Search

BACKGROUND: Few studies examine older African Americans' beliefs and attitudes toward depression, yet this population is more likely than other ethnic groups to be underdiagnosed and undertreated for depression. OBJECTIVE: To examine the beliefs and attitudes about depression in a sample of community-dwelling older African Americans. STUDY DESIGN: A qualitative approach embedded within a survey design was used. The sample included 51 community-dwelling African Americans older than age 60 who were recruited from a northeast state. Participants' descriptions of the meaning of depression were analyzed using editing analysis style. RESULTS: Four major themes emerged from the data: (a) Keeping the Bully Out, (b) God Will Provide, (c) Losing Control, and (d) That's Not Me. CONCLUSIONS: These data can assist mental health nurses in understanding older African Americans' beliefs and attitudes toward depression. Culturally sensitive educational programs, reminiscence interventions, and suggestions to assist with screening for depression in this population are discussed. [ABSTRACT FROM AUTHOR]

The increase in our minority elder population has created a need to develop innovative programs that prepares students who are competent in gerontological nursing skills and sensitive to cultural differences. The purpose of this pilot study was to test the effects of a reminiscence education program on BSN students' cultural self-efficacy in caring for elders. An interrupted time series design with a nonequivalent, no-treatment control group was used with 64 nursing students recruited from a northeast university in the United States. The intervention consisted of a two-hour reminiscence education program and a 13 week period in which the experimental group implemented integrative reminiscence with elders during their community health practicum. The eldercare cultural self-efficacy scale was the outcome measure. Results indicated that students receiving the reminiscence education program demonstrated significantly higher levels of eldercare cultural self-efficacy F(1, 62)=5.34, p=0.024 than those not receiving the intervention. Reminiscence education programs implemented as part of clinical practicums may assist to increase nursing students' perceptions of confidence in caring for elders. Implications for nursing education and the care of diverse elders are discussed. [ABSTRACT FROM AUTHOR]

The projected increase in the diversity of the older adult population in the United States has generated a demand for nurses prepared to care for older adults from different cultural backgrounds. Nurse educators are challenged to develop innovative experiences to help prepare students who are competent in gerontological nursing and sensitive to cultural differences. The purpose of this study was to examine baccalaureate nursing students' perceptions of their reminiscence experiences with older adults. Forty-one nursing students who participated in a reminiscence education program during their clinical practicum completed an open-ended questionnaire. Data were analyzed, and three major themes emerged: 'Making a Connection,' 'Seeing the World Through Their Eyes,' and 'Benefits of Reminiscence.' Results indicate that implementing reminiscence education programs in clinical experiences can help students develop gerontological nursing skills, increase their cultural sensitivity, and improve their care of older adults. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the development and psychometric evaluation of the Eldercare Cultural Self-Efficacy Scale (ECSES). Bandura's Theory of Self-Efficacy provided the theoretical framework. The sample consisted of students (N=248) from seven schools of nursing in a northeast state. The psychometric evaluation included: item analysis, principal factor analysis (PFA) with orthogonal rotation, and internal consistency reliability using Cronbach's alpha. Descriptive statistics were used to determine levels of eldercare cultural self-efficacy among the sample. The PFA revealed a four factor structure (Assessing for Lifestyle and Social Patterns, Determining Cultural Health Practices, Determining Cultural Beliefs, and Dealing with Grief and the Losses Associated with Aging) that accounted for 61% of explained variance. The subscales alpha coefficients ranged from .82 to .95. Findings demonstrate the 28 item scale to be a reliable and valid instrument for use in nursing education to examine students' confidence in caring for ethnically diverse elders. [ABSTRACT FROM AUTHOR]

With the unprecedented growth in the African American elderly population, there exists an urgent need to prepare nurses to deliver culturally competent care. The PURPOSE: (a) nobody ever asked me before, (b) stories of discrimination, (c) coping with discrimination, (d) the hurt of discrimination, and (e) self-discoveries. Nurses, through the use of reminiscence, can gain insight into the cultural heritage, worldviews, and life experiences of African American elders and improve their ability to deliver culturally competent care to this population. [ABSTRACT FROM AUTHOR]

