The determinants of actual place of death among noncancer patients with end-stage chronic health conditions: a scoping review.

A home is a preferred place of death by most people. Nurses play a key role in supporting end-of-life home care, yet less is known about the factors that determine home as a place of death. This scoping review describes the percentage of actual places of death and determines social factors related to home as the place of death among noncancer patients with end-stage chronic health conditions. Inclusion criteria included (1) noncancer chronic illness conditions, (2) outcomes of place of death, and (3) factors that determine home as a place of death. Sources of evidence included PubMed, CINAHL, and Web of Science databases, which were searched in May 2022, and additional searches from May 2022 to November 2023.The JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension were used. Twenty-eight studies were included in this analysis. The range of percentages is varied within the same place of death among the sample. Two major constructs that determine a home as a place of death were identified: preceding factors and social capital. The results suggest that the place of death among noncancer patients with end-stage chronic health conditions should be continued to be understood. Two constructs determined home as a place of death and are considered as a fundamental to increasing equal accessibility in the initiation of palliative care services to promote home death and meet end-of-life care goals.

Evaluation of Family and Community Social Network Characteristics Among High-Risk Family Members to Improve Cancer-Related Health Behaviors.

OBJECTIVES: To evaluate the effects of social network characteristics of individuals with a family history of cancer on the use of cancer-related services (e.g., screening, genetic counseling/testing). SAMPLE & SETTING: 170 family members of individuals with the most common hereditary or familial cancers. METHODS & VARIABLES: Data collection occurred between March and September 2021 using an online survey. RESULTS: Having strong within-immediate family relationships and family members who underwent more screening procedures was associated with increased breast cancer screening, and having more family members with cancer was associated with colorectal cancer screening. Having a large family, having family members who underwent screening for more cancers, and having strong social cohesion among families were associated with an increased rate of genetic testing. IMPLICATIONS FOR NURSING: Nurses working with families affected by cancer should focus on strategies to strengthen relationships among family members to improve knowledge of cancer screening and available genetic services.

Testing Leash Walking Training as a Physical Activity Intervention for Older Adult Dog Owners: A Feasibility Study.

Dog walking is a physical activity (PA) with many health benefits for older adults. Dog behavior issues can be a barrier to dog walking. This study piloted leash manners training as a PA intervention for dog owners ages 60+ years. Fourteen dog owners (mean age = 65 years, female = 71%) enrolled in a leash manners training course. Process evaluation data were collected to determine feasibility and acceptability of the intervention and study procedures. Twelve of fourteen enrolled participants (86%) completed the course, and most were highly engaged with the program, as evidenced by high class attendance (92% of participants who completed the course attended ≥5 of 6 classes) and a majority (64%) reporting frequent skills practice at home. Further, most participants (73%) reported their leash walking skills improved. The PA assessment protocol (7 days of 24 h data collection using activPAL monitors) was well tolerated, with all participants who completed assessments at each time point (pre-program, post-program, 4-week follow-up) providing ≥6 valid days of data. In sum, the intervention approach and study procedures were feasible and acceptable in this sample of older adults. More research is needed to determine the effectiveness of leash manners training for increasing PA in this population.

Social Influences on Perceptions of Sense of Control and Attributed Dignity Among Older People Managing Multiple Chronic Conditions.

PURPOSE: The aim of this study was to explore associations between social support, sense of control, and attributed dignity in persons aged 65 years and older who self-manage multiple chronic conditions while living in the community. DESIGN: A descriptive, nonexperimental, correlational design was used in this study. METHODS: Eighty-nine participants completed telephone surveys that measured social support, sense of control and attributed dignity. Regression analysis was used to identify associations. RESULTS: Participants were independent in seven of the eight instrumental activities of daily living, with participants having an average of 11 (±4) chronic conditions. Significant positive relationships between social support, perceived sense of control, and attributed dignity were identified. CONCLUSIONS: Positive social support is strongly associated with perceived sense of control and attributed dignity. CLINICAL RELEVANCE: Healthcare professionals, especially rehabilitation nurses, can assess social support and offer ways to improve social support, thus enhancing sense of control and attributed dignity. These concepts enhance older individuals' ability to manage multiple chronic conditions.

Usability Experience of a Personal Sleep Monitoring Device to Self-manage Sleep Among Persons 65 Years or Older With Self-reported Sleep Disturbances.

