bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE AND PREDICTORS OF DECISIONAL CONFLICT AMONG OLDER AFRICAN AMERICANS WITH ADVANCED KIDNEY DISEASE
Authors: Hamler Tyrone 
Published: December 2023

Abstract
Chronic kidney disease (CKD) is a major public health concern in the U.S., particularly among African Americans. African Americans are just under four more times likely to develop CKD than White individuals. Older African Americans are a vulnerable and understudied population in CKD literature, despite future projections of an increasingly diverse population of older adults. This study’s objectives were: (1) to determine the prevalence of decisional conflict for pre-dialysis older African Americans (2) whether perceived CKD knowledge, clinical characteristics (self-rated health, depression, anxiety, and number of comorbidities), and personal characteristics predicted decisional conflict. Study participants (N =125) were recruited from an outpatient nephrology clinic in a midwestern hospital and administered a telephone survey. Participants were African American, ≥ 50 years of age, pre-dialysis and diagnosed with Stage 4 or 5 CKD. A hierarchical ordinary least-squares (OLS) regression analysis was conducted to examine the relationship between variables. Participants reported mean scores of DC in the moderate range (M = 36.69). Approximately 42% (n =53) of patients’ decisional conflict scores were above 37.5, which is the cut-point for scores indicating uncertainty (O’Connor, 1995). Multivariate analyses indicated that DC was only significantly associated with perceived chronic kidney disease knowledge. Lower levels of perceived chronic kidney disease knowledge were associated with higher levels of DC. Findings indicated that DC is a critical area to continue to investigate among older African Americans with advanced CKD. Social workers are well-positioned to impact levels of knowledge in this population through working on interdisciplinary teams in medical settings.
SECONDARY ROLE STRAIN AND GRIEF OF DEMENTIA FAMILY CAREGIVING AS PREDICTORS OF BURDEN
Authors: Mason Hannah , Falzarano Francesca 
Published: December 2023

Abstract
Services often aim to improve caregiver experiences for dementia family caregivers by addressing challenges in daily care activities and enhancing care quality for care-recipients. Supporting caregivers should not exclusively focus on supporting activities related to direct care provision (e.g., primary stressors), but should also include services that holistically support the caregiver’s well-being. Identifying an individual’s unique needs beyond their caregiving role is crucial; the growing phenomenon of caregiver burnout, burden, and psychosocial struggle includes experiencing a loss of identity, increased desire to escape, and intense role captivity. While some services are more individualized, such as one-on-one therapy, there is an overall gap in caregiver support in secondary domains. The current study examined whether primary stressors (e.g., activities of daily living and everyday care tasks) or secondary stressors (e.g., strain on other relationships and responsibilities) were more predictive of burden in a sample of 46 participants who completed a mixed-method study examining the heterogenous experiences and unmet needs of dementia family caregivers. Analysis shows that interference of the care role with responsibilities to other family (i.e., secondary role strain) and feeling pre-loss grief over their loved one’s illness were significant predictors of greater burden compared to primary stressors. Results indicate the importance of addressing secondary stressors such as pre-loss grief and deterioration of one’s microenvironment (including social support, familial relationships, and identity) in intervention efforts to better enhance quality of life and well-being in dementia care.
SELF- AND PROXY-REPORTED MET NEEDS IN PERSONS WITH DEMENTIA ARE ASSOCIATIED WITH A LOWER HEALTH-RELATED QUALITY OF LIFE
Authors: Wammes Joost , Laws Holly , van Hout Hein , Vroomen Janet MacNeil , Monin Joan 
Published: December 2023

