Sarah Hall Gueldner

Supporting Older Adults Living With Multiple Chronic Conditions

This qualitative study was conducted using focus groups to explore the strategies commonly employed by older adults (N = 37) to manage multiple chronic conditions. Key strategies identified were relating with health care providers, medicating, exercising, changing dietary patterns, seeking information, relying on spirituality and∕or religion, and engaging in life. Although social support was not mentioned as a discrete strategy, the participants’ social networks were embedded in all of the categories. This study supports building a partnership of care in which nurses and other health care professionals function in supportive and educative roles to enhance the older person’s lifelong self-care management and ability to stay in control of multiple chronic health conditions.

The Well-Being Picture Scale: A Revision of the Index of Field Energy:

This paper reports the development and psychometric properties of the Well-Being Picture Scale, a 10-item non-language based pictorial scale that measures general well-being, based on Martha Rogers’view of human beings as energy fields in continual mutual process with their environment. The Well-Being Picture Scale was designed for use with the broadest possible range of adult populations, including persons who are unable to respond to English-based text or lengthy, complex measurement instruments. Psychometric properties were established in a sample of more than 2,000 individuals from the United States, Taiwan, Japan, and Africa. The overall Cronbach’s alpha is .8795.

The oldest-old: how do they differ from the old-old?

This article reviews findings from the Berkeley Older Generation Study, a long-term longitudinal study of aging. The findings show many important differences between the oldest-old age group and other, younger-old individuals. Marked variation is demonstrated in the verbal scale of intelligence. More than half of oldest-old individuals did not decline, and some actually increased in verbal IQ. Four personality traits (i.e., agreeableness, satisfaction, intellect, extroversion) are stable. The fifth trait, energetic, may reflect responses to external circumstances, including physical health. As for social relationships, most individuals--including the oldest-old--still retain ties with important family members and friends. Individual differences are great, stressing the danger of accepting stereotypes about old individuals.

Health Motivation: A Determinant of Older Adults' Attendance at Health Promotion Programs

The primary purpose of conducting this study¹ was to determine if there is a significant relation between health motivation and participation in health promotion programs in a sample of community-dwelling older adults (n = 106). Health motivation was measured using Coxs (1985) Health Self-Determinism Index, and participation in health promotion programs was measured by tallying the self-reported number of programs attended within the past year by each individual. The effects of selected demographic variables on these two variables were also examined. The conceptual framework guiding the study was the Health-Promoting Self-Care System Model (Simmons, 1990). Intrinsically motivated older persons attended fewer programs (p < .01) than those who were more extrinsically motivated. Higher educa-tional level (p < .001) and fewer health problems (p < .01) emerged as significant predictor variables for intrinsic health motivation, and those with less formal education attended more health promotion programs (p < .05).

Models for community-based long-term care for the elderly in a changing health system

Abstract Serving the health care needs of the rapidly expanding number of elders in the United States will require creative restructuring of the present long-term care system. Four programs that provide innovative, community-based, long-term care to the elderly are described, and policy, practice, and educational implications are presented.

Health as Expanding Consciousness With Families With a Child With Special Healthcare Needs

Families have health experiences that become enfolded within their life patterns. Based within Newmans conceptualization of health as expanding consciousness, the purpose of this study was to develop knowledge about the nurse-client process of facilitating health in families who have a child with special healthcare needs. The research as praxis method was used to answer the research question, What is the evolving pattern of the nurse-client process that facilitates health as expanding consciousness in families who have a child with special healthcare needs?

Environmental Interaction Patterns Among Institutionalized and Non-Institutionalized Older Adults

The purpose of this survey was to describe characteristic environmental interaction patterns of ambulatory, mentally alert, nursing home residents, and to compare their patterns with individuals of similar age and health who live independently within the community setting. The sample (n = 81) consisted of 39 nursing home residents and 42 community dwellers, including 64 females and 17 males. The mean age of the sample was 77.4 years. Chi square analysis confirmed (P = .05) that the nursing home residents went outside, had visitors, talked on the telephone, and received mail less often than their counterparts who lived independently.

The undergraduate student as research assistant: promoting scientific inquiry.

As nurse scientists, we must find a way to excite our undergraduate students about research so that they will value it and include it as an integral part of their practice. The ambience surrounding scientific inquiry cannot be captured from readings and classroom activities alone, but must be modelled by enthusiastic faculty who are actively involved in research. Two exemplary cases involving the use of undergraduate students as integral members of faculty-directed research teams are described.

Remember when...? Using mnemonics to boost memory in the elderly.

Memory loss associated with normal aging is frequently confused with dementia. Self-perceived memory loss can lead to social withdrawal, which can contribute to an ongoing pattern of memory impairment. Memory instruction utilizing mnemonic techniques can lead to improvement in both memory and self-esteem in the elderly. A simple, four-session mnemonics instruction program can provide an effective intervention to assist older persons in coping with memory problems.

Healthcare providers’ perspectives: Estimating the impact of chronicity

Purpose To compare elders’ self‐ratings of the impact of their chronic conditions with healthcare providers’ estimates of the impact of the same conditions on older adults. The effect of length of time in clinical practice and rural or urban clientele on healthcare providers’ impact ratings was also explored. Data sources A pen‐and‐paper survey was administered to 122 community‐dwelling adults aged 55 years and older, attending health education or exercise programs held by a hospital in a city of approximately 60,000 people. Elders were asked to identify which of 11 common chronic conditions they had and then to rate the impact each condition had on their daily lives. A sample of 290 healthcare providers who are members of the Gerontological Society of America completed a mailed survey asking them to estimate the impact that each of the 11 conditions had on older adults. Conclusions Healthcare providers consistently overestimated the impact that chronic health conditions had on older adults when compared with the elders’ self‐ratings of impact. Greater levels of experience were not significantly related to providers’ impact ratings of chronic conditions. Implications for practice Nurse practitioners, as primary care providers, must understand the impact of chronic conditions on older adults’ daily lives in order to provide effective, efficient, and evidence‐based health care. This study points to the need for more research to discover why older adults and healthcare providers have such different perspectives on the impact of chronic health conditions.