Search

Background: Older care receivers of long-term care at home or in residential care are in sustained and close contact with nurses. Consequently, nurses' attitudes towards older adults and their care influences the quality of the delivered care. There is a dearth of research on long-term care nurses' attitudes towards older adults. We aimed to investigate Austrian long-term care (residential care and home care) nurses' attitudes towards adults 80 + and towards geriatric care, as well as possible influencing factors like personal and professional contact with older adults. Methods: An online survey using a cross-sectional design was carried out in fall 2023 with a convenience sample of 875 Austrian nurses (qualified nurses, specialised nurses, nurses without diploma). The questionnaire included three scales: (1) The Aging Semantic Differential which measures general attitudes towards older adults, (2) the Perspectives on Caring for Older People Scale, and (3) the Positive/Negative Contact Scales. Results: Nurses were found to hold neutral to positive attitudes towards adults 80 + and their care. Attitudes towards older adults and their care were positively influenced by positive contact experiences and few negative experiences in their work environment. Nurses in home care had significantly more positive contact with care receivers and held more positive attitudes towards adults 80 + than residential care nurses. Conclusion: These results suggest that intergenerational contact can positively impact attitudes of nurses towards older care receivers. In order to further facilitate positive attitudes, it is recommended to create positive contact opportunities between nurses and care receivers by, for example, implementing intergenerational educational interventions. [ABSTRACT FROM AUTHOR]

Aim Background Methods Results Conclusion Implications for nursing practice and policy To understand the role adaptation process of nurses caring for older adult patients with terminal diseases in Chinese geriatric hospitals.The Chinese government has been encouraging the conversion of secondary general hospitals and some tertiary hospitals into specialized geriatric hospitals; however, research on nurses’ adaptation to caring for older adult patients with terminal diseases in these hospitals is lacking.Individual in‐depth interviews were conducted with 13 registered nurses with a minimum of two years of experience caring for older adults with terminal diseases. Following Glaserian grounded theory, open, selective, and theoretical coding were conducted for data analysis. The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.“Guards of the shining sunset” emerged as the core category. Participants experienced three stages: “chaotic me,” “rational me,” and “inclusive me.” They highlighted two causes, three contexts, two intervention conditions, three strategies, and two consequences.The study shows that nurses play a key role in “guarding the shining sunset” of older adult patients with terminal diseases. The observed role adaptation process provides theoretical support for interventions to assist nurses in becoming inclusive “guards of the shining sunset.”Nurses play a unique role as guardians protecting the end‐of‐life quality of elderly patients. Their role needs to be expanded and strengthened via effective coping strategies and comprehensive legal, education, welfare, and professional promotion support policies. The substantive theory offered by this study may be applied by nurses, department leaders, geriatric hospital managers, and national‐level institutions to underpin future interventions and improve role adaptation. [ABSTRACT FROM AUTHOR]

Background: Nurse staffing levels are increasingly challenged while pressures on healthcare systems are rising. There is a clear need to optimise efficiency in healthcare delivery in order to deliver safe, effective and quality health care. Aim: To understand how nurses working shifts spend their time and explore opportunities to improve efficiency in care delivery. Method: A time-motion study was conducted on three acute care wards in a district general hospital in West Wales; 13 nurses were observed over 14 shifts, each activity undertaken was recorded in real time. Findings: In all, 109 hours were observed. Approximately half of nurses' time is spent delivering direct patient care, with medications administration taking the majority of time. Conclusion: A number of recommendations are made involving processes and workforce modelling with the aim of improving efficiency and safety. Further research would be required to assess the impact of their introduction. [ABSTRACT FROM AUTHOR]

Background: Physical activity is recognized as beneficial for older individuals in preventing falls. Achieving high adherence to exercise programs among the elderly poses challenges for administrations and healthcare systems. This study explored the facilitators and barriers perceived by both the participants and nurse trainers involved in an exercise program aimed at preventing falls in primary healthcare. Methods: Sixteen semi‐structured interviews with elderly people who had participated in the Otago Exercise Program and a focus group of nurse trainers of this program were conducted between October 2018 and September 2019 in primary health care centers in Lleida, Spain. Interviews were transcribed and analyzed using inductive thematic analysis with Atlas.ti 8 software. Results: Analysis revealed five overarching categories and 17 subcategories. Key facilitators included personal motivation, the perceived benefits of exercise, and the supportive role of nurse trainers. Primary barriers encompassed factors such as the excessive duration of the program, not considering personal preferences for individual or group participation, and differences in physical condition among group participants. Conclusions: To increase participation and adherence to exercise programs, it is necessary to consider the important role of the nursing professionals that recommend program enrolment and the participants' personal motivations. The program with group sessions is a model that is easy to integrate into Primary Healthcare centers, which must always take into account the preferences and physical conditions of the participants. [ABSTRACT FROM AUTHOR]

Background: The health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses' accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources. When these challenges mount, residents are put at greater risk of adverse outcomes, such as avoidable clinical deterioration and hospital transfers. This study describes the adaptation and implementation of the emergency nursing framework, HIRAID® (History including Infection risk, Red Flags, Assessment, Interventions, Diagnostics, reassessment, communication and plan)—a tool to assist nurses' assessment, decision-making and care in residential aged care. Methods: The HIRAID® framework will be adapted for residential aged care using a real-time Delphi and panel of aged care and nursing experts. The co-designed HIRAID® Aged Care framework will be trialled in 23 residential aged care homes in Sydney, Australia, in a modified stepped-wedge cluster randomised controlled trial design. All homes will be randomised into one of four clusters. Outcomes of interest include the rate of clinical deterioration events resulting from nurses' actions, the rate of hospital transfers determined to be inappropriate, performance against the national mandatory aged care quality indicators, resident satisfaction with care, nurse and medical staff satisfaction with communication, and the quality of nursing documentation. These outcomes will be evaluated using a combination of qualitative and quantitative analysis of routinely collected resident data, expert assessments of facility documentation events against validated criteria, and pre- and post-intervention surveys of residents, family carers, nurses, and medical staff. Discussion: This protocol describes a pragmatic trial that aims to translate an evidence-based framework from the emergency care context into residential aged care. The adapted HIRAID® Aged Care framework will be the first of its kind to standardise and guide holistic nursing assessment, decision-making, and documentation in residential aged care in Australia. Ethics and dissemination: This research has been approved by the Western Sydney Local Health District Human Research Ethics Committee: 2023/ETH00523. A waiver of consent has been approved to access resident health data and nursing documentation at each participating site. Trial registration: Australian and New Zealand Clinical Trial Registry, ACTRN12623000481673. Registered 12 May 2023. Protocol version: Version 1.0 6 February 2024. [ABSTRACT FROM AUTHOR]

