PURPOSE:Nurse practitioners (NPs) in the United States play a critical role in meeting the demand for older adult care, a demand that will continue to increase over the next few years. Yet little is known about how the practice environment affects job satisfaction and intention to remain on the job for NPs who focus primarily on older adults (GNPs). To address this knowledge gap, we characterized the current geriatric NP workforce and examined how the practice environment relates to job dissatisfaction and intention to leave. METHOD:The current study draws on nationwide survey data from GNPs and NPs. RESULTS:GNPs were dissatisfied with the paperwork burden, their input into organizational policies, and the level of available administrative support. Dissatisfaction with input into organizational or practice policies, opportunities for professional development, patient load, patient mix, respect from physician colleagues, salary and benefits, and sense of being valued were significantly associated with a greater likelihood of intending to leave their position. CONCLUSION:These findings offer practical guidance for health care administrators and managers seeking to build practice environments that support GNPs, improve job satisfaction, and strengthen workforce retention.
PURPOSE:To examine the effects of a 3-month, sarcopenia-focused exercise intervention on depressive symptoms and quality of life (QoL) among community-dwelling older adults with dementia. METHOD:A quasi-experimental pre-post design was conducted in Taiwan. Eighty participants were recruited; 77 completed posttests (intervention, n = 38; control, n = 39). The intervention group attended 50-minute supervised exercise sessions three times per week for 12 weeks, whereas the control group received usual care. Depressive symptoms and QoL were assessed at baseline and after 3 months using validated instruments. RESULTS:Postintervention, the intervention group showed significantly higher QoL than the control group (t = 3.63, p < .001). Within-group analyses revealed significant reductions in depressive symptoms (t = 5.12, p < .001) and improvements in QoL (t = 3.36, p = .002). CONCLUSION:Structured, nurse-led exercise interventions can enhance psychological well-being and QoL in older adults with dementia, supporting their integration into community-based dementia care.
PURPOSE:National dementia strategies in the United States and United Kingdom emphasize developing a skilled nursing workforce capable of delivering person-centered dementia care. However, little is known about how prepared nursing students are to provide such care, and few validated tools exist to measure preparedness. METHOD:A literature review informed initial item generation, which was refined through expert review and cognitive interviews with 12 nursing students in the United States and United Kingdom. The final 59-item Student Nurse Preparedness Assessment for Dementia Care (SNAP-D) was tested with 328 nursing students to assess reliability and validity. RESULTS:The SNAP-D comprises eight domains and 59 items rated on a 5-point Likert scale. It demonstrated adequate construct validity, good convergent validity, and strong internal and test-retest reliability. CONCLUSION:The SNAP-D provides educators with a validated tool to evaluate curricula, identify learning gaps, and assess nursing students' preparedness to deliver high-quality dementia care.
Purpose: As symptoms progress in people with Alzheimer's disease and related dementias (ADRD), caregivers assume increasing responsibility. The objective of the current study was to summarize evidence on artificial intelligence (AI) technologies designed to support caregivers of people with ADRD. Method: A comprehensive literature search was conducted in CINAHL and PubMed. A scoping review methodology was used to synthesize study designs, AI modalities, caregiver populations, intervention settings, outcomes measured, and key findings. Results: Forty-three studies were included. Identified technologies included physical robots, conversational agents, and predictive algorithms. These AI interventions supported caregivers through education, task assistance, social support, and clinical management. Conclusion: As the population of older adults with ADRD grows, so will demand for caregiver support. Current research demonstrates a wide range of AI applications. Future research should focus on rigorous, long-term empirical evaluation of these technologies.
PURPOSE:To examine the readability and linguistic characteristics of Alzheimer's disease and related dementias (ADRD) prevention, symptom, and treatment information from generative artificial intelligence (GenAI) chatbots. METHOD:We analyzed 66 outputs from free-to-use GenAI chatbots. We extracted readability (word count, Fleisch Reading Ease, and Fleisch-Kincaid Grade Level) and linguistic scores (analytical thinking, clout, authenticity, and emotional tone) using Microsoft Word and the Linguistic Inquiry and Word Count software. Data were analyzed using descriptive statistics, t tests, analysis of variance, and multivariate analysis of variance. RESULTS:ADRD information from GenAI chatbots, especially treatment information, had college-level readability. Linguistic analyses indicate a high analytical thinking score and low scores for clout, authenticity, and emotional tone. CONCLUSION:Our sample of ADRD GenAI information exceeded recommended reading levels for patient education materials. Although the outputs exhibited logical thinking, they also included uncertain, inauthentic, and negative tones. ADRD caregivers should be aware of these characteristics when using GenAI chatbots for ADRD information-seeking.
