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Background: Durable learning is the teaching/learning methods that result in retained knowledge that can be transferred to practice. There is limited research on durable learning in nursing education (NE)., Purpose: The purpose of this study was to understand the perceptions of how learners acquire and retain knowledge., Methods: Nursing students and recent graduates were recruited from 2 large universities. Focus groups (n = 7) were audio-recorded, and transcripts were analyzed., Results: Thematic analysis of learners' perceptions revealed (1) effective learner-initiated techniques, (2) effective instructor-initiated techniques, (3) learner-initiated techniques that were not effective, and (4) instructor-initiated techniques in the classroom, clinical practice, and simulation that were not effective., Conclusion: Additional research is needed to understand faculty perspectives on durable learning techniques and their effectiveness. Findings from student, graduate, and faculty perspectives will guide the development of a validated, reliable tool to evaluate durable learning in NE., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Substance use disorder is a public health crisis that is a financial strain to many healthcare systems and communities, but more importantly, it costs lives. Nurses interact with people experiencing substance use disorders and their families in many settings. Nurses can provide insights into the experiences of working with this population. This descriptive qualitative study aimed to examine nurses' experiences and perspectives on caring for people with substance use disorder and their families. After receiving institutional review approval, purposive sampling was used to recruit registered nurses (n = 16) who worked in a variety of settings, and interviews were conducted. Constant comparison analysis was conducted concurrently with data collection until saturation was reached. Code development and refinement was an iterative process. Three themes were generated from the data. Personal Experiences Affect Professional Practice represented participants varied personal experiences and included two subthemes: Reflecting on Personal Experiences and Seeing the Person Beyond the Substance Use Disorder. A second theme is Professional Experiences Affect Professional Practice, which included two subthemes: Professional Experiences are Stressful and Rewarding and Substance Use Disorder Education Increases Confidence. Finally, Stigma Affects Substance Use Disorder Care is the third theme. Future implications range from the individual engaging in self-reflection, to nursing leadership establishing a framework to incorporate reflection and creating a culture that supports and reinforces these activities. The findings of this study support the need for stigma awareness/reduction education starting in undergraduate nursing programmes, throughout practice, with extension to inter-professional groups and the community., (© 2024 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Objectives: Nursing home (NH) leaders remain challenged to deliver quality care, despite the COVID-19 transition to an endemic phase. This study describes NH leadership perspectives on preparing and maintaining quality care during times of diminishing resources as experienced through the COVID-19 pandemic to gain insight on how best to support NHs moving forward., Design: This was a cross-sectional, parallel convergent mixed methods study., Setting and Participants: This study reports quantitative data from N = 5001 NHs across 12 states along with qualitative data from a subsample of NH leaders (N = 15)., Methods: Publicly reported survey data were analyzed using descriptive statistics. Individual in-depth interviews with NH leaders conducted at 12-month follow-up were analyzed using inductive thematic coding organized by a guiding framework. Data were integrated using convergent analysis and a joint display., Results: NH leaders (licensed administrators, clinical directors, and managers) reported resident and staff infection rates, and access to resources (such as personal protective equipment and testing supplies) that aligned with national trends. Leaders described their NHs (n = 14; 43% rural; 71% not for profit) to be in varied states of operational readiness (standard, contingency, crisis) to support quality infection prevention and control (IPC) at the transition to the endemic COVID-19 phase. Leadership reported continued challenges in addressing resident and staff vaccinations, securing testing supplies, obtaining financial resources to maintain acceptable levels of personal protective equipment, continued staffing shortages, and issues in implementing isolation practices in current facilities., Conclusion and Implications: NH leaders continue to struggle delivering quality IPC care post-pandemic and require focused support in several areas. Clinical practice guidelines should include IPC practices to prevent the infection and spread of any COVID-19 variant in this endemic phase. Policies should support continued reporting of IPC-related metrics and adequate funding to account for the long-term financial burden NHs face., Competing Interests: Disclosures The authors declare no conflicts of interest., (Copyright © 2024 Post-Acute and Long-Term Care Medical Association. Published by Elsevier Inc. All rights reserved.)