University and community partnerships are being created to increase community-based educational experiences for nursing students and to assist agencies in facing ever-decreasing resources to pay for health services for clients. Many challenges often burden these partnerships, leading to a less than satisfying experience for all those involved. The Partners in Caring Model described in this article is one approach to forming a successful partnership, proven effective in meeting the educational needs of the University of Connecticut, School of Nursing students, while providing additional resources to the Visiting Nurse Association of Central Connecticut, Inc. Using Anderson and McFarlane's Community as Partner Model as the framework, the essential principles behind the development of this successful partnership are discussed. The Partners in Caring Model demonstrates that community-university partnerships can sustain themselves when the partners have a commitment to care for the population being served, and it is a shared responsibility between education and practice. [ABSTRACT FROM AUTHOR]

Purpose: In cross-cultural research, there is a need for standard rules for translating research measurement instruments. This article describes the Reminiscence Functions Scale (RFS) translation process from English into Arabic and the rigorous process followed in translating the scale. The process described can serve as a blueprint for translating research instruments for cross-cultural studies and clinical practice., Method: Six integrated steps were used to establish content and semantic equivalences. Six bilingual professional translators participated in the translation project and utilized the Flaherty 3-point scale to assess and rate the translated RFS., Findings: The difficulties encountered during the study were finding nuanced translation equivalences for Likert scale responses, the translation of phrases and idioms, and logistical issues., Conclusions: Combining translation methods is the ideal choice to achieve robust translation., Implication for Nursing Practice: The proposed translation method for research instruments would assist nurses in appraising prior research's findings, delineating potential effective nursing interventions, and facilitating comparisons of individuals from various cultures and contexts., (© 2023 NANDA International, Inc.)

Background: Current literature lacks evidence about the relationship between reminiscence functions and depression and the mediating role of clinical constructs such as loneliness and religion. The study aimed to examine the mediating effects of loneliness and religion on the association between reminiscence functions and depression in a sample of older Jordanian adults., Methods: An anonymous online cross-sectional survey was employed to collect data from 365 older Jordanian adults. Convenience and snowball sampling methods were used to recruit participants through social media., Results: In the depression model, Bitterness Revival and Intimacy Maintenance factors, educational level, and Intrinsic Religiosity were statistically significant predictors of depression. Bitterness Revival and Intimacy Maintenance factors, work sector, and Intrinsic Religiosity were statistically significant predictors of loneliness. Loneliness has a negative, partial mediating effect on Intimacy Maintenance and depression., Conclusion: Depression caused by significant losses in the Arab Jordanian environment might be mitigated by Intimacy Maintenance by reducing feelings of loneliness. Understanding how Intimacy Maintenance correlates with depression through loneliness could help psychiatric nurses develop psychosocial interventions that reduce depression among older adults., (© 2023 Japanese Psychogeriatric Society.)

Background: Hospital readmissions within 30 days post-cardiac arrhythmia ablation are typically related to postoperative complications and arrhythmia recurrence and considered mostly preventable., Purpose: To evaluate the impact of a cardiac ablation patient education program on hospital readmissions and patient satisfaction., Methods: An education intervention was established for patients who underwent cardiac ablation based on the Project RED framework. Hospital readmissions rates 30 days postprocedure and satisfaction via a single-blinded posttest design were assessed to evaluate the program., Results: Those in the intervention group had a significantly lower rate of 30-day readmissions (7.1% vs 53.3%, P = .014). A large magnitude of effect and higher total patient satisfaction scores were also seen in the intervention group ( M = 633, SD = 78) than in the control group ( M = 508, SD = 137, P = .005)., Conclusions: Results of this study support the implementation of an enhanced cardiac arrhythmia patient education intervention with consideration of identified facilitators and barriers., Competing Interests: The authors declare no conflicts of interests., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Recognizing reminiscence functions can help psychiatric nurses promote patients' mental health. This study aimed to confirm the six-factor, 39-item structure of the Arabic version of the Reminiscence Functions Scale (RFS) in a sample of Jordanian adults (N = 470) and examine the invariance of structure across gender., Design and Method: Post hoc model adjustment was conducted sequentially using modification indices (MI) to improve model fit. Measurement invariance across gender was examined using this adjusted Arabic RFS score (ARFS)., Findings: After post hoc adjustment using MI, the fit indices for the adjusted (32-item) ARFS improved, indicating a good fit for the data. The adjusted ARFS factor structure indicated strict measurement invariance across gender., Conclusions: CFA supports a 32-item, six-factor model., Practice Implications: Psychiatric nurses can use the adjusted ARFS to measure subjects' reminiscence functions and predict the psychological and emotional distress associated with these functions., (© 2022 Wiley Periodicals LLC.)