Aim: To determine the effects of nurse‐coordinated interventions in improving readmissions, cumulative hospital stay, mortality, functional ability and quality of life for frail older adults discharged from hospital. Design: Systematic review with meta‐analysis. Methods: A systematic search using key search terms of 'frailty', 'geriatric', 'hospital' and 'nurse'. Covidence was used to screen individual studies. Studies were included that addressed frail older adults, incorporated a significant nursing role in the intervention and were implemented during hospital admission with a focus on transition from hospital to home. Data Sources: This review searched MEDLINE (Ovid), CINAHL (EBSCO), PubMed (EBSCO), Scopus, Embase (Ovid) and Cochrane library for studies published between 2000 and September 2023. Results: Of 7945 abstracts screened, a total 16 randomised controlled trials were identified. The 16 randomised controlled trials had a total of 8795 participants, included in analysis. Due to the heterogeneity of the outcome measures used meta‐analysis could only be completed on readmission (n = 13) and mortality (n = 9). All other remaining outcome measures were reported through narrative synthesis. A total of 59 different outcome measure assessments and tools were used between studies. Meta‐analysis found statistically significant intervention effect at 1‐month readmission only. No other statistically significant effects were found on any other time point or outcome. Conclusion: Nurse‐coordinated interventions have a significant effect on 1‐month readmissions for frail older adults discharged from hospital. The positive effect of interventions on other health outcomes within studies were mixed and indistinct, this is attributed to the large heterogeneity between studies and outcome measures. Relevance to Clinical Practice: This review should inform policy around transitional care recommendations at local, national and international levels. Nurses, who constitute half of the global health workforce, are ideally situated to provide transitional care interventions. Nurse‐coordinated models of care, which identify patient needs and facilitate the continuation of care into the community improve patient outcomes. Implications for the Profession and/or Patient Care: Review findings will be useful for key stakeholders, clinicians and researchers to learn more about the essential elements of nurse‐coordinated transitional care interventions that are best targeted to meet the needs of frail older adults. Impact: When frail older adults experience transitions in care, for example discharging from hospital to home, there is an increased risk of adverse events, such as institutionalisation, hospitalisation, disability and death. Nurse‐coordinated transitional care models have shown to be a potential solution to support adults with specific chronic diseases, but there is more to be known about the effectiveness of interventions in frail older adults. This review demonstrated the positive impact of nurse‐coordinated interventions in improving readmissions for up to 1 month post‐discharge, helping to inform future transitional care interventions to better support the needs of frail older adults. Reporting Method: This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

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

Purpose: This evidence-based initiative assessed the effect of adding a mobility champion to an existing progressive mobility protocol on functional decline in hospitalized older adults as evidenced by recommended discharge to home versus an inpatient rehabilitation facility. Method: Older adults admitted from home to a 47-bed medical-surgical telemetry unit who were assessed as ambulatory, either independently or with assistance (Level 5), and with a progressive mobility order in the electronic health record were included in the initiative. Patient care associates who volunteered to be mobility champions were trained how to safely ambulate patients. Results: Patients who worked with a mobility champion were less likely to be referred to inpatient rehabilitation post discharge for further care due to functional decline. Conclusion: Mobility has a critical role in the maintenance of hospitalized older adults' functional abilities and is a determinate of their post discharge disposition. [Journal of Gerontological Nursing, 50(11), 37–43.] [ABSTRACT FROM AUTHOR]

Purpose: To ascertain current nutritional knowledge and training needs of community-based nurses caring for older adults in the United Kingdom. Method: A descriptive cross-sectional, anonymized, online survey of nurses' knowledge, attitudes, and practices related to older adults' nutrition was developed. Community-based nurses working with older adults in the United Kingdom were recruited via social media and convenience sampling. Results: Responses were received from 194 community-based nurses. Nutritional care was seen as a multidisciplinary responsibility by 62% of participants. Most undertook nutrition screening (93%), were confident in providing nutritional advice (83%), and ease of identifying those in need (88%) was high. However, some aspects of nutritional knowledge were less complete, including recommended daily intakes of protein (60% unsure) and fiber (52% unsure). Conclusion: High confidence in delivering nutritional advice contrasted with uncertainty around some aspects of nutritional knowledge, suggesting opportunities to improve training on the nutritional needs of older adults. [Journal of Gerontological Nursing, 50(11), 13–19.] [ABSTRACT FROM AUTHOR]

Background: Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox. Methods: Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study. Results: Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness. Conclusion/Application to Practice: Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented. [ABSTRACT FROM AUTHOR]

The article discusses the need for geriatric nursing for individuals aged 50 and above living with HIV. It includes a survey to understand the specific requirements for geriatric care among this population, covering aspects such as living care needs, healthcare needs, psychological comfort needs, and social support. The survey also addresses issues related to stigma and discrimination faced by people living with HIV, emphasizing the importance of support and understanding in their social interactions. [Extracted from the article]

Objectives: People living with HIV are aging. This study aimed to assess the factors influencing the requirements for geriatric nursing of older adults living with HIV (OALHIV). Methods: Convenience sampling was used to conduct a survey on the 295 OALHIV aged over 50 in Luzhou, China. Results: OALHIV had few needs for living care needs. Most people indicate a requirement for reducing medical costs. Regarding psychological comfort needs, disease privacy and confidentiality were the greatest requirement. Multivariable regression analyses found that social support had a positive influence on the requirements for geriatric nursing. Conclusion: It is necessary to provide more social support for OALHIV. Most importantly, China should incorporate OALHIV into national pension security plan, integrate various resources and improve social security for them. [ABSTRACT FROM AUTHOR]