Abstract
This study examined the dyadic association of self and informal caregiver proxy-reported met needs in persons living with dementia on the health-related quality of life (HRQOL). A total of 237 dementia care dyads were included from the Case Management of Persons With Dementia and Their Caregivers Study. HRQOL was assessed by the EuroQol-5D and the number of met needs by the Camberwell Assessment of Needs for the Elderly. The Actor-Partner Interdependence Model framework was used to analyze the effect of an individual’s self or proxy-reported met needs on their own HRQOL (actor effects), and an individual’s self or proxy-reported met needs on the other dyad member’s HRQOL (partner effects). The number of self-reported met needs by persons living with dementia was negatively associated with their own HRQOL (actor effect b = -0.200, p &lt; 0.001), and the HRQOL of informal caregivers (partner effect b = -0.114, p = 0.001). The number of proxy-reported met needs by informal caregivers was negatively associated with their own HRQOL (actor effect b = -0.105, p &lt; 0.001) but not the person living with dementia’s HRQOL (-0.025, p = 0.375). Study findings suggest that both self-reported and informal caregiver proxy-reported met needs in persons living with dementia should be considered in research and practice because they have different implications for each dyad members’ HRQOL.
BRINGING COMMUNITY-BASED FALLS PREVENTION PROGRAM TO IMPROVE GLOBAL HEALTH (BRIGHT)
Authors: Thiamwong Ladda , Tongsiri Sirinart , Xie Rui , Ng Boon Peng , Park Joon-Hyuk , Li Wenjun , Eckstrom Elizabeth 
Published: December 2023

Abstract
Older adults in low- and middle-income countries (LMICs) experience a disparate burden of non-communicable diseases (NCDs) and barriers to accessing health care. Unintentional injuries are among the major NCDs, and falls are the second leading cause of these injuries and deaths. Falls were reported in up to 50% of older people living in Asia, including Thailand. There is a lack of community-based multifactorial fall prevention interventions that target both older adults and the primary care systems. We aimed to culturally adapt the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) for Thai older adults and explore the feasibility, appropriateness, and acceptability of using STEADI by trained community health workers (CHWs) and care managers (CMs). STEADI consists of three steps: screening, assessing, and intervening. In Step a, CHWs screened fall risk using three key questions and found that all of participants had fall risk, then CHWs screened with a Stay Independent questionnaire (range 0-14) and found that 100% have high fall risk (total scores 9.7± 2.4). In Step b, CMs assessed risk factors and CHWs assessed home hazards. They found that 50% had poor balance, 70% took 4+ medications, 75% fell on the walkway, and 70% had no bathroom modifications. In Step c, individual participants received fall prevention interventions and participants attended all sessions. Our results indicated that STEADI delivered by CHWs and CMs is feasible and acceptable for older adults. The mean scores of acceptability, appropriateness, and feasibility were 19.20,18.80, and 18.60 out of 20 totals, respectively.
RESULTS OF AN ONLINE CAREGIVING DURING CRISIS COURSE
Authors: Clevenger Carolyn , Epps Fayron , Higgins Melinda , Brewster Glenna , Raina Kirandeep , Hepburn Kenneth 
Published: December 2023

Abstract
Caregiving during Crisis (CDC) is an online, asynchronous, self-paced course for dementia family caregivers. The course was developed to enhance caregivers’ sense of mastery for their role as systems navigator with the secondary effects of improving their own and their person’s quality of life. CDC was drafted by subject matter experts and finalized by family caregivers. The final version focused on three main topics: Safe Home; Navigating the Healthcare System; and Managing the Day divided into 54 short interactive segments. One hundred caregivers were enrolled in a randomized waitlist control group design, with measures of mastery and quality of life at three timepoints over 16 weeks. We employed multi-level mixed effects models (MLM) with random (participant) and fixed (group) effects to test linear (or possibly non-linear) trajectories of change for the immediate and waitlist groups and model group X time and group*time interactions. Of 100 consented participants (50 in immediate and 50 in waitlisted group), 76 completed the midpoint study activities (38 in each group). For the immediate group, there was an increase in mastery such that by the midpoint at 2 months, the caregivers in the immediate group had significantly higher mastery scores (p=.039) than those in the waitlist group, with a moderate effect size (d=0.501) difference. Fourteen course participants completed semi-structured interviews. Their responses to the course were very positive, noting it was well organized, logical, and not too technical. They also indicated a need to include guidance for interactions with legal, regulatory, social service, and financial systems.
CULTIVATING AN ATTITUDE OF GRATITUDE: A BRIEF GRATITUDE INTERVENTION FOR OLDER ADULTS WITH CHRONIC PAIN
Authors: Condon Shelley , Cox Brian , Parmelee Patricia 
Published: December 2023