Increasingly, persons with self-reported health symptoms are using mobile health technologies to better understand, validate, and manage their symptoms. These off-the-shelf devices primarily utilize actigraphy to estimate sleep and activity. The purpose of this study was to describe qualitatively the experience of using a personal sleep monitoring device for sleep self-management in adults 65 years or older with self-reported sleep disturbances. This study followed a hybrid qualitative design using deductive and emergent coding derived from open-ended interviews (n = 25) after a period of 4 weeks using a wearable personal sleep monitoring device. Results expanded existing theoretical models on usability with the theme of personal meaning in the interaction between health and self-monitoring technology that were associated with age and technology use, privacy, and capability. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring devices should continue to collect qualitative information in extending the understanding of user experience across different symptom clusters, such as sleep disturbances, that manifest more commonly in older age populations. This research is important for application in the use of mobile health technologies for nursing led health self-management interventions.

Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study.

BACKGROUND: Social relationships influence health, yet less is known on how social relationships influence self-care among older people living with multiple long-term conditions. OBJECTIVES: The purpose of this study was to determine how social networks influence therapeutic self-care behaviours and health among community dwelling older people living with multiple long-term conditions. DESIGN: Explanatory sequential mixed-methods. SETTING/SAMPLE: Community dwelling older people living in the Northeast United States. METHODS: A cross-sectional sample of eighty-nine people aged sixty-five and older participated in telephone surveys. A nested sample of twelve participants completed a follow-up open-ended interview. Descriptive statistics, bivariate correlations and regression statistics were used to examine the associations between social network features and functions with the dependent variables of therapeutic self-care behaviours and health. Qualities that emphasised the contexts of the relationships were integrated in the data analysis. RESULTS: The strength of the social network and level of social support influenced the outcomes of therapeutic self-care and mental health. Thematic analysis expanded this explanation of self-care in relation to social network size, psycho-social support, activation of support, interaction frequency and type. CONCLUSION: In supporting older people living with multiple long-term conditions, this nursing research offers new ways to understand close social relationships influence on self-care in developing systems of care at the community level. IMPLICATIONS FOR PRACTICE: Designing care systems that include small trusted formal and informal caregivers that integrate social network members could improve health outcomes and improve access to supportive resources.

Reducing Stress and Increasing Mindfulness in Nursing Students: An Online Mindfulness Intervention Study.

ABSTRACT: This pilot study evaluated the outcomes of stress and mindfulness among a convenience sample ( n = 60) of nursing students. Students participated in an online mindfulness-based intervention and completed the Perceived Stress Scale and the Five Facet Mindfulness Questionnaire. Although mean stress scores lowered, there was no statistically significant reduction in stress. There were significant increases in mindfulness scores (posttest, p = .000) that were sustained at four-week follow-up ( p = .012). Larger increases in mindfulness were associated with larger decreases in stress.

Feasibility of Technology-Enhanced Faculty Mentorship Use to Increase Retention of Minority Nursing Students.

Mentoring can enhance retention of academically at-risk students. The purpose of this project was to determine the feasibility of technology-enhanced faculty mentorship use in retention of minority undergraduate nursing students. The project consisted of a unique, blended (face-to-face and tablet-based) mentoring approach. Eight faculty mentors and 29 nursing student mentees participated across two cohorts. We used descriptive statistics instead of inferential statistics; therefore our findings are observational instead of inferential. We observed that after participation, the semester passing rate of the students was 100% in the first cohort and 90.5% in the second cohort. Another observation was that the overall program retention rate was improved compared to the preceding year, and that mentee satisfaction ranged from 90.9% to 100%.

Use of a Personal Sleep Self-Monitoring Device for Sleep Self-Management: A Feasibility Study.

The purpose of the current study was to establish feasibility of personal sleep monitoring devices (PSMDs) as an intervention for sleep self-management in older adults. This study followed a mixed-methods experimental design based on the World Health Organization's International Classification of Functioning, Disability, and Health, and the proposed conceptual model of symptom management in a social context. Results showed an acceptable recruitment and retention rate of participants, and acceptability of PSMDs by users. Participants were able to meaningfully interpret PSMD data as evidenced by the numeracy evaluation scores, initiate sleep goals, and share their sleep data and goals with friends or relatives. Findings support extending this research protocol to a larger sample. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring are recommended. [Journal of Gerontological Nursing, 47(1), 28-34.].

A Place for the Professional Introduction in Practice.

This article describes a survey exploring the use of professional introductions by nurses.For this project, a survey inquiring about introduction practices was administered to nurses attending a regional research conference.

Self-management after hospitalisation.

