Geriatric Nursing (New York, N.Y.)[JOURNAL]
Sun
200 papers
Consumer-driven co-design of an advanced practice nursing role for older adults undergoing surgery.
Taylor A, Craswell A, Woollett K … +1 more , Duff J
Geriatr Nurs · 2026 Jun · PMID 42114222 · Publisher ↗
PURPOSE/AIM: To establish foundational parameters of a gerontology-informed advanced practice nursing (APN) role to support older adults undergoing surgery, using a multi-phase, evidence-informed co-design process. METHO...
PURPOSE/AIM: To establish foundational parameters of a gerontology-informed advanced practice nursing (APN) role to support older adults undergoing surgery, using a multi-phase, evidence-informed co-design process. METHODS: This study adopted a participatory co-design approach informed by the Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing role development (PEPPA) framework. Data were collected sequentially through a scoping review, semi-structured interviews and surveys with older adults and carers, a pre-workshop clinician survey and a multi-stakeholder co-design workshop. Interviews incorporated a Rose-Bud-Thorn reflective activity, and workshop discussions used dot-voting to support shared prioritisation. Qualitative content analysis and descriptive statistics were used to integrate findings across stakeholder groups. RESULTS: Twelve older adults (including two supported by carers) and 15 clinicians participated across study phases, with 13 attending the co-design workshop. Older adults identified three priority areas for improvement: communication and information needs, coordination and continuity of care and preparation for discharge. Clinicians emphasised frailty-focused assessment, perioperative optimisation, interprofessional coordination and the need for senior APN expertise. Consensus was reached on targeting frail and high-risk surgical patients, adopting a Nurse Practitioner (NP) level for the role and implementing shared governance between perioperative medicine and geriatrics. CONCLUSION/IMPLICATIONS: The foundational parameters of a gerontology-informed APN role were developed through a rigorous, multi-source co-design process, addressing a critical gap in perioperative care for older adults in Australia. The findings provide a robust evidence base for implementing and evaluating a perioperative APN role that aims to enhance continuity, communication and gerontological support for older adults undergoing surgery.
Physical activity personas of older adults based on the capability, opportunity, motivation-behavior model: a cross-sectional study.
Zhang Y, Qian L, Liu F … +8 more , Zhang J, Lu Y, Wu VX, Si K, Zhang R, Zhi Z, Jia D, Huang X
Geriatr Nurs · 2026 Jun · PMID 42105626 · Publisher ↗
AIM: To construct physical activity (PA) personas of older adults using a data-driven health persona approach based on the Capability, Opportunity, Motivation-Behavior (COM-B) model. METHODS: Older adults were recruited...
AIM: To construct physical activity (PA) personas of older adults using a data-driven health persona approach based on the Capability, Opportunity, Motivation-Behavior (COM-B) model. METHODS: Older adults were recruited from two community health centers. PA was measured using the Physical Activity Scale for the Elderly. Variables potentially associated with PA were investigated based on the COM-B model, including capability, motivation, and opportunity factors. These variables were first screened through univariate analysis and subsequently underwent dimensionality reduction using exploratory factor analysis. Then, k-means clustering was employed to construct PA personas by integrating PA levels with the key factors derived from factor analysis. PA personas were further visualized. RESULTS: A total of 313 valid questionnaires were collected for data analysis. Nine variables were identified as correlated with PA through univariate analysis, and subsequently reduced to three underlying factors via exploratory factor analysis: the motivation-opportunity factor, the psychological capacity factor, and the physical capacity factor. Considering both PA levels and the three factors, clustering analysis revealed four distinct PA personas: the highly active cluster (25.6%; with the highest PA levels), the physically constrained inactive cluster (18.8%; with the poorest physical capability), the knowledge-skill deficient inactive cluster (32.6%; with the lowest psychological capability), and the motivation-opportunity deficient inactive cluster (23.0%; with the lowest motivation and opportunity). CONCLUSION: This study identified four distinct PA personas with typical characteristics among older adults based on the COM-B model. These findings suggest that personalized interventions targeting specific barriers are warranted to promote PA in this population.
Heterogeneous social isolation and its psychosocial and functional correlates in older adults with chronic heart failure: An integrated latent profile and network analysis.