Introduction: The number of older adults who are cancer survivors is rapidly growing. Evidence is needed to inform interventions to support successful aging among older adults (including older adult cancer survivors). Active engagement with life, that is, spending time with family and/or close friends, may be related to health outcomes, but this concept remains understudied., Methods: We used survey data to assess active engagement among older adults (ages 50 + years) from seven mid-Atlantic US states (n = 2,914), and geocoded their residence to collect collected measures of community availability of social interaction. Outcomes were physical and mental health-related quality of life (HRQoL), assessed with the SF-12. We used multivariable, multilevel linear regression to evaluate relationships between social interactions (i.e., "active engagement with life," or visiting with family and/or friends at least once per week and having at least three close friends, and community-level availability, measured with census tract-level park land and walkability and with county-level availability of social associations) and HRQoL. Finally, we explored differences in these relationships by recent cancer survivorship., Results: Overall, 1,518 (52.3%) participants were actively engaged. Active engagement was associated with higher physical HRQoL (estimate = 0.94, standard error [SE] = 0.46, p = .04) and mental HRQoL (estimate = 2.10, SE = 0.46, p < .001). The relationship between active engagement and physical HRQoL was stronger for recent cancer survivors (estimate = 4.95, SE = 1.84, p < .01) than for the general population (estimate = 1.10, SE = 0.43, p = .01). Community-level availability of social interaction was not associated with HRQoL., Conclusion: Our analysis demonstrated promising associations between active engagement with life and HRQoL among older adults, with large benefits for older cancer survivors. Additional research is needed on how active engagement is associated with better HRQoL, which can inform future policies and programs to optimize the aging process in the US., (© 2024. The Author(s).)

A person-centered approach to advance care planning is recognized as a fundamental need, yet its routine implementation remains a challenge across disparate settings, such as prisons. The purpose of this study was to gain the perspectives of people who are incarcerated about advance care planning. Four focus groups were conducted with people living in 1 men's and 1 women's state prison (n = 26). Handwritten field notes were taken, transcribed, deidentified, and verified before the completion of independent thematic analysis by 2 experienced qualitative researchers. Key themes regarding advance care planning were identified: components of advance care planning, initiation and continuation of advance care planning, barriers to implementing advance care planning, and facilitators to implementing advance care planning. Participants noted several key components related to the name, structure, and content of advance care planning programs. Insights about who should initiate the conversation, when to continue the conversation, and how to deliver education about advance care planning were obtained. Findings contribute to identifying best practices for infusing advance care planning into prisons. Best practices will inform the development of a toolkit of contextually relevant, person-centered approaches to advance care planning that are tailored to meet the unique needs of people who are incarcerated., Competing Interests: The author has no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Demographic shifts toward an older and sicker prison population present challenges for corrections leaders and incarcerated people. The priority of custody and control over care in prisons can deprive people of a modicum of autonomy even about expressing their end-of-life wishes. This study was undertaken to inform best practices and identify essential components of end-of-life care planning (EOLCP) for people who will likely die incarcerated. Individual interviews with formerly incarcerated people (n = 16) provided insights on EOLCP knowledge, perceptions, and future plans as each reflected on experiences while incarcerated. Zoom Video Communications were used for the interviews, and audio recordings were transcribed verbatim, verified, and deidentified prior to thematic analysis. Themes were defined and discussed until consensus was reached between the 2 researchers. End-of-life care planning themes included the following: understanding of and experience with advanced directives/care planning (AD/ACP), defining AD/ACP, timing of AD/ACP accessibility to health care resources, how to approach EOLCP in prison, advantages of EOLCP, and barriers to EOLCP. Formerly incarcerated peoples' knowledge, perceptions, and future plans revealed important considerations when developing a contextually relevant toolkit for EOLCP for people living in prison., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 by The Hospice and Palliative Nurses Association. All rights reserved.)

