The mediating role of religion and loneliness on the association between reminiscence functions and depression: a call to advance older adults' mental health.

BACKGROUND: Current literature lacks evidence about the relationship between reminiscence functions and depression and the mediating role of clinical constructs such as loneliness and religion. The study aimed to examine the mediating effects of loneliness and religion on the association between reminiscence functions and depression in a sample of older Jordanian adults. METHODS: An anonymous online cross-sectional survey was employed to collect data from 365 older Jordanian adults. Convenience and snowball sampling methods were used to recruit participants through social media. RESULTS: In the depression model, Bitterness Revival and Intimacy Maintenance factors, educational level, and Intrinsic Religiosity were statistically significant predictors of depression. Bitterness Revival and Intimacy Maintenance factors, work sector, and Intrinsic Religiosity were statistically significant predictors of loneliness. Loneliness has a negative, partial mediating effect on Intimacy Maintenance and depression. CONCLUSION: Depression caused by significant losses in the Arab Jordanian environment might be mitigated by Intimacy Maintenance by reducing feelings of loneliness. Understanding how Intimacy Maintenance correlates with depression through loneliness could help psychiatric nurses develop psychosocial interventions that reduce depression among older adults.

Scoping review of reminiscence research undertaken in long-term care communities.

Mental health conditions ranging from minor depressive symptoms to major depression, loneliness and poor quality of life are significant concerns in long-term care communities. Reminiscence is one intervention that has shown to reduce depressive symptoms and improve quality of life. The purpose of this scoping review was to determine the extent of reminiscence research undertaken in long-term care communities. Arksley and O'Malley's six stage method provided the framework for the review. Studies published in peer reviewed literature were identified based on searches in three databases (CINAHL, PUBMED, PsycINFO). Thirty-two studies met inclusion criteria. Of the 32 articles examined, 2 studies were conducted in the United States. Twenty-five health outcomes were examined, including twenty-three psychological outcomes and two physiological outcomes. Depression and cognitive functions were the most frequently measured outcomes. Lack of theoretical frameworks underpinning the studies, inadequate sample sizes, and weak methodology were noted in this review. Recommendations for future reminiscence research in long-term care communities are discussed.

Uses of reminiscence intervention to address the behavioral and psychosocial problems associated with dementia: An integrative review.

INTRODUCTION: Reminiscence is a non-pharmacological technique used to manage the behavioral and psychological symptoms of dementia. This integrative review aims to synthesize the research on the health benefits of reminiscence intervention for people with dementia. METHODS: Whittemore and Knafl's five-step method provided the framework for this review. A comprehensive search of PubMed, CINAHL Plus, SCOPUS, and PsycINFO was conducted. The articles were reviewed for eligibility, critically appraised, and extracted the data. RESULTS: Twenty-seven studies met the inclusion criteria. Four themes emerged: (a) Recovery from the Darkness of Depressive Symptoms, (B) Enhancement of Cognitive Functions and Filling the Memory Gap, (C) Living a Fulfilling Life in Late Adulthood, and (D) Fulfilling Reminiscence Functions. DISCUSSION: This review provides a better understanding of the potential benefits of using reminiscence intervention for addressing the behavioral and psychological symptoms of dementia. However, improving the methodological rigor of future studies is necessary to attain conclusive evidence.

A mixed methods evaluation of got care!

This study aimed to assess the relationship between an Interprofessional Collaborative Practice (IPCP) intervention for community-dwelling older adults, Geriatric Outreach and Training with Care! (GOT Care!), and the observed 26% reduction in Emergency Department (ED) visits for the 51 older adult participants. A convergent parallel mixed-methods design was utilized. Demographic data and ED visit data were collected and analyzed using paired-samples t-tests, poisson regression and generalized poisson regression. Stakeholder perspectives were assessed via emailed open-ended surveys and analyzed using content analysis. The quantitative results were transformed into trends that were compared and contrasted with the qualitative themes. The results were consistent with the current literature that IPCP models may have a greater impact on older adults with certain demographic characteristics such as polypharmacy, diabetes and prior ED use, while nursing was identified as an ideal leader for IPCP teams.

