BACKGROUND: Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. METHODS: We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. RESULTS: Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714-0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699-0.771). CONCLUSIONS We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.
Aged ; Cohort Studies ; Female ; Geriatric Assessment/statistics & numerical data* ; Humans ; Independent Living/statistics & numerical data* ; Japan ; Male ; Middle Aged ; Nursing Homes/statistics & numerical data* ; Risk Assessment ; Risk Factors

PURPOSE: This study was done to identify the factors involved in ageism in nurses.METHODS: The participants in this study were 178 general hospital nurses. Data were collected in March 2019 using self-report questionnaires, and were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, and stepwise multiple linear regression.RESULTS: The total score for ageism was 39.75±5.44 out of a maximum of 72. Ageism had a statistically significant relationship with contact experience (r=-.47, p < .001), attitude (r=.40 p < .001), and aging anxiety (r=.35 p < .001). The determining factors affecting ageism were contact experience (β=-.45, p < .001), attitude(β=.20, p=.002), work place (β=.22, p < .001), marital status (β=.21, p < .001), geriatric nursing preference (β=.18, p=.006), geriatric education (β=.17, p=.006), and aging anxiety (β=.14, p=.041). The explanation power of these variables was 39%.CONCLUSION: The results suggest that contact experience with elders had the largest influence on ageism in nurses. Therefore, it is necessary to develop tailored education programs by hospital type to increase positive contact experience and promote understanding of older patients in acute care settings. Furthermore, the importance of the perception of ageism needs to be highlighted in nursing education and continuing education for nurses.
Ageism ; Aging ; Anxiety ; Education ; Education, Continuing ; Education, Nursing ; Geriatric Nursing ; Hospitals, General ; Humans ; Linear Models ; Marital Status ; Workplace

This study explored the interplay of the care culture (C), caring process (P) and care agent (A) in the care of older adults towards care satisfaction and quality of life. Two elderly care facilities (public and private) were considered as cases of this study. Using case study design, four elderly clients were asked to answer the Modified Patient Satisfaction Questionnaire, and five care facility personnel were interviewed and observed. The cross-case analysis derived the themes: a) a caring governance is a felt privilege for the elderly; b) housing arrangement: security or vulnerability?; c) How did you take care of me?: Its influence on patient care outcomes; and d) Elderly care provider: What am I?. The landscape of elderly care is a combination of the environment, culture, process and the agent who made the care more effective through patient outcomes and satisfaction. These factors have interacting relationship which one to the other but ultimately leads to a question of the elderly clients' present disposition and conditions.

Frailty is a distinct clinical syndrome wherein the individual has low reserves and is highly vulnerable to internal and external stressors. Although it is associated with disability and multiple comorbidities, it can also be present in individuals who seem healthy. Frailty is multidimensional and its pathophysiology is complex. Early identification and intervention can potentially decrease or reverse frailty, especially in the early stages. Primary care physicians, community nurses and community social networks have important roles in the identification of pre-frail and frail elderly through the use of simple frailty screening tools and rapid geriatric assessments. Appropriate interventions that can be initiated in a primary care setting include a targeted medical review for reversible medical causes of frailty, medication appropriateness, nutritional advice and exercise prescription. With ongoing training and education, the multidisciplinary engagement and coordination of care of the elderly in the community can help to build resilience and combat frailty in our rapidly ageing society.
Aged ; Aging ; Community Health Services ; Frail Elderly ; Frailty ; Geriatric Assessment ; methods ; Geriatrics ; methods ; Humans ; Nurses ; Nursing ; Primary Health Care ; methods ; Social Support