Background and Purpose : The Reminiscence Functions Scale (RFS), a reliable and valid 43-item scale, measures eight specific reasons as to why people reminisce. The current literature lacks an Arabic version of empirically-validated tools that measure reminiscence functions. This study aimed to test the psychometric properties of the translated version of the RFS in a sample of Arabic speakers from Jordan. Methods : The scale was first translated into Arabic and then was translated back into English. A committee of experts reviewed the Arabic scale and then confirmed its content validity. A convenience, snowball sample of 422 subjects completed the Arabic RFS. Exploratory factor analysis (EFA) and the internal consistency method were used to evaluate the factorial structure and reliability of the Arab RFS, respectively. Results : The Arabic RFS reported excellent content validity. EFA yielded a six-factor, 39-item structure that accounted for 52% of the variance. Cronbach's alphas for the six factors ranged from 0.82 to 0.91, indicating good to excellent internal consistency. Conclusions : The Arabic RFS is a valid and reliable measure of reminiscence functions for Jordanian adults., (© Copyright 2022 Springer Publishing Company, LLC.)

Mental health conditions ranging from minor depressive symptoms to major depression, loneliness and poor quality of life are significant concerns in long-term care communities. Reminiscence is one intervention that has shown to reduce depressive symptoms and improve quality of life. The purpose of this scoping review was to determine the extent of reminiscence research undertaken in long-term care communities. Arksley and O'Malley's six stage method provided the framework for the review. Studies published in peer reviewed literature were identified based on searches in three databases (CINAHL, PUBMED, PsycINFO). Thirty-two studies met inclusion criteria. Of the 32 articles examined, 2 studies were conducted in the United States. Twenty-five health outcomes were examined, including twenty-three psychological outcomes and two physiological outcomes. Depression and cognitive functions were the most frequently measured outcomes. Lack of theoretical frameworks underpinning the studies, inadequate sample sizes, and weak methodology were noted in this review. Recommendations for future reminiscence research in long-term care communities are discussed., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background and Objectives: Interprofessional education (IPE) is necessary to train health care professionals to work collaboratively for the care of older adults. Geriatric Outreach and Training with Care! (GOT Care!) was an innovative academic training program designed to provide an IPE opportunity for health care students and faculty while providing care to community-dwelling older adults. The objectives of this program evaluation were to: (a) examine students', older adult participants', and primary care providers' (PCPs) perceptions toward their participation GOT Care! and (b) examine patient outcomes to identify program strengths and areas for improvement., Research Design and Methods: Formative and summative program evaluation methods were utilized to evaluate student, older adult participant, and provider perceptions of participating in GOT Care!. A total of 221 pharmacy, physical therapy, nursing, social work, medicine, and public health students from a single public university in northeastern United States, 38 community-dwelling older adults, and 33 PCPs were included. Means, standard deviations, and percentages were computed for survey data. The contextual data gathered from interviews and open-ended questions were analyzed using Borkan's immersion-crystallization approach to generate themes., Results: Overall, the students, older adults, and PCPs appreciated GOT Care!. Students reported learning about the unique challenges to geriatric care and how to communicate with other professionals. The older adults appreciated the thorough interprofessional assessment and that the students could learn from them. The PCPs noted the unique insights into their patients' health that would not present at a typical office visit., Discussion and Implications: GOT Care! leveraged academic and community partnerships to provide an IPE opportunity and care to vulnerable older adults. Positive outcomes such as older adult, student, and PCP satisfaction, and a reduction in emergency department visits support ongoing utilization and evaluation of these IPE programs., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Introduction: Reminiscence is a non-pharmacological technique used to manage the behavioral and psychological symptoms of dementia. This integrative review aims to synthesize the research on the health benefits of reminiscence intervention for people with dementia., Methods: Whittemore and Knafl's five-step method provided the framework for this review. A comprehensive search of PubMed, CINAHL Plus, SCOPUS, and PsycINFO was conducted. The articles were reviewed for eligibility, critically appraised, and extracted the data., Results: Twenty-seven studies met the inclusion criteria. Four themes emerged: (a) Recovery from the Darkness of Depressive Symptoms, (B) Enhancement of Cognitive Functions and Filling the Memory Gap, (C) Living a Fulfilling Life in Late Adulthood, and (D) Fulfilling Reminiscence Functions., Discussion: This review provides a better understanding of the potential benefits of using reminiscence intervention for addressing the behavioral and psychological symptoms of dementia. However, improving the methodological rigor of future studies is necessary to attain conclusive evidence., (Copyright © 2021 Elsevier Inc. All rights reserved.)