AIMS AND OBJECTIVES: The aim of this research was to explore the processes used by older individuals to self-manage their health during the first 30 days after being discharged from the hospital. The underlying philosophy for this research was symbolic interactionism. From this perspective, individuals make meaning out of their experiences and act on the basis of those meanings. BACKGROUND: Little is known about the processes older adults use to adjust to and self-manage their evolved health status after returning home from the hospital. Few studies have explored this period from the perspective of the older individual living in the situation. METHODS: We used case study method to develop a collective, instrumental case to explain the phenomena of older individuals self-managing their health after hospitalisation. Data included interviews, participant diaries and researcher field notes. RESULTS: The sample included three women who were at least 75 years old, had been hospitalised for at least 24 hr and had been discharged within the week prior to the first interview. Data from the participants were used to create a composite case, Mrs. C. She managed her autonomy, activity, attitude, health and relationships across three phases of posthospitalisation, returning home, adjusting and the evolved normal. CONCLUSIONS: This study provides insight into the experience of older individuals during the first 30 days after a stay in a healthcare facility and supports previous research findings regarding hospitalisation and self-management of chronic health problems. IMPLICATIONS FOR PRACTICE: The findings provide evidence that returning home is a process that usually takes about a month to get into a new routine. Nurses can use this case study to describe some people's experience after discharge, and to help the older individual to identify friends and family who can provide physical and emotional support during the time immediately after discharge.

Self-care among older people living with chronic conditions.

PURPOSE: The aim of this study was to clarify the concept of self-care among older people living with chronic health conditions. This concept clarification will assist nurses in addressing self-care among older people through research, policy and practice in offering an expanded conceptual model. BACKGROUND: Several policy influences over the past decade directly relate to the increased importance and economic necessity to require self-directed care for older people living with chronic health conditions to maintain their care at home in the community. METHOD: A selective review of literature on the concept of self-care included 31 sources. The Norris Concept Clarification method (1982) was used for clarification. The phenomenon is described historically according to its antecedents, attributes and consequences. RESULTS: A proposed definition is provided based on the clarification of this concept. A conceptual model is presented through an ecological framework. Self-care among older people living with chronic conditions is multidimensional and has multilevel influences (individual, community, system levels) and is mediated by the contexts and processes of ageing. Self-care originates along one's life course and is learned. Self-care responses are based on care needs when living with chronic health conditions. CONCLUSION: Self-care is an individual capacity, disposition and activity older people manifest in living with multiple chronic conditions. These features (capacity, disposition, action) influence one another and are hierarchical and continuous. Research, practice and policies that promote self-care among older people can focus on these features to improve health outcomes and promote new models of care consistent with personal development and chronic care needs in older age. IMPLICATIONS FOR PRACTICE: This concept clarification can offer a model to support self-care among older people living with chronic conditions.

Benefits of Implementing and Improving Collection of Sexual Orientation and Gender Identity Data in Electronic Health Records.

Individuals in lesbian, gay, bisexual, and transgender communities experience several disparities in physical and mental health (eg, cardiovascular disease and depression), as well as difficulty accessing care that is compassionate and relevant to their unique needs. Access to care is compromised in part due to inadequate information systems that fail to capture identity data. Beginning in January 2018, meaningful use criteria dictate that electronic health records have the capability to collect data related to sexual orientation and gender identity of patients. Nurse informaticists play a vital role in the process of developing new electronic health records that are sensitive to the needs and identities of the lesbian, gay, bisexual, and transgender communities. Improved collection of sexual orientation and gender identity data will advance the identification of health disparities experienced by lesbian, gay, bisexual, and transgender populations. More inclusive electronic health records will allow providers to monitor risk behavior, assess progress toward the reduction of disparities, and provide healthcare that is patient and family centered. Concrete suggestions for the modification of electronic health record systems are presented, as well as how nurse informaticists may be able to bridge gaps in provider knowledge and discomfort through interprofessional collaboration when implementing changes in electronic health records.

Digital story telling in social justice nursing education.

OBJECTIVES: The purpose of this study was to explore and evaluate how digital stories integrated into public health nursing education can teach social justice concepts essential for nurse leadership. DESIGN AND SAMPLE: Four digital stories were selected and incorporated into a public health nursing course. Students were asked to reflect on these stories. A retrospective qualitative analysis was completed on the student narrative reflections and analyzed for themes. A total of 108 narrative reflections of public health nursing students were included from 2015 to 2016. RESULTS: Themes were identified based on analysis and include-Encountering Vulnerability, Questioning Systems and Choosing Moral Courage. CONCLUSIONS: Digital stories offer an innovative medium to convey the importance of story, advance social justice as an essential practice of nursing, and create opportunities that addresses social justice in nursing and in developing nursing leaders.

The Professional Introduction.

The key to establishing the relationship between nurse and patient.