Examining Patterns and Functions of Reminiscence in a Sample of Black Adults: Implications for Psychiatric Nurses.

The patterns and functions of reminiscence have been shown to be associated with mental health and well-being. The purpose of this study was to examine age and gender differences in the patterns and functions of reminiscence among a sample of Black adults. Multivariate analysis of variance findings revealed age and gender differences on specific reminiscence functions. Age groups >70 scored highest on the Teach/ Inform function. Men reminisce more for Bitterness Revival while women reminisce more frequently to Teach/Inform and for Intimacy Maintenance. Results indicate there are age and gender differences in the reasons why and how often the participants in this study reminisce for a specific purpose. These findings are informative for psychiatric nurses in order to facilitate therapeutic reminiscence to improve the mental health and well-being of this underserved population.

Developing a dedicated education unit in long-term care: a pilot project.

Within long-term care, the transitional care setting provides post-acute and short-stay rehabilitation to older adults, easing the transition between the acute care hospital and home or long-term care. The current nursing shortage makes it difficult for these facilities to attract and retain qualified nursing staff. In order to meet the rehabilitation needs for this patient population while at the same time addressing the challenge in nursing education of limited clinical placements and severe nurse faculty shortages, an academic-practice partnership was developed to establish a Dedicated Education Unit (DEU). The DEU is an innovative clinical education model in which experienced staff nurses serve as clinical teachers to nursing students. This paper describes the process of developing a DEU using the Partners in Caring Model as the framework. Formative and summative evaluation results and recommendations for program improvement of this pilot project are discussed.

Psychometric testing of the Modified Reminiscence Functions Scale.

BACKGROUND AND PURPOSE: The Modified Reminiscence Functions Scale (MRFS) measures the patterns and functions of reminiscence. The purpose of this study was to examine the factor structure of the MRFS in a sample of community-dwelling Black adults. METHODS: A convenience sample (N = 335) of Black adults from the Northeast completed the 39-item MRFS. Seven- and 8-factor models were evaluated given the uncertainty regarding the number of factors in previous reminiscence research. RESULTS: Confirmatory factor analysis established validity of the 7-factor model (relative chi-square [χ2/df] = 1.9, Tucker-Lewis index [TLI] = .919, comparative fit index [CFI] = .929, root mean square error of approximation [RMSEA] = .05). Reliability of the subscales ranged from .64 to .90. CONCLUSIONS: The MRFS is a reliable and valid measure of reminiscence patterns and functions in Black adults with similar characteristics.

An integrative research review of instruments measuring religious involvement: implications for nursing research with African Americans.

BACKGROUND AND PURPOSE: Many instruments in which religious involvement is measured often (a) contain unclear, poorly developed constructs; (b) lack methodological rigor in scale development; and (c) contain language and content culturally incongruent with the religious experiences of diverse ethnic groups. The primary aims of this review were to (a) synthesize the research on instruments designed to measure religious involvement, (b) evaluate the methodological quality of instruments that measure religious involvement, and (c) examine these instruments for conceptual congruency with African American religious involvement. METHODS: An updated integrative research review method guided the process (Whittemore & Knafl, 2005). RESULTS: 152 articles were reviewed and 23 articles retrieved. Only 3 retained instruments were developed under methodologically rigorous conditions. All 3 instruments were congruent with a conceptual model of African American religious involvement. CONCLUSIONS: The Fetzer Multidimensional Measure of Religious Involvement and Spirituality (FMMRS; Idler et al., 2003) was found to have favorable characteristics. Further examination and psychometric testing is warranted to determine its acceptability, readability, and cultural sensitivity in an African American population.

Transcultural adaptation in translating measurement instruments: Challenges and learned lessons.