Lu Y, Cao S, Zeng F … +4 more , Cui Z, Wu X, Diao X, Zhao Y
Geriatr Nurs · 2026 Jun · PMID 42105625 · Publisher ↗
OBJECTIVE: This study aimed to identify latent subgroups of social isolation (SI) among older adults with chronic heart failure (CHF) and to explore psychosocial and functional interrelations using an integrated latent p...
OBJECTIVE: This study aimed to identify latent subgroups of social isolation (SI) among older adults with chronic heart failure (CHF) and to explore psychosocial and functional interrelations using an integrated latent profile analysis (LPA) and network analysis (NA). METHODS: A cross-sectional survey was conducted with 352 hospitalized CHF patients aged ≥60 years. SI was assessed using the Lubben Social Network Scale-6, frailty with the FRAIL scale, depression with the PHQ-9, family function with the APGAR index, and functional ability with the Barthel Index. LPA was applied to identify SI profiles, NA was used to map inter-variable associations, and multinomial logistic regression examined predictors of subgroup membership. RESULTS: Three SI profiles were identified: high isolation-family reliant (18.2%), medium isolation-friend connected (55.7%), and low isolation-family supported (26.1%). The overall prevalence of SI was 51.4%. Frailty consistently emerged as the most central node across profiles, bridging depression, ADL, and family support. Depression showed particularly high centrality in the high-isolation group. Independent predictors of high isolation included older age, lower income, multimorbidity, frailty, impaired ADL, and poor family function (all P < 0.05). CONCLUSION: SI among older CHF patients is heterogeneous. The integration of LPA and NA not only revealed distinct isolation subgroups but also identified frailty as a pivotal bridge linking physical, psychological, and social domains. Subgroup-specific vulnerabilities were also uncovered, with depressive symptoms and poor family function being especially important in medium isolation.
Important outcomes for patients with frailty admitted to hospital with peripheral arterial disease, their caregivers and their health professionals: A Nominal Group Technique study.
Gordon EH, Young AM, Wu D … +3 more , Muller J, Hubbard RE, Ludlow K
Geriatr Nurs · 2026 Jun · PMID 42090897 · Publisher ↗
AIMS: This study aimed to identify outcomes that are important to older patients with frailty admitted to hospital with peripheral arterial disease (PAD), informal caregivers and health professionals, and to ascertain th...
AIMS: This study aimed to identify outcomes that are important to older patients with frailty admitted to hospital with peripheral arterial disease (PAD), informal caregivers and health professionals, and to ascertain the attitudes, values and beliefs underpinning prioritisation of these outcomes. METHODS: Focus groups using Nominal Group Technique were conducted with older adult patients with frailty and PAD, informal caregivers, vascular surgeons, nurses, and allied health professionals (AHPs). The 10 highest ranked outcomes for each group were identified, and qualitative data were thematically analysed. RESULTS: Six patients, four caregivers, six surgeons, four nurses and four AHPs participated in six focus groups and identified 88 outcomes. Outcomes relating to independence, wellbeing and quality of life were prioritised by all groups. Discharge home and pain relief were highly prioritised by patients, nurses, AHPs and surgeons. Communication and relationship-centred outcomes were important to patients and caregivers. Outcomes unique to caregivers related to knowledge gain and future planning. Six themes related to the prioritisation of clinical outcomes (including 'importance of getting home' and 'restoring and maintaining independence') and five themes related to the experience of being, or caring for, a frail patient with PAD (including complexity of making the 'right' decisions', and 'importance of relationships and communication'). CONCLUSION: Knowledge about prioritised outcomes may optimise shared decision-making with this vulnerable group and may guide the implementation and evaluation of new models of vascular surgery care such as geriatric co-management.
Structural, process, and clinical factors associated with hospital-acquired conditions in older adults: A retrospective study.
Verdon M, Agoritsas T, Mabire C
Geriatr Nurs · 2026 Jun · PMID 42068893 · Publisher ↗
PURPOSE: This study aimed to describe hospital-acquired conditions in older patients hospitalized in an acute care hospital and to examine their associations with clinical patient-related and organizational factors. METH...