Background: Social cohesion refers to an individual's sense of belonging to their community and correlates with health outcomes. Rural communities tend to have higher social cohesion than urban communities. Social cohesion is relatively understudied as a factor impacting COVID-19 prevention behaviors. This study explores the associations between social cohesion, rurality, and COVID-19 prevention behaviors., Methods: Participants completed a questionnaire assessing rurality; social cohesion (subscales of (1) attraction to neighborhood, (2) acts of neighboring, and (3) sense of community); COVID-19 behaviors; and demographics. Chi-square tests were used to characterize participant demographics and COVID-19 behaviors. Bivariate and multivariable logistic regression models were used to analyze the relationship between COVID-19 outcomes and rurality, social cohesion, and demographics., Results: Most participants (n = 2,926) were non-Hispanic White (78.2%) and married (60.4%); 36.9% were rural. Rural participants were less likely than urban participants to practice social distancing (78.7% vs 90.6%, P<.001) or stay home when sick (87.7% vs 93.5%, P<.001). Social distancing was more common among participants with higher "attraction to neighborhood" scores (adjusted odds ratio [aOR] = 2.09; 95% confidence interval [CI] = 1.26-3.47) but was less common among participants with higher "acts of neighboring" scores (aOR = 0.59; 95% CI = 0.40-0.88). Staying home when sick was also more common among participants with higher scores on "attraction to neighborhood" (aOR = 2.12; 95% CI = 1.15-3.91), and less common among participants with higher scores on "acts of neighboring" (aOR = 0.53; 95% CI = 0.33-0.86)., Conclusions: Efforts to maximize COVID-19 behavioral prevention, particularly among rural communities, should emphasize the importance of protecting the health of one's neighbors and how to support one's neighbors without face-to-face interactions., (© 2023 The Authors. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.)

Background: Health professions (HP) students must achieve durable learning (DL) to transfer and apply knowledge from the classroom to the clinical setting. This review examines the state of the science of classroom-based DL in HP., Method: The Joanna Briggs Systematic Review Methodology was used. MEDLINE, CINAHL, PsycINFO, and ERIC databases were searched for articles published from 2006 to 2022. A total of 2,000 titles were identified for review, with 51 studies being selected for inclusion., Results: Multiple classroom-based learning strategies generally reported as being effective were identified, including flipped classroom, educational technology, spaced learning, team-based learning, concept mapping and schema, testing, and case study and problem-based learning., Conclusion: Although DL has been proven to be effective in the classroom setting for HP, no one type has been shown to be more effective than others. Additional research is needed within the context of transferring knowledge to clinical settings and in nursing education. [ J Nurs Educ . 2024;63(1):24-31.] .

Social cohesion can influence health. It is higher among rural versus urban residents, but the burden of chronic disease is higher in rural communities. We examined the role of social cohesion in explaining rural/urban differences in healthcare access and health status. Rural (n = 1080) and urban (n = 1846) adults (ages 50+) from seven mid-Atlantic U.S. states completed an online, cross-sectional survey on social cohesion and health. We conducted bivariate and multivariable analyses to evaluate the relationships of rurality and social cohesion with healthcare access and health status. Rural participants had higher social cohesion scores than did urban participants (rural: mean = 61.7, standard error[SE] = 0.40; urban: mean = 60.6, SE = 0.35; adjusted beta = 1.45, SE = 0.54, p < .01). Higher social cohesion was associated with greater healthcare access: last-year check-up: adjusted odds ratio[aOR] = 1.25, 95% confidence interval[CI] = 1.17-1.33; having a personal provider: aOR = 1.11, 95% CI = 1.03-1.18; and being up-to-date with CRC screening: aOR = 1.17, 95% CI = 1.10-1.25. In addition, higher social cohesion was associated with improved health status: higher mental health scores (adjusted beta = 1.03, SE = 0.15, p < .001) and lower body mass index (BMI; beta = -0.26, SE = 0.10, p = .01). Compared to urban participants, rural participants were less likely to have a personal provider, had lower physical and mental health scores, and had higher BMI. Paradoxically, rural residents had higher social cohesion but generally poorer health outcomes than did urban residents, even though higher social cohesion is associated with better health. These findings have implications for research and policy to promote social cohesion and health, particularly for health promotion interventions to reduce disparities experienced by rural residents., Competing Interests: Declaration of Competing Interest The authors have no real or perceived conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study is to continue research and development of the ECAD-P learning system with an emphasis on developing a scalable unit for testing in a larger number of more diverse correctional settings. There are almost 2.3 million US persons incarcerated. Geriatric and end-of-life (EOL) care in corrections is not as equitable as care in the free world. Technological delivery of geriatric training to staff through computer-based learning (CBL) offers a novel approach to improve care and reduce disparities among those who are most vulnerable during confinement., Design/methodology/approach: This mixed methods study built an interactive CBL for multidisciplinary staff to address EOL and geriatric issues in prisons. The CBL was iteratively built and tested prior to launching a full-scale evaluation using a pre/post-intervention design., Findings: Evaluation of the CBL occurred at 7 sites (i.e. 6 state prisons and 1 prison health-care vendor). A total of 241 staff were recruited with 173 completing post-tests. Outcomes were knowledge acquisition regarding care for aging and dying incarcerated persons (i.e. cognitive measure) and attitudes, motivations and values for providing care (i.e. affective measure). Cognitive and affective post-tests were significantly better than at pre-test (all ps < 0.01). ANCOVAs revealed no significant differences for sex or ethnicity., Originality/value: Outcomes reveal that the CBL is acceptable, feasible and usable in corrections. Staff improved their knowledge after receiving the training. Correctional settings face increasing pressures to better address the health care and management needs of aged, chronically ill and dying incarcerated persons. This e-learning holds promise to contribute to better preparation of corrections staff to effectively care for these populations., (© Emerald Publishing Limited.)

