators was conducted. RESULTS: The results indicate a paradox between the educators' knowledge about the implications of global aging, their hope of own aging, and LTC. The ethical responsibility of being credible and a source of inspiration in teaching about aging are focused, while GN seem to be less important. DISCUSSION: To increase students' interest in GN, measures need to be taken within the educational arenas, where the educators' own conceptions toward GN, cultural aspects of aging, and LTC are discussed.

Family participation in the care of older hospitalised patients: Patients', family caregivers' and nurses' preferences on family caregivers performing care tasks.

BACKGROUND: It is estimated that there are 101 million older care-dependent people (60+). This group is expected to double by 2050 due to the ageing of the world's population and the rise in life expectancy. Although people tend to live longer, there is little evidence that they live their later years in better health. In the future, this might put even more stress on an already overburdened acute care health system. Hospitals therefore need to focus on preventive measures to avoid rehospitalisation of older people. Family participation could be part of the solution. OBJECTIVES: This study aimed to gain insight into the preferences of family caregivers, patients and nurses towards family caregivers taking up care tasks during hospitalisation, after receiving education. METHODS: Data were collected using a cross-sectional survey of nursing staff, family caregivers and older patients in nine wards for older people within three hospitals. Data collection ran from October 2019 till March 2020 using a questionnaire of 25 care tasks with three answer options (perform alone, together with a nurse, do not perform). A consecutive sample of 330 patients and 133 family caregivers (81 dyads could be formed) next to a convenience sample of 67 nurses was obtained. RESULTS: Patients (65%) are more prepared to let their family caregiver perform tasks alone than family caregivers (59%) and nurses (52%). Only few patients (3.8%) and family caregivers (13%) prefer the family caregiver to perform a task together with a nurse. The latter answer thus rather dichotomously, while nurses answer more dynamically over the three answer options. Of all family caregivers, 50% indicate willingness and ability to perform tasks on a regular basis. Significant correlations indicate that patients, family caregivers and nurses agree on which care tasks would be more preferable to be performed by a family caregiver. Looking at the dyads, preferences of a patient are not suspected to be more similar with his family caregiver than with a random family caregiver. CONCLUSIONS: Patients, FCGs and nurses indicate to be prepared to engage in family participation. Further research needs to concentrate on the different attitudes and perceptions towards performing care tasks through qualitative research and how a successful implementation can be set up. IMPLICATIONS FOR PRACTICE: Our study indicates that implementation of family participation in physical care within the hospital could be viable. TRIAL REGISTRATION: The study protocol was approved by the ethical committee of the Ghent University Hospital (B670201940430).

Nursing students' competence profiles in gerontological nursing-A cross-sectional study.

AIM: The study aimed to describe and explain the self-assessed gerontological nursing competence levels of Finnish nursing students and factors relating to it. DESIGN: A cross-sectional study design, reported by The Strengthening the Reporting of Observational studies in Epidemiology guidelines. METHODS: Data were collected with the GeroNursingCom instrument, which features 53 items relating to 11 competence factors. The K-clustering technique and the Chi-squared, Kruskal-Wallis and Mann Whitney tests were used to analyse the data. RESULTS: Seven hundred and ninety-nine nursing students from nine randomly selected higher education institutions were invited to participate in 2019. Three distinct student profiles were identified according to the data (N = 274): Profile A-lower intermediate competence (23.1% of students), Profile B-intermediate competence (45.8%) and Profile C-high competence (31.1%). The strongest competence area for all students was appreciative encounter and interaction, and the weakest was supporting the older person's sexuality. Nursing students have diverse backgrounds and their overall competence in gerontological nursing is shaped in part by their previous education, motivations and work experience. RELEVANCE TO CLINICAL PRACTICE: Recognizing students' different gerontological nursing competence profiles enables the implementation of targeted education to improve competence in clinical practice.

Nursing students' willingness to work in geriatric care: An integrative review.

AIMS: This integrative review aims to explore the willingness of nursing students to work in geriatric care over the past 10 years and to explore the factors influencing nursing students to work in geriatric care. DESIGN: An integrative review. METHODS: Studies investigating nursing students' willingness in gerontological nursing work and related influencing factors published in English in Cochrane Library, MEDLINE, Embase, PsycINFO and CINAHL between 2010-2020 were included. Data collected in April 2020. RESULTS: Twenty-four studies were analysed. Most studies presented a contradictory or negative attitude about the willingness of nursing students to engage in gerontological nursing work. In most studies that rank the intention to work in nursing fields, gerontological care received the lowest or a relatively low ranking. The main factors affecting work related to gerontological nursing include prior experience caring for older adults, attitudes towards geriatrics, anxiety about ageing, clinical practice environment and living experience with older family members.