PURPOSE: This study aimed to describe hospital-acquired conditions in older patients hospitalized in an acute care hospital and to examine their associations with clinical patient-related and organizational factors. METHODS: A secondary analysis of data collected in the electronic health records of a Swiss teaching hospital. The study included 5813 older adults hospitalized in 2019 across 21 medical and surgical units. RESULTS: Hospital-acquired conditions were observed with notable prevalence rates for delirium (3.1%), falls (3.6%), pressure ulcers (5.2%), and weight loss (8.8%). Despite the availability of geriatric assessment scales, their use was inconsistent and limited, with assessment rates for most scales ranging from 1.8% to 28.2%. Only the scales for falls risk (Stratify, 51.0%) and pressure ulcer risk (Braden, 94.8%) were documented routinely. Multivariable analysis revealed that, beyond age and length of stay, the use of benzodiazepines (OR=1.76) and antipsychotics (OR=2.05) during hospitalization were significantly associated with an increased risk of falls. Furthermore, few care units had implemented patient-centered approaches tailored to older adults. CONCLUSION: Hospital-acquired conditions in older patients remain a major concern in acute care settings. Our findings highlight a significant disconnect between the availability of geriatric assessment tools and their clinical application. This pattern suggests that assessment practices may be driven more by institutional requirements than by patient-centered clinical needs, underscoring the urgent need to improve the implementation and culture of geriatric-focused care.
The influence of daily activities and health locus of control on quality of life and life satisfaction among older people with chronic diseases: A cross-sectional study.
Saiki M, Usui I, Gotoh T … +10 more , Hirota K, Nishimiya G, Nosaki A, Amai K, Ide N, Jiaru S, Joshi S, Upendra S, Kaur J, Sakai I
Geriatr Nurs · 2026 Jun · PMID 42054757 · Publisher ↗
OBJECTIVE: The aging global population has coincided with increased prevalence of chronic diseases, impacting quality of life (QOL) and life satisfaction among older people. Understanding related factors for QOL and life...
OBJECTIVE: The aging global population has coincided with increased prevalence of chronic diseases, impacting quality of life (QOL) and life satisfaction among older people. Understanding related factors for QOL and life satisfaction is essential to develop effective interventions. This study examined the relationships between health locus of control and daily activities with QOL and life satisfaction in older people with chronic disease. METHODS: This cross-sectional study used the following self-administered questionnaires: WHOQOL26, Satisfaction with Life scale, and Multidimensional Health Locus of Control scales. Data on daily activities (outings and communication with friends) and socioeconomic status were also collected. A total of 600 questionnaires were distributed to outpatients aged ≥65 years with chronic diseases; 357 questionnaires were returned (response rate: 59.5%). Hierarchical multiple regression analyses were conducted to assess related factors for two outcomes (QOL and life satisfaction). RESULTS: After applying the eligibility criteria, 267 participants were included in the analysis. Perceptions that personal health outcomes were controlled by external factors- either by powerful others (such as doctors or nurses) or by chance-positively influenced life satisfaction but did not influence QOL score. Frequent outings were associated with higher QOL, while communication with friends was associated with increased life satisfaction. Insufficient household finances were related to both outcomes, but monthly income influenced only life satisfaction. CONCLUSIONS: Daily activities and perceived financial strain were associated with both quality of life and life satisfaction among older people with chronic diseases, whereas health locus of control showed differential associations with these outcomes.
Corrigendum to 'The Effect of Art-Based Mandala Intervention on Death Anxiety and Anger Levels in Elderly Adults Living in Nursing Homes: A Randomized Controlled Study' [Geriatric Nursing 69 (2026) 103956].
Dincer B, Demir S, Demir K … +4 more , Özalp K, Ayaz EY, Bahçecik AN, Çelik S
Geriatr Nurs · 2026 Jun · PMID 42030697 · Publisher ↗
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Implementation and evaluation of postoperative pain management protocols in older adults.
Tabesse A, Nicolle C, Fiant AL … +8 more , Guillaume C, Pape K, Lafont C, Bourderont A, Villain C, Baudon-Lecame M, Hamon M, Meurant A
Geriatr Nurs · 2026 Jun · PMID 42001715 · Publisher ↗
OBJECTIVES: To evaluate if the two new post-operative pain management protocols for older patients were well prescribed, administered, and monitored. METHODS: A retrospective clinical audit of 100 older patients who were...