PURPOSE: To culturally adapt and evaluate the content validity of the Empathy Circle (EC) intervention for Brazilian dementia care settings. METHOD: The current methodological study was guided by the Planned Intervention Adaptation protocol. Adaptation and validation used a modified Delphi technique with expert panels (n = 5: nursing, geriatrics, neurology, philosophy). Qualitative data from experts and participants were descriptively analyzed and organized according to the Delphi method. For pilot sessions, a directed content analysis was used, grouping responses into predefined units. Quantitative analysis included the content validity index (CVI) and Gwet's coefficient. RESULTS: Qualitative analysis revealed a positive emotional effect and suggestions for improving the physical setting and session duration. The EC achieved a mean CVI of 96%, with strong expert agreement. Participants reported enhanced emotional support, empathy, and reflective practice. CONCLUSION: The EC showed cultural validity and potential as a psychosocial tool for promoting empathy in dementia care, with high acceptability and adaptability.
PURPOSE: To evaluate whether an artificial intelligence (AI)-assisted surveillance device, AUGi, improves documentation of falls and injury rates in assisted living facilities (ALFs). METHOD: The current study represents a secondary analysis of existing facility fall documentation data. An interrupted time series design analyzed monthly fall data from 9 months before and 4 months after AUGi installation. Segmented regression assessed changes in fall documentation trends. RESULTS: No statistically significant immediate or trend changes were observed for total, injured, or non-injured falls. Injury rate slightly declined (Cohen's d = -0.54) without significance. Although statistical power was low (13%), the effect size suggests potential clinical relevance. CONCLUSION: Findings suggest pre-installation under-documentation and improved post-installation accuracy. AI-assisted surveillance may enhance fall reporting, patient safety, and quality improvement in long-term care. Findings may serve as a springboard for more rigorous studies examining injury prevention, quality of life, and mortality outcomes in ALFs.
PURPOSE:To investigate consistency in awareness, attitudes, and engagement in advance care planning (ACP) among older adults with chronic illnesses and their families, as well as influencing factors. METHOD:A mixed methods sequential explanatory design was used, with data collected from 312 patient-family member dyads via validated questionnaires and 11 dyads through semi-structured interviews. RESULTS:Key findings revealed low consistency in ACP awareness (Kappa = 0.191 to 0.449), with 97.76% of participants unfamiliar with ACP terminology. General positive attitudes toward ACP were observed, with 70.51% viewing it as meaningful (Kappa = 0.431), although engagement consistency was low (intraclass correlation coefficient = 0.109 to 0.390). Qualitative findings identified personal and familial characteristics, family dynamics, traditional culture, and clinical decision-making models as influential factors. CONCLUSION:Despite generally positive attitudes toward ACP, low consistency in awareness and engagement among Chinese older adults and their families necessitate the implementation of culturally sensitive, family-centered ACP interventions.
PURPOSE:Immunoglobulin A nephropathy (IgAN) is the most common pattern of primary glomerular disease worldwide and remains a leading cause of chronic kidney disease and kidney failure. The intent of the current article is to review the 2025 Clinical Practice Guideline from Kidney Disease: Improving Global Outcomes (KDIGO) for the management of IgAN and summarize updated evidence-based diagnostic and therapeutic strategies. METHOD:Current literature, clinical evidence, and guideline recommendations on the management of IgAN are reviewed. RESULTS:The updated guideline emphasizes early biopsy-confirmed diagnosis, proteinuria-guided risk assessment, and optimized supportive care, including strict blood pressure control and kidney protective therapies. In addition, newer disease-specific treatments that target pathogenic forms of IgA and IgA-immune complexes should be used simultaneously. CONCLUSION:The 2025 KDIGO guideline advances IgAN management through an interdisciplinary, multi-targeted, evidence-based approach aimed at reducing proteinuria, preserving kidney function, and improving long-term renal outcomes.
PURPOSE: The incidence of self-neglect among hospitalized older adults is relatively high, yet there is lack of research on the factors that influence this phenomenon. The current study aimed to explore the factors that influence self-neglect among hospitalized older adults from the perspective of nurses. METHOD: Purposive sampling was used to select 15 nurses working in geriatric wards of four comprehensive hospitals in southeastern China, from November to December 2020. Semi-structured face-to-face interviews were used to collect data. Content analysis was used to summarize, analyze, and refine themes derived from interviews. RESULTS: Four main themes and 10 subthemes were found. The four main themes included Individual Characteristics, Health Beliefs and Perceptions, Physical Functional Status, and Social Support Systems. CONCLUSION: A comprehensive assessment should be conducted on the physical, psychological, social, and medical aspects of hospitalized older adults to identify high-risk individuals who are prone to self-neglect.