Goal: In January 2019, the first cohort of rural hospitals began to operate under the Pennsylvania Rural Health Model for all-payer prospective global budget reimbursement as part of a demonstration funded by the Center for Medicare and Medicaid Innovation. Using information from primary source documents and interviews with key stakeholders, we sought to identify challenges and lessons learned throughout the design, development, and early implementation stages of the model., Methods: We relied on two qualitative research approaches: (1) review of primary source documents such as peer-reviewed publications and news accounts related to the model and (2) semistructured interviews with key staff and stakeholders, including current and former members of the Pennsylvania Department of Health, first-year applicant hospitals, technical assistance providers, and members of state and federal organizations and agencies familiar with the Pennsylvania and Maryland payment reform efforts for rural health and rural hospitals (N = 20)., Principal Findings: We identified four primary attributes that innovative projects such as the model need: (1) a champion at the state and hospital level, significant cooperation across state agencies and between federal and state agencies, and support from nongovernment stakeholders; (2) ongoing engagement and education of all stakeholders, particularly related to rural health disparities, the challenges faced by rural hospitals (especially resource limitations), and the differences between rural and urban health and health service delivery; (3) realistic time lines, noting that stakeholder relationships with hospital leadership develop over many months; and (4) multistakeholder collaboration, because participating hospitals must have ongoing engagement with community members (i.e., consumers of healthcare), nonacute community partners, and other rural hospitals to foster a "rural health movement.", Applications to Practice: A successful Pennsylvania model holds promise for other states seeking to address the needs of rural populations and the hospitals that are vital to those communities. The lessons in this article can assist others in making the transition from volume to value in rural healthcare., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Foundation of the American College of Healthcare Executives.)

The growing aged and dying incarcerated population increases demands on corrections health care. People who are incarcerated can assist in care delivery; however, currently, their training is typically face-to-face, home grown, and variable in content and duration. Six focus groups conducted with peer caregivers (PCs) ( n  = 12) and staff ( n  = 15) identified priority training topics. Three prototype modules (Standard Precautions; Loss and Grief; and Role of the Inmate Caregiver in the Final Hours) were developed in consultation with an advisory board. Face-to-face usability testing with ( n  = 20) PCs and staff confirmed contextual relevance and feasibility of the Inmates Care training. The mean system usability score for all participant segments was 86.5. Inmates Care holds promise to complement nurse-led training with a standardized e-training package.