OBJECTIVES: To evaluate if the two new post-operative pain management protocols for older patients were well prescribed, administered, and monitored. METHODS: A retrospective clinical audit of 100 older patients who were prescribed these protocols was conducted. RESULTS: Only 17% of patients met all prescriptions criteria (age> 75 gt; 75 years, opioid naïve patient, recent surgery, no co-prescribing of inappropriate analgesics for older patients, no duplicate prescription and tramadol dosage following recommandations). Prescriptions issues were mostly inappropriate analgesic prescriptions (29%), duplicate medications (28%), and tramadol under-dosing (88%). None of the patients received 100% of the prescribed antalgics doses, administrations compliance was below 50%, only 8% for morphine. Pain was assessed rigorously (99%), monitoring for opioid-related side effects, like respiratory (6%) and vigilance (12%), was incomplete. CONCLUSIONS: This highlights challenges in implementing new postoperative analgesia protocols in a healthcare facility.
Corrigendum to "'What role should I play? ': A systematic review of the experiences of relatives caring for people with mild cognitive impairment" [Geriatric Nursing 68 (2026) 103777].
Ma J, Zhang H, Li Z
Geriatr Nurs · 2026 Jun · PMID 42001714 · Publisher ↗
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Initiating advance care planning and DNACPR conversations in the emergency department: A narrative review and reflective case analysis to inform nursing practice.
Zhang Y
Geriatr Nurs · 2026 Jun · PMID 42000531 · Publisher ↗
AIM: To explore considerations for initiating advance care planning (ACP), particularly regarding Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders in the Emergency Department (ED). This article integrates evi...
AIM: To explore considerations for initiating advance care planning (ACP), particularly regarding Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders in the Emergency Department (ED). This article integrates evidence from the literature with reflective analysis of real-world cases to inform clinical education and training for healthcare professionals. BACKGROUND: ACP enables individuals to express their values and preferences for future care, especially when decision-making capacity may be lost. Despite its significance, initiating ACP in the ED remains challenging due to clinical urgency, limited patient information, and time pressures. As around half of older adults attend the ED in their last month of life, the setting offers a vital but underused opportunity for timely, patient-centred conversations. METHODS: A narrative review with integrated practice-based reflective pedagogical analysis was conducted. To enhance transparency, a structured search of CINAHL and MEDLINE (2009-2024) was undertaken, supplemented by Google Scholar and reference list screening. Seven anonymised ED clinical scenarios were analysed using a structured reflective framework. FINDINGS: Nurses, through their close patient engagement and communication expertise, are well placed to initiate ACP discussions. However, they require enhanced communication training, legal awareness, and institutional support. Reflective, case-based learning helps translate theoretical knowledge into confident practice within time-critical environments. IMPLICATIONS: Embedding ACP and DNACPR communication training into nursing education and professional development may strengthen confidence, improve patient-centred care, and reduce decisional conflict at the end of life.
The effects of non-pharmacological interventions on sleep disturbances in people with subjective cognitive decline: A systematic review.
Xia Y, Wang S, Luo Y … +3 more , Moyle W, Vitiello MV, Yorke J
Geriatr Nurs · 2026 Jun · PMID 41997093 · Publisher ↗
BACKGROUND: Fifty to eighty percent of people aged over 60 have subjective cognitive decline, and more than half report sleep disturbances, which may accelerate their cognitive decline. Non-pharmacological interventions...
BACKGROUND: Fifty to eighty percent of people aged over 60 have subjective cognitive decline, and more than half report sleep disturbances, which may accelerate their cognitive decline. Non-pharmacological interventions have been identified as the first-line treatment to improve sleep disturbances for people of any age. However, the effectiveness of non-pharmacological interventions among people with subjective cognitive decline varies, and there is a lack of systematic reviews synthesizing their effectiveness in improving sleep disturbances in this population. OBJECTIVE: This study aimed to identify, appraise, and synthesize the effects of non-pharmacological interventions for improving sleep disturbance among people with subjective cognitive decline. METHODS: Six databases (Medline, Web of Science, Scopus, PsycINFO, EMBASE, CINAHL) and relevant references of included studies were systematically searched. Two researchers screened the literature, extracted data, and independently assessed the quality of the studies. Version 2 of the Cochrane collaboration risk of bias tools for randomized controlled trials was used to assess the quality of studies. RESULTS: Seven studies were included in this review. Two studies reported small positive effect sizes for music and meditation interventions based on pre-post within-group comparisons. Another study combined the results of meditation and music and compared them with the usual care group, which reported no improvement in sleep disturbance. A fourth study reported a small positive effect of a brain photobiomodulation intervention, while a fifth reported that mobile-based multidomain interventions did not improve sleep disturbance. Finally, two studies reported acupuncture with medium to large positive effect sizes on improving sleep disturbance. Caution is necessary in interpreting the results, as all studies had methodological limitations and insufficient sample sizes. CONCLUSION: A small number of studies with small sample sizes and methodological limitations support the limited effectiveness of non-pharmacological interventions to improve sleep disturbance in people self-reporting cognitive decline. More rigorous studies are needed to better characterize the impact of non-pharmacological interventions in this population.