PURPOSE: The current study sought to develop a set of core competency assessment metrics for dementia care for geriatric nurse specialists, serving as a foundational resource for training assessment and competency evaluation. METHOD: An initial framework was established through literature review and qualitative interviews. Then, using Delphi expert consensus method, a questionnaire was distributed to experts across eight Chinese provinces. RESULTS: Three rounds of expert consensus were conducted. The resulting core competency framework comprised six dimensions and 39 competencies. Expert authority coefficients were 0.904, 0.891, and 0.891, with importance scores of entries ranging from 3.76 to 4.95, and coefficients of variation ranging from 0.06 to 0.24. CONCLUSION: The developed dementia care core competency indicator system exhibited robust scientific validity and reliability, serving as a valuable reference for the training, assessment, and standardization of dementia care competencies among geriatric nurse specialists in China.
Purpose: Measuring person-centered care (PCC) is essential for assessing care quality, yet a comprehensive review of PCC measurement tools in long-term supports and services (LTSS) is lacking. The current study identified and evaluated tools for measuring PCC in older adults in LTSS. Method: Following Arksey and O'Malley's scoping review framework, a search was conducted in PubMed and CINAHL. Peer-reviewed articles in English on PCC measurement tools for older adults (aged ≥65 years) in LTSS were included, excluding family-reported tools and gray literature. Results: From 914 studies, 25 articles were selected, revealing 11 tools categorized as non-observational (e.g., self-report) and observational (e.g., structured observation). Most tools ( n = 8) demonstrated strong reliability and validity. Conclusion: This study identified current tools available while also highlighting limitations, such as inconsistencies among tools. Findings can guide future research and practice to enhance PCC in LTSS.
PURPOSE: Promoting physical activity (PA) among nursing home (NH) residents, particularly those with cognitive impairment, often generates ethical tensions that may be rooted in paternalism, risk-averse cultures, and institutional routines. Therefore, it is necessary to address ethical considerations that can inform policy and practice aimed at promoting safe and effective PA intervention strategies. METHOD: PA promotion was examined through the bioethical principles of autonomy, beneficence, nonmaleficence, and justice. The analysis was extended by introducing a relational autonomy framework suited to contexts of cognitive vulnerability. RESULTS: By situating agency within relational, cultural, and organizational structures, the relational autonomy framework clarifies how ethically grounded and cognitively responsive PA can be enabled or constrained in long-term care settings. The analysis further demonstrated that principlist approaches alone are insufficient to address the relational dependencies and fluctuating capacities that shape NH residents'participation. CONCLUSION: Meaningful PA requires communication strategies attuned to cognitive fluctuation, identity-aligned activity design, and institutional flexibility that reduces structural barriers. Integrating relational autonomy into PA policy, staff training, and everyday care practices is ethically necessary to not only promote overall health, but to uphold agency, equity, and personhood for cognitively impaired NH residents.
PURPOSE:The current study aimed to co-design an intervention and evaluate its effects on knowledge, perceived self-efficacy, group facilitation skills, and core competencies in alleviating loneliness among Thai older adults. METHOD:A quasi-experimental design with two groups and pre-/posttest measures was used. Sixty-one health volunteers from a district in Thailand were randomly assigned to a control group (n = 30), which received a 1-day educational session on addressing loneliness, or an experimental group (n = 31), which participated in a 7-week self-efficacy-based leader development program. Outcome measures included the Loneliness Multiple-Choice Examination and General Perceived Self-Efficacy Scale. Skills and competencies were assessed using the Skills in Facilitating Groups to Address Loneliness Scale and Loneliness Alleviation Competency Scale, with evaluations conducted by trained assessors during simulated sessions and supervised community practicums. RESULTS:The experimental group demonstrated significantly greater improvements in knowledge and perceived self-efficacy compared with the control group (p < .05). Furthermore, participants in the experimental group achieved proficiency in ≥75% of skills and core competencies for alleviating loneliness in older adults during real-world community practice. CONCLUSION:The self-efficacy-based leader development program effectively enhanced health volunteers' knowledge, self-efficacy, and competencies in addressing loneliness. Structured, competency-based training can strengthen community-based interventions led by health volunteers and contribute to improved psychosocial well-being among older adults.