This study aimed to assess the relationship between an Interprofessional Collaborative Practice (IPCP) intervention for community-dwelling older adults, Geriatric Outreach and Training with Care! (GOT Care!), and the observed 26% reduction in Emergency Department (ED) visits for the 51 older adult participants. A convergent parallel mixed-methods design was utilized. Demographic data and ED visit data were collected and analyzed using paired-samples t-tests, poisson regression and generalized poisson regression. Stakeholder perspectives were assessed via emailed open-ended surveys and analyzed using content analysis. The quantitative results were transformed into trends that were compared and contrasted with the qualitative themes. The results were consistent with the current literature that IPCP models may have a greater impact on older adults with certain demographic characteristics such as polypharmacy, diabetes and prior ED use, while nursing was identified as an ideal leader for IPCP teams., (Copyright © 2020 Elsevier Inc. All rights reserved.)

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

Background and Purpose: Reed's theory of self-transcendence is a nursing theory originally derived from inquiry on well-being in older adults. It has since become a viable theory for promoting well-being in all age groups and health/illness experiences. The current theory analysis aimed to uncover the applicability of Reed's theory in promoting individuals' self-transcendence and enhancing well-being. Although there is a wealth of evidence supporting the usefulness of Reed's theory, little is known about how nurses can understand and apply the theory in clinical practice., Methods: The authors of this current theory analysis adopted Meleis' (2018) approach to theory analysis and evaluation., Results: Reed's theory provides concepts that relate to nursing interventions, which foster the patients' ability to experience multi-level self-transcendence and, thus, enhanced well-being. Applying Reed's theory in clinical practice underpins professional enrichment and brings forth holistic care that assists in facilitating well-being., Conclusion: Reed's theory of self-transcendence propels the individual beyond constrictive viewpoints of self and the world. The theory is useful for patients at all life-stages and in many different contexts., Relevance to Clinical Practice: Nurses can draw on Reed's theory to develop activities that enhance patients' environment in order to promote self-transcendence. These theory-based activities can expand healthy self-boundaries intrapersonally, interpersonally, transpersonally, and temporally., (© Copyright 2020 Springer Publishing Company, LLC.)

Aim: To clarify the concept of reminiscence in the care of people with mild dementia, highlight its uses as a nursing intervention in dementia care, and propose an operational definition of the concept., Background: Reminiscence is one of the leading nonpharmacological interventions in dementia care. The existing literature lacks a unified definition of reminiscence as it applies to the care of patients with mild dementia and a precise understanding of the concept's applications in nursing care., Data Sources: We derived data from literature searches in CINAHL, PsycINFO, PubMed, Google Scholar, Scopus, and Cochrane Library databases., Design: Concept Analysis., Review Methods: The review method used was the Walker and Avant's (2019) eight-step method., Results: Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies reminiscence in the care of patients with mild dementia as a cognitive, functional process of recalling and reconstructing distant memories using memory stimuli through mutual interaction with a trained facilitator., Conclusion: Clarifying the concept will add validity to the current and future literature, help to develop new research instruments that accurately measure this concept, and function as a framework for holistic nursing interventions., (© 2020 Wiley Periodicals, Inc.)