PURPOSE: In cross-cultural research, there is a need for standard rules for translating research measurement instruments. This article describes the Reminiscence Functions Scale (RFS) translation process from English into Arabic and the rigorous process followed in translating the scale. The process described can serve as a blueprint for translating research instruments for cross-cultural studies and clinical practice. METHOD: Six integrated steps were used to establish content and semantic equivalences. Six bilingual professional translators participated in the translation project and utilized the Flaherty 3-point scale to assess and rate the translated RFS. FINDINGS: The difficulties encountered during the study were finding nuanced translation equivalences for Likert scale responses, the translation of phrases and idioms, and logistical issues. CONCLUSIONS: Combining translation methods is the ideal choice to achieve robust translation. IMPLICATION FOR NURSING PRACTICE: The proposed translation method for research instruments would assist nurses in appraising prior research's findings, delineating potential effective nursing interventions, and facilitating comparisons of individuals from various cultures and contexts.

Engaging students in gerontological research.

There is a critical need to prepare undergraduate and graduate nursing students to take active roles in gerontological nursing research. Nursing educators are faced with multiple challenges such as the demands of the tripartite role (teaching, scholarship, and service), and managing large numbers of students. These issues make it difficult to actively engage nursing research. Students Advancing Reminiscence Research (STARR) is and example of an innovative program that fosters student engagement in research using available resources while enhancing the faculty advisor's program of reminiscence research. The impetus for creating the STARR program is described in this article, and implications and recommendations for nursing education, practice, and policy are presented.

Psychometric Testing of the Arabic Version of the Reminiscence Functions Scale.

Background and Purpose: The Reminiscence Functions Scale (RFS), a reliable and valid 43-item scale, measures eight specific reasons as to why people reminisce. The current literature lacks an Arabic version of empirically-validated tools that measure reminiscence functions. This study aimed to test the psychometric properties of the translated version of the RFS in a sample of Arabic speakers from Jordan. Methods: The scale was first translated into Arabic and then was translated back into English. A committee of experts reviewed the Arabic scale and then confirmed its content validity. A convenience, snowball sample of 422 subjects completed the Arabic RFS. Exploratory factor analysis (EFA) and the internal consistency method were used to evaluate the factorial structure and reliability of the Arab RFS, respectively. Results: The Arabic RFS reported excellent content validity. EFA yielded a six-factor, 39-item structure that accounted for 52% of the variance. Cronbach's alphas for the six factors ranged from 0.82 to 0.91, indicating good to excellent internal consistency. Conclusions: The Arabic RFS is a valid and reliable measure of reminiscence functions for Jordanian adults.

Outcomes From an Interprofessional Geriatric Outreach and Training Program.

Background and Objectives: Interprofessional education (IPE) is necessary to train health care professionals to work collaboratively for the care of older adults. Geriatric Outreach and Training with Care! (GOT Care!) was an innovative academic training program designed to provide an IPE opportunity for health care students and faculty while providing care to community-dwelling older adults. The objectives of this program evaluation were to: (a) examine students', older adult participants', and primary care providers' (PCPs) perceptions toward their participation GOT Care! and (b) examine patient outcomes to identify program strengths and areas for improvement. Research Design and Methods: Formative and summative program evaluation methods were utilized to evaluate student, older adult participant, and provider perceptions of participating in GOT Care!. A total of 221 pharmacy, physical therapy, nursing, social work, medicine, and public health students from a single public university in northeastern United States, 38 community-dwelling older adults, and 33 PCPs were included. Means, standard deviations, and percentages were computed for survey data. The contextual data gathered from interviews and open-ended questions were analyzed using Borkan's immersion-crystallization approach to generate themes. Results: Overall, the students, older adults, and PCPs appreciated GOT Care!. Students reported learning about the unique challenges to geriatric care and how to communicate with other professionals. The older adults appreciated the thorough interprofessional assessment and that the students could learn from them. The PCPs noted the unique insights into their patients' health that would not present at a typical office visit. Discussion and Implications: GOT Care! leveraged academic and community partnerships to provide an IPE opportunity and care to vulnerable older adults. Positive outcomes such as older adult, student, and PCP satisfaction, and a reduction in emergency department visits support ongoing utilization and evaluation of these IPE programs.