Abstract
Gratitude interventions have emerged as a promising approach to ameliorate the negative impact of pain and enhance quality of life. Despite the high prevalence of older adults with chronic pain, there are very few gratitude intervention studies in this population. The current study examined the feasibility and effectiveness of a two-week daily gratitude journaling intervention in a sample of 38 older adults (M=67.53 years) with chronic knee or hip pain. Participants were randomly assigned to the gratitude group (n=21), who wrote down three things they were grateful for every day, or the attention-matched control group, who did not journal. All participants completed pre- and post-intervention interviews and received 14 nightly phone calls, allowing for “global” (pre/post interviews) and “daily” (nightly calls) analyses of the study aims. Aim 1 examined the effects of gratitude on well-being using regression and multilevel model analyses, while Aim 2 examined the effects of the intervention on changes in well-being using repeated measures analyses of variance and multilevel model analyses. In Aim 1, significant associations were found between trait and state gratitude and well-being, supporting previous research and a multifaceted conceptualization and measurement of gratitude. In Aim 2, significant main effects for time emerged, suggesting that participants’ well-being improved regardless of their treatment group. Income level was also a consistent predictor of well-being, demonstrating disparities in chronic pain. The impact of small sample size, COVID-19, and methodological limitations will be discussed. Future research plans and recommendations will also be provided.
THE CURIOUS CASE OF CONSCIENTIOUSNESS AND DEPRESSION: FINDINGS FROM THE IOWA UNMARRIED SURVIVORS STUDY
Authors: Hensley Robert , Bishop Alexander , Martin Peter 
Published: December 2023

Abstract
The purpose of this study was to analyze the association between personality traits, coping, social support, stress, and loneliness relative to depression reported by N = 227 (M = 78.2, SD = 8.1) participants from the Iowa Unmarried Survivors Study. Using the Development Adaptation Model as a conceptual framework, a series of blocked multiple regression analyses were conducted. In the first block, age, gender, ethnicity, total years of education, and current marital status were included. The second block contained total life events and childhood poverty, whereas the third block included activities of daily living and total number of illnesses. The fourth block contained the aforementioned personality variables, and the fifth block included coping, social support, stress, and loneliness. Lifetime illnesses emerged as a significant predictor of depression, β = .158, p &lt; .01. The more illnesses over one’s lifetime, the higher the levels of depression. In addition, both Neuroticism and Conscientiousness were significant predictors of depression, β = .453, p &lt; .00, β = .139, p &lt; .05 respectively. Finally, stress served as a significant predictor of depression, β = .200, p &lt; .01. This model explained 58% of the variance in depression scores. Being unmarried and navigating through late adulthood presents a challenge to sustaining positive mental health. Results from this study have implications relative to how clinically trained counselors, geriatric social workers, and aging service providers develop interventions and programming to improve mental health and quality of life for persons who remain unmarried throughout later life.
THE NARRATIVES OF NURSING HOME RESIDENTS WITH PERSISTENT PAIN ABOUT THE PAINCQ-33
Authors: O’Connor Timothy 
Published: December 2023

Abstract

Problem
Persistent pain in older adults, often multimodal, remains poorly managed among nursing home residents. The resident’s perceptual barriers can interfere with how clinicians treat pain. Current pain instruments do not identify how older nursing home residents perceive interdisciplinary pain management care (IPMC). Purpose: This study explores the use of the Pain Care Quality (PainCQ-33) to measure how older nursing home residents with persistent pain perceive their IPMC and how these individuals communicate their persistent, multimodal pain to caregivers. Furthermore, this research determines how older residents prioritize their pain management expectations for maintaining their quality of life. Research design: A focus group design was used to explore residents’ viewpoints about the ability of the PainCQ-33 to accurately measure the perception of the quality of their pain management care. Data analysis: Transcripts and field notes from focus group discussions were analyzed using descriptive content analysis.