Objective: To understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work., Study Setting: A purposive sample of 24 health systems in 4 states., Study Design: Data were systematically reviewed to identify how system leaders define and implement initiatives to redesign primary care delivery and identify challenges. Researchers applied codes which were based on the theoretical PCR literature and created new codes to capture emerging themes. Investigators analyzed coded data then produced and applied a thematic analysis to examine how health systems facilitate PCR., Data Collection: Semi-structured telephone interviews with 162 system executives and physician organization leaders from 24 systems., Principal Findings: Leaders at all 24 health systems described initiatives to redesign the delivery of primary care, but many were in the early stages. Respondents described the use of centralized health system resources to facilitate PCR initiatives, such as regionalized care coordinators, and integrated electronic health records. Team-based care, population management, and care coordination were the most commonly described initiatives to transform primary care delivery. Respondents most often cited improving efficiency and enhancing clinician job satisfaction, as motivating factors for team-based care. Changes in payment and risk assumption as well as community needs were commonly cited motivators for population health management and care coordination. Return on investment and the slower than anticipated rate in moving from fee-for-service to value-based payment were noted by multiple respondents as challenges health systems face in redesigning primary care., Conclusions: Given their expanding role in health care and the potential to leverage resources, health systems are promising entities to promote the advancement of PCR. Systems demonstrate interest and engagement in this work but face significant challenges in getting to scale until payment models are in alignment with these efforts., (© Health Research and Educational Trust.)

Background: The opioid epidemic is complex problem. In order to provide a comprehensive intervention plan, understanding all stakeholders' perspectives is essential. Stakeholders in this epidemic include the individual with substance use disorder (SUD), family and friends who care for the person with SUD, the community, the state, and the nation; however, there is limited research that explains the lived experience of individuals with SUD and their families and friends., Objectives: The purpose of the study is to understand the family members (FMs) lived experience with an individual with SUD., Methods: Using an interpretative phenomenological method of inquiry, a semi-structured interview guide was used. Eight participants ( n  = 8; i.e., mothers, a father, a wife, a grandmother, and an aunt) who care for a person with a SUD were interviewed. During the time of the interview, the persons with the SUD were in the following stages of the SUD trajectory: recovery ( n  = 4), active addiction ( n  = 1), and died from an overdose ( n  = 3). Interviews ranged from 60 to 90 minutes were conducted in a quiet, private location chosen by the participant. Interviews were audio recorded, transcribed, and deidentified. Transcripts were uploaded to NVIVO, secure qualitative data storage software., Results: Analysis revealed four themes of the FMs lived experience with an individual with SUD: (1) confirming the addiction, (2) living with addiction, (3) sorting out addiction, and (4) reflecting on addiction. Findings will provide evidence to support comprehensive interventions.

Conducting research in corrections can contribute to improved individual and public health. Challenges to gaining entry to correctional settings to conduct research can impede research productivity, delay the launch of studies and inhibit researchers from proposing health research in corrections. The purpose of this paper is to share lessons learned from a large-scale corrections research project designed to develop computer-based learning modules to train front-line corrections personnel about geriatric and end-of-life care. Key lessons learned include the importance of building a team of experts, planning and punting, coordinating with institutional review boards and examining denied applications to inform future planning. To be effective in a correctional setting, leaders in nursing research and corrections nursing must work together within the contextual nature of prisons and jails to advance evidence-based practices for this vulnerable population. These lessons serve to establish best practices on how to access correctional settings and to enable more research in corrections., (Copyright © 2020 Longwoods Publishing.)

Emerging nurse leaders are not adequately prepared to handle the pervasive health care problems and threats related to the changing environment. Nurse educators prepare nurses for an extensive variety of roles and responsibilities necessary to meet the health care needs of society. The Penn State College of Nursing implemented several initiatives to support environmental sustainability within the college and nursing education. The inclusion of environmental sustainability in nursing education is foundational if students are to become informed members and emerging leaders of a broader health care team, advocates for conscientious and ethical resource use, and contributors to improved patient outcomes., Competing Interests: Disclosure The authors have no commercial or financial conflicts of interest. Funding was received from the Sustainability Institute at Penn State for the Nursing Simulation Laboratory Recycling of Medical Waste and Organic Composting Program. Funding was received from the Penn State College of Nursing for the 3 sustainability projects: Take Back Penn State, Lion Pantry, and Sustainable Filtered Water Alternatives: Local to Global Effects., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: Self-reported memory complaints in older adults are common and may be an early indicator of future cognitive decline or dementia. However, there is wide variety in self-reported memory items that lack consensus on what they intend to measure. This study explored the perspectives of older adults on items currently used to assess self-reported memory. Method: A convenience sample of community dwelling older adults ( n  = 51) completed a free card sorting task of 16 commonly used items assessing self-reports of memory problems. Multidimensional scaling (MDS) was used to extract dimensions that describe the similarities among the self-reported items. Visual maps were created to interpret the content of each dimension and validity of the dimensions was checked using the labels provided by the participants. Results: Three underlying dimensions describing the items were identified: time frame, problem specificity, and framing. These dimensions were supported by participant provided labels. Conclusion: The three identified dimensions suggest that the commonly used self-reported memory items assess substantively different aspects of the same broad concept. To avoid inconsistencies in assessing self-reported memory problems in older adults, we recommend researchers specify the aspects of memory problems that they are interested in and link their items to those aspects. In addition, they should develop items that are a good match to their research question rather than simply selecting items that are commonly used or appear to have high face validity.