BACKGROUND: Recent studies report that nursing home elderly (NHE) have significantly lower serum levels of 25-hydroxy-vitamin D (25-OHD) than community dwelling elderly (CDE); however, in Korea such studies are lacking. We aimed to compare the vitamin D status between NHE and CDE in Korea. METHODS: This study included 203 patients over 65 years, admitted to the geriatric department of Seoul Medical Center between 01/2015 and 12/2015. Their medical records were reviewed for demographic data, type of residence, medical and drug history, serum 25-OHD, albumin, creatinine, and calcium levels, and geriatric assessment results. After excluding 36 subjects who had taken vitamin D supplements, anticonvulsants, or steroids, 33 NHE and 134 CDE were included for final analysis. RESULTS: Almost 80% of subjects showed a vitamin D deficiency (25-OHD <20 ng/mL); 54% were severely deficient (25-OHD <10 ng/mL). NHE had a significantly lower serum 25-OHD level than CDE (5.47±2.95 ng/mL vs. 14.72±11.35 ng/mL, p<0.001). Serum 25-OHD level was related to serum albumin level, the Geriatric Depression Scale score, and the Korean version of the Mini Mental State Examination score (p=0.004, p=0.041, p=0.032, respectively). After adjustment for confounding factors using multiple logistic regression analysis, diagnosis of severe vitamin D deficiency was more likely in NHE than CDE (odds ratio, 8.72; 95% confidence interval, 1.53-49.81). CONCLUSION: This study suggests a high prevalence of vitamin D deficiency in Korean NHE. To prevent falls and osteoporotic fractures in this population, vitamin D supplementation should be considered.
Accidental Falls ; Aged* ; Anticonvulsants ; Calcium ; Creatinine ; Depression ; Diagnosis ; Geriatric Assessment ; Humans ; Independent Living ; Korea* ; Logistic Models ; Medical Records ; Nursing Homes* ; Nursing* ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Seoul ; Serum Albumin ; Steroids ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

PURPOSE: The quality of nursing care in geriatric hospitals has been of concern. Nurses need to provide evidence-based nursing using best available research findings in order to maximize the quality of care. Research utilization is a major part of evidence-based nursing practice. Empowerment is an important factor that may influence the context of nursing practice. The purpose of this study was to identify the barriers to research utilization in nursing practice and its relationship to empowerment perceived by registered nurses (RNs) in geriatric hospitals. METHODS: A descriptive, correlational design was used. A total of 147 RNs from six geriatric hospitals in K province of Korea participated. The BARRIERS scale and the Conditions of Work Empowerment Questionnaire-II were administered to identify perceived barriers to the use of research findings and the level of perceived empowerment respectively. RESULTS: Participants rated that research reports being written in English constituted the greatest barrier to the use of research findings. The score was the highest for the Communication domain, suggesting the greatest barrier, and the lowest for the Adopter domain. Subscales of the Conditions of Work Empowerment Questionnaire-II were significant predictors of the Adopter, Organization, and Communication domains of the BARRIERS scale. CONCLUSIONS: This study found that RNs in geriatric hospitals perceived that interpreting and understanding research reports in English was the greatest barrier to the use of research findings. Administrators and nurse managers of geriatric hospitals need to provide RNs with opportunities to participate in research-related activities and to empower RNs in order to facilitate research utilization.
Adult ; *Attitude of Health Personnel ; Female ; *Geriatric Nursing ; Humans ; Middle Aged ; *Nursing Research ; Nursing Staff, Hospital/*psychology ; Power (Psychology) ; Republic of Korea ; Surveys and Questionnaires ; Young Adult

Comprehensive geriatric assessment (CGA) is a diagnostic process evaluating frail older patient's medical problems and functional status to make overall plan for treatment and long-term care plan. It emphasizes on functional status and quality of life and uses interdisciplinary team and assessment tool frequently. CGA is associated with significant benefit in improved diagnostic accuracy with increased survival, improved physical and cognitive function, appropriate medication use, reduced hospital and nursing home use and reduced health care costs. Although frailty patients might have greatest benefits, careful periodic screening and follow up monitoring of all older persons is also very important. The goal of CGA in the older patients might be independence. To improve the quality of life of frail old patients and to reduce long-term care population number and care costs, performing geriatric assessment would be the best choice in geriatric field.
Geriatric Assessment* ; Health Care Costs ; Humans ; Long-Term Care ; Mass Screening ; Nursing Homes ; Quality of Life

