International Journal of Older People Nursing

Publications in this journal

• Article: Testing reliability and validity of Lorensen’s Self-care Capability Scale (LSCS) among older home-living, care-dependent individuals in Norway

  Bjørg Dale, Hans Inge Sævareid, Olle Söderhamn
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  ABSTRACT: Aim and objective. The aim of this study was to test reliability and validity of the orensen’s Self-Care Capability Scale (LSCS). Background. The assessment of self-care capability among older people living at home is essential for maintaining independence for as long as possible. Method. The study sample consisted of 242 home nursing patients who were 75 + years old and living at home. The responsible home nurses documented their answers. In addition to the LSCS, help dependency, subjective health and demographic characteristics were recorded. Various statistical analyses were used to assess reliability and validity of the LSCS. Results. Reliability of the LSCS was supported by a Cronbach’s alpha coefficient of 0.97. Regarding validity, six factors extracted in the factor analysis explained 69.8% of the variance in the group. The extracted factors supported the underlying theoretical assumptions of the instrument. Construct validity was supported by significant differences between groups with expected low and expected high LSCS scores, respectively. Concurrent validity was established by a significant correlation between LSCS and Barthel’s ADL Index. Conclusion and implications for practice. This study has shown that LSCS is a reliable and valid instrument for assessing self-care capability in older people living at home. Key words: assessment, gerontological nursing, reliability, validity
  International Journal of Older People Nursing 01/2013; 8:166–173..
• Article: International Journal of Older People’s Nursing; Practice Development

  Jill Manthorpe, Steve Iliffe, Kritika Samsi, Laura Cole, Claire Goodman, Vari Drennan, James Warner
  International Journal of Older People Nursing 01/2010;
• Article: Guest Editorial: Health literacy in later life.

  Debbie Tolson
  International Journal of Older People Nursing 09/2008; 3(3):159-60.
• Article: Development and psychometric testing of a new geriatric spiritual well-being scale.

  Karen S Dunn
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  ABSTRACT: Aims and objectives.  Assess the psychometric properties of a new geriatric spiritual well-being scale (GSWS), specifically designed for older adults. Background.  Religiosity and spiritual wellness must be measured as two distinct concepts to prevent confounding them as synonymous among atheist and agnostic population. Design.  A test-retest survey design was used to estimate the psychometric properties. Methods.  A convenience sample of 138 community-dwelling older adults was drawn from the inner city of Detroit. Data were collected using telephone survey interviews. Data analyses included descriptive statistics, structural equation modelling, reliability analyses, and point-biserial correlations. Results.  The factorial validity of the proposed model was not supported by the data. Fit indices were χ(2)  = 185.98, d.f. = 98, P < 0.00, goodness-of-fit index of 0.85, comparative fit index of 0.87 and root mean error of approximation of 0.08, indicating a mediocre fit. Reliability statistics for the subscales ranged from being poor (0.36) to good (0.84) with an acceptable overall scale alpha of 0.76. Participants' performance stability and criterion-related validity were also supported. Conclusions.  The GSWS is an age-specific assessment tool that was developed specifically to address a population's cultural diversity. Future research endeavors will be to test the psychometric properties of this scale in culturally diverse older adult populations for further instrument development. Relevance to clinical practice.  Nurses need to recognize that agnostics/atheists have spiritual needs that do not include religious beliefs or practices. Thus, assessing patients' religious beliefs and practices prior to assessing spiritual well-being is essential to prevent bias.
  International Journal of Older People Nursing 09/2008; 3(3):161-9.
• Article: Discovery Interviews with older people: reflections from a practitioner.

  Rob Way
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  ABSTRACT: This paper reports on a nurse consultant's experiences of using Discovery Interview technique with older patients and their relatives about their urgent care experiences.
  International Journal of Older People Nursing 09/2008; 3(3):211-6.
• Article: Editorial: Developing user-centred services.

  Jan Reed
  International Journal of Older People Nursing 09/2008; 3(3):204-5.
• Article: Discovery Interviews: a mechanism for user involvement.