Background: In emergency care settings, screening for disease or risk factors for poor health outcomes among older adults can identify those in need of specialist and early intervention. The aim of this study was to identify barriers and facilitators to implementing older person-centred screening in emergency care settings in the Mid-West of Ireland. Methods: This study employed a qualitative descriptive design underpinned by the theoretical domains framework (TDF). This design informs implementation strategy by establishing a theoretical foundation for focused objectives. One on one semi-structured interviews were conducted with a purposive sample of healthcare workers (HCWs) to explore their screening experiences with older adults in emergency care settings. Information power guided sample size calculation. In data analysis, verbatim interview transcripts were deductively mapped to TDF constructs forming meta-themes that revealed specific barriers and facilitators to person-centred screening for older individuals. These findings will directly inform implementation strategies. Results: Three themes were identified; Preconditions to Implementing Older Person-Centred Screening; Knowledge and Skills Required to Implement Older Person-centred Screening and Motivation to Deliver Older Person-Centred Screening. Overall, screening in emergency care settings is a complicated process which is ideally undertaken by knowledgeable and skilled practitioners with a keen awareness of team dynamics and environmental challenges in acute care settings. These practitioners serve as champions and sources of specialist knowledge and practice. Less experienced clinicians seek supervision and support to undertake screening competently and confidently. Education on frailty and aged related syndromes facilitates screening uptake. Recognition of the value of screening is a clear motivator and leadership is vital to sustain screening practices. Conclusions: Screening serves as an entry point for specialist intervention, necessitating a specialist multidisciplinary team (MDT) approach for effective implementation in emergency care settings. Strengthening screening practices for older adults who attend emergency care settings involves employing audit, supervision and tailored supports. Skilled and experienced practitioners play a key role in mentoring and supporting the broader MDT in screening engagement. Long-term and sustainable implementation relies on utilising existing managerial, practice development and educational resources to underpin screening practices. Communication between Emergency Department (ED) staff, the specialist team and wider geriatric team is vital to ensure a cohesive approach to delivering older person-centred care in the ED. [ABSTRACT FROM AUTHOR]

The spiritual health of elderly residents in nursing homes is an essential aspect of their overall health that has been overlooked. There are no specific practical models available in this area. Therefore, the present study aimed to design a model to promote the spiritual health of Muslim elderly residents in nursing homes. This qualitative study is part of a larger study conducted in Iran in 2021 to design a model for the spiritual health of elderly residents in nursing homes in Islamic countries. The first part of the study was conducted using a qualitative method and a grounded theory approach. In the second part, using the findings of the qualitative stage and the theoretical production approach of Walker and Avant (2011), which includes three stages of determining central concepts, reviewing texts, and organizing concepts and statements within a relevant whole, a model for the spiritual health of elderly residents in nursing homes was designed. The resulting model includes assumptions, concepts, objectives, and operational strategies. Some crucial strategies of this model include improving social and organizational infrastructure, spiritual needs assessment, improving the structure and facilities of nursing homes, providing spiritual support, empowering nurses, likewise caregivers, and monitoring and evaluating corrective spiritual care. This model can provide a framework for enhancing the spiritual health of elderly Muslim residents in nursing homes by emphasizing improving the social structure and elderly care centers, assessing spiritual needs, providing spiritual support, and evaluating implemented measures. [ABSTRACT FROM AUTHOR]

Aim: To explore interventions employed to foster speaking‐up behaviours of registered nurses (RNs) working in the care of older people. Design: Scoping review. Methods: The updated Joann Briggs Institute scoping review methodological guidelines were followed. Data Sources: CINAHL, PubMed, PsycINFO, and Scopus were searched. Results: A total of 1691 titles and abstracts were screened, resulting in 11 articles that met the inclusion criteria. Analysis focused upon intervention types, methodologies, speaking up strategies, barriers and effectiveness. Education was the most used intervention. Conclusion: There is a lack of published research on successful interventions to promote speaking‐up behaviours in the care of older people, particularly relating to poor care practices. Evidence of speaking‐up interventions in the residential aged care setting is absent. This highlights the need to develop strategies to support the RN to lead and enable others to raise care concerns. Implications for the Profession and/or Patient Care: Developing strategies that enable staff, care recipients and their families to speak up about care concerns is a vital future area for nursing practice development. Nursing leadership of such strategies is central to improving the quality of care for older people, particularly those living in residential aged care. Impact: Older people receiving care should feel respected and be treated humanely. Evidence suggests this is often not the case. This review found a paucity of interventions to promote speaking‐up about poor care practices among RNs working in the care of older people. Future research needs to address this, to empower RNs and improve the care afforded to older people. Reporting Method: The PRISMA‐ScR (Tricco et al., Annals of Internal Medicine, 169, 467–473, 2018) were adhered to throughout this scoping review. Patient or Public Contribution: No patient or public contribution in this review. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of what critical reflection entails and its potential benefits • To enhance your understanding of some of the reflective models that nurses can use to support them • To consider how you could use critical reflection to enhance your practice. Reflection is an essential aspect of nursing practice that facilitates continuing professional development and practice improvement. Critical reflection is a more in-depth form of reflection and can be described as a creative, dynamic and transformative learning process that enhances practice by promoting self-awareness and critical thinking. Older adults often present with complex and multiple healthcare needs. Engaging in critical reflection can assist nurses to provide the high-quality, person-centred care required to meet those needs, support older people to retain their independence and enhance their well-being. This article discusses critical reflection within the context of nursing older people and describes various models that can be used to support the reflective process. The authors use a practice example to illustrate how using critical reflection in practice can enable nurses to develop a deeper understanding of themselves and use what they have learned to enhance their delivery of person-centred care. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To explore and describe the meaning of nurses working in care for older adults give to the nursing professional identity.A qualitative approach was taken.Semi‐structured interviews were conducted with 50 bachelor and vocational‐educated nurses working in care for older adults. Interviews were conducted between December 2019 and May 2020. Data were analysed and interpreted through inductive content analysis.Five themes embody the meaning of the nursing professional identity of nurses who work in care for older adults. The five themes are: born to care: a lifelong motivation to nursing; nursing through the noise: dedication in a demanding profession; the silent backbone: caught in the crossfire of interdisciplinary teams; learning under pressure: the demand for expanded nursing expertise and against the current: the barriers to advocacy in nursing.The professional nursing identity of nurses working in care for older adults is multi‐faceted. A personal dedication to patient care, where patients ‘human’ aspect is heavily valued, commits nurses to their profession and underscores their dedication to upholding the quality standard in nursing practice.The older adults' nursing identity highlights that nursing deserves acknowledgement as a professional occupation. Nurses should speak to the public about their professional roles to improve the public view of older adult nursing.A clear understanding of the older adult nursing professional identity clarifies specific roles, experiences and expectations. This can help attract and retain nurses whose views of older adult nursing align with the nursing professional identity. This could help resolve nurse turnover and reduce shortages in older adult care.We adhered to Consolidated Criteria For Reporting Qualitative Research guidelines.No patient or public contribution. [ABSTRACT FROM AUTHOR]

