Eco-nursing competencies for nurses: A scoping review

Background

Nurses are tasked with addressing the health impacts of climate change. Eco-nursing competencies, covering knowledge, attitudes, and skills related to climate change, equip nurses to actively mitigate and adapt to its effects on health and the environment.

Objective

To synthesize existing literature on eco-nursing roles and competencies for nurses.

Methods

A scoping review of published papers examined nurses' roles and eco-nursing competencies. Databases searched included Academic Search Complete, CINAHL Plus, MEDLINE (PubMed), and Google Scholar. Search terms encompassed climate change and nursing synonyms, limited to English articles up to April 15, 2023. Thematic analysis was used to synthesize findings, delineating roles, and eco-nursing competencies. Results were tabulated.

Results

Out of 445 papers identified, 31 underwent data analysis. These papers highlighted nurses' roles in climate change (42%), along with climate change knowledge and skills (64.5%), and attitudes (13%). Roles encompassed research, education, advocacy, leadership, and clinical practice, with corresponding competencies embedded within existing core competencies for general nurses, nurse specialists, and nurse managers.

Conclusion

The review demonstrates that nurses' roles in climate change necessitate relevant knowledge, attitudes, and skills. Future research should contextualize these roles and eco-nursing competencies based on geographical locations, considering the distinct disease burden in each area.

Registration

The study protocol was registered in the Open Science Framework on 5 March 2023 before conducting the full study https://doi.org/10.17605/OSF.IO/9GC4N.

Tweetable abstract

Amidst growing concerns about climate change, nurses are increasingly tasked with preparing to mitigate its health impacts through the delineation of eco-nursing competencies. These competencies will equip nurses to effectively tackle the health and environmental ramifications of climate change, building upon existing core competencies tailored to various geographic contexts.

Aging in climate change: Unpacking residential mobility and changes of social determinants of health in southern United States

The southern coastal states of the United States are susceptible to extreme weather and climate events. With growing move-in and -out older populations in the region, health implications of their residential mobility lack sufficient knowledge. Using 126,352 person-level records from 2012 to 2021, we examined geospatial and temporal patterns of older populations' residential mobility, considering the changing social determinants of health and disparities. We found the moves of older populations with socioeconomic or health disadvantages were related to increased exposure to environmental hazards and reduced access to health resources. The findings inform targeted strategies for climate adaptation that address the needs of vulnerable aging populations.

Social Capital as a Framework to Address Organizational Climate Change Policy

PURPOSE

To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels.

METHOD

Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy.

RESULTS

AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies.

CONCLUSION

Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11-15.].

How to communicate with older adults about climate change: a systematic review

Introduction

Although older adults are particularly vulnerable to the effects of climate change, they seem to be overall less concerned about it, and less inclined to support climate policies. The study aims to identify the communication strategies that have been evaluated in promoting awareness and/or climate friendly behaviors in older adults.

Methods

We searched multiple electronic databases for studies that evaluated the effects of any interventions aimed at communicating climate change to older persons (over 65 years) and assessed the results as awareness and /or behavioral changes. We selected quantitative, qualitative and mixed methods studies, and we also included systematic reviews for cross-referencing. Risk of bias of included studies was evaluated using different tools according to the study design.

Results

From a total of 5,486 articles, only 3 studies were included. One mixed-method study engaged older adults to assess the community vulnerability to climate change and to develop adaptation recommendations based on their perspectives; one qualitative study conducted focus groups to identify the more effective language, values and themes based on participants' responses to narratives; one quantitative study utilized a 360-degree audio-visual platform allowing users to engage with immersive visualizations of sea-level rise scenarios.

Discussion

Despite the paucity of literature, this review demonstrates the potential for different strategies to increase the awareness of older persons about climate change. The involvement of older adults in the communication process, the identification of their priorities, and the integration of technology in their daily lives are promising approaches but more research, including both quantitative and qualitative studies is recommended on this topic.

Systematic review registeration

For further details about the protocol, this systematic review has been registered on PROSPERO on July 1, 2023 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023438256).

Climate Change Policies and Older Adults: An Analysis of States' Climate Adaptation Plans

BACKGROUND AND OBJECTIVES

As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states' climate adaptation plans to assess the methods through which they address the impact of climate change on older adults.

RESEARCH DESIGN AND METHODS

This study uses content analysis to analyze available climate change adaptation plans for all U.S. states for strategies designed to increase the resilience of older adults to the impacts of climate change.