  Jackie Bridges, Wendy Gray, Graham Box, Sheelagh Machin
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  ABSTRACT: Discovery Interviews have become widely used in the UK National Health Service as a service improvement tool and patient involvement mechanism. This first paper in a series of three explores the development of Discovery Interviews in the NHS in the context of explicit central government policy of the development of patient-centred services and user involvement in shaping health service organization and delivery. It draws on the published literature on Discovery Interviews to date, including that on evaluation.
  International Journal of Older People Nursing 09/2008; 3(3):206-10.
• Article: Editorial: 'They sentenced me to 20 years of boredom'.

  Jan Reed
  International Journal of Older People Nursing 06/2008; 3(2):79.
• Article: Editorial: ageing, spirituality and nursing.

  Jan Reed
  International Journal of Older People Nursing 06/2008; 3(2):138.
• Article: Practice development in aged care nursing of older people: the perspective of ageing and spiritual care.

  Elizabeth Mackinlay
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  ABSTRACT: This third paper on older people nursing and spirituality moves beyond the literature reviewed in the two previous papers, exploring directions for the practice and continuing research in this field. Issues of chronic illness challenge nurses working with older people to focus on continuing health promotion and opportunities for spiritual promotion of resilience and transcendence. The changes from monocultural to multicultural societies challenge nurses to know how to provide culturally and faith appropriate care. The extension of palliative care to the needs of those growing older and dying is noted as an important area for developing spiritual care. It is asserted that spiritual assessment forms a basis for the provision of spiritual care for all of these themes. Ethical perspectives of older people nursing must be carefully addressed as frail and vulnerable older people struggle with issues of compromised autonomy. Further research should focus on spirituality as seen through the eyes of older people and examine the interface between nurses and patients, where the relationship becomes the guiding basis for practice. Education in nursing courses and through continuing programmes of education is needed to ensure adequate understanding of spirituality in the nursing role.
  International Journal of Older People Nursing 06/2008; 3(2):151-8.
• Article: A mapper's reflection on Dementia Care Mapping with older residents living in a nursing home.

  Martha Mansah, Lyn Coulon, Peter Brown
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  ABSTRACT: Aim and objective.  This paper explores reflection stemming from a Dementia Care Mapper's own learning and development concerning person-centred care with older residents living in a dementia specific nursing home. Background.  Dementia Care Mapping has been employed in few Australian residential care facilities to promote person-centred care and the well-being of residents. Reflection has also been used selectively in some practices to improve and evaluate the care process. However, contemporary nursing literature has failed to highlight the usefulness of applying reflection following Dementia Care Mapping with older residents. Method.  The mapper's reflections arose from the Dementia Care Mapping observation of five older residents and writing a daily reflective journal. Findings.  From the reflection, a dominant major theme emerged named as the Learning Experience from Mapping Residents with two sub-themes entitled Mapper's Identification of Resident's Unique Needs and Mapper's Empowerment of Clinicians. Dementia Care Mapping recommendations from the mapper's experience highlighted effective approaches to conducting Dementia Care Mapping in residential care facilities. Conclusions.  The valuable process of reflection to Dementia Care Mapping provided the mapper with clinical insights. Further from the mapper's final reflection, a poem entitled Come Back Mind, Come Back to Me was conceived and penned. Relevance to clinical practice.  The mapper's engagement in ongoing reflection incorporated with Dementia Care Mapping has the potential to promote best practice for the care of older people living in aged care facilities.
  International Journal of Older People Nursing 06/2008; 3(2):113-20.
• Article: A review of the literature in 2006.

  Elizabeth Mackinlay, Rosalie Hudson
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  ABSTRACT: In this, the first of three papers, attention is drawn to the literature for one year, reflecting a sample of the interrelated themes of ageing, spirituality and nursing. It is clear that nurses are unsure how to include this component of care in their daily practice. However, with the rapidly increasing ageing population, and the recent escalation of literature on spirituality, it seems timely to analyse some of these findings and to consider the implications for practice. Some of the major emerging themes have been identified in this paper, with a view to further exploration of the themes in the second paper, and expanding the discussion in the third paper.
  International Journal of Older People Nursing 06/2008; 3(2):139-44.
• Article: Multiprofessional collaboration promoting home care clients' personal resources: perspectives of older clients.

