Family Caregivers' Needs in Long-Term Care Facilities: A Descriptive Qualitative Study.

PURPOSE: To explore the needs of family caregivers (FCs) and how these are addressed in long-term care facilities (LTCFs). METHOD: A descriptive qualitative study was performed, using semi-structured interviews with 23 FCs from seven LTCFs in Japan. RESULTS: Inductive content analysis revealed three main themes: Coexistent Needs Related to Residents' and FCs' Own Well-Being, Means by Which FCs Promote Residents' and Their Own Well-Being, and Managing Conflicting Needs by Prioritizing and Compromising. FCs recognized that their needs relate to the well-being of residents and themselves, and both needs coexist. To address these multifaceted needs, FCs engaged in various activities while seeking support. However, limited availability of means often made it challenging to meet multiple needs simultaneously, leading FCs to manage these conflicting needs by prioritizing or compromising. CONCLUSION: The current study underscores the significance of comprehensive support that simultaneously addresses FCs' conflicting needs, rather than approaching each need separately. [Research in Gerontological Nursing, 17(4), 177-187.].

Factors affecting the critical appraisal of research articles in Evidence-Based practices by advanced practice nurses: A descriptive qualitative study.

AIM: To describe factors affecting critical appraisal of research articles in evidence-based practice by certified nurse specialists who were advanced practice nurses in Japan. DESIGN: A descriptive qualitative study. METHODS: Fourteen certified nurse specialists with master's degree were included by a snowball sampling to maximize the variety of specialty fields for advanced practice nurses in Japan. Individual semi-structured interviews were conducted between November 2016 and March 2017. Interview guides included the experience of evidence-based practice and learning about critical appraisal. RESULTS: The following four aspects were identified as factors affecting the critical appraisal of research articles in evidence-based practices-individual beliefs and attitude, learning status, organizational readiness and availability of research evidence. Each factor included both positive and negative aspects for critical appraisal in evidence-based practice. PATIENT OR PUBLIC CONTRIBUTION: If advanced practice nurses acquire knowledge/skills of critical appraisal, they would be able to select more appropriate care. This will increase to improve the health-related outcome for patients or populations.

Effect of an end-of-life gerontological nursing education programme on the attitudes and knowledge of clinical nurses: A non-randomised controlled trial.

AIMS: To evaluate how a structured interactive two-day education programme for clinical nurses on end-of-life (EOL) care for older people affects nurses' attitudes and knowledge. DESIGN: Non-randomised controlled trial. METHODS: Nurses were recruited separately for intervention and control groups. The intervention group assisted older patients with EOL care and recruited patients for the programme. To prevent sampling bias, control group nurses were recruited from a facility with numerous EOL care opportunities. The intervention was a two-day educational programme. Using valid and reliable scales, we evaluated the attitudes (total score range: 26-130) and knowledge (total score range: 0-51) of the intervention group four times (pretraining, post-training, 3 months, 6 months) and the control group three times (baseline, 3 months, 6 months) between January 2016 and April 2017. Analysis of covariance examined both groups' score changes at 3 and 6 months while adjusting for confounding factors. RESULTS: Participants were 338 nurses caring primarily for older people (intervention group: 164; control group: 174); 142 responded at all measurement points. The change in mean value of the attitude scale from baseline to 3 months (differences in the groups' attitude scores = 7.33; 95% CI = 2.43-12.24; p = .004) and 6 months (differences in groups' attitude scores = 5.77; 95% CI = 0.17-11.37; p = .044) was greater in the intervention group. Moreover, the mean knowledge scale score change from baseline to 3 months was greater in the intervention group (differences in groups' knowledge scores = 5.74; 95% CI = 4.07 to 7.39; p < .001). There was no evidence of a change in this score between baseline and 6 months. CONCLUSION: The programme improved nurses' medium- to long-term attitudes and knowledge. Thus, it may help nurses enhance the quality of care they provide. IMPLICATIONS FOR PRACTICE: A two-day educational program improves nurses' medium- to long-term attitudes and knowledge on end-oflife care. For quality end-of-life care for older people, a structured and evidence-based educational program should be provided to nursing staff.

Developing a Measure of End-of-Life Care Nursing Knowledge for Japanese Geriatric Nurses.

This study developed an end-of-life (EOL) care nursing knowledge scale for Japanese geriatric nurses (ELNKS-JG) to measure nurse knowledge of EOL care for older adults. It also was used to evaluate the quality of The End-of-Life Nursing Education Consortium-Japan Geriatric. Participants were 1168 nurses employed in 32 institutions across Japan. The items of our measure were developed to cover 8 important topics: principles of EOL care for older adults; pain management; symptom management; ethics of care; cultural and spiritual considerations; communication; loss, grief, and bereavement; and caring for final days. The measure included 51 items with an overall Cronbach α coefficient of 0.87 and an intraclass correlation coefficient of 0.81. Our measure, the ELNKS-JG, was confirmed to have good internal consistency, test-retest reliability, content validity, and known-groups validity. This scale's items included knowledge about noncancerous diseases, physical changes due to aging, family care, and multidisciplinary collaboration. The ELNKS-JG comprehensively measures a nurse's knowledge of EOL care for older adults in any EOL setting. Furthermore, this scale can evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.

Development of the End-of-Life Care Nursing Attitude Scale for Japanese Geriatrics.

This study aimed to develop an end-of-life (EOL) care nursing attitude scale for Japanese geriatric nurses (ELNAS-JG). The items of the ELNAS-JG were developed to cover important topics related to EOL care (eg, motivation for providing EOL care, pain and symptom management, and decision-making support care for older adults). Participants were 1663 nurses employed in 32 institutions across Japan. Of these, 1298 participants were analyzed. An exploratory factor analysis of the 26 scale items revealed a 3-factor solution describing the concepts of responsibility, willingness, and confidence: responsibility and willingness were captured in factor 1 (16 items), and confidence was split into factor 2 (6 items) and factor 3 (4 items) to capture individual and collaborative behaviors. The overall Cronbach α coefficient for the 26 items was 0.95, and the intraclass correlation coefficient was 0.83. Overall, the ELNAS-JG was confirmed to have good internal consistency, test-retest reliability, content validity, known-groups validity, and construct validity. It can comprehensively measure nurses' attitudes toward EOL care for older adults in any EOL setting. Furthermore, this scale can be used to evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.