RESULTS

A total of 19 states have climate adaptation plans, of which 18 describe older adults as a population group with specific health impacts and risk factors. There are 4 categories of adaptation strategies for older adults that includes communications, transportation, housing, and emergency services. State plans vary in terms of the risk factors and adaptation strategies included.

DISCUSSION AND IMPLICATIONS

To varying degrees, states' climate change adaptation planning addresses health, social, and economic risks specific to older adults, as well as strategies for mitigating those risks. As global warming continues, collaborations between public and private sectors and across regions will be needed to prevent negative outcomes such as forced relocation and other social and economic disruptions as well as disparate morbidity and mortality.

Extreme Heat Vulnerability Among Older Adults: A Multilevel Risk Index for Portland, Oregon

BACKGROUND AND OBJECTIVES

Extreme heat is an environmental health equity concern disproportionately affecting low-income older adults and people of color. Exposure factors, such as living in rental housing and lack of air conditioning, and sensitivity factors, such as chronic disease and social isolation, increase mortality risk among older adults. Older persons face multiple barriers to adaptive heat mitigation, particularly those living in historically temperate climates. This study measures two heat vulnerability indices to identify areas and individuals most vulnerable to extreme heat and discusses opportunities to mitigate vulnerability among older adults.

RESEARCH DESIGN AND METHODS

We constructed two heat vulnerability indices for the Portland, OR, metropolitan area: one using area scale proxy measures extracted from existing regional data and another at the individual scale using survey data collected following the 2021 Pacific Northwest Heat Dome event. These indices were analyzed using principal component analysis and Geographic Information Systems.

RESULTS

Results indicate that the spatial distribution of areas and individuals vulnerable to extreme heat are quite different. The only area found among the most vulnerable on both indices has the largest agglomeration of age- and income-restricted rental housing in the metropolitan area.

DISCUSSION AND IMPLICATIONS

Due to spatial variations in heat-related risk at the individual and area scales, measures addressing heat risk should not be spatially uniform. By focusing resources on older adult individuals and areas in particular need of assistance, heat risk management policies can be both highly efficient and cost effective.

Effectiveness of psycho-educational program on climate change distress and risk perception among older adults

BACKGROUND

Climate change is a global environmental phenomenon that affects human health. It has a negative impact on the health and well-being of older adults. Therefore, educating older adults about coping with climate change and providing psychological interventions could promote successful aging.

AIM

To determine the effectiveness of psycho-educational program on climate change distress and risk perception among older adults.

METHODS

A quasi-experimental research design, "pre-test and post-test was followed. The study used the Climate Change Distress, the Impairment Scale, and the Risk Perception Scale. Data were collected from 80 older adults aged 60 years and above at three elderly clubs in Damanhour City, El-Behaira Governorate, Egypt.

RESULTS

The difference in mean severity of climate change distress, impairment, and risk perception scores between the study and control groups after the psycho-educational program was statistically significant.

CONCLUSION

Psycho-educational interventions can reduce climate change distress and impairment among older adults and increase their risk perception.

Elegant Nematodes Improve Our Understanding of Human Neuronal Diseases, the Role of Pollutants and Strategies of Resilience

The prevalence of neurodegenerative disorders such as Alzheimer's and Parkinson's disease are rising globally. The role of environmental pollution in neurodegeneration is largely unknown. Thus, this perspective advocates exposome research in C. elegans models of human diseases. The models express amyloid proteins such as Aβ, recapitulate the degeneration of specifically vulnerable neurons and allow for correlated neurobehavioral phenotyping throughout the entire life span of the nematode. Neurobehavioral traits like locomotion gaits, rigidity, or cognitive decline are quantifiable and carefully mimic key aspects of the human diseases. Underlying molecular pathways of neurodegeneration are elucidated in pollutant-exposed C. elegans Alzheimer's or Parkinson's models by transcriptomics (RNA-seq), mass spectrometry-based proteomics and omics addressing other biochemical traits. Validation of the identified disease pathways can be achieved by genome-wide association studies in matching human cohorts. A consistent One Health approach includes isolation of nematodes from contaminated sites and their comparative investigation by imaging, neurobehavioral profiling and single worm proteomics. C. elegans models of neurodegenerative diseases are likewise well-suited for high throughput methods that provide a promising strategy to identify resilience pathways of neurosafety and keep up with the number of pollutants, nonchemical exposome factors, and their interactions.

