Kelley Strout

The Six Dimensions of Wellness and Cognition in Aging Adults

Objective: Examine how wellness in six dimensions (occupational, social, intellectual, physical, emotional, and spiritual) protects cognition in aging adults. Background: cognitive impairment increases with age. Baby boomers represent a significant percent of the population at risk for cognitive impairment. Cognitive impairment has a negative impact on nursing resources, health care finances, patient mortality, and quality of life. Wellness and prevention is one focus of Institute of Medicine’s vision for the future of nursing. Method: Literature was retrieved from Cumulative Index to Nursing and Allied Health Literature and MEDLINE. Research that examined the affect of wellness in each of the six dimensions on cognition in older adults was included. Results: One or more of the following may protect cognition in aging: midlife occupation complexity, marriage, social networks, formal education, intellectual activities, physical activity, healthy nutrition, motivational ability, purpose in life, and spirituality. Conclusion: Wellness in one or more of the six dimensions may protect cognition in aging. The cognitive protective benefits may increase when wellness in more than one dimension is demonstrated. High wellness in one dimension may protect cognition by compensating for low wellness in another dimension. The interconnectedness of each of the dimensions signifies the importance of evaluating older adults holistically. Wellness throughout the life span may result in improved cognition in aging. Application: Future research is needed to examine the relationship between the six dimensions of wellness and cognition, and to determine if one dimension of wellness is a significant predictor of cognitive health in aging adults.

Five Dimensions of Wellness and Predictors of Cognitive Health Protection in Community-Dwelling Older Adults: A Historical COLLAGE Cohort Study

Wellness is associated with cognitive health protection; however, findings are limited because they only examine variable(s) within one dimension of wellness. This research examined the association between multiple dimensions of wellness and cognition among aging adults. The sample included 5,605 male and female community-dwelling adults 60 years and older. Four dimensions of wellness demonstrated a statistically significant higher mean difference in cognitively healthy older adults compared to cognitively impaired older adults, F(4, 5,595) = 47.57, p < .001. Emotional wellness demonstrated the strongest association with cognitive health, followed by physical and spiritual wellness, F(5, 5,372) = 50.35, p < .001. Future research is needed to examine the cognitive protective benefits of wellness using longitudinal, prospective designs that control for the potential temporal relationship between wellness and cognition.

Behavioral Interventions in Six Dimensions of Wellness That Protect the Cognitive Health of Community‐Dwelling Older Adults: A Systematic Review

To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community‐dwelling older adults using a holistic wellness framework.

Application of the Rasch model to measure five dimensions of wellness in community-dwelling older adults.

Background and Purpose: Nurse researchers and practicing nurses need reliable and valid instruments to measure key clinical concepts. The purpose of this research was to develop an innovative method to measure dimensions of wellness among older adults. Method: A sample of 5,604 community-dwelling older adults was drawn from members of the COLLAGE consortium. The Wellness Assessment Tool (WEL) of the COLLAGE assessment system provided the data used to create the scores. Application of the Rasch analysis and Masters’ partial credit method resulted in logit values for each item within the five dimensions of wellness as well as logit values for each person in the sample. Results: The items fit the Rasch model, and the composite scores for each dimension demonstrated high reliability (1.00). The person reliability was low: social (.19), intellectual (.33), physical (.29), emotional (.20), and spiritual (.29). The small number of items within each dimension and the homogenous sample appear to have contributed to this low reliability. Conclusion: Ongoing research using multidimensional tools to measure dimensions of wellness among older adults is needed to advance wellness science and wellness promotion in nursing practice.

Interprofessional Mass Casualty Incident Simulation Design Protocol to Prepare Prelicensure Nursing Students to Respond to a Disaster

Nurses need to be prepared to respond to mass casualty incidents. Simulation is an ideal teaching intervention that can be used to prepare nursing students to effectively triage patients and allocate limited resources. This article describes a detailed interprofessional mass casualty simulation of a bus crash with 32 victims. Nursing students trained with emergency responders with students acting as charge nurses throughout the simulation. The details of the simulation are provided for faculty to replicate.