Introduction: Corrections agencies are exploring ways to securely and cost-effectively increase access to high-quality, evidence-based educational programs for personnel. Technology-based instructional tools hold strong potential for continuing education. The Institute for Healthcare Improvement's Framework for Going to Full Scale was employed to guide a systematic approach., Purpose: The purpose of this article is to outline and describe the design and development of a media-rich interactive computer-based learning product, Enhancing Care for Aged and Dying in Prison, which addresses geriatric and end-of-life care issues in corrections., Method: Through an iterative process, the research team developed the computer-based educational program that included program and module-specific objectives in alignment with goals and priorities of the end users, detailed evidence-based content that was engaging and visually appealing, and assessments aimed at testing the user's knowledge., Results: The Enhancing Care for Aged and Dying in Prison contains six modules, created under the careful guidance of the research team and the two advisory boards. Contents, including images and testimonials, were selected purposefully and strategically. Module objectives were developed in alignment with the goals and priorities of each module, and assessments tested user knowledge level pre/post module exposure. Completion of the training product advances the research and development necessary to further the goal of full-scale dissemination of the computer-based education., Discussion/conclusions: The goal of this program is to enhance care and improve quality of life for aged and dying inmates. Evidence-based training products are critical in preparing not only forensic nurses who work in corrections but also the broader group of correctional personnel in how to better meet the care needs of incarcerated persons.

The purpose of this article is to explain the strategies used in the "Set-up" phase of developing computer-based education on the care and management of incarcerated people who are older and/or dying. Public health nurses have an opportunity to support efforts in educating corrections staff to enhance health care for older and dying inmates. Such endeavors can promote social justice through inmates receiving evidence-based care that parallels that received by the community at large. "Set-up" is the first of four phases in the Institute for Healthcare Improvement's Framework for Going to Full Scale. Our design approach was threefold and included an environmental scan, a modified Delphi survey, and a usability study. An expert advisory board was consulted throughout the Set-up Phase. Participants for the Delphi Survey had expertise in geriatrics and corrections health care. Usability testing was conducted at two State Correctional Institutions. The Delphi Survey consisted of three Qualtrics surveys. Usability testing examined navigability; detected problems; observed time spent solving problems; identified problem severity; and developed recovery strategies. The Set-up established proof of concept, three prototype modules, and a specifications document to guide future programming. In addition, a Technology Niche Analyses ® provided a preliminary commercialization plan (NIH, 2017). The Set-up phase has been instrumental in exposing the available infrastructure for dissemination of an educational product within corrections and may be a first step in addressing public health concerns on issues in aging. Commercial feasibility of the program and the need for continued research for Developing the Scalable Unit were established., (© 2019 Wiley Periodicals, Inc.)

Objectives: The objective of this study was to describe the experiences of older adults living with subjective memory impairment (SMI) and examine the extent to which SMI severity was associated with impact of SMI on daily life., Method: A mixed methods convergent design was utilized. Participants with SMI (n = 19, mean age 80.7 years) were recruited from community settings. Semi-structured interviews were analyzed using thematic analysis; these findings were integrated with descriptive statistics from questionnaire and cognitive status data., Results: The impact of SMI varied depending on the personal meaning individuals attributed to the experience. Older adults with normal cognition reported episodic memory problem compared to more pervasive problems reported by participants with mild cognitive deficits. The impact of memory problems ranged from frustration/embarrassment to avoidance of social activities, but the degree of emotional impact was not reflected in SMI severity or cognitive status., Conclusion: SMI is common in older adults without dementia but the impact on function and well-being is variable and does not seem to be associated with objective cognition. Future research is needed to validate these associations and to inform the development of SMI measures that accurately reflect older adults' experiences.