Anticipating older populations' health risk exacerbated by compound disasters based on mortality caused by heart diseases and strokes

The health of older populations in the Southeastern U.S. receives threats from recurrent tropical cyclones and extreme heat, which may exacerbate the mortality caused by heart diseases and strokes. Such threats can escalate when these extremes form compound disasters, which may be more frequent under climate change. However, a paucity of empirical evidence exists concerning the health threats of compound disasters, and anticipations regarding the health risks of older populations under future compound disaster scenarios are lacking. Focusing on Florida, which has 67 counties and the second-largest proportion of older populations among U.S. states, we calibrate Poisson regression models to explore older populations' mortality caused by heart diseases and strokes under single and compound disasters. The models are utilized to estimate the mortality across future disaster scenarios, the changing climate, and the growing population. We identify that under multiple hurricanes or heat, current-month hurricanes or heat can affect mortality more heavily than previous-month hurricanes or heat. Under future scenarios, co-occurring hurricanes and extreme heat can exacerbate the mortality more severely than other disaster scenarios. The same types of compound disasters can coincide with an average of 20.5% higher mortality under RCP8.5-SSP5 than under RCP4.5-SSP2. We assess older populations' future health risks, alerting health agencies to enhance preparedness for future "worst-case" scenarios of compound disasters and proactively adapt to climate change.

A Descriptive Qualitative Study of Older Persons and Family Experiences with Extreme Weather Conditions in Northern Thailand

Extreme weather can cause ill health in older persons due to a direct thermal effect on the body's thermoregulation and difficulties in maintaining a healthy lifestyle and accessing the health services they need. To understand experiences in relation to their exposures to extreme weather and how they responded to such weather conditions, including cold snaps, heat and air pollution in northern Thai communities, a descriptive qualitative study was conducted to uncover details and the essence of perspectives and experiences of older persons and family members. Three focus group discussions with 15 older persons and 15 family members occurred in three communities in Chiang Rai, a northern province of Thailand. Thematic analysis was performed. Experiences of older persons and families in relation to extreme weather conditions were described in five themes: local actions against weather changes, the double challenges, awareness and reactions to weather changes, protective and comfortable living environments, and mitigation of the impacts of weather conditions. Seasonal adaptability was key for older persons to stay safe and healthy during extreme weather changes. Heat, cold snaps, and air pollution made health and daily living routine maintenance among older persons challenging, especially among those with declining health. Older persons and families employed predictive and adaptive strategies to avoid and minimise extreme weather impacts and maximise their comfort and optimal living.

Climate Change and Water Crises in Pakistan: Implications on Water Quality and Health Risks

Pakistan is vulnerable and most affected by adverse impacts of climate change. The study examines the impact of climate change on Pakistan during the year 2022, resulting into unprecedented heatwave and drought in summers followed by the abnormal rains and floods during monsoon season. Agriculture is the backbone of Pakistan's economy, which has been devastated by both drought and floods. While the flood water is gradually receding, the stagnant contaminated water is causing several health risks for the inhabitants. This research argues that water security is the emerging national security challenge for Pakistan. The article investigates the status of water availability vis-a-vis the burgeoning population, agriculture, and other uses of water. Impact of abnormal melting of glaciers, nonavailability of dams for storage of rainwater, and lack of smart means for agriculture water have been examined to empirically validate the arguments.

Effects of climate change in the elderly's health: a scoping review protocol

INTRODUCTION

Climate change is a global problem that affects human health, especially the most vulnerable groups, including the elderly. However, no scope review includes the perspective of institutions specialised in climate change and health and whose reports are the basis for policies orientated on the environmental health. Therefore, this study aims to identify these effects on older people health. The results will allow health professionals to have valuable information enabling them to provide quality care in meeting the demand that this situation is producing.

METHODS AND ANALYSIS

A scoping review of the relevant literature will be performed from 2008 to 2021. The Joanna Briggs Institute guidelines and the PRISMA-Scoping Review Extension checklist will be used. A peer-reviewed search will be conducted using the electronic databases Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PsycINFO and Cuiden Plus between October and December 2021. Original quantitative studies and reports from official agencies on the effects of climate change on the elderly health in any health and geographical context will be included. Literature selection will be made by two reviewers. The table format used for data extraction will be reviewed by the review team and tested by two reviewers.

ETHICS AND DISSEMINATION

This study does not require approval by an ethics committee to be conducted. This article will result in the mapping of the direct and indirect effects of climate change on the health of the elderly. The results will be published in scientific journals to be accessible to health professionals in the creation of care plans for the elderly at climate risk.