Fragilidade física e mobilidade funcional em idosos da atenção primária à saúde / Physical frailty and functional mobility in elderly people in primary health care

Resumo: Trata-se de estudo quantitativo de corte transversal, cujo objetivo foi analisar a associação da condição e dos marcadores de fragilidade física à mobilidade funcional de idosos. Participaram-se 389 idosos (?60 anos) assistidos em uma Unidade Básica de Saúde em Curitiba, Paraná. Para a coleta de dados, aplicaram-se questionários sociodemográfico e clínico, testes do fenótipo de fragilidade física e o timed up and go para avaliar a mobilidade funcional. Analisaram-se os dados mediante estatística descritiva, associação (Teste de Qui-quadrado com nível de significância estatístico considerado de p<=0,05 (a=0,05) e de correlação (Teste de Pearson). As chances de associação entre os marcadores de fragilidade e a mobilidade funcional diminuída foram analisados pela Odss Ratio, com intervalo de confiança de 95%. O modelo de regressão final foi elaborado pelo critério da acurácia, sensibilidade, especificidade, coeficientes de correlação linear e ajustado. O estudo foi aprovado pelo Comitê de Ética do Setor de Ciências da Saúde da Universidade Federal do Paraná, sob o parecer n°2918847. Dos 389 idosos, 34 (8,7%) eram frágeis, 186 (47,8%) pré-frágeis, 169 (43,5%) não frágeis, e 330 (84,8%) apresentaram mobilidade funcional diminuída. Os marcadores de fragilidade mais expressivos foram o baixo nível de atividade física (n=82; 21,0%), redução da força de preensão manual (n=82; 21,0%), redução da velocidade da marcha (n=81; 20,8%). Houve associação significativa entre a mobilidade funcional preservada e a condição de não frágeis (p=0,001). Correlacionaram-se à mobilidade funcional diminuída, a fragilidade (r=2,08; p=0,037), pré-fragilidade (r=2,04; p=0,041) e os marcadores redução da força de preensão manual (p=0,026), baixo nível de atividade física (p=0,026) e redução da velocidade da marcha (p<0,001). A razão de chance de idosos frágeis apresentarem mobilidade funcional diminuída é significativamente elevada (RC 9,25) quando comparada aos não frágeis. No modelo preditivo final permaneceram os marcadores redução da força de preensão manual, baixo nível de atividade física e redução da velocidade da marcha. O idoso com redução da força de preensão manual tem 1,96 vezes mais chance de desenvolver MF diminuída, quando comparado aquele FPM preservada (OR 1,968, IC95%, 0,798-4,854, p=0,141), e o idoso com baixo nível de atividade física tem 2,10 vezes mais chances de desenvolver declínio da mobilidade funcional, em relação ao fisicamente ativo (OR 2,101, IC95%, 0,855-5,163, p=0,105). O idosos com redução da velocidade da marcha possui 7,21 vezes mais chances de apresentar diminuição na MF, ao comparar com a condição de não frágil para esse componente (OR 7,213, IC95%, 1,703-30,537, p=0,007). Conclui-se que, os idosos frágeis e com o marcador redução da velocidade da marcha possuem chances elevadas de desenvolverem mobilidade funcional diminuída. Apesar da correlação entre mobilidade funcional e redução da força de preensão manual e baixo nível de atividade física, esses marcadores não se mostraram preditivos para mobilidade funcional diminuída. O presente estudo destaca resultados expressivos para a prática clínica de enfermagem gerontológica, os quais são essenciais para subsidiar estratégias preventivas para a mobilidade funcional do idoso e proporcionar uma visão mais ampla e clara na gestão dos cuidados, sobretudo para a fragilidade marcada pelo componente velocidade da marcha.