Frailty, resilience, instrumental activities of daily living, and cognitive function in older adults with type 2 diabetes: A parallel mediation analysis.
Chou CC, Chen HF, Lin JN … +3 more , Chen CW, Liao YM, Yeh AY
Geriatr Nurs · 2026 Jun · PMID 41990615 · Publisher ↗
BACKGROUND: Previous studies have identified physical frailty as a key factor associated with cognitive function. However, the potential roles of psychological resilience and instrumental activities of daily living (IADL...
BACKGROUND: Previous studies have identified physical frailty as a key factor associated with cognitive function. However, the potential roles of psychological resilience and instrumental activities of daily living (IADL) in this association remain underexplored. OBJECTIVE: To examine the associations among frailty, psychological resilience, IADL, and cognitive function in older adults with type 2 diabetes. METHODS: This cross-sectional study included 313 older adults with type 2 diabetes. Cognitive function, frailty, psychological resilience, and IADL were assessed using validated instruments. Associations were examined within a mediation analysis framework using the PROCESS macro v4.0 (Model 4), adjusting for age, gender, years of education, and glycated hemoglobin (HbA1c). RESULTS: The results indicated that frailty was negatively correlated with cognitive function. Both psychological resilience and IADL demonstrated significant indirect associations in the relationship between frailty and cognitive function. CONCLUSIONS: These findings highlight interrelationships among frailty, functional capacity, and psychological factors and provide a basis for future longitudinal research on cognitive health in older adults with type 2 diabetes.
Assessment of loneliness and somatization in elderly women admitted to the emergency department.
Kaplan Ö, Bülbül E
Geriatr Nurs · 2026 Jun · PMID 41990614 · Publisher ↗
PURPOSE: This study aims to assess the levels of loneliness and somatization in older women presenting to the emergency department, explore the relationship between these factors, and evaluate how socio-demographic varia...
PURPOSE: This study aims to assess the levels of loneliness and somatization in older women presenting to the emergency department, explore the relationship between these factors, and evaluate how socio-demographic variables influence them. METHODS: This cross-sectional and correlational study was conducted between May-July 2025. The study population consisted of women aged 65 and older who were admitted to the emergency department of a university hospital. A total of 292 women were included in the study through purposive sampling. Data were collected using the Descriptive Characteristics Information Form, the Somatization Subscale of the SCL-90-R, and the Loneliness Scale for the Elderly. RESULTS: The participants' loneliness levels were moderate (9.55 ± 5.66), while their somatization levels were low to moderate (1.71 ± 0.87). Marital status, level of social support, presence of chronic illness, educational level, and frequency of emergency department visits were all found to be significantly associated with both loneliness and somatization levels (p <0.05). A strong, positive, and statistically significant correlation was observed between loneliness and somatization (r = 0.578, p <0.001). Loneliness was a substantial predictor of somatization (β = 0.578), accounting for 33.4 % of the variance in somatization levels (R² = 0.334). CONCLUSION: Loneliness is associated with increased somatic symptoms in older women who visit the emergency department and is a predictor of repeated visits. Many complaints caused by loneliness cannot be explained by medical diagnoses, resulting in unnecessary diagnostic procedures and resource use. Enhancing psychosocial assessment procedures in emergency departments may help identify individuals who are lonely and enable appropriate referrals, ultimately benefiting both individuals and the healthcare system.
Modified wound negative pressure suction technology combined with silver nanoparticle dressings in elderly chronic wound care.
Huang L, Fen X, Xie J … +4 more , Lu M, Tan J, Wang Y, Ou J
Geriatr Nurs · 2026 Jun · PMID 41990613 · Publisher ↗
OBJECTIVES: The aim of this study was to evaluate the clinical efficacy of modified wound negative pressure suction technology combined with nano-silver dressings in the management and care of chronic wounds in elderly p...