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

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

Within long-term care, the transitional care setting provides post-acute and short-stay rehabilitation to older adults, easing the transition between the acute care hospital and home or long-term care. The current nursing shortage makes it difficult for these facilities to attract and retain qualified nursing staff. In order to meet the rehabilitation needs for this patient population while at the same time addressing the challenge in nursing education of limited clinical placements and severe nurse faculty shortages, an academic-practice partnership was developed to establish a Dedicated Education Unit (DEU). The DEU is an innovative clinical education model in which experienced staff nurses serve as clinical teachers to nursing students. This paper describes the process of developing a DEU using the Partners in Caring Model as the framework. Formative and summative evaluation results and recommendations for program improvement of this pilot project are discussed., (Copyright © 2014 Mosby, Inc. All rights reserved.)

Older adults reporting social isolation are at increased risk for numerous negative health outcomes, including depressive symptoms, decreased quality of life, and cardiovascular disease. The purpose of this study was to test the effects of a university student model of care intervention offered through the CARELINK program on social isolation in a sample of community-dwelling older adults (N = 56). Older adults in the comparison group, who had not yet received the CARELINK program, were nearly 12 times more likely to be socially isolated. Results indicate the empowerment intervention offered through the CARELINK program had positive effects on reducing social isolation in older adults. The CARELINK program has important implications for nursing as it provides an uncomplicated and inexpensive intervention to decrease social isolation for older adults in the community. Given the sample selection limitation in this study, a randomized controlled trial is warranted. Future research should examine specific aspects of the CARELINK program and the amount each aspect affects social isolation., (Copyright 2013, SLACK Incorporated.)

There is a critical need to prepare undergraduate and graduate nursing students to take active roles in gerontological nursing research. Nursing educators are faced with multiple challenges such as the demands of the tripartite role (teaching, scholarship, and service), and managing large numbers of students. These issues make it difficult to actively engage nursing research. Students Advancing Reminiscence Research (STARR) is and example of an innovative program that fosters student engagement in research using available resources while enhancing the faculty advisor's program of reminiscence research. The impetus for creating the STARR program is described in this article, and implications and recommendations for nursing education, practice, and policy are presented., (Copyright 2012, SLACK Incorporated.)

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

The purpose of this article is to describe barriers and strengths of a study testing the effects of reminiscence on depressive symptoms in community-dwelling older African Americans. Primary data sources included debriefing sessions, reflective journals, participant observations, and key informant interviews. Data were analyzed using immersion/crystallization technique. Mistrust between gatekeepers and universities, recruitment and retention of research assistants and participants, culturally insensitive instruments, and stigma associated with depression were barriers. Successful approaches used to overcome the barriers experienced by the research team are described. Implications for transcultural nursing research and practice are discussed.

A collaborative study between faculty from the United States and Spain was undertaken to investigate levels of cultural self-efficacy among a sample of Spanish nursing students and nurses. Bandura's self-efficacy theory provided the conceptual framework for this descriptive study. The Spanish version of the Cultural Self-Efficacy Scale (CSES-S) was translated from the original developed by Bernal and Froman using the back-translation technique recommended by Brislin. The CSES-S was administered to 113 Spanish nurses and students. Alpha coefficient results for the CSES-S ranged from .90 to .95. Low to neutral levels of confidence in caring for four ethnic groups were found. Regression analyses showed significant relationships between cultural exposure and cultural self-efficacy for the practicing nurses. Results will assist this collaborative transcultural nursing research effort between the United States and Spain to develop and implement programs and experiences to increase cultural self-efficacy among Spanish nurses and improve care provided to Spain's diverse population.