PURPOSE: This study aimed to evaluate the effectiveness of the empowerment intervention on the levels of self-esteem, interpersonal relationships and adjustment to nursing home life of the Korean nursing home residents. METHODS: Participants (n=47) whose period of stay was less than one year were purposefully selected from 3 nursing homes in Korea. The experimental group (n=21) attended 10 weekly hour-long empowerment sessions. The empowerment program comprised two components; group education and group discussion. The control group (n=26) received a two-hour education about health management. RESULTS: Compared with the control group, the experimental group showed significantly higher mean scores of self-esteem (t=5.51, p<.001), interpersonal relationships (t=2.73, p=.009) and adjustment to nursing home life (t=2.10, p=.041). CONCLUSION: Findings of this study suggest that empowerment interventions may be effective in enhancing nursing home residents' self-esteem, interpersonal relationships and adjustment to nursing home life. Future research is needed to determine if such an empowerment program could be used with newly institutionalized elders to speed as well as enhance their adjustment to nursing home life.
Adaptation, Psychological ; Aged ; Aged, 80 and over ; Female ; Geriatric Assessment ; Health Status ; Humans ; Interpersonal Relations ; Male ; Nursing Homes ; *Program Evaluation ; Self Concept

This study was conducted to detail tooth loss patterns in older adults with special needs. A total of 491 elderly subjects with special needs were retrospectively selected and followed during 10/1999-12/2006. Medical, dental, cognitive, and functional assessments were abstracted from dental records and used to predict risk of tooth loss. Tooth loss events were recorded for subjects during follow-up. Chi-squared tests were used to study the association between tooth loss and the selected risk factors. Logistic, poisson, and negative binomial regressions were developed to study tooth loss patterns. Overall, 27% of the subjects lost at least one tooth during follow-up. Fourteen subjects had tooth loss events per 100 person-years. Tooth loss pattern did not differ significantly among different special-needs subgroups (i.e. community-dwelling vs. long-term care, physically disabled vs. functionally independent). Special-needs subjects with three or more active dental conditions at arrival had more than twice the risk of losing teeth than those without any existing conditions. After adjusting other factors, the number of carious teeth or retained roots at arrival was a significant predictor of tooth loss for older adults with special needs (P = 0.001). These findings indicate that appropriately managing active caries and associated conditions is important to prevent tooth loss for older adults with special needs.
Aged ; Analysis of Variance ; Chi-Square Distribution ; Cohort Studies ; Dental Care for Aged ; statistics & numerical data ; Dental Caries ; epidemiology ; Disabled Persons ; statistics & numerical data ; Follow-Up Studies ; Geriatric Assessment ; Humans ; Incidence ; Independent Living ; Logistic Models ; Longitudinal Studies ; Minnesota ; epidemiology ; Nursing Homes ; Prognosis ; Retrospective Studies ; Risk Factors ; Tooth Loss ; epidemiology

PURPOSE: The purpose of this study was to identify factors which predict depression in resdents of geriatric medical and welfare facilities in metropolitan areas. METHODS: The participants were 125 elderly people who resided in geriatric medical and welfare facilities. A structured questionnaires was used to collect data during the period from Sept. 28 to Oct. 23, 2009, and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and Stepwise Multiple Regression with the SPSS/WIN 15.0 program. RESULTS: The mean score per item for perceived health status was 2.6, and the mean depression score was 3.40. Depression showed a negative correlation with perceived health status (r=-.44, p<.001). Variables that predicted depression were perceived health status, perceived economic status, and attitude of staff towards the elders (33.6%). CONCLUSION: The findings indicate a need to develop, geriatric mental health program to prevent depression in elders who reside in geriatric medical and welfare facilities.
Aged ; Depression* ; Geriatric Nursing ; Humans ; Mental Health ; Surveys and Questionnaires