OBJECTIVES: The aim of this study was to evaluate the clinical efficacy of modified wound negative pressure suction technology combined with nano-silver dressings in the management and care of chronic wounds in elderly patients. METHODS: 101 elderly patients with chronic wounds admitted to hospital between January 2023 and December 2023 were selected as research subjects. Patients were divided into control (50 cases: routine dressing changes) and treated groups (51 cases: modified wound negative pressure suction technology combined with nano-silver dressings). The wound bed score (WBS) and visual analogue score (VAS) of each group at different time points were collected, as well as relevant wound characteristics data, to compare therapeutic effects. RESULTS: Both groups completed the expected treatment and follow-up period, and there were no significant differences in the baseline data before treatment (P > 0.05). Before treatment, the WBS score of the treated group (6.53±2.75) was lower than that of the control group (8.06±2.05), and the VAS score of the treated group (4.55±2.38) was higher than that of the control group (3.42±0.79), albeit not statistically significant (P > 0.05). After the stipulated treatment period, the WBS score of the treated group (11.94±2.03) was significantly higher than that of the control group (10.84±1.91, P < 0.001, and the VAS score of the treated group (1.92±0.75) was significantly lower than that of the control group (0.75±0.72, P < 0.001. The number of dressing changes, exudate reduction time, pain onset time, hospital stay, and dressing satisfaction of the treated group were significantly better than those of the control group (P < 0.5). In addition, the positive rate of bacteria was decreased, the wound healing rate was increased, and the healing time was shortened (P < 0.05). CONCLUSIONS: Modified wound negative pressure suction technology combined with nano-silver dressings is effective for the treatment of elderly chronic wounds.
Impact of comprehensive geriatric assessment interventions and professional follow-up on health outcomes in elderly patients.
Cypel D, Roitblat SS, Raz Y
Geriatr Nurs · 2026 Jun · PMID 41980498 · Publisher ↗
BACKGROUND: Comprehensive Geriatric Assessment (CGA) represents a multidimensional approach for evaluating older adults' complex health needs, though real-world outcomes data remains limited. OBJECTIVE: To examine whethe...
BACKGROUND: Comprehensive Geriatric Assessment (CGA) represents a multidimensional approach for evaluating older adults' complex health needs, though real-world outcomes data remains limited. OBJECTIVE: To examine whether CGA-led interventions with professional follow-up affect health outcomes in community-dwelling older adults at frailty risk. METHODS: This retrospective cohort study analyzed Clalit Health Services data for adults aged ≥65 years identified as frailty-risk using a validated prediction model (2015-2019). Outcomes were compared six months pre-assessment, six months postassessment, and one year post-assessment. RESULTS: Among 135,445 older adults (mean age 79.9 ± 7.9 years, 54.5% female), significant improvements occurred at six months: 46.77% reduction in hip fractures (449 vs 239, p < 0.001), 17.94% decrease in hospitalization days (p = 0.008), and increased preventive care including influenza vaccinations (53.06% increase, p < 0.001) and pneumonia vaccinations (96.26% increase, p < 0.001). Family physician visits increased 5.39% (p = 0.032) and nursing visits increased 17.83% (p = 0.003). Linear regression demonstrated significant inverse relationships between primary care utilization and acute care services (p < 0.01). Benefits persisted but attenuated at one year. CONCLUSIONS: Systematic geriatric screening followed by comprehensive nursing assessment significantly improved health outcomes in community-dwelling older adults at frailty risk. Substantial reductions in hip fractures and hospitalization days, combined with increased preventive care uptake, support integration of CGA programs into routine healthcare systems.
Prediction of unplanned readmission in older adults during hospital stay: a data-driven approach to support care transition.
Miguel CG, Favalesso MM, Hida GS … +7 more , Dos Reis Lucena W, Nogueira WA, Barbosa MS, Chater RC, Kim H, da Costa Rozzino TP, Szlejf C
Geriatr Nurs · 2026 Jun · PMID 41967359 · Publisher ↗
PURPOSE/AIMS: Accurately predicting 30-day unplanned readmission in older adults is critical for improving care transitions and reducing preventable hospitalizations. Most existing models rely only on data available at d...