This study aims to explore the mediating and moderating effect of health-promoting lifestyles on the relationship between frailty and depressive symptoms to provide a practical reference for effectively promoting the mental health of older adults. A cross-sectional survey of community-dwelling older adults (n = 3107) was conducted in three cities of Ningxia Province, China. Depressive symptoms, frailty, and health-promoting lifestyles were assessed through the 30-item Geriatric Depression Scale, frailty scale, and health-promoting Lifestyle profile-II, respectively. The Bootstrap methods PROCESS program is employed to test the mediation and moderation model. The findings indicated that health-promoting lifestyles are negatively related to depressive symptoms and frailty, while frailty is positively associated with depressive symptoms. Health-promoting lifestyles have mediated the relationship between frailty and depressive symptoms. Besides, the health-promoting lifestyles weakened the positive relationship between frailty and depression symptoms; there existed a moderating effect of health-promoting lifestyles on the relationship between frailty and depression symptoms among older adults. Given the cross-sectional study, it is impossible to make causal inferences. A health-promoting lifestyle might be a protective factor for older adults' health in China. The mediating and moderating effect of a health-promoting lifestyle on the relationship between frailty and depression symptoms among older adults should be integrated to achieve maximum utility. Healthcare practitioners and medical service personnel are recommended to advance health education and publicity, encouraging healthy lifestyles among community-dwelling older adults with frailty to prevent depressive symptoms and promote healthy aging. • Focusing on frailty and depressive symptoms among the Chinese older adults • The relationship is mediated and moderated by health-promoting lifestyle. • First study to explore the moderated and mediated model of the study variables • The relationship should be integrated to achieve maximum utility. [ABSTRACT FROM AUTHOR]

Background. Sarcopenia is prevalent in older adults. It is essential for nurses to sustain updated information regarding the knowledge of sarcopenia, particularly in relation to approaches to diagnosing and addressing sarcopenia. However, there are limited studies examining the attitudes and awareness of nurses in relation to this condition. Objective. To assess the attitude and knowledge of nurses regarding sarcopenia and correlation between positive attitude and scores on knowledge. Materials and Methods. An electronic survey was carried out among the nurses of the Faculty of Medicine, Khon Kaen University, Thailand, during November 2022 and January 2024. This survey encompassed questionnaires aimed at evaluating the nurses' perspectives and understanding of sarcopenia. The participants were invited to complete the survey, and they were returned to the researchers for analysis. Results. A total of 231 nurses were recruited (response rate 46.2%). Only 58.4% of them were familiar with "sarcopenia," while only 16% had confidence in diagnosing it. For general knowledge, they achieved a total score of 19/30 (63.3%). They demonstrated proficiency in "etiology" (75%), while their performance was fair in "management and prevention" (62.5%) and low in "terminology & importance" (50%) and "diagnosis" (50%). The correlation between positive attitude and knowledge on sarcopenia was 0.22 (p < 0.05). Conclusion. Nurses exhibited a reduced awareness regarding "sarcopenia." Their comprehension about terminology, diagnosis, prevention, and management of this condition was limited. There was a weak correlation between positive attitude and knowledge. The findings emphasize the essentiality of augmenting the educational programs to enhance the recognition of sarcopenia among nurses. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention. Methods: The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions. Results: The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification. Conclusion: The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains. [ABSTRACT FROM AUTHOR]

Background: The prevalence of heart failure is increasing owing to the aging of the population, resulting in growing medical costs and an increasing number of patients with multimorbidity. The optimal management of heart failure by general physicians in addition to internal medicine physicians, such as cardiologists, is essential, although the specifics are unclear. In this study, we aimed to determine the differences in heart failure management outcomes among older patients between those managed by general physicians and those managed by internal medicine physicians, especially in terms of hospitalization and mortality rates. Methods: This was a retrospective cohort study of patients with heart failure who visited a community hospital in Japan. Patients with heart failure were selected based on International Classification of Diseases codes from electronic medical record data over 9 years, from September 2015 to August 2023. The independent variables were whether a general physician treated the patient; the primary outcome was death; the secondary outcome was hospitalization; and the covariates were patient background, including comorbidities. Multiple logistic regression analysis was used to evaluate the association between being managed by a general physician and death and hospitalization, after adjusting for confounding factors. Results: A total of 1032 patients with heart failure were identified, with a mean age of 82.4 years, and 48.9% were men. Patients treated by general physicians were older, were more likely to have dementia and were more likely to need care than those treated by internal medicine physicians. Being treated by a general physician was significantly negatively associated with death (odds ratio [OR], 0.62) and hospitalization (OR, 0.73). Conclusions: In Japan, where medical specialties are increasingly differentiated, the comprehensive management of older patients with heart failure and multiple comorbidities by general physicians may reduce hospitalization and mortality rates. Appropriate education of general physicians and an increase in their numbers may prove essential for the successful management of patients with heart failure in aging communities. [ABSTRACT FROM AUTHOR]

The article explores the challenges faced by internationally qualified nurses when they migrate to a new country, focusing on the ethical concerns surrounding international nurse recruitment. It specifically discusses the case of New Zealand, which has a high percentage of internationally qualified nurses but is currently experiencing a cooling nursing employment market. The article raises questions about the responsibility of governments and agencies in ensuring that nurses are not recruited into situations of employment uncertainty. It also highlights the difficulties faced by international nurses in adapting to a new healthcare system, culture, and workplace, emphasizing the need for support and orientation programs. [Extracted from the article]

The article explores key areas which can improve efficiency, increase satisfaction, and build and sustain nurses to response to the aging population around the world. Topics discussed include the nursing shortages worldwide, the need to promote the specialty of gerontological nursing, and the relevance of older person nursing for clinical nursing practice.

