Protein bassoon (Zinc finger protein 231) [KIAA0434] [ZNF231]
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Nurses' perspectives: hospitalized older patients and end-of-life decision-making.
To explore pressing issues identified by nurses caring for older patients in US NICHE (Nurses Improving Care for the Healthsystem Elders) hospitals, regarding palliative care and end-of-life (EOL) decision-making. Objectives are to (1) identify the most pressing palliative care and EOL decision-making issues and strategies to address them and (2) identify the association of nursing demographics (age, gender, race, education and experience), institutional/unit characteristics and these issues. Critical care nurses have an integral role in supporting older patients and families faced with palliative care and EOL decision-making issues. Despite national imperatives to improve the quality of palliative care, patients continue to experience uncontrolled pain, inadequate communication, disregard of their wishes and life prolonging interventions. These contribute to increased hospitalizations and costs. Understanding the prevalent issues is needed to address patient needs at the end-of-life. It is a mixed method study. A secondary analysis of the NICHE Geriatric Institutional Assessment Profile (GIAP) database (collected 1/08-9/13) was conducted using the sample of Critical Care RNs who provided comments regarding palliative care and EOL decision-making. Qualitative data were analyzed using Dedoose software. Data clusters and patterns of co-occurring codes were explored through an iterative analysis process. Themes were examined across nurse demographics, institutional and unit characteristics. Comments specifically addressing issues regarding EOL decision-making were provided by 393 critical care nurses from 156 hospitals (x‾ age = 42·3 years, 51% BSN degree). Overarching theme was discordance in goals of care (prolonging life versus quality of life), ineffective physician-patient-family communication, lack of time and unrealistic expectations. Nurses' descriptions highlight the need for increased communication, staff education and availability of palliative care services. Palliative care and EOL decision-making will remain a nursing priority as people age and require increased care.
MeSH Terms
- Adult
- Aging
- Communication
- Critical Care Nursing
- Decision Making
- Female
- Humans
- Male
- Nurse's Role
- Palliative Care
- Qualitative Research
- Terminal Care
- United States
Keywords
- Adult intensive care
- Intensive care
- Nurses
- Older adults
- Qualitative research
- Quality of life
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Buddhist social networks and health in old age: A study in central Thailand.
Religious social networks are well known for their capacity to improve individual health, yet the effects of friendship networks within the Buddhist context remain largely unknown. The present study aimed to compare health status and social support in community-dwelling older adults according to their level of Buddhist social network (BSN) involvement, and to examine the association between BSN involvement and functional health among older adults. A cross-sectional survey was carried out among 427 Buddhist community-dwelling older adults aged ≥60 years in Nakhon Pathom, Thailand. Data were collected from home-based personal interviews using a structured questionnaire. Health status was defined according to the measures of basic and advanced activities of daily living (ADL), the 15-item Geriatric Depression Scale and subjective quality of life. Perceived social support was assessed across the four dimensions of tangible, belonging, emotional and information support. Multiple logistic regression was used for analysis. Older adults with BSN involvement reported better functional, mental and social health status, and perceived greater social support than those without BSN involvement. In addition, BSN involvement was positively associated with independence in basic and advanced ADL. After adjusting for age, sex, education, income, morbidity and depressive symptoms, BSN showed a strong association with advanced ADL and a weak association with basic ADL. The results show that involvement in BSN could contribute positively to functional health, particularly with regard to advanced ADL. Addressing the need for involvement in these networks by older adults might help delay functional decline and save on healthcare costs.
MeSH Terms
- Aged
- Aged, 80 and over
- Aging
- Buddhism
- Cross-Sectional Studies
- Female
- Geriatric Assessment
- Health Status
- Humans
- Independent Living
- Logistic Models
- Male
- Middle Aged
- Multivariate Analysis
- Quality of Life
- Social Support
- Socioeconomic Factors
- Surveys and Questionnaires
- Thailand
Keywords
- Buddhism
- Thailand
- community-dwelling elderly
- quality of life
- social network
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Retaining the wisdom: Academic nurse leaders' reflections on extending the working life of aging nurse faculty.
Aging nurse faculty members are vital human resources who serve as educators, researchers, and leaders within baccalaureate nursing (BSN) programs. On average, aging nurse faculty members are over 50 years of age and face key retirement decisions over the next decade. The purpose of this study was to begin to build substantive theory about academic nurse leaders' perceptions of extending the academic working life of aging nurse faculty members. Nine academic nurse leaders from BSN programs nationwide were interviewed in this grounded theory study. Data were analyzed using constant comparative analysis. Four categories emerged: valuing aging nurse faculty, enduring environmental challenges, recognizing stakeholder incongruence, and readjusting. Findings reveal that aging nurse faculty members are highly valued by academic nurse leaders, bringing wisdom, experience, and institutional, historical, and cultural awareness to their many roles. Yet, some aging nurse faculty fail to keep knowledge, skills, and teaching modes current, which is problematic given the multiple environmental challenges that academic nurse leaders face. Stakeholder incongruence arises as a mismatch between the needs of the BSN program and the skills and contributions of aging nurse faculty members. BSN programs, program leaders, and aging nurse faculty members can lessen incongruence by readjusting to address the pressures, tensions, and ongoing change.
MeSH Terms
- Aged
- Faculty, Nursing
- Humans
- Leadership
- Middle Aged
- Population Dynamics
Keywords
- Academia
- Aging
- Dean, academic
- Employment of older workers
- Faculty
- Nursing education
- Nursing shortage
- Retention
- Workforce
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The Longitudinal Elder Initiative: helping students learn to care for older adults.
This paper describes an educational innovation called the Longitudinal Elder Initiative (LEI), which was developed by a BSN program to improve students' knowledge about the health needs and nursing care of older adults. In the LEI, new nursing students are paired with older adults in the community and develop a relationship with them over the duration of the nursing program. Students complete a variety of assignments designed to facilitate learning gerontological nursing concepts. They also complete specific assessments designed to target common problems in aging. Students develop nursing care plans and interventions during the course of the project and monitor progress toward goals over time. Through the LEI, students develop relationships with older adults in the community and view their health changes longitudinally. In addition, students can observe how social, financial, and health-related factors affect health and well-being over time.
MeSH Terms
- Aged
- Aging
- Clinical Competence
- Continuity of Patient Care
- Curriculum
- Education, Nursing, Baccalaureate
- Empathy
- Geriatric Assessment
- Geriatric Nursing
- Humans
- Longitudinal Studies
- Needs Assessment
- Nurse-Patient Relations
- Nursing Assessment
- Nursing Education Research
- Patient Care Planning
- Program Development
- Program Evaluation
- Students, Nursing
{{medline-entry
|title=The fusion of gerontology and technology in nursing education: History and demonstration of the Gerontological Informatics Reasoning Project--GRIP.
|pubmed-url=https://pubmed.ncbi.nlm.nih.gov/17102305
|abstract=Phase I of our Gerontological Reasoning Informatics Project (GRIP) began in the summer of 2002 when all 37 senior undergraduate nursing students in our accelerated BSN nursing program were given PDAs. These students were oriented to use a digitalized geriatric nursing assessment tool embedded into their PDA in a variety of geriatric clinical agencies. This informatics project was developed to make geriatric nursing more technology oriented and focused on seven modules of geriatric assessment: intellect (I), nutrition (N), self-concept (S), physical activity (P), interpersonal functioning (I), restful sleep (R), and elimination (E)--INSPIRE. Through phase II and now phase III, the GRIP Project has become a major collaboration between the College of Nursing