  Sini Eloranta, Seija Arve, Pirkko Routasalo
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  ABSTRACT: Home care can be decisive in supporting older people in the home environment. However, one professional in home care cannot take the whole responsibility for promotion alone; on the contrary multiprofessional collaboration is needed. The aim of the study is to describe the experiences of multiprofessional collaboration in promoting personal resources among older home care clients (75+ years) in Finland. The data were collected by unstructured interviews with 21 older home care clients. Their mean age was 83.5 years, ranging from 75 to 91, with 17 female and four male participants. Inductive content analysis was used to analyze the data. The interviewees described the work of professionals from four perspectives: expertise, communication, decision-making and responsibility. Multiprofessional collaboration promoted the personal resources of interviewees with physical, psychological and social support. This study showed that the professionals worked as being expert-oriented: in the multiprofessional collaboration, each expert took care of his/her own part of the client's situation. This included the risk,, that the client's overall situations remained uncharted. However, the client's overall situation is a very important aspect when professionals suppport older people living in their own homes as long as possible. This study revealed the need for developing collaboration skills between social and health care professionals so that the staffs serve the needs of aged clients better together.
  International Journal of Older People Nursing 06/2008; 3(2):88-95.
• Article: Transitions in men's caring identities: experiences from home-based care to nursing home placement.

  Henrik Eriksson, Jonas Sandberg
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  ABSTRACT: Objectives.  The aim of this study is to describe, from a gender identity perspective, the experiences of older men involved in the process of caring for a partner at home and the placement into a nursing home. Background.  Few studies have paid attention to the importance of gender when considering the social experiences of older men providing care for an ill spouse and finally placing a partner in a nursing home. Further understanding is much needed of how older men experience the process of caring for a spouse from a gender identity perspective. Design.  A qualitative constructivist approach was adopted for this study. Participants.  Data consists of interviews with seven men that have been informal carers and experienced the placement of their wife in a nursing home. Methods.  Interviews were analysed with a constructivist approach. Results.  The results indicate that men go through two transitions in their gender identity during the caregiving process and placement. From the mutual loving relationship of being a loving husband, the social responsibility of daily care of their wives changes the situation into that of being a caring husband, and finally with the move to a nursing home there is a transition from intimate care to a relationship based on friendship. Conclusions.  The results show that older caregiving men undergo a process involving a reconstruction of gender identity. To formally recognize men's caring activities and to make them sustainable, we believe that men in an informal caring relationship need support. Relevance to clinical practice.  Nurses need to recognize the identity struggles resulting in sadness and suffering that are related to changes in men's lives during the caregiving process. Understanding the dynamics and changes that occur when men take on a caring task is important for the development of their role as carers.
  International Journal of Older People Nursing 06/2008; 3(2):131-7.
• Article: Older immigrants' experiences of their life situation in the context of receiving public care in Sweden.

  Boel Hovde, Ingalill R Hallberg, Anna-Karin Edberg
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  ABSTRACT: Objectives.  The aim of this study was to illuminate older immigrants' experience of their life situation in the context of receiving public care in Sweden. Background.  To meet the varying needs from the growing number of older immigrants, more knowledge about the experience of their life situation, health, illness and family ties is needed, especially in the context of receiving public health care and service. Methods.  Data were collected through interviews with sixteen immigrants aged 65 years and older, originally from nine different countries, living in Southern Sweden and receiving continuous care and service. The texts were analysed using qualitative content analysis. Results.  The overall impression from the texts was that the informants expressed a debt of gratitude to Swedish society. Their experience could be understood as - being burdened with health complaints; experiencing painful losses; wanting to manage by oneself and feeling exposed and deserted. Conclusions.  The results show that older immigrants are vulnerable when receiving public care. This was related to previous life events, cultural differences as well as communication difficulties. When planning for and providing care for older immigrants, it is important to be aware of their exposed situation and to acknowledge their life history and family context.
  International Journal of Older People Nursing 06/2008; 3(2):104-12.
• Article: The feasibility of developing a standards rating system for all Australian government aged care homes.