An Interprofessional Approach to Continuing Education With Mass Casualty Simulation: Planning and Execution

Many natural and man-made disasters require the assistance from teams of health care professionals. Knowing that continuing education about disaster simulation training is essential to nursing students, nurses, and emergency first responders (e.g., emergency medical technicians, firefighters, police officers), a university in the northeastern United States planned and implemented an interprofessional mass casualty incident (MCI) disaster simulation using the Project Management Body of Knowledge (PMBOK) management framework. The school of nursing and University Volunteer Ambulance Corps (UVAC) worked together to simulate a bus crash with disaster victim actors to provide continued education for community first responders and train nursing students on the MCI process. This article explains the simulation activity, planning process, and achieved outcomes. J Contin Educ Nurs. 2017;48(10):447-453.

GROW: Green Organic Vegetable Gardens to Promote Older Adult Wellness: a Feasibility Study

ABSTRACT Protecting older adult’s cognitive health is a public health priority. Wellness behaviors within 6 domains have demonstrated effectiveness in protecting older adult’s cognitive abilities. Interventions targeted to low-income older adults are needed because these populations experience greater social and physical health disparities compared to adults in higher socioeconomic statuses. This study examined the feasibility of engaging independent, community-dwelling older adults living in low-income senior housing in cultivating raised-bed gardens and reviewed the improvements in cognition and nutrition. Ten participants received ergonomic garden tools, seeds, waist-height garden beds, and weekly garden education. Participants planted vegetables of their choosing and tended to their garden beds for 17 weeks. Cognition and nutrition outcomes were measured before and after the intervention. Adults successfully engaged in the intervention throughout the duration and experienced improvement in cognitive and nutrition outcomes.

Short-Term Lifestyle Strategies for Sustaining Cognitive Status

Cognitive decline impacts older adults, particularly their independence. The goal of this project was to increase understanding of how short-term, everyday lifestyle options, including physical activity, help an older adult sustain cognitive independence. Using a secondary analysis of lifestyle choices, we drew on a dataset of 4,620 community-dwelling elders in the US, assessed at baseline and one year later using 2 valid and reliable tools, the interRAI Community Health Assessment and the interRAI Wellness tool. Decline or no decline on the Cognitive Performance Scale was the dependent variable. We examined sustaining ones status on this measure over a one-year period in relation to key dimensions of wellness through intellectual, physical, emotional, social, and spiritual variables. Engaging in physical activity, formal exercise, and specific recreational activities had a favorable effect on short-term cognitive decline. Involvement with computers, crossword puzzles, handicrafts, and formal education courses also were protective factors. The physical and intellectual domains of wellness are prominent aspects in protection from cognitive decline. Inherent in these two domains are mutable factors suitable for targeted efforts to promote older adult health and well-being.

Self-care project for faculty and staff of future health care professionals: Case report

Self-care among health care providers is an important component of their ability to provide quality health care to patients. Health care institutions have programs in place for students that emphasize health and wellness, but few programs are available for faculty and staff. To address this gap and facilitate modeling health and wellness strategies for students, a New England institution that educates health care practitioners began a pilot self-care project for faculty and staff. Both quantitative and qualitative data were collected. The template used for this project could be used as a stepping-stone for future wellness self-care program in higher education for faculty, staff, and students.

The mediator role of positive emotion interventions and cognitive health in community-dwelling older adults: A longitudinal cohort study

Background: As adults age, there is a greater risk of cognitive health decline, and thus protecting cognitive health is a public health priority. Negative mood is a risk factor for losing cognitive abilities among aging adults. The Broaden and Build Theory of Positive Emotion suggests that activities that build positive emotion may mediate the negative effects of negative mood. This theory guided an examination of the relationship between mood and activities that promote positive emotions and their effects on cognitive decline among aging adults. Methods: The sample included 492 community‐dwelling adults 60 years and older who completed a Community Health Assessment (CHA) and a COLLAGE Wellness Assessment (WEL) twice between the years 2007 and 2013. Cognition was measured using items from the CHA that formed the Cognitive Performance Scale (CPS) and activities that promote positive emotions was measured using items from the WEL. Negative mood was measured using items from the CHA. Logistic regression was used to associate CPS, mood, and positive emotion activities at baseline and after at least one year. Results: All three of the negative mood variables were statistically significant predictors of a poor CPS score. The presence of negative statements (p=0.036), anger (p=0.017), and withdrawal (p=0.009) were statistically significant. Conclusions: None of the activities that cultivate positive emotions were significantly associated with changes in CPS score. Future research should examine interventions to reduce negative mood and determine if they mediate the risk of cognitive decline among aging adults.