Results
The identified codes illustrate how pain interference affects the ratings an older resident assigns to their pain management care and expectations of whether their pain can be relieved. Additional codes demonstrate an older resident’s pain-relieving measures and who they identify as helping to alleviate their pain. A theme from the codes emerged, where the relevance of pain management was based on the caring nature for chronic pain, which is the underpinning of the PainCQ-33 instrument. Significance: Clinicians, including nurses, can benefit from having a pain assessment tool uniquely designed to assess how this population perceives the quality of their pain management care.
THE PREDICTIVE VALIDITY OF SUBJECTIVE SURVIVAL PROBABILITIES AMONG OLDER ADULTS WITH PAIN
Authors: Fennell Gillian 
Published: December 2023

Abstract
Chronic pain, which afflicts 20% of US adults, is associated with heightened mortality risk and lower subjective survival probabilities (SSPs) to advanced ages. However, the accuracy of SSPs for individuals with chronic pain is unknown. To assess whether individuals with and without pain and pain-related activity interference report SSPs that are veridical to their actual lifespans, we exploited multi-wave data from the Health and Retirement Study. Baseline SSPs and covariate data were obtained from the 2000 wave among respondents aged 57-89 with and without pain (N=7,075). SSP reports were then compared to the age at which respondents actually died (if they did) using mortality data from exit interviews in subsequent waves. We conducted a multinomial logistic regression using baseline pain and covariates to predict membership into one of four groups summarizing the accuracy and valence of SSP assessments. The groups were: (1)correctly pessimistic, (2)falsely optimistic, (3)falsely pessimistic, and (4)correctly optimistic. Findings suggest that individuals with baseline pain were significantly more likely to be correctly pessimistic about their longevity with low, but accurate SSPs (falsely optimistic (RRR=.56, p&lt;.001), falsely pessimistic (RRR=.65, p&lt;.001), or correctly optimistic (RRR=.44, p&lt;.001)). This study highlights that chronic pain and associated disability are features of health that individuals use to estimate their own lifespans with greater accuracy. Future research should assess the extent to which this connection is due to self-fulfilling prophecy.
CAREGIVING THROUGH COVID: POSITIVE ASPECTS OF CAREGIVING AND CAREGIVER STRESS OVER TIME
Authors: Schneider Haley , Donohoe Maria , Thompson Lena , Ashida Sato 
Published: December 2023

Abstract
With an increase of age-related diseases due to population-aging, there are more caregivers in need of support services. Caregivers are known to experience poor health status due to caregiving burden, stress, and psychological impacts. Caregivers often experience care-related negative health consequences, and such experiences can be exacerbated during stressful times such as COVID-19 pandemic. The concepts of positive aspects of caregiving (PAC) help identify protective factors (sense of meaningfulness in role, familial cohesion, etc.) that have been shown to decrease negative health impacts and enhance caregiver satisfaction. This study included 43 caregivers of individuals diagnosed with Alzheimer’s Disease or related dementias (ADRDs) who participated in a randomized-controlled trial (2020-2021) to test an intervention that provides caregiver education and referral to community-based services. A regression model was built using the data from baseline and three-month post-intervention surveys. Controlling for baseline COVID-19 distress levels and gender, an increase in COVID-19 distress from baseline to three months was significantly associated with lower levels of PAC at baseline (b=-0.337, p-value=0.029); there was also a trend for a decrease in PAC over three months (b=-0.300, p-value=0.058). Understanding how lower levels of PAC leads caregivers to experience higher stress levels during the pandemic likely will help identify the opportunity to address caregiver stress. Future studies may explore the strategies to enhance caregiver PAC and investigate how changes in PAC may impact caregiver wellbeing. Future interventions may benefit from incorporating the concepts of PAC to support and empower caregivers during stressful events like the pandemic.
HOME CARE AND QUALITY OF LIFE AMONG COMMUNITY-DWELLING FRAIL OLDER ADULTS IN ISRAEL: A MULTIPLE MEDIATOR MODEL
Authors: Khalaila Rabia 
Published: December 2023