Elder abuse, a pervasive and distressing phenomenon, continues to pose a significant challenge globally, affecting older adults across diverse socioeconomic backgrounds. This article provides an overview of the prevalence of elder abuse, highlighting its multifaceted nature, risk factors and the imperative need for intervention and prevention strategies. A synthesis of empirical studies, meta-analyses and reputable sources is used to delineate the prevalence rates and patterns of elder abuse across various geographical regions. [ABSTRACT FROM AUTHOR]

Objectives Religious exemptions (exceptions to nondiscrimination laws for individual religious/moral beliefs) in health care have surged, negatively affecting LGBTQ+ older adults in nursing homes with some of the highest caregiving needs. Given job differences between floor staff and managers, this study asks: How does meaning-making differ between nursing home floor staff and managers when staff refuse to care for LGBTQ+ residents? To answer this question, this study uses social coherence as a conceptual framework to understand the process of reflection that staff employ when a colleague invokes a religious exemption to care. Methods This qualitative comparative study uses in-depth semistructured interviews to compare responses from nursing home floor staff and managers (n  = 80). Qualitative content analysis incorporated inductive and deductive coding approaches. Results Staff invoked 5 frames to reach social coherence: fairness, resident safety and comfort, individual religious beliefs, job obligations, and laws/policies. Floor staff and managers invoked the same 2 reasons (fairness, resident safety and comfort) to reach social coherence. However, floor staff differed from managers by also invoking individual religious beliefs and job obligations; whereas managers turned to laws and policies to reconcile tensions between religious rights and LGBTQ+ resident rights to care. Discussion In an increasingly polarized world, findings from this study illuminate nuances (and potential new areas of allyship) in how floor staff and managers understand and use various frames when deciding whether or not to accommodate a colleague who refuses care to an LGBTQ+ resident because of religious or moral reasons. [ABSTRACT FROM AUTHOR]

Older adults often present with multiple comorbidities and face significant postoperative complications. This study aimed to describe the role of Nurse Practitioner (NP)-led orthogeriatric services in managing hip fracture patients. We conducted a review of health records of older adults with hip and proximal femoral fractures between July 2017 and June 2018, presenting descriptive statistics on patient characteristics, surgical outcomes, and the involvement of orthogeriatric services. A total of 197 participants were included, with a majority being female (n = 132; 67.0%). Most patients (53.8%; n = 106) had between five and nine pre-existing conditions. Among the 192 patients who underwent surgery, 69.8% (n = 134) experienced up to four surgical complications. The Nurse Practitioner provided care to 89.1% (n = 163) of the patients within the orthogeriatric service, with half of the patients (n = 82) requiring at least five NP interventions to manage complex pre- and postoperative needs. Refining the NP-led model could potentially help reduce the burden on physicians and surgeons in treating complex medical conditions, especially in settings where geriatricians may not be readily available. [ABSTRACT FROM AUTHOR]

Purpose: Despite the importance of measuring delirium severity in patients with Alzheimer's disease and related dementias (ADRD), no validated instrument currently exists. Our goal was to generate items for use in such an instrument. Method: An interdisciplinary expert panel developed items to assess seven domains and 21 subdomains of delirium severity. Nursing experts provided input on items. Results: Experts achieved consensus on 21 items, including best respondents for each item, and appropriate look-back periods. Nursing experts emphasized the need for educating nursing staff and obtaining information from caregivers. Conclusion: Careful, nuanced identification of distinguishing features is key for generating items for measuring delirium severity in persons with ADRD. Once developed, engaging nurses will be essential to facilitate adoption and relevance of the tool. [Journal of Gerontological Nursing, 50(9), 24–30.] [ABSTRACT FROM AUTHOR]

Background. In recent years, the size of geriatric population seems to have grown larger than that of younger children and is expected to grow even larger in few years from now. As older individuals are more vulnerable to health concerns and loneliness, it is necessary to focus on providing them opportunities for healthy ageing. Animalassisted therapy (AAT) has emerged as one of the simple yet effective approach to enhance physical, psychological, and social well-being in older adults. Methods. This review article presents collective information from various experiments on AAT's effectiveness in promoting healthy ageing. Results. The physiological impacts of AAT, on cardiovascular health, mobility, and day to day activities have been discussed. The psychological benefits of AAT, such as improvement of mood, cognition, and alleviation of anxiety, loneliness, and depression, are explored. This review also presents the possible mechanisms underlying the effectiveness of AAT, such as release of oxytocin, dopamine, and endorphins, which contribute to emotional well-being along with reduction of stress. The human-animal bond established during AAT sessions is discussed as a significant factor in promoting positive outcomes. Challenges faced and limitations involved in employing therapy animals within ageing populations are also discussed. Conclusions. Avenues for future research and potential applications of AAT in diverse healthcare settings are proposed, emphasizing the need for further empirical investigation to fully elucidate the mechanisms and benefits of AAT for healthy ageing. Through this comprehensive review, we aim to highlight the potential of AAT as a holistic intervention to enhance the well-being of older adults, providing valuable insights for healthcare practitioners, researchers, and policymakers invested in promoting healthy ageing strategies. Clin Ter 2024; 175 (5):362-369 doi: 10.7417/ CT.2024.5126 [ABSTRACT FROM AUTHOR]

Aim: To the determinants and the underlying mechanism of health literacy, social support, and resilience on the health‐related quality of life (HRQoL) among older stroke survivors. Design: A cross‐sectional design was applied at four comprehensive hospitals in Chongqing via convenience sampling from January 2020 to June 2021. Methods: Health literacy, social support, and resilience were designed as independent variables, and HRQoL was measured as a dependent variable. Structural equation modelling with the bootstrap method was used to test the hypotheses. Results: The theoretically derived model exhibited a good fit (χ2/df ratio = 2.830, GFI = 0.987, CFI = 0.978, RMSEA = 0.066). Health literacy (β = 0.12, p < 0.05) and social support (β = 0.14, p < 0.05) directly affect HRQoL. Resilience (β = 0.40, p < 0.01) also mediated the relationship between health literacy, social support, and HRQoL. The three variables explaining 29.0% of HRQoL variance. Patient or Public Contribution: There was no direct patient or public involvement in the design, conduct, or reporting of this study. Participants were recruited through convenience sampling from four comprehensive hospitals in Chongqing, and their perspectives or contributions were not explicitly sought. The study focused on examining the determinants and underlying mechanism of health literacy, social support, and resilience on the health‐related quality of life among older stroke survivors. Nonetheless, the findings of this research may inform the development of interventions aimed at improving the health‐related quality of life in post‐stroke older patients. [ABSTRACT FROM AUTHOR]