  Susan Koch, Rhonda Nay, Linda McAuliffe, Bill Koch
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  ABSTRACT: Aims and objectives.  The main objective of this project was to investigate the likelihood of creating an easily understood rating system for all aged care homes. A secondary objective was to canvas the feasibility of alternative systems that could better inform aged care consumers. Background.  Standards rating systems are used internationally to enable comparisons in healthcare. In Australia, the performance of numerous services and products are measured according to the star system of ratings, yet despite their widespread use, star ratings remain absent from the healthcare industry. Methods.  A National Consultative Group (NCG) consisting of key stakeholder representatives was consulted, and a literature review performed on existing standards (or 'star') rating systems. Telephone interviews were conducted with representatives from aged care homes, as well as consumers. Results.  A standards rating system for aged care homes was not found to be feasible in the current climate. However, an alternative system that emphasises empowering aged care consumers, such as one that allows consumers to search for an aged care home using their own criteria of preference, was considered more feasible. Conclusion.  The need for information to assist consumer choice - limited as it may be - is real. Ways of providing more consumer friendly, useful information need to be further explored and developed. Recommendations are made for future work in this area.
  International Journal of Older People Nursing 06/2008; 3(2):80-7.
• Article: Application to practice guidelines.

  Rosalie Hudson
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  ABSTRACT: Drawing on the international literature for 2006 as discussed in the previous paper, this paper explores key issues for translating the evidence into practice. It brings the themes of ageing, spirituality and nursing more sharply into focus, providing practical suggestions for care in a variety of settings. Taking seven identified themes into consideration, the paper draws out implications for practice from each theme. This discussion is intended to provide encouragement for nurses to consider the spiritual domain in holistic care, not as an optional extra but as the centre of a dynamic partnership with the older people in their care. The paper concludes with recommendations for further research and development work.
  International Journal of Older People Nursing 06/2008; 3(2):145-50.
• Article: Natural activity: an explorative study of the interplay between cage-birds and older people in a Swedish hospital setting.

  Hanna Falk, Helle Wijk
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  ABSTRACT: Aim.  The aim of this study was to describe the interaction between cage-birds and older people as it arises in spontaneous situations in a Swedish hospital ward setting. Background.  Older people are at risk of being affected by mental fatigue because of various age-related reductions and disease. Mental fatigue manifests itself through a reduced ability to concentrate. The method of alleviating mental fatigue with the use of stimulating natural settings or animal-assisted activities is so far unexplored in Sweden and subsequently it is important to study the method in a Swedish context to implement it as a recognized nursing intervention in the care of older people. Design.  The study had an explorative observational design, and was conducted at a geriatric ward with a consecutive selection of participants. Method.  The observations were analysed using a constant comparative method influenced by Grounded Theory. 'Attention restorative theory' was used as the theoretical framework to guide the study. Result.  Our findings indicate that animal-assisted therapy has a positive effect on involuntary attention and mental restoration, as well as on enhanced social behaviour among older people. Relevance to clinical practice.  The result strengthens the assumption that animal companionship should be considered a beneficial nursing intervention for older people to prevent mental fatigue.
  International Journal of Older People Nursing 03/2008; 3(1):22-8.
• Article: Shielding or caging? Healthcare staffs' views on fall risk and protection in Stockholm.

  Edit Fonad, Philip Burnard, Azita Emami
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  ABSTRACT: Aim.  To describe Registered Nurses' and enrolled nurses' views and reasoning on falls, fall risk, use of physical restraints and patients' safety and security in nursing homes. Background.  Nursing home patients frequently suffer from diseases which require medication. Both Registered Nurses and enrolled nurses must make decisions about how to protect patients from falls and fall-related injuries. Physical restraints are frequently used. When patients are unable to understand or do not wish to limit their freedom of movement, staff must consider each decision carefully. Method.  A qualitative approach was used. Data were analysed using a thematic content analysis method. Findings.  Staff have sufficient knowledge about which pathologically related conditions lead to fall risk. An insufficient number of staff on duty jeopardizes patient safety. Wheelchairs with safety belts, and bed rails, are sometimes used. For Registered Nurses it was not an easy decision to use restraints. Enrolled nurses' actions were based on standard procedure, to protect and supervise patients. Conclusion.  Staff often use restraints to protect their patients, even though this may mean compromising the patient's integrity. Relevance to clinical practice.  Nurses, occupational therapists, physiotherapists and physicians should plan the care together. Restrictive measures should be adapted to each individual patient.
  International Journal of Older People Nursing 03/2008; 3(1):46-54.