Celeste Shawler

PALLIATIVE AND END-of-LIFE CARE: Using a Standardized Patient Family FOR Gerontological Nurse Practitioner Students

&NA; This article describes an innovative approach to educating gerontological nurse practitioner students about the needs of patients and their families related to palliative and end‐of‐life care. By using a standardized patient family and creatively using resources from the End‐of‐Life Nursing Education Consortium (ELNEC), this author maximized learning experiences for advanced practice students who will care for elderly individuals and their families.The goal of ELNEC is to strengthen nursing education to improve end‐of‐life care. Principles for developing and implementing a complex standardized patient scenario for graduate nursing students are offered.

Living Vigilant Lives with Chronic Illness: Stories from Older Low-Income Minority Women

Our purpose in this pilot study is to test the validity of the concepts in the Evolutionary Empowerment–Strength model, which was developed through analysis of data from a previous study that observed how older women coped with a hip fracture. Thirteen minority women aged 63 to 88 years with chronic illness participated in this pilot study. Findings indicate four themes: (1) Positive Self-Talk, (2) Strong Spiritual Faith, (3) Refusal to Dwell on Deficits, and (4) Sense of Survival. Three of the five concepts in the Evolutionary Empowerment–Strength model were supported, which demonstrates initial usefulness of the model for varied populations.

Beyond social support: Self-care confidence is key for adherence in patients with heart failure:

Background: Adherence to treatment is crucial to improve outcomes in patients with heart failure. Good social support is associated with better adherence, but the mechanism for this association has not been well-explored. Aims: The aim of this secondary analysis was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in heart failure patients hospitalized with acute exacerbation. Methods: A total of 157 inpatients with heart failure (63.5±13 years, 73% New York Heart Association class III/IV) were recruited from two hospitals located in urban areas in the USA. Participants completed the Self-Care of Heart Failure Index, the Multidimensional Perceived Social Support Scale, and the Medical Outcomes Study Specific Adherence Scale. A series of regression models were used to determine the mediation relationship. Results: Controlling for marital status and hospital site, social support was associated with adherence (p=0.03). When self-confidence was included in the model, the effect of social support became non-significant, indicating full mediation of the relationship between social support and adherence by self-care confidence. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% confidence interval: 0.01–0.09). Conclusion: Heart failure self-care confidence mediated the relationship between social support and treatment adherence. Thus interventions targeting patients’ self-care confidence is essential to maximize patients’ treatment adherence.

Assessing and Maintaining Mental Health in Elderly Individuals

This article provides detailed information about assessing the mental health needs of older adults as well as strategies to maintain mental health. An overview of the public health needs of older adults is provided that includes examples of policies that ensure minimum physical and mental health for older adults. Multiple resources are described that will enable clinicians to access information that will increase their knowledge of assessment of mental health needs of older adults.

The impact of dementia caregiving on self-care management of caregivers and facilitators: a qualitative study: Self-care of dementia caregivers

Caregivers of patients with dementia or Alzheimers disease (AD) face special health challenges due to the progressive nature of the disease. Self‐care has crucial importance on individuals’ management of life, health, and well‐being. However, limited evidence is available on self‐care management of dementia and AD caregivers. This study aimed to investigate the influence of caregiving on the self‐care management of dementia and AD caregivers based on the caregivers’ experience. In addition, the facilitators of caregivers’ self‐care management were assessed.

Impact of Mother-daughter Relationship on Hypertension Self-management and Quality of Life: Testing Dyadic Dynamics Using the Actor-partner Interdependence Model

Background: Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure. Objectives: The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct (“actor”) and indirect (“partner”) effects of 46 dyads. Results: The mothers’ perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters’ self-management. Similarly, the daughters’ perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers’ self-management and HRQOL.

The lived experience of help-seeking by South African women after sexual assault

ABSTRACT The purpose of this study was to explore the lived experience of help-seeking by South African women following sexual assault. Hermeneutic phenomenology guided the study. Interviews were conducted with six women who had experienced sexual assault at some point in their lives. Three venues were most significant to womens help-seeking experiences: the criminal justice system, health care facilities, and/or social service agencies. Essentially, the womens help-seeking experiences in these three venues are best described as fraught justice-seeking, pragmatic help-seeking, and desperate help-seeking. The study findings have implications for the provision of services for women who experience sexual assault in South Africa.

Elucidating the Aging Process Through Poetry: An Elderly Woman's Life

The purpose of this case study was to explicate the life story and gain deeper understanding of the aging experience of an elderly woman. Through poetry, this woman transformed challenging life experiences. Data analysis revealed themes of determination, spiritual strength, and creatively aging. The findings support knowledge development about how older women age and express their lives. Most of the participants poetry was in the sonnet form, which can convey deep and universal insights. Thus, the aging experience was seen from an extraordinary perspective. The study led to a deeper understanding of a dynamic holistic perspective of aging.