Nurses play a critical role in caring for elderly patients; however, the emphasis on aging care in undergraduate programs may be insufficient. The present study aims at identifying the relevance given to theoretical and/or practical gerontological and geriatric contents in undergraduate study plans in Portugal and Spain. Presenting a two-part investigation, an integrative review approach examines nursing education on a global scale and a comparative analysis, using Bereday's comparative method, to assess the nursing curricula between Portugal and Spain. The search found 117 documents, with 16 being included. Studies covered diverse educational practices in geriatric and gerontological nursing, emphasizing curriculum development, faculty expertise, practical training, attitudes towards elderly care, and future directions. The comparative analysis of nursing curricula revealed that Portugal places a priority on building foundational theoretical knowledge in the first year and then gradually integrating practical training. In contrast, Spain emphasizes an extensive and integrated approach with a strong focus on practical skills and comprehensive assessments. Our research emphasizes the need to incorporate aging-focused education into nursing curricula and update the curriculum, providing hands-on training with early exposure to these environments. Additionally, simulation classes can enhance critical thinking by allowing students to experience aging effects firsthand. [ABSTRACT FROM AUTHOR]

Purpose: To investigate risk factors for falls in hospitalized older adults to justify the adoption of targeted nursing measures. Method: Meta-analysis was used to synthesize national and international published studies on risk factors for falls in hospitalized older adults. Results: A total of 10 studies were included. Administration of psychotropic drugs, limb weakness, weak walking ability or unsteady gait, visual impairment, and history of falls were risk factors for the occur-rence of falls in hospitalized older adults. Administration of psychotropic drugs had the highest association with falls (odds ratio [OR] = 1.86; 95% confidence interval [CI] [0.58, 3.14]) followed by limb weakness (OR = 1.59; 95% CI [0.26, 2.92]) and visual impairment (OR = 1.51; 95% CI [0.22, 2.80]). The lowest combined OR for the association between weak walking ability or unsteady gait and falls was 1.05 (95% CI [0.60, 1.50]) compared with 1.38 (95% CI [1.15, 1.60]) for history of falls. Conclusion: The current meta-analysis derived risk factors for falls in hospitalized older adults, with results having greater stability and reliability than those of a single study. [Research in Gerontological Nursing, 17(5), 238–245.] [ABSTRACT FROM AUTHOR]

Objective: Burnout syndrome can have a negative impact on people who work in occupations that require close interaction with others, contributing to a decline in their psychological well‐being. This study aimed to examine the effectiveness of Group Interpersonal Therapy (IPT‐G) in reducing burnout among care workers for older adults in a Turkish long‐term care facility. Methods: The study employed a pretest–post‐test randomised experimental design. Fifty care workers scoring 27 or above on emotional exhaustion and 10 or above on depersonalisation subscales of the Maslach Burnout Inventory (MBI) were randomly assigned to the intervention or control group for 8 weeks. The study utilised the World Health Organization (WHO) Group Interpersonal Therapy for Depression manual as a guide. The post‐test was conducted immediately after the last session of the intervention. Results: In comparing pre‐ and post‐test scores of the intervention group, a statistically significant difference was found in overall burnout scores (pretest M = 74.10, post‐test M = 63.08, p < 0.001; d = 1.12). Additionally, emotional exhaustion scores (pretest M = 30.99, post‐test M = 24.89, p < 0.001; d = 1.11) and depersonalisation scores (pretest M = 12.76, post‐test M = 8.53, p < 0.001; d = 1.69) exhibited significant differences. However, no significant difference was observed in personal accomplishment scores (p > 0.05). The control group had no significant differences concerning the overall burnout scores and all three subscales (p > 0.05). Conclusion: The IPT‐G used in this study effectively decreased burnout among care workers in a long‐term care facility in Türkiye. In addition, the participants reported high satisfaction with the IPT‐G program. Implications for Practice: Our results support the usefulness of the IPT‐G program for care workers in long‐term care facilities considering adding it to their occupational health management. This research aimed to determine whether IPT‐G successfully decreased care worker burnout. Future research focusing on various types of healthcare workers in long‐term care facilities and examining factors such as burnout, job satisfaction and self‐efficacy could provide more information on the effects of IPT‐G. [ABSTRACT FROM AUTHOR]

Geriatric nurses are both ageing and at high risk for developing burnout symptoms. Burnout symptomatology relates to lower job performance and lower care quality. Developing impairments in cognitive functioning might explain such relationships. We examined prospective relationships of burnout symptoms and cognitive functioning (memory and executive functions objectively assessed). We included age as well as several control variables as predictors and searched for interaction effects to explain prior inconsistencies. German nurses (N = 191) from geriatric care filled out self-administered questionnaires at the workplace (t1) and performed a comprehensive cognitive test battery in the lab six months later at t2. Results showed expected age effects on executive functions but no relationships between burnout symptoms and cognitive functioning nor any interaction effects with age. Exhausted subjects had a slightly better performance in updating. The nearly robust null findings in this study indicate that the relationship of burnout symptoms and decreased cognitive functioning may be a predominantly clinical issue. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To identify nursing students’ attitudes toward older people. METHOD: Second-year undergraduate nursing students were invited to complete a questionnaire at the beginning of the geriatric nursing curricular unit. A quantitative study was conducted by administering the validated Portuguese version of Kogan’s attitudes toward old people scale (KOAP). RESULTS: The sample included 39 students who answered the data collection instrument. The mean KOAP score was 135.56, which was slightly above the median value (119). No statistically significant relationships were found between any of the variables: gender, age, experience with older people, and living with older people. CONCLUSIONS: The nursing students’ mean score for attitude toward older people was slightly positive, which could serve as a starting point for the development of an intervention to modify their attitudes with respect to aging.

OBJECTIVE: To describe the perception of a multidisciplinary team on the use of physical restraint in older adults. METHODS: Qualitative research conducted with 58 health professionals in two long term care facilities for older adults located in the state of Rio de Janeiro, Brazil. Semi-structured interviews were further analyzed using thematic content analysis. The data was collected from November 2017 to June 2018. RESULTS: Twenty-one initial codes were identified and organized in three categories: team perception of the consequences and risks of a physical restraint (the patient's safety paradox); implications of the decision of physical restraint of the older adults; and strategies to restrain and not restrain. CONCLUSIONS: The results reinforce the need for training of professionals on restraint-free alternatives of care, as part promoting a culture of care that respects the right to freedom and the dignity of people — especially the most vulnerable ones.