PURPOSE/AIMS: Accurately predicting 30-day unplanned readmission in older adults is critical for improving care transitions and reducing preventable hospitalizations. Most existing models rely only on data available at discharge, limiting early intervention. This study aimed to develop and evaluate machine learning models to predict 30-day unplanned readmissions using information from the first 48 h of hospitalization, and to compare their performance with discharge-based models. METHODS: We analyzed data from 14,140 older adult admissions to a quaternary hospital. We built ML algorithms to predict 30-day unplanned readmission at 48 h after admission and at discharge [Logistic Regression, Random Forest, Light Gradient Boosting Machine (LGBM), and others] using administrative data and clinical information extracted from the electronic health record. Model's performance was assessed using confusion matrix and discrimination metrics. RESULTS: The Light Gradient Boosting Machine demonstrated the best performance at both 48 h (Sensitivity = 79%, Specificity = 59%, AUC-ROC = 0.75) and discharge (Sensitivity = 74%, Specificity = 65%, AUC-ROC = 0.76). Discriminative ability at 48 h was comparable to discharge (DeLong test p-value = 0.17). The application of both, the 48-hour and discharge models, could potentially predict 82% of readmissions. CONCLUSION: ML algorithms using data commonly obtained in electronic health records showed fair performance to predict 30-unplanned readmission in older adults using data from the first 48 h after admission, which was comparable to performance at discharge. If corroborated by external validation studies, these findings create opportunities to design and implement risk mitigation interventions during hospital stay.
Self-neglect, self-compassion, and psychological well-being in older adults: correlational study.
Sayım E, Öztürk Z
Geriatr Nurs · 2026 Jun · PMID 41967358 · Publisher ↗
BACKGROUND: Self-neglect is an important public health problem in older adults and may be associated with poorer psychosocial outcomes. The relationship between self-neglect, self-compassion, and psychological well-being...
BACKGROUND: Self-neglect is an important public health problem in older adults and may be associated with poorer psychosocial outcomes. The relationship between self-neglect, self-compassion, and psychological well-being in older adults was investigated. MATERIALS AND METHODS: This study was conducted as a descriptive and correlational study. The study was carried out with 275 individuals aged 65 and over who applied to a Family Health Center. The data were collected between November 2024 and February 2025. The Personal Information Form, Elder Self-Neglect Scale (ESNS), Self-Compassion Scale-Short Form (SCS-SF), and Psychological Well-Being Scale for the Older People (PWBS) were used to collect data. Data were analyzed using the SPSS 29 statistical package program using descriptive statistics, correlation analysis, and multiple linear regression. RESULTS: The mean ESNS score of the older adults participating in the study was 108.33±34.99, the mean SCS-SF score was 33.56±10.31, and the mean PWBS score was 49.45±13.68. The study identified a statistically significant negative relationship between the mean ESNS scores and both the SCS-SF and PWBS scores among older adults (p < 0.001). Furthermore, significant negative relationships were observed between self-compassion (β=-0.457) and self-neglect, and between psychological well-being (β=-0.237) and self-neglect (both p < 0.001). The regression model explained 41.0% of the variance in self-neglect (R²=0.410). CONCLUSION: In this study, higher self-compassion and psychological well-being were found to be associated with lower self-neglect levels in older adults.
The effect of perceived stress on turnover intention among Chinese geriatric caregivers of nursing institutions: The mediation of psychological resilience and coping style.
Fan LH, Luo QP, Huang WC … +2 more , Pan GQ, Yi LJ
Geriatr Nurs · 2026 Jun · PMID 41967357 · Publisher ↗
OBJECTIVE: This study, based on the stress-coping theory, aims to examine the impact of perceived stress, psychological resilience, and coping styles on turnover intention among geriatric caregivers in China. It also aim...