Purpose: To review use of the Cultural Self-Efficacy Scale (CSES) and to summarize the cumulative findings., Methods: A combination of literature searches and questionnaires to those who have requested the scale indicated 26 known uses. Fifteen reported sufficient data for statistical analysis., Findings: Of the 26 known uses of the CSES, 8 were published in peer-reviewed journals, 5 in dissertations, 8 in theses, and 3 as data sets only. Two additional theses were not retrievable for the study. On a 5-point Likert-type scale, nurses reported the highest degree of self-efficacy with African American (3.1) and Hispanic (3.1) patients and the lowest with Asian American patients (2.4). Six of the reports include Cronbach's alpha coefficients, ranging from .86 to .98. In the final sample of 15 studies, nurses did not report feeling confident caring for patients from other cultures., Conclusions: Although the CSES has been used in many settings with over 3,000 nurses, inconsistencies in the data preclude specific conclusions. Further research is needed using consistent reporting practices and sufficient predictor variables to draw further conclusions regarding the scale's psychometric properties.

Knowledge and self-efficacy concerning interactions of prescription medications with over-the-counter (OTC) agents were assessed in community health nurses. Three convenience samples of community nurses were recruited to complete the instruments. The first was a sample of 20 experienced nurses working for a local visiting nurse agency (VNARNs). The second was a sample of 20 bachelor of science in nursing (BSN) students (graduate nurses [GNs]) completing their final nursing rotation with the VNARNs. The third was a sample of 31 nurses enrolled in a graduate program training nurses for advanced practice (APRNs). There were no significant differences in overall mean self-efficacy scores among the groups of community health nurses. The mean scores indicated moderate self-efficacy about prescription-OTC interactions. Post-hoc analyses determined VNARNs had significantly greater knowledge scores than APRNs. Overall mean self-efficacy was not correlated with mean knowledge scores. Inspection of the knowledge item responses revealed nine general misconceptions about OTC medications held by many community nurses in the sample. The data can guide the development of continuing education programs about prescription-OTC interactions aimed at community health nurses.

An interactive computer program (Personal Education Program [PEP]) designed for the learning styles and psychomotor skills of older adults was used to teach older adults about potential drug interactions that can result from self-medication with over-the-counter (OTC) agents and alcohol. Subjects used the PEP on notebook computers equipped with infrared sensitive touchscreens. Subjects were recruited from senior centers. Those who met age, vision, literacy, independence, and medication use criteria were randomly assigned to one of three groups: (1) PEP plus information booklet; (2) information booklet only; or (3) control. A repeated measures (three time periods 2 weeks apart), three-group design was used. Users of PEP had significantly greater knowledge and self-efficacy scores than both the conventional and control groups at all three time points. The PEP group reported fewer adverse self-medication behaviors over time. Reported self-medication behaviors did not change over time for either the conventional or control groups. Subjects indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.

Preventing Drug Interactions in Active Older Adults is an educational intervention to prevent prescription and over-the-counter (OTC) drug and alcohol interactions in active, community-living older adults. The objectives of the program are to increase older adults' knowledge of potential interactions of prescription medications with OTC drugs and alcohol and to increase their confidence (self-efficacy) about how to avoid such interactions. An interactive multimedia computer software program (Personal Education Program or PEP) was designed for the learning styles and psychomotor skills of older adults. Focus groups of older adults evaluated PEP components in a formative manner during development. The program content dealing with antacids, calcium supplements, and acid reducers was pilot tested with 60 older adults recruited from local senior centers. Participants used the PEP on notebook computers equipped with infrared-sensitive touchscreens. Users of PEP had greater knowledge and self-efficacy scores than controls. Participants indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.

As the American population ages, we can expect to find greater numbers of older adults with chronic diseases and health concerns. Therefore the implementation of communitybased blood pressure clinics that promote elder wellness becomes increasingly important. This article will describe the development, implementation, and evaluation of a community-focused elder wellness program in a rural community using Anderson and McFarlane's (1996) Community-as-Partner model as a theoretical framework for community health nursing practice. Evaluation results of the elder wellness program suggest that blood pressure screenings provide community health nurses (CHNs) with unique opportunities to promote wellness in older adults when provided in an atmosphere that encourages nurse-client interactions.