Background: Technology-based attention training programs have demonstrated promise in improving cognitive functioning in older adults., Aims and Objectives: The purpose of this study was to evaluate the usability and acceptability of a modified version of a mobile attention training application., Design: A descriptive, mixed-methods design was used to capture older adults' feedback on the usability and acceptability of the modified attention training application., Methods: A convenience sample of older adults (n = 12) participated in three study visits and a one-week testing period of the modified attention training application in their homes. Descriptive statistics were calculated for all quantitative data, and an iterative content analysis was used to characterise participant responses., Results: On average, participants rated the modified attention training application more positively than negatively in terms of usability, interest, enjoyment and satisfaction. The qualitative analyses revealed positive aspects of using the app including working through challenges, perceived benefit and helpfulness of instructions., Conclusions: The modified attention training application was usable by and acceptable to the majority of older adults in our sample who had varying degrees of experience with mobile technology. Future development should specifically consider personal characteristics as well as individual preferences to maximise the potential of the modified attention training application., Implications for Practice: This technology may be helpful for providing memory improvement interventions to older persons with cognitive impairment who do not have access to memory clinics., (© 2017 John Wiley & Sons Ltd.)

Informal family caregivers make a significant contribution to the U.S. health care system, and the need for caregivers will likely increase. Gaining deeper insights into the caregiver experience will provide essential knowledge needed to support the future caregiver workforce delivering care. Discourse analysis is a viable approach in analyzing textual caregiver data that focuses on the end-of-life caregiving experience. The purpose of this study was to conduct an in-depth discourse analytic examination of 13 hours of caregiver interview data, which reveal the multiplicity of shifting stances and perceptions of one caregiver in the midst of end-of-life care, specifically with regard to his perceptions of self (caregiver) and other (care recipient). By isolating a specific but limited set of reference terms used throughout the discourse, we gained systematic glimpses into the mind and perceptions of this single caregiver in relation to his role as caregiver for his terminally ill wife.

The purpose of this study was to examine the infusion of a Toolkit for Enhancing End-of-Life Care in prisons, as well as the outcome and impact on the quality of prison end-of-life care. A total of 74 front-line staff and administrators were in attendance across two post-Toolkit-infusion evaluation visits. Applying qualitative analysis, co-researcher outcome findings were related to activities, community outreach and relations, multidisciplinary team, quality improvement approach, and participatory action research team effects. Organizational outcomes included barriers and challenges, cost, organizational features, sphere of influence, readiness (for change), and sustainability., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity., Purposes: Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training., Methods: An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings., Results: Environmental scan findings focused on content of training, desirable qualities of training, prominence of "homegrown" products, and feasibility of commercial e-learning., Conclusions/implications: This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.

The purpose of this study was to examine the values, beliefs, and perceptions of end-of-life (EOL) care held by inmates caring for peers approaching the end of their lives. The study is part of a broader participatory action research project to infuse enhanced EOL care into state prisons. Face-to-face interviews using a semistructured discussion guide were conducted with 17 male prisoners who were providing care for peers with advanced chronic illness and approaching end of life. Qualitative data were analyzed using content and thematic analyses. Key themes were getting involved, living the role, and transforming self through caring for others. As well, contextual features at the organizational, peer, and personal levels were identified, which either facilitated or impeded inmate caregiving. Provision of enhanced EOL care by inmate peers shows promise for improving prison community relations and morale, reducing suffering, and demonstrating care and compassion within the harsh prison environment. This study provides clear evidence that providing compassionate care for dying peers may result in transformative experiences for inmate caregivers. Implications for correctional nursing practice include providing training for inmate caregivers, including them in team meetings, and implementing grief support programs. Also, upholding nursing's code of ethics and watching for predatory behavior are critical.