This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated. [ABSTRACT FROM AUTHOR]

Background: In the wake of an increasingly ageing population, Norway has a growing need for healthcare workers, especially in nursing homes. This study explored the employment experiences of migrant nursing assistants working in elderly care in Norway. Methods: A qualitative interview‐based study was carried out between March and August 2020. In‐depth, semi‐structured interviews were performed with 13 purposively selected immigrant nursing assistants working in a nursing home within Western Norway. Data were thematically analysed. Results: Migrant nursing assistants working in Norwegian elderly care faced mixed experiences. On the one hand, study participants experienced several barriers in their workplace, resulting from insufficient command of the Norwegian language, heavy workload and mistreatment and discrimination by both patients and colleagues. On the other hand, participants cited the financial compensation from work, the meaningfulness derived from helping others and the flexible day‐off requests as workplace facilitators. Participants also made continuous efforts to learn the Norwegian language and to build good relations with their co‐workers. Conclusion: There is a need to enhance migrant nursing assistants' positive experiences in the Norwegian eldercare sector by making targeted workplace reforms and fostering a supportive and inclusive environment. [ABSTRACT FROM AUTHOR]

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

Abstract Background As the global population continues to age, social realities such as advanced age, disability and living alone are coming to the fore, and the demand for medical care and health services for the elderly is increasing dramatically, especially in geriatrics. Given the important role geriatric nurses play in the diagnosis and treatment of diseases and rehabilitation of elderly patients, and due to the uniqueness and complexity of geriatric work, this requires geriatric nurses not only to have the competencies that are available in general nursing, but also to ensure that they have sufficient geriatric core competencies in order to effectively meet the needs of the patients and accelerate their recovery. Although previous studies have investigated the core competencies of nursing staff, there has been little research on geriatric nurses’ core geriatric nursing competencies and their predictors. The aim of this study was to investigate the current status of the geriatric nursing competency inventory (GNCI) among geriatric nurses using latent profiling, to identify potential subgroups and their population characteristics, and to explore the factors that influence the potential subgroups. Methods From January to March 2024, 1,313 geriatric nurses in Hefei City were selected by stratified cluster sampling method and surveyed with general information questionnaire, geriatric nursing competency inventory, and occupational coping self-efficacy scale for nurses(OCSE-N). Potential subgroups of GNCI differences among geriatric nurses were identified by latent profile analysis (LPA). Multiple logistic regression analyses were used to explore the factors influencing the GNCI of geriatric nurses with different latent profiles. Results Geriatric nurses’ OCSE-N was positively correlated with GNCI, and the GNCI score was 123.06(41.60), which indicated that geriatric nurses’ GNCI was at an intermediate level. The OCSE-N score was 35.44(7.34), which was at a relatively high level. There was heterogeneity in the GNCI of geriatric nurses, which was classified into three subgroups i.e., Low-competency group, Medium-competency group, High-competency group. The results of multiple logistic regression analyses showed that OCSE-N, title, whether or not they attended geriatric nurse specialist training, and specialist nurse status were predictors of GNCI among geriatric nurses (P

ABSTRACT Aims Design Methods Data Sources Results Conclusions Impact Reporting Method Patient or Public Contribution What Does This Paper Contribute to the Wider Global Clinical Community To identify the evidence of gender disparities in frailty and explore the factors contributing to male–female differences.A longitudinal study.A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca–Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty.The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University.Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate.The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender‐specific geriatric care policies are needed in order to address gender inequality in health.The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender‐specific perspective in order to achieve health equity.This study has adhered to the STROBE guideline.No Patient or Public Contribution. This study provided implications on gender‐specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing. [ABSTRACT FROM AUTHOR]

Singapore’s population is aging. Currently, 15% of Singapore’s population is 65 years and above. Low birth rates and high life expectancy have fueled a high demand for geriatric care in Singapore. This research explores the role of knowledge that nursing students have about aging, their attitudes toward older adults, and their inclination to pursue careers in geriatric nursing. This cross-sectional study administered standardized scales to understand 347 nursing students’ knowledge (Palmore Facts on Aging Quiz), attitudes (Kogan’s Attitudes toward Older People) and inclinations (Nolan’s Intent to Work with Older People). Results showed that Singapore nursing students have a moderate level of knowledge about aging and showed a strong willingness to work with older adults. Younger students displayed higher knowledge, better attitudes, and a greater inclination to work with older adults than older students. Furthermore, local students exhibited higher knowledge, more positive attitudes, and greater interest in working with older adults than their international counterparts. This study, conducted during the COVID-19 pandemic, revealed valuable insights into our nursing students’ perspectives on aging. Nursing students displayed a moderate understanding of aging, a positive attitude toward older adults and a strong desire to serve them, suggesting a potential future workforce ready to fulfill the demands of Singapore’s aging population. This insight is valuable for educators, guiding them to bridge knowledge gaps and foster open conversations about aging. [ABSTRACT FROM AUTHOR]

Aim: To identify Egyptian older adults' awareness, concerns, and mental health about the monkeypox outbreak. Background: In light of the ongoing COVID-19 pandemic, monkeypox disease is receiving more attention. The monkeypox virus outbreak has posed a global concern, especially to older adults with comorbidities. Natural disasters, and endemic affect older persons' mental health. Design: A cross-sectional descriptive design was followed. Methods: 254 older adults were recruited from three outpatient clinics using consecutive sampling using four tools. Results: 74.0% of older study participants were unaware of monkeypox. Gender, level of education, residence, worry about contracting monkeypox infection, and mental distress are predictors of awareness about monkeypox (p <.001). Worry of contracting monkeypox infection was common among female participants (p =.038), highly educated (p =.001), who had a low level of awareness and high level of mental distress (p =.001 for both). Conclusion: Awareness of monkeypox was associated with worry and mental distress. Gerontological nurses have a vital role in contacting older adults and providing care and education that decreases worry and preserves minds and feelings, improving their quality of life. Establishing a national strategic planning and crisis prevention framework to alleviate psychological distress and prevent mental health issues from deteriorating in this group is crucial. [ABSTRACT FROM AUTHOR]

This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, and end-of-life care. Through semi-structured interviews with 15 nurses in Riyadh, Saudi Arabia, the research highlights the complexities of obtaining informed consent from patients with cognitive impairments and the ethical dilemmas of balancing autonomy and safety. The management of polypharmacy emerged as a significant concern, with nurses emphasizing the importance of thorough documentation and coordination among healthcare providers to prevent adverse drug interactions. End-of-life care and advance directives posed further challenges, particularly when family members disagreed with patients' documented wishes. The study underscores the need for comprehensive strategies, including ongoing education, clear communication, and supportive institutional policies, to address these issues effectively. The findings suggest that enhancing nurses' understanding of ethical principles and legal requirements is crucial for improving patient care and ensuring compliance with regulatory standards. Future research should aim to develop evidence-based guidelines to support nursing practice in managing these ethical and legal challenges. [ABSTRACT FROM AUTHOR]