Abstract
The aim of the current study is to examine the association between two types of home care provision (combined formal and informal home care vs. family-only home care) and quality of life (QoL) of older adults, as well as the mediating effects of loneliness, social isolation and satisfaction with family relationships and support. A convenience sample of 360 Israeli adults aged 65+ responded to questionnaires. Using bootstrapping, we tested the strength and significance of the conditional indirect effects of the four simultaneous mediators. The results showed that combined formal and informal home care (vs. family-only home care) for older adults was associated with lower QoL of care-recipients, and was fully mediated by feelings of loneliness, social isolation, and low satisfaction with family support. Satisfaction with family relationships did not emerge as a mediator but was positively associated with QoL. Formal home care might reduce the QoL of care-recipients by increasing their feelings of loneliness, social isolation and reduced perceived family support. Practitioners should encourage family members to continue with family regular support and contact alongside the use of formal home care in order to maintain satisfaction and QoL of older relatives.
INTEGRATING PRIMARY CARE AND COMMUNITY-BASED PROVIDERS IN AN INTERPROFESSIONAL TEAM FOR OLDER ADULTS
Authors: Kropp Denise , Clay Danielle , Fosnight Susan , Drost Jennifer , Hughes Michelle , Warren Lorrie , Wilson Jess 
Published: December 2023

Abstract
The integration of healthcare and community-based providers has been long-recognized as the gold standard in the optimal care of older adults. Social determinants of health account for more than 80% of health outcomes. Therefore, optimal care requires meaningful collaboration between medical and community-based care providers. We present here a collaborative model of care integrating community providers and healthcare system. This is a long-standing collaborative approach where our Area Agency on Aging care managers present their complex cases to a team, which includes nursing, social work, geriatric medicine, and geriatric pharmacy. This team meets weekly for case presentations and interprofessional care planning. We have recently expanded these meetings to extend the reach of the team to remote Area Agencies on Aging, to ACO care managers, to a local FQHC, and to a local Habitat for Humanity affiliate for the Aging in Place initiative. Since September 2022 this expanded team reviewed 12 consumers. On average there were 4.25 medication issues identified (maximum=13, minimum=0). The team addressed the following in at least half of consumers: falls (58%), depression/anxiety (50%), advance care planning (67%), function (50%), caregiver support (58%), and dementia (50%). Additional issues included mobility (42%), finances (42%), pain, (33%), elder abuse (25%), safety (17%), behavioral health (17%), sleep (17%), spiritual care (17%), language barriers (17%), and substance abuse (8%). This team model has been shown to be replicable across provider settings. Expansion of this model extends the limited resources of geriatricians and geriatric pharmacists.
INTERVENTIONS FOR SENSE OF COHERENCE AMONG OLDER ADULTS WITH CHRONIC DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Liu Yaqian , Leung Angela Y M , Montayre Jed 
Published: December 2023

Abstract

Background
Sense of Coherence (SoC) is a core concept of “salutogenesis” in positive psychology, correlated with emotional distress and disease development in older adults with chronic disease (OACD). A diversity of interventions has been developed to enhance SOC, but research findings are conflicting and only a few studies have reviewed the effectiveness. Objective: This paper aimed to explore appropriate interventions and evaluate the effectiveness of these SoC interventions on OACD.

Methods
Search terms including ‘sense of coherence’, ‘older adult’ and ‘randomized controlled trial’ were performed in nine electronic databases and two grey literature sources. Publications were written in English from January 1979 to January 2023. A narrative synthesis was performed to determine intervention details, and classical meta-analysis was used to analyze available data on SoC using RevMan.

Results
27 RCT studies were identified, involving salutogenic-based program, cognitive behavior treatment, and self-management intervention. Meta-analysis was carried out with 21 RCTs involving 1,687 patients. It showed significant effects of all interventions on SoC, compared to usual care, among OACD (SMD=0.19, 95%CI [0.09, 0.28], p&lt;0.001) and at 3-month follow-up (SMD=0.14, 95%CI [0.03, 0.24], p&lt;0.001), but no significant difference was observed at 6-month or 12-month follow-up (SMD=0.12, 95%CI [-0.13, 0.43], p=0.07; SMD=0.15, 95%CI [-0.27, 0.47], p=0.09).

Conclusions
Interventions for SoC were shown to be effective right after the intervention and at 3 months. However, its effects were not sustained over a longer period. Further research is needed to explore optimal duration and components of interventions for SoC in this population.