Abstract: This is a quantitative cross-sectional study, with the aim of analyzing the association between the condition and the markers of physical frailty and functional mobility in the elderly. Three-hundred and eighty-nine elderly people aged (?60 years) assisted at a Basic Health Unit in Curitiba, Paraná, participated. For data collection, sociodemographic and clinical questionnaires, physical frailty phenotype and timed up and Go tests were used to evaluate functional mobility. Data were analyzed using descriptive statistics, association (Chi-square test) with a level of statistical significance considered of p<=0.05 (a=0.05) and correlation (Pearson test). The chances of an association between frailty markers and decreased functional mobility were analyzed by the Odss Ratio, with a 95% confidence interval. The final regression model was elaborated by the criterion of accuracy, sensitivity, specificity, linear and adjusted correlation coefficients. The study was approved by the Ethics Committee of the Health Sciences Sector of the Universidade Federal do Paraná, under Opinion Report No. 2918847. Of the 389 elderly, 34 (8.7%) were frail, 186 (47.8%) pre-frail, 169 (43.5%) non-frail, and 330 (84.8%) had reduced functional mobility. The most expressive markers of frailty were low level of physical activity (n=82; 21.0%), reduced handgrip strength (n=82; 21.0%), reduced gait speed (n=81; 20.8). Frailty (r=2.08; p=0.037), pre-frailty (r=2.04; p=0.041) and, markers of handgrip strength (p=0.026), level of physical activity (p=0.026) and gait speed (p<0.001) associated to the decreased functional mobility. There was a significant association between preserved functional mobility and the condition of not being frail (p=0.001). The odds ratio for frail elderly people with reduced functional mobility is significantly high (OR 9.25) when compared to non-frail people. In the final predictive model, the markers remained: reduced handgrip strength, low level of physical activity and reduced gait speed. The elderly with reduced handgrip strength is 1.96 times more likely to develop decreased MF when compared to that preserved HGS (OR 1.968, 95%CI, 0.798-4.854, p=0.141), and the elderly with low activity level physical activity is 2.10 times more likely to develop a decline in functional mobility, compared to physically active (OR 2.101, 95%CI, 0.855- 5.163, p=0.105). The elderly with reduced gait speed are 7.21 times more likely to have a decrease in MF, when compared to the condition of non-frail for this component (OR 7.213, 95%CI, 1.703-30.537, p=0.007). It is concluded that the frail elderly and with the marker reduced gait speed have a high chance of developing reduced functional mobility. Despite the correlation between functional mobility and reduced handgrip strength and low level of physical activity, these markers were not predictive for decreased functional mobility. The present study highlights expressive results for the clinical practice of gerontological nursing, which are essential to support preventive strategies for the functional mobility of the elderly and provide a broader and clearer view in the management of care, especially for the frailty marked by the gait speed component.

Development and psychometric testing of the Gerontological Nursing Competence (GeroNursingCom) instrument.

AIM: To develop and psychometrically test an instrument - GeroNursingCom - that measures gerontological nursing competence of nursing students. DESIGN: An instrument development guided by COSMIN guidelines. METHOD: The development and testing of the GeroNursingCom instrument proceeded according to four distinct phases: (a) establishing a theoretical background; (b) testing face and content validity; (c) examining structural validity; and (d) testing internal consistency. The items of instrument were based on a theoretical framework developed from a comprehensive literature review and focus group interviews with experts (N = 27) in spring 2018. Content validity was assessed by nine experts in gerontological nursing, while face validity was tested in a pilot study including 36 nursing students. Structural validity was examined with exploratory factor analysis with 267 nursing students from nine universities of applied sciences. The internal consistency was established with Cronbach's alpha. The data were collected in spring and autumn 2019. The data analysis was conducted with multivariate statistical methods. RESULTS: The GeroNursingCom development and testing process yielded an instrument that includes 53 items across 11 factors: (a) appreciative encounters and interactions with older people; (b) medication for older people; (c) nutrition for older people; (d) safe living environment for older people; (e) supporting the functioning of older people; (f) end-of-life care; (g) developing one's competencies; (h) supporting an older person's mental well-being; (i) supporting an older person's sexuality; (j) guiding self-care among older people; and (k) responding to challenging situations. The instrument was able to explain 66.15% of the total observed variance, while Cronbach's alpha values for individual items varied from 0.75-0.89. CONCLUSION: TheGeroNursingCom instrument can be used to measure gerontological nursing competence among nursing students to improve gerontological nursing education and/or geriatric care. IMPACT: Graduating nursing students must develop versatile competencies to face the multiple needs of older patients and curriculums need to be further developed to ensure students are prepared for gerontological nursing.