PURPOSE:This study aimed to explore the perspectives of older adults, caregivers, and managerial informants regarding institutional elder care in Indonesia. METHODS:This study used an interpretive qualitative design to explore participants' lived experiences in a faith-oriented nursing home in Gresik, Indonesia. Fifteen participants, including six older adult residents, six caregivers, and three managerial informants, participated in in-depth semi-structured interviews and non-participant observations. Data were analyzed using thematic analysis guided by interpretive principles, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethical approval was obtained from an authorized review board prior to data collection. RESULTS:Five themes identified were (1) family deception and prejudice leading to loss of belonging; (2) praying and working as strategies for emotional endurance; (3) waiting for family with persistent hope amid sorrow; (4) caregivers' moral and economic tensions in care practices; and (5) systemic scarcity and managerial constraints in institutional elder care. CONCLUSION:Aging in Indonesian institutional settings reflects complex interactions among cultural expectations, spiritual coping, economic limitations, and structural care challenges. These findings reveal the need for culturally and spiritually grounded models of gerontological care in Indonesian societies.
PURPOSE:In comprehensive nursing care service units (CNCSUs), where family caregivers are rarely present, nurses are primarily responsible for both medical treatment and daily care, making professional gerontological nursing practice essential. This study investigated factors associated with gerontological nursing practice among nurses in CNCSUs. METHODS:A cross-sectional descriptive study was conducted. The participants included 153 nurses at two general hospitals in Korea. A structured self-reported questionnaire was administered to assess general characteristics, perceived patient safety culture, moral sensitivity, organizational communication satisfaction, and gerontological nursing practice. Data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson correlation coefficients, and multiple linear regression. RESULTS:The 153 participants had a mean age of 29.32 years. In the multiple regression analysis, the factors associated with gerontological nursing practice of subjects included perceived patient safety culture (β=.23, p=.004), experience volunteering with older adults (β=.20, p=.008), moral sensitivity (β=.20, p=.009), and organizational communication satisfaction (β=.16, p=.046). The regression model explained 29.0% of the variance in gerontological nursing practice (F=7.78, p<.001). CONCLUSION:Enhancing perceived patient safety culture, moral sensitivity, and organizational communication satisfaction among nurses in CNCSUs may improve their gerontological nursing practice and the quality of nursing care for older adults.
PURPOSE:This study aimed to identify risk factors for falls and fall-related injuries among community-dwelling older adults in Korea. METHODS:This longitudinal study analyzed 3,186 adults aged 65 or older using nationally representative data from the Korean Longitudinal Study of Aging across three waves (2018, 2020, and 2022). We conducted multiple logistic regression analyses to identify risk factors for falls and fall-related injuries. RESULTS:Over the 4-year follow-up, 148 participants (4.6%) experienced a fall, and 118 of these (79.7% of fallers) sustained a fall-related injury. The risk of falls increased with advanced age (odds ratio [OR]=2.01, 95% confidence interval [CI]=1.37~2.96), female sex (OR=1.64, 95% CI=1.07~2.52), lower self-rated health (OR=1.94, 95% CI=1.01~3.77), and being underweight (OR=2.71, 95% CI=1.36~5.42) or obese (OR=1.69, 95% CI=1.11~2.55). For fall-related injuries, significant risk factors included advanced age (OR=1.74, 95% CI=1.14~2.65), female sex (OR=1.71, 95% CI=1.06~2.75), lower self-rated health (OR=2.61, 95% CI=1.22~5.59), and being underweight (OR=3.01, 95% CI=1.46~6.20). CONCLUSION:These findings indicate that falls and fall-related injuries among older adults are complex health issues that extend beyond simple physical problems. Further research should continue to identify risk factors through repeated studies and support the development and implementation of comprehensive education and intervention programs that address the risk factors identified in this study.
PURPOSE:Nursing homes face a growing demand for high-quality palliative wound care. Nursing home staff require not only knowledge but also clinical judgment to address the complex needs of residents at the end of life. This study aimed to develop and evaluate a web-based palliative wound care education program using a clinical judgment model. METHODS:An educational program was developed using the ADDIE model through needs analysis with 10 nursing home staff, program design and development, and pilot implementation and evaluation. Program effectiveness was evaluated in a quasi-experimental study with facility-level random allocation. Four nursing homes were randomly allocated to the experimental or control condition, and 52 nursing home staff were included in the final analysis (n=26 per group). The experimental group received clinical judgment model-based web education, whereas the control group received general web-based palliative wound care education without the clinical judgment model. Clinical judgment was assessed before and after the intervention using nonparametric tests. RESULTS:Both groups showed significant improvements in clinical judgment. However, the experimental group demonstrated greater improvements than the control group in noticing (Z=-3.91, p<.001), interpreting (Z=-3.39, p=.001), responding (Z=-3.64, p<.001), reflecting (Z=-2.30, p=.021), and the total clinical judgment score (Z=-4.62, p<.001). CONCLUSION:The findings support the effectiveness of clinical judgment model-based education in improving clinical judgment in palliative wound care. This web-based approach supports continuing education and improves care quality in nursing homes.
PURPOSE:This descriptive study aimed to identify the factors associated with falls in older adults according to frailty status. METHODS:Data from 9,955 older adults in the 2023 National Survey of Older Koreans were analyzed. Differences in demographic, socioeconomic, and health-related behaviors by frailty status were evaluated using the Rao-Scott X2 test. A complex-sample general linear model was used to evaluate the frequency of falls. Complex-sample multiple logistic regression analyses were performed with falls as the dependent variable to examine their associations with Instrumental Activities of Daily Living limitation, cognitive impairment, and depression according to frailty status, adjusting for demographic, socioeconomic, and health-related factors. RESULTS:The number of falls was 1.40±0.08 in the robust group, 1.89±0.10 in the prefrail group, and 2.88±0.43 in the frail group. Instrumental Activities of Daily Living limitation was significantly associated with fall experience only in the prefrail group. Depression was identified as a significant fall-related factor including the robust, prefrail, and frail groups. CONCLUSION:Higher frailty levels were associated with an increased number of falls, suggesting that frailty management should be included in fall prevention strategies. Different fall prevention interventions based on frailty status are needed. Therefore, screening for depression should be included in fall prevention programs for older adults.