Confirmatory factor analysis of the Arabic version of the reminiscence functions scale with strict measurement invariance across gender.

PURPOSE: Recognizing reminiscence functions can help psychiatric nurses promote patients' mental health. This study aimed to confirm the six-factor, 39-item structure of the Arabic version of the Reminiscence Functions Scale (RFS) in a sample of Jordanian adults (N = 470) and examine the invariance of structure across gender. DESIGN AND METHOD: Post hoc model adjustment was conducted sequentially using modification indices (MI) to improve model fit. Measurement invariance across gender was examined using this adjusted Arabic RFS score (ARFS). FINDINGS: After post hoc adjustment using MI, the fit indices for the adjusted (32-item) ARFS improved, indicating a good fit for the data. The adjusted ARFS factor structure indicated strict measurement invariance across gender. CONCLUSIONS: CFA supports a 32-item, six-factor model. PRACTICE IMPLICATIONS: Psychiatric nurses can use the adjusted ARFS to measure subjects' reminiscence functions and predict the psychological and emotional distress associated with these functions.

Barriers to depression care for black older adults. Practice and policy implication.

Late-life depression is a public health problem in the United States. Untreated, depression contributes to poorer health outcomes and increased mortality among older adults. Specifically, Black older adults are at higher risk for misdiagnosis, undertreatment, and more severe depressive symptomatology than other groups. Barriers to identification and treatment of depression in Black older adults include lack of access to quality mental health care, the stigma of mental illness, mistrust of mental health providers, and poor provider-client communication. Recommendations for gerontological nursing practice, education, and research to improve the care of depressed Black older adults are discussed. Implications for policy development are presented.

Reminiscence in the Care of People with Mild Dementia: A Concept Analysis.

AIM: To clarify the concept of reminiscence in the care of people with mild dementia, highlight its uses as a nursing intervention in dementia care, and propose an operational definition of the concept. BACKGROUND: Reminiscence is one of the leading nonpharmacological interventions in dementia care. The existing literature lacks a unified definition of reminiscence as it applies to the care of patients with mild dementia and a precise understanding of the concept's applications in nursing care. DATA SOURCES: We derived data from literature searches in CINAHL, PsycINFO, PubMed, Google Scholar, Scopus, and Cochrane Library databases. DESIGN: Concept Analysis. REVIEW METHODS: The review method used was the Walker and Avant's (2019) eight-step method. RESULTS: Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies reminiscence in the care of patients with mild dementia as a cognitive, functional process of recalling and reconstructing distant memories using memory stimuli through mutual interaction with a trained facilitator. CONCLUSION: Clarifying the concept will add validity to the current and future literature, help to develop new research instruments that accurately measure this concept, and function as a framework for holistic nursing interventions.

Analysis and Evaluation of Reed's Theory of Self-Transcendence.

BACKGROUND AND PURPOSE: Reed's theory of self-transcendence is a nursing theory originally derived from inquiry on well-being in older adults. It has since become a viable theory for promoting well-being in all age groups and health/illness experiences. The current theory analysis aimed to uncover the applicability of Reed's theory in promoting individuals' self-transcendence and enhancing well-being. Although there is a wealth of evidence supporting the usefulness of Reed's theory, little is known about how nurses can understand and apply the theory in clinical practice. METHODS: The authors of this current theory analysis adopted Meleis' (2018) approach to theory analysis and evaluation. RESULTS: Reed's theory provides concepts that relate to nursing interventions, which foster the patients' ability to experience multi-level self-transcendence and, thus, enhanced well-being. Applying Reed's theory in clinical practice underpins professional enrichment and brings forth holistic care that assists in facilitating well-being. CONCLUSION: Reed's theory of self-transcendence propels the individual beyond constrictive viewpoints of self and the world. The theory is useful for patients at all life-stages and in many different contexts. RELEVANCE TO CLINICAL PRACTICE: Nurses can draw on Reed's theory to develop activities that enhance patients' environment in order to promote self-transcendence. These theory-based activities can expand healthy self-boundaries intrapersonally, interpersonally, transpersonally, and temporally.

