Implementation and Outcomes of Complementary Therapies in Hospice Care: An Integrative Review

Complementary therapies are increasingly integrated into hospice care, emphasizing the need to examine the evidence regarding implementation and effects on end-of-life outcomes. This review synthesizes the evidence regarding the implementation of complementary therapies and effects on end-of-life outcomes in hospice care. Whittemore and Knafl’s five-step integrative review process was applied. Using predefined search terms, research-based articles between 2006 and 2020 were reviewed. Twenty-three quantitative/mixed method studies conducted across eight countries met the final review criteria. Most commonly used complementary therapies were music, biofield therapies (reiki, therapeutic touch), and massage therapy. Most studies reported significant findings on physical symptoms (pain, dyspnea, fatigue, gastrointestinal symptoms, agitation) and/or psychosocial/spiritual symptoms (anxiety, depression, spirituality, well-being, quality of life); 40% of studies had both significant and nonsignificant findings. Methodological limitations included study design (few randomized controlled trials), small sample size, high attrition rate, lack of racial/ethnic diversity, unstandardized intervention implementation, and multiple outcome measurement instruments. Complementary therapies are promising components of hospice care; however, rigorous studies are needed to validate the effect on end-of-life outcomes and determine the most efficacious implementation. Complementary therapy studies face challenges consistent with end-of-life research; however, efforts to design rigorous trials and address methodological issues are required to enhance the state of the science

Risk Factors Associated With Cardiovascular Disease Among Adult Nevadans

© 2021 Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective Cardiovascular disease (CVD) remains the number one cause of death in the US and Nevada is ranked 11th highest for CVD mortality. The study sought to examine the association between self-reported risk factors and CVD presence among adult Nevadans, between years 2011 and 2017. Methods This is a cross-sectional, population-based study that utilized the 2011 and 2017 Nevada Behavioral Risk Factor Surveillance System data. Data were analyzed between 2019 and 2020. Results A total of 5,493 and 3,764 subjects in 2011 and 2017, respectively were included. BMI (overweight/obesity) remained the most prevalent CVD risk factor. The second most common CVD risk factor was high cholesterol, followed by hypertension. Compared to females, males were 1.64 times more likely to have reported CVD in 2011, which increased to 1.92 in 2017. Compared to non-smokers, everyday smokers were 1.96 times more likely in 2011 and 3.62 times more likely in 2017. Individuals with high cholesterol status were 2.67 times more likely to have reported CVD compared to those with normal levels in 2011. In 2011, individuals with hypertension were 3.74 times more likely to have reported CVD compared to those who did not have hypertension. This relationship increased its magnitude of risk to 6.18 times more likely in 2017. In 2011, individuals with diabetes were 2.90 times more likely to have reported CVD compared to those without the condition. Conclusions Public health and healthcare providers need to target preventable cardiovascular risk factors and develop recommendations and strategies locally, nationally, and globally

“A World Upside Down”: Experiences of Informal Caregivers During the COVID-19 Pandemic

The caregiving process may result in negative outcomes for caregivers. The coronavirus disease 2019 pandemic has contributed additional challenges for family caregivers of older adults with chronic illnesses. Little is known about the additional impact of the pandemic on caregivers. The purpose of the current study was to understand the effects of the pandemic on the caregiving experience. A qualitative descriptive content analysis was conducted on nine blogs of caregivers