Resourcefulness training intervention: assessing critical parameters from relocated older adults' perspectives

The population of American elders is increasing rapidly and relocation to retirement communities has been found to adversely affect their adjustment. This pilot study of 38 relocated elders evaluated, from elders' perspectives, six critical parameters of a resourcefulness training (RT) intervention designed to help elders adjust to relocation. Within the context of Zauszniewski's theory of resourcefulness, a pre-/post-test design with random assignment to RT or to diversionary activities (DA) was used. Objective questionnaires measured demographic and relocation factors. An intervention evaluation questionnaire was designed and given to the relocated elders in order to assess the six critical parameters--necessity, acceptability, feasibility, safety, fidelity, and effectiveness. Data concerning the critical parameters were collected during structured interviews within a week after the intervention. Seventy-six of the elders who scored less than 120 in the resourcefulness scale indicated a strong need for RT. While all non-white elders reported needing RT, 43% of white elders reported the same need. Elders indicated that learning about the experiences of others and taking part in discussions were the most interesting part of the RT. Approximately 95% of participants mentioned that they learned all parts of the intervention; few suggested having a stronger leader to keep the group on track. The qualitative findings from this pilot intervention study will inform future, larger clinical trials to help recently relocated elders adjust to relocation.     

Examining older adults' perceptions of health care providers: identifying important aspects of older adults' relationships with physicians and nurses

This article describes older adults' conversations about their relationships with health care providers. Focus group participants (N = 23) were from three ethnic groups (Black, White, and Hispanic) and ages 53 to 92. All but three of the participants were women. Content analysis revealed an overarching theme of genuine caring and three sub-themes: interest in patients' well-being, respectful dialogue, and sharing of information. Older adults' perceptions of genuine caring by physicians and nurses did not differ by ethnicity. Older adults want to engage in a caring, respectful, and educational relationship with their health care providers, which is consistent with fundamental professional values.     

The purpose of nursing work with families dealing with mental disease in their daily lives

The article reflects upon the purpose of the nursing work inserted in a particularly important historical moment to Mental Health System of the state of Rio Grande do Sul. It approaches the psychiatric assistance reform and in it the insertion of nurses and families that deal with mental illness, searching to define its purpose at the convergence between the essence of the proposal of the mental health assistance restructure and the daily lives of professional practice.     

Understanding the lives of older women

AIM: To understand why some women adjust successfully in later life while others, in similar circumstances, become overwhelmed by life and dislike their old age. METHOD: Qualitative data were generated from field notes of participant observation carried out over ten months. In-depth interviews were also carried out with 11 young older and frail older women, aged 60 to 89 years, attending day centres. A grounded theory approach was adopted to collect and analyse participant observation and interview data. FINDINGS: Adjustment in later life occurs regardless of circumstance. Three areas were identified as being the main obstacles for many. These are depression, maintaining intimacy through friends and family, and managing the change process associated with older age. In addition, a core category of searching for meaning was discovered and used to understand how depression, intimacy and managing change affect adjustment in later life. CONCLUSION: Nurses could use their skills and experience of listening carefully to older patients to discover whether they are distressed, and assess whether there is a need for psychological and emotional support. There is a need for more research into carrying out adjustment work with older women who are struggling to enjoy their later years and with older men to discover themes that are relevant to them.     

Korean older adults' perceptions of the aging process

This qualitative study was conducted to describe Korean older adults' perceptions of the aging process. A total of 18 Korean older adults were interviewed, and a grounded theory approach was used to analyze the interview data.The participants were found to perceive aging as a process of Generating, Expressing, and Transforming of Growing Futility. The degree to which they perceived their Growing Futility depended on the actions and interactions of a set of conditional structures. This study revealed five patterns of Korean older adults' perception of the aging process. These findings allow for the possibility of a more refined theoretical development for the aging process, especially when a comparative study becomes available through cross-cultural qualitative research.     

老年人能力等级划分方式的研究

目的：对老年人能力等级划分方式进行探索性研究,探讨可行的老年人能力等级划分方案,为社区和养老机构开展长期护理服务,老年人选取合适的养老护理服务等提供参考。方法：应用层次分析法和秩和比法对581例老年人能力进行综合评价。结果：通过综合评价得出老年人能力的四级型、七级型划分方式。结论：老年人能力包括日常生活活动能力、心理状态、社会参与状况等多方面,需要使用综合评价技术对其进行统筹考虑和有效区分,得出合理的能力划分方式;划分结果对提供长期护理服务、确保老年人安全、维持与促进老年人健康具有重要的指导意义。     

Maintaining the square. How older adults with Parkinson's disease sustain quality in their lives

In this article, the author's objective is to uncover the common practices that help sustain quality in the lives of older adults with Parkinson's disease. Interpretive phenomenology was the method used to gather and analyze the stories of six men and six women with idiopathic Parkinson's disease. The results show a constitutive pattern of Maintaining the Square. Five relational themes, including Learning How, Accepting Limitations, Seeking Knowledge, Engaging in Meaningful Experiences, and Living for Today, emerged from the participants' stories. The participants' ability to sustain continuity in their lives indicates their successful maintenance of the square. By identifying markers of continuity, they are able to maintain quality in their lives. As nurses, we can promote continuity in the lives of our patients if we take the time to learn what gives them meaning and purpose in life and then facilitate ways to help them maintain this connection.     

Understanding the lives of older gay people

Ten research articles were examined with the aim of increasing our understanding of the lives of older gay people. It is clear from the literature that nurses must not rely on stereotypes of older gay people to inform their professional practice. It is also important for nurses to appreciate that older homosexuals have different health and social care needs from their heterosexual contemporaries.     

Building partnerships to continue older adults' residence in the community

Current care of older adults focuses on maintenance of independence and frames assessment and decision making about when to intervene. This conceptualization focuses on older adults' deficits and how to compensate for loss of function. Instead of considering independence to continue community residence, an alternative-interdependence-provides a conceptualization that focuses on older adults in the family context and on supportive services, which are the main components of community residence. This article presents the concept of interdependence by analyzing the current research, practice, and policy literature. The article concludes with a discussion of the application of interdependence in gerontological nursing practice and research.     

The relationship of movement and time to older adults' functional health

The relationship of movement (measured by walking cadence) and time (measured by perceived duration) to functional health was investigated in a sample of community-based, white, older women (N = 114). Significant relationships were found between health and movement, and between movement and time. Speed, inherent in both movement and time, may be an important qualitative dimension of functional health. Walking cadence shows the most promise for use as an inexpensive, noninvasive, easy-to-use clinical measure of health.     

Managing pain in older persons who receive home-help for their daily living. Perceptions by older persons and care providers

Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.     

Cognitive-behavioral therapy, exercise, and older adults' quality of life

This study examined health-related quality of life (HRQL) at baseline and 6, 9, and 12 months after initiating exercise training in three groups of older adults. The conditions were cognitive-behavioral therapy, attention-control health promotion education, and a control group. Participants (N = 332) were mainly women (n = 252, 75.9%) with a mean age of 71.8 (SD = 5.1) years. Therapy participants were trained to modify their negative interpretations of exercise. Participants in the education group received information unrelated to exercise. After controlling for exercise behavior over time, the therapy group reported lower general health, more role limitations because of emotional problems, and somewhat less vitality than the control group did. The education group also reported lower general health and vitality than the control group did. Social interaction and discussion may heighten participants' awareness of these health aspects and influence their appraisal of HRQL. Findings demonstrate the complexities of HRQL and the challenge in developing effective methods for helping older adults adopt and maintain an active lifestyle.