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Nordaunet OM, Gjevjon ER, Olsson C, Aagaard H, Borglin G. What about the fundamentals of nursing-its interventions and its continuity among older people in need of home- or facility-based care: a scoping review. BMC Nurs 2024; 23:59. [PMID: 38254154 PMCID: PMC10801980 DOI: 10.1186/s12912-023-01675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
AIM This scoping review investigated and descriptively summarised previous research about fundamental nursing, its focus (what care needs are described, how is it described and by whom is it described), continuity of care (is it described in relation to fundamental nursing) and possible nursing interventions or activities targeting older people's fundamentals of care needs in home- or facility-based care. METHODS This scoping review was carried out following the steps of Arksey and O'Malley's methodology and PRISMA-ScR reporting guidelines. Searches were conducted in PubMed via NIH, CINAHL via EBSCO and PsycInfo via ProQuest for the time period between January 2002 and May 2023. RESULTS Forty-two studies were included where the majority had been conducted in a facility-based care context. Nutrition-or rather nutritional care activities targeting eating and drinking-was the most frequently described fundamental care needs addressed. After this came personal care such as cleansing, dressing, oral care, skin, and foot care. Few studies addressed more than one fundamental care need at the time. The nursing staff described fundamental nursing as complex, comprehensive, and demanding. Older people and relatives described a gap between the fundamental nursing provided and their perceived need for support. Less attention was given to older peoples relational and psychosocial needs. Identified nursing interventions mainly targeted physical care needs. Our findings also implied that interventions focusing on fundamental nursing were described as feasible in practice with favourable or moderate results, while long-term effects were difficult to detect. No studies were identified focusing on fundamental nursing in relation to outcomes such as continuity of care. CONCLUSION Fundamental nursing was mainly described in relation to physical care needs, which were essentially conducted within facility-based care contexts. Interventions and activities primarily focused on one fundamental need at the time, mainly within the physical domain. No nursing interventions were identified focusing on relational and psychosocial needs where continuity of care can be viewed as a relevant outcome. Such limited focus are especially concerning as research has highlighted the importance of that older people with complex care needs can benefit from a holistic and person-centred approach i.e. fundamental nursing. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/XJ39E Protocol: http://dx.doi.org/10.1136/bmjopen-2022-069798.
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Affiliation(s)
- O M Nordaunet
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway.
- Institute of Health Sciences, Department of Nursing, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.
| | - E R Gjevjon
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
- UiT The Arctic University of Norway, Havnegata 5, 9404, Harstad, Norway
| | - C Olsson
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
- Institute of Health Sciences, Department of Nursing, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - H Aagaard
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
| | - G Borglin
- Department of Bachelor Education (Nursing), Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway
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Bhar S, Davison TE, Schofield P, Quinn S, Ratcliffe J, Waloszek JM, Dunkerley S, Silver M, Linossier J, Koder D, Collins R, Milte R. Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents. BMC Geriatr 2023; 23:555. [PMID: 37700236 PMCID: PMC10498637 DOI: 10.1186/s12877-023-04257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND This protocol describes a study of the effectiveness of cognitive behaviour therapy (CBT) for reducing depressive symptoms in older adults living in residential aged care (RAC) facilities in Australia. Depressive symptoms are highly prevalent in this population, yet the benefits of CBT for reducing such symptoms in RAC facilities have not been widely investigated. Elders at Ease (ELATE) is a 16-session CBT intervention designed for implementation in RAC facilities. The intervention includes cognitive, behavioural and reminiscence strategies and is delivered by mental health trainees (MHTs) in collaboration with RAC facility staff and residents' family. METHODS AND ANALYSIS ELATE will be evaluated using a cluster randomised trial comparing outcomes for residents who participate in the intervention with those living in usual care control facilities. The participants are RAC residents aged 65 years or above, with depressive symptoms (Patient Health Questionnaire-2 ≥ 3) and normal cognition or mild cognitive impairment (Standardised Mini Mental Status Examination ≥ 21). They are assessed at four time points: baseline prior to randomisation (T1), mid-treatment (T2; 2.5 months post randomisation), post-treatment (T3; 5 months post-randomisation) and 3-month follow-up (T4; 8 months post randomisation). The primary outcome is change in depressive symptoms between T1 and T3. Secondary outcomes are depressive symptoms at T4, anxiety, suicide ideation, sleep problems, quality of life, staff and family knowledge of late-life depression, stress levels and efficacy in caring for residents, and MHT levels of geropsychology competencies. Residents receiving the intervention are hypothesised to report a greater decrease in depressive symptoms between T1 and T3 compared to residents receiving usual care. The primary analysis is a regression, clustered over site to account for correlated readings, and independent variables are condition and depressive symptoms at T1. A cost-utility analysis is also undertaken. DISCUSSION ELATE is a comprehensive CBT intervention for reducing depressive symptoms in RAC residents. It is designed to be implemented in collaboration with facility staff and residents' families, individually tailored to residents with normal cognition to mild cognitive impairment and delivered by trainee therapists. ELATE offers a model that may be widely applicable across the RAC sector. TRIAL REGISTRATION Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number ACTRN12619001037190, prospectively registered on 22 July 2019.
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Affiliation(s)
- Sunil Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia.
| | - Tanya E Davison
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Silverchain, Osborne Park, WA, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
- Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Stephen Quinn
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Joanna M Waloszek
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Sofie Dunkerley
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Mark Silver
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Jennifer Linossier
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Deborah Koder
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rebecca Collins
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, Hawthorn, VIC, 3122, Australia
| | - Rachel Milte
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Jiang M, Zeng J, Liao M, Li Q. The work status of nurses in long-term care institutions in elderly care: A qualitative descriptive study. Nurs Open 2023; 10:6428-6434. [PMID: 37332177 PMCID: PMC10416048 DOI: 10.1002/nop2.1892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/14/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023] Open
Abstract
AIM To understand the work status of nurses in long-term care institutions in China for elderly care to provide a reference for further formulating management strategies and promoting the development of long-term care teams. METHODS Using qualitative descriptive research methods, 31 nurses from three long-term care institutions were selected through purposive sampling for in-depth interviews, and a three-week participatory observation was conducted on the daily work of nurses in the above three long-term care institutions. Content analysis was used to analyse data. RESULTS In our sample, nurses in long-term care institutions had insufficient manpower, generally had low academic qualifications, and lacked professional ability. Their work enthusiasm and initiative need to be further improved. Long-term care nurses were moderately paid, and their salary satisfaction was lower than in other trades. At the same time, the social understanding of the long-term care industry was insufficient, and the social identity of nurses in long-term care institutions was low. CONCLUSION The development of long-term care requires the joint efforts of nurses, medical institutions, and society. By improving the system, cultivating talents and building a harmonious atmosphere, we aim to enhance the work enthusiasm of long-term care nurses and promote the stable and orderly development of the long-term care team. IMPLICATIONS FOR NURSING MANAGEMENT Nurses in long-term care institutions are at the core of the ageing age and play a vital role in coping with the ageing problem, meeting long-term care needs, improving the quality of life of old people and reducing the cost of long-term care. The training and management of nurses in long-term care institutions and the construction of the entire long-term care system should be based on China's national conditions and actual needs.
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Affiliation(s)
- Menglin Jiang
- West China Xiamen Hospital of Sichuan UniversityAmoyChina
- Chengdu Medical CollegeChengduChina
| | | | | | - Quanlei Li
- School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
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Booker SQ, Sowicz TJ, Knisely MR, Saravanan A, Bai J, St Marie B. Original Research: The Impact of COVID-19 on Pain Care Among Older Adults. Am J Nurs 2023; 123:26-36. [PMID: 37166166 DOI: 10.1097/01.naj.0000937180.48669.ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE In this qualitative descriptive study, we sought to understand the professional experiences and perceptions of pain management nurses who cared for older adults in the United States during the height of the COVID-19 pandemic. METHODS Data were collected between July 2020 and July 2021 through individual, semistructured interviews with a nonprobability sample of 18 pain management nurses. An inductive content analysis approach, in which categories were derived from a coding process based on a close reading of data extracts from the interview transcripts, was used to reveal the major theme related to the study aim. RESULTS Notwithstanding the variable consequences of COVID-19 on patients' health, a single overarching theme was pronounced: "Pain management for older adults remained unchanged during the pandemic despite unpredictable survival, restrictions on human interactions, and communication challenges." This theme was supported by four categories that emerged from the data: unpredictable survival, restriction-induced isolation, perceived continuity and equality of pain management, and communication challenges. CONCLUSIONS During the COVID-19 pandemic, pain management nurses stepped in and joined interdisciplinary teams providing general and specialized pain care to ensure that older adults, whether inpatient or outpatient, continued to receive quality care. These study findings highlight the many challenges pain management nurses faced during this unprecedented public health crisis, as well as opportunities to improve the health system and enhance nursing practice to meet the needs of older patients.
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Affiliation(s)
- Staja Q Booker
- Staja Q. Booker is an assistant professor at the University of Florida College of Nursing in Gainesville. Timothy Joseph Sowicz is an assistant professor at the University of Arizona College of Nursing in Tucson. Mitchell R. Knisely is an associate professor at the Duke University School of Nursing in Durham, NC. Anitha Saravanan is an assistant professor at Northern Illinois University School of Nursing and Health Studies in DeKalb. Jinbing Bai is an assistant professor at the Emory University Nell Hodgson Woodruff School of Nursing in Atlanta. Barbara St. Marie is an associate professor at the University of Iowa College of Nursing in Iowa City. Contact author: Staja Q. Booker, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Research on Supply and Demand of Aged Services Resource Allocation in China: A System Dynamics Model. SYSTEMS 2022. [DOI: 10.3390/systems10030059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
With the rapid growth of the elderly population of China in recent years, the service demands of older Chinese people continue to increase. The increasingly severe situation with respect to the elderly population is an important social problem that China will face for a long time into the future. It is urgent to solve the problem of how to scientifically carry out allocation planning of service resources for the aged and guide the effective supply of service resources. This paper analyzes the factors affecting service resources for the aged, divides China’s service resource supply and demand system into a supply subsystem, a demand subsystem, and a population and economy subsystem. Using system dynamics methods to analyze the causal relationship between variables and the state space method to build a mathematical model and perform simulation analysis, we research the the current situation of China’s service resources supply and demand balance for the aged. In addition, we put forward resource configuration optimization measures for the future allocation of service resources for the aged, providing a practical basis for future decision-making.
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Rodrigues NG, Han CQY, Su Y, Klainin‐Yobas P, Wu XV. Psychological impacts and online interventions of social isolation amongst older adults during COVID-19 pandemic: A scoping review. J Adv Nurs 2022; 78:609-644. [PMID: 34625997 PMCID: PMC8661520 DOI: 10.1111/jan.15063] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/10/2021] [Accepted: 09/26/2021] [Indexed: 01/09/2023]
Abstract
AIM To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation. DESIGN A scoping review was performed. DATA SOURCES A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar. REVIEW METHODS Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes. RESULTS Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention. CONCLUSION The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions. IMPACT With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis.
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Affiliation(s)
- Natalie Grace Rodrigues
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Claudia Qin Yun Han
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Ya Su
- Faculty of Health SciencesHokkaido UniversitySapporoJapan
| | - Piyanee Klainin‐Yobas
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
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