Metasynthesis of Patients' Perspectives about Reminiscence in Dementia Care.

Dementia is a serious condition that has become a public health priority worldwide. Reminiscence is the process of recollecting personal memories from the distant past. This metasynthesis aims to present a thorough analysis of available qualitative literature concerning patients' perspectives about reminiscence in dementia care. A search of CINAHL, PubMed, PsycINFO, Scopus, and ProQuest for qualitative studies published in English between 2005 and 2019 generated 110 studies. Eleven studies were retrieved, assessed for quality using the Critical Appraisal Skills Programme tool, and then synthesized according to Noblit and Hare's seven-step approach. Metaphors were arranged in a list and translated into one another. Five reciprocal themes emerged: Promoting a Comfort Zone, Keeping the Conversation Going, Creating a Dynamic Life, Reliving Painful Memories and Emotional Turmoil, and Strengthening Inner Forces. Increased awareness of patients' perspectives about reminiscence can help design a better framework for interventions that will serve this vulnerable population.

The effects of integrative reminiscence on depressive symptoms in older African Americans.

The purpose of this pilot study was to evaluate the effect of integrative reminiscence on depressive symptoms in older African Americans. Fifty-six community-dwelling participants from a northeast urban setting were randomized into a reminiscence intervention group (n = 19), attention control group (health education; n = 19), or true control group (n = 18). Data were collected pre- and posttest using the Center for Epidemiological Studies Depression Scale. Significant differences were found between groups, F(2, 52) = 8.6, p = .001, eta(2) = .10. Using Holm's method of post hoc analysis, the mean score for the reminiscence group was 6.8 (SD = 4.7), significantly different from the control group 14.6 (SD = 10.1) and the health education group 11.7 (SD = 7.1). Findings demonstrate that integrative reminiscence has a positive effect on decreasing depressive symptoms in older African Americans.

Reminiscence About Physical Activity: A Pilot Study to Reduce Pain in Older Adults.

The aim of the current randomized attention control pilot study was to conduct a preliminary test of a facilitated reminiscence intervention about past physical activity for the effect on increased physical activity and reduced pain in older adults with osteoarthritis. Thirteen older adults were randomized to the facilitated reminiscence or health education group and participated in six individual sessions over 6 weeks. Reminiscence functions, self-reported physical activity, pain intensity, and pain interference with function were measured at baseline and 1 and 3 months postintervention. Facilitated reminiscence did not result in increased physical activity, but instead resulted in increased pain intensity. Content analysis of reminiscence session transcripts indicated most reminiscence was conversational. Benefits from reminiscence included reconnecting with estranged family and distraction from pain. Past physical activities might be helpful to include as part of a program of facilitated integrated reminiscence for individuals with sufficient history of past physical activity. [Res Gerontol Nurs. 2019; 12(4):193-202.].

Reducing Risks for Older Adults With an Interprofessional Community-Academic Partnership: A Case Study.

As the older adult population in the United States increases and diversifies, understanding and reducing risks for hospitalization and institutionalization can reduce burdens for this vulnerable population. Using evidence-based assessment tools to understand medical, psychosocial, pharmacologic, and functional status can aid an interprofessional team to best evaluate older adults at risk. By providing culturally competent care for a diversifying older adult demographic, attention to social determinants can improve health equity for this population. This article describes in a case study exemplar, how one such interprofessional collaborative practice program, Geriatric Outreach and Training with Care (GOT Care!) provides a comprehensive assessment for high-risk older adults, identifies and documents these risks, and shares recommendations and rationale with the primary care provider toward risk reduction and improvement of outcomes.