Background: The Geriatrics Health Behavior Questionnaire (GHBQ) is essential for assessing health-related behaviors among older adults populations. This study focuses on the translation, cultural adaptation, and psychometric evaluation of the Arabic version of the GHBQ to ensure its relevance and accuracy for Arabic-speaking older adults individuals. Methods: This cross-sectional study was conducted at the Cairo University Educational Hospital's outpatient clinic. The GHBQ was translated and culturally adapted through a systematic process, including initial translation, back-translation, expert review, and pilot testing. The psychometric properties of the Arabic-translated GHBQ were evaluated using a sample of 200 older adults Arabic-speaking participants. Reliability was assessed using Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC). Validity was evaluated through Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results: The Arabic GHBQ demonstrated excellent reliability with Cronbach's alpha values ranging from 0.74 to 0.87 across subscales and ICC values confirming reproducibility (ICC = 0.82). The CVI indicated strong content validity (average CVI = 0.91). EFA revealed a five-factor structure, explaining 72% of the variance, with all factor loadings exceeding 0.60. CFA supported the questionnaire's structure with fit indices meeting recommended criteria: χ²/df = 2.05, NFI = 0.92, TLI = 0.94, GFI = 0.90, SRMR = 0.05, AIC = 140.35, and BIC = 160.22. Criterion validity was confirmed through significant correlations with established health behavior measures (r = 0.63, p < 0.001). Conclusions: The culturally adapted Arabic version of the GHBQ is a reliable and valid tool for assessing health behaviors in the older adults population in Egypt. This instrument can aid healthcare providers in identifying and addressing health behaviors, ultimately improving the well-being of this demographic. Future research should focus on expanding the sample and comparing the GHBQ with other similar tools used in Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Geriatric emergency management (GEM) nursing has emerged as a critical response to the increasing number of emergency department (ED) visits by older people, particularly in North America and specifically in Canada. This demographic often presents with complex medical conditions and atypical disease manifestations. The GEM programme, implemented in Ontario, Canada, aims to provide targeted assessment and establish community connections for frail older individuals, helping prevent their decline and loss of independence. There is a significant demand for specialised wound care services in EDs and frontline ED staff have a limited capacity to provide these. Advanced wound management was integrated into the GEM nursing scope of practice in an initiative. Patients who received wound care from GEM nurses and clinical nurse specialists had positive outcomes; those treated by GEM nurses had shorter wait times. Although the wound care role requires additional training and adds to the GEM nurse workload, the advantages appear substantial. Merging geriatric-focused care with specialist wound management may significantly benefit the care and satisfaction of older people attending the ED, as well as improve patient flow in the ED. This initiative requires further consideration by healthcare leaders and policymakers. [ABSTRACT FROM AUTHOR]

Given the increased demand for health professionals to work with older adults, research on the factors that influence students' career choices is critical in order to increase the popularity of gerontology. The purpose of this study was to investigate willingness and related factors of undergraduate nursing students to work with older adults. A descriptive and cross-sectional study was conducted with 579 undergraduate nursing students in Turkiye. The data were collected using the descriptive characteristics form, the 12-item expectations regarding aging scale (ERA-12), Kogan's attitudes toward old people scale (KAOP), and willingness to work with elderly people scale (WEPS). Descriptive statistics and multiple regression were used for data analysis. The WEPS, ERA-12, and KAOP mean score of the students were 68.57 ± 11.54 (range: 20–120), 59.83 ± 15.09 (range: 0–100), and 142.98 ± 18.63 (range: 34–238), respectively. Expectations regarding aging, attitudes toward older adults, prior experience caring for older adults, and completing an elective geriatric nursing course positively predicted the total score of WEPS. These variables accounted for 14% of total variance of WEPS (R2: 0.137, F: 12.995, p <.001). Age, sex, and academic year also positively predicted the total score of WEPS, but it was not statistically significant. The willingness of nursing students to work with older adults was moderate. To enhance nursing students' willingness to work with older adults, nursing programs should foster a positive attitude toward older adults and expectations regarding aging. Greater willingness of nursing students to care for older adults will eventually improve the quality of care for the geriatric population. [ABSTRACT FROM AUTHOR]

With the world's population aging, geriatric care is more important than ever before. However, many studies have shown that nursing students are less likely to choose geriatric nursing as career than other nursing fields. Nursing students play a vital role in the development of geriatric nursing. Thus, this study aimed to explore the current situation of nursing students' career choice motivation in geriatric nursing and to analyze the influencing factors. A cross-sectional survey was conducted. This study was performed from March 2021 to September 2022 among nursing students from four universities in Shandong Province, China. Data on nursing students' attitudes toward geriatric, aging anxiety, knowledge about aging, and career choice motivation were collected through questionnaires, and analyzed by ANOVA, Pearson correlation, and multiple linear regression. A total of 1007 questionnaires were collected. Nursing students' career expectancy score for geriatric nursing was 19.06 ± 4.00 and the value score was 46.65 ± 7.50. The study revealed that gender, education level, taking geriatric care courses, experience in caring for older adults, believing in bright prospects for geriatric care, geriatric attitudes, and aging anxiety were critical factors that influenced nursing students' motivation in choosing a career in geriatric nursing. Nursing students' motivation to choose a career in geriatric care needs to be improved in China. Nursing educators should take interventions to actively guide students and promote the cultivation of geriatric nursing talent. [ABSTRACT FROM AUTHOR]

This editorial comments on the article by Mueller et al. [ABSTRACT FROM AUTHOR]

The compelling evidence that higher RN to resident ratios improve health outcomes in nursing homes underscores the necessity of implementing evidence‐based RN nursing home staffing standards. However, there are other dimensions to RN staffing in nursing homes beyond the numbers or hours per resident day (HPRD) that influence the quality of care. Without attending to a broader focus on nurse staffing, the benefits of increased RN staffing levels will not be achieved. This article outlines how RN HPRD can be maximized by magnifying the RN's scope of practice and attending to how nursing care is organized and delivered in nursing homes using a nursing practice model framework. This framework addresses the accountability of the RN and the RN's role in supporting and facilitating: (1) collective decision‐making among the nursing staff about the care of residents and the work environment, (2) continuity of information among care providers, and (3) ensuring residents have continuity with the care providers assigned to their care. Attention to the RN's expertise in gerontological nursing and leadership capacity further leverages the RN's ability to influence the quality of care for nursing homes residents. See related Editorial by Bakerjian. [ABSTRACT FROM AUTHOR]