OBJECTIVE: This study, based on the stress-coping theory, aims to examine the impact of perceived stress, psychological resilience, and coping styles on turnover intention among geriatric caregivers in China. It also aims to explore potential mediating pathways. METHODS: A multi-center cross-sectional survey was conducted from September to December 2024. This survey included 408 geriatric caregivers across China. Structural equation modeling (SEM) with robust maximum likelihood estimation was employed to analyze the direct and indirect relationships among variables. RESULTS: The mean turnover intention score was 12.61. Perceived stress had a significant direct effect on turnover intention (β = 0.288, P < 0.001, 95% CI: 0.177-0.394) and exerted an indirect effect through four significant pathways: (a) psychological resilience (β = 0.093, P < 0.001, 95% CI: 0.043-0.149); (b) positive coping style (β = 0.026, P < 0.001, 95% CI: 0.008-0.056); (c) negative coping style (β = 0.057, P < 0.001, 95% CI: 0.006-0.113); and (d) the sequential mediation of psychological resilience and positive coping style (β = 0.044, P = 0.001, 95% CI: 0.019-0.071). CONCLUSION: Perceived stress influences turnover intention both directly and indirectly through psychological resilience and coping styles. Policymakers and institutional managers can design age-specific retention schemes and strengthen institutional training for caregivers, specifically by enhancing their psychological resilience and promoting adaptive coping strategies to reduce turnover intention among geriatric caregivers.
Perceived burdensomeness and happiness in cohabiting older adults: The serial mediating roles of mental well-being and loneliness.
Akeren Z, Akeren I, Kalyoncuo S
Geriatr Nurs · 2026 Jun · PMID 41966621 · Publisher ↗
BACKGROUND: Aging-related changes and increased dependence on family members may negatively affect older adults' psychological well-being. Perceived burdensomeness refers to the belief that one is a burden on others and...
BACKGROUND: Aging-related changes and increased dependence on family members may negatively affect older adults' psychological well-being. Perceived burdensomeness refers to the belief that one is a burden on others and has been associated with lower happiness, reduced mental well-being, and greater loneliness. Among adults living with their families, mental well-being and loneliness may explain how perceived burdensomeness relates to happiness in later life. PURPOSE: This study examined the associations between perceived burdensomeness and happiness among older adults living with their families and evaluated the serial mediating roles of mental well-being and loneliness. METHODS: This cross-sectional study included individuals aged ≥65 years residing with family members in a city in Turkey's Eastern Black Sea region. Data were collected from 273 older adults; after preliminary screening, 7 cases were excluded, resulting in a final analytic sample of N = 266. Measures included the Geriatric Feelings of Burdensomeness Scale, WHO-5, the Happiness Scale, and the Loneliness Scale for the Elderly. Serial mediation was tested using a regression-based approach with bootstrap confidence intervals. RESULTS: Perceived burdensomeness was associated with lower mental well-being and higher loneliness. The total association between burdensomeness and happiness was negative (β=-0.467), and more than two-thirds of this association operated indirectly through mental well-being and loneliness. CONCLUSION AND IMPLICATIONS: Perceived burdensomeness was associated with lower happiness among older adults living with their families, primarily through reduced mental well-being and increased loneliness. In geriatric nursing and primary care, routinely assessing these psychosocial factors and implementing family-centered and social support-oriented interventions may help improve happiness.
Factors related to unmet nursing care needs for home-visit nursing among long-term care insurance beneficiaries.
Yang E, Lee Y, Bae J … +2 more , Ko YH, Kown YJ
Geriatr Nurs · 2026 Jun · PMID 41966620 · Publisher ↗
This retrospective, population-based study aimed to identify factors associated with unmet nursing care needs among long-term care insurance (LTCI) beneficiaries for whom home-visit nursing (HVN) was recommended during c...
This retrospective, population-based study aimed to identify factors associated with unmet nursing care needs among long-term care insurance (LTCI) beneficiaries for whom home-visit nursing (HVN) was recommended during care planning. We analyzed 1,445,835 LTCI beneficiaries using home care services between 2018 and 2022 in South Korea. Among those recommended for HVN, 91.4% did not utilize these services. The most frequent unmet needs were dialysis nursing, cancer pain control, and diabetic foot care. Logistic regression revealed that unmet needs were significantly associated with living alone (adjusted odds ratio [aOR] 1.32), the highest income quintile (aOR 1.37), LTCI benefit grade (aOR 1.18-2.00), higher comorbidity burden (aOR 1.03), cognitive decline (aOR 1.01), and behavioral/psychological symptoms including agitation, aggression, and inappropriate behaviors (aOR 1.03). These findings demonstrate substantial unmet nursing care needs despite clinical recommendations. Healthcare providers and policymakers should prioritize identifying barriers to HVN utilization and implement tailored strategies to improve care delivery.
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