Media Portrayal of Older Adults Across Five Canadian Disasters

We conducted a constructivist grounded theory approach in which discourse analysis was used to explore how Canadian news media portrays older adults and aging in a disaster context. We analyzed 119 articles covering five Canadian disasters and identified four themes: (a) stereotypes of older adults are presented on a positive-negative continuum in journalistic coverage of disasters, (b) journalistic coverage tends to exclude perspectives of older adults from relevant discourse, (c) journalists assess the value of losses for older adults-"home" as a central concept, and (d) disasters are framed as disrupting retirement ideals. A model was created to provide an overview of the journalistic coverage of older adults in disaster contexts. Understanding how old age and aging are presented by the media in a disaster context is important because it has further implications for informing and structuring disaster risk reduction policies.

Rural Older Adults in Disasters: A Study of Recovery From Hurricane Michael

OBJECTIVE

This study aims for a greater understanding of how older adults (age 65 and older) in Jackson County, Florida, are prepared for and cope with the effects of a natural disaster.

METHODS

A multidisciplinary, international research team developed a survey examining: (1) resources available to individuals aged 65+ in rural communities for preparing for a disaster; (2) challenges they face when experiencing a disaster; and (3) their physical, social, emotional, and financial needs when it strikes. The survey was administered with older adults (65+) in Jackson County, Florida, following Hurricane Michael in 2018. The descriptive, multivariate logistic, and linear regression analyses were performed to examine the relationship between respondents' demographic information and needs, concerns, and consequences of disaster.

RESULTS

Results indicated (n = 139) rural community-dwelling older adults rely on social support, community organizations, and trusted disaster relief agencies to prepare for and recover from disaster-related events.

CONCLUSIONS

Such findings can be used to inform the development of new interventions, programs, policies, practices, and tools for emergency management and social service agencies to improve disaster preparedness and resiliency among older populations in rural communities.

Advancing Gerontological Nursing Science in Climate Change

Older adults have unique health risks related to climate change. This commentary addresses the health impacts of climate change for older adults, identifies gaps in gerontological nursing research, and highlights areas for research to address the significant gap in nursing science. Climate risks of extreme weather events, such as heat, rain, flooding, and wildfires, as well as poor air quality, vector-borne diseases, interruptions of services, and treatment plans all place older adults at risk of experiencing greater morbidity and early mortality. Despite these risks, there is a gap in nursing research related to climate change and aging. Nurse scientists can address this gap with an interdisciplinary approach. There are climate resources and theoretical frameworks to support scientific inquiry. Funding sources must be made available to assure rigorous scholarship of climate-related health impacts for older adults. Gerontological nurse researchers must build capacity to address climate change and health. [Research in Gerontological Nursing, 13(1), 6-12.].

Finnish nurses' perceptions of the health impacts of climate change and their preparation to address those impacts

BACKGROUND

Climate change has a direct and indirect impact on human health that include health impacts from rising temperatures and poor air quality. This challenges the health sector in many ways. Nurses should be aware of these health effects and the patients who are particularly vulnerable to the health impacts caused by climate change.

PURPOSE

The objective of the study was to identify the health issues that Finnish registered nurses associate with climate change and to determine nurses' perception of their preparation to address the health impacts of climate change.

METHODS

A qualitative descriptive study was conducted through semi-structured focus group interviews.

RESULTS

Nurses reported observing changes in health of their patient populations. The nurses attributed some changes in their patients' health to climate change. Interviewed nurses felt that climate change was not adequately addressed in their basic nursing education and in staff development.

CONCLUSIONS

It is important to include climate change and its impact on human health in the nurses' curriculum and in continuing education for practicing nurses.

Climate Change Should Be on Every Nursing Research Agenda

Human-caused climate change is a global emergency, and its harms are predicted to increase exponentially in the coming years, particularly if unsustainable practices continue unmitigated. Adverse effects of climate change on communities affected by or at risk for cancer, such as frail older adults, are already measurable and deadly. If nurse scientists continue to ignore these realities, more people are likely to suffer and die as a result. The purpose of this critical reflection is to discuss the vital necessity of including climate change in the research agenda of the Oncology Nursing Society and all nursing science. Using an approach grounded in critical theory and design justice, the authors provide specific suggestions for the incorporation of scientific considerations and nursing measures related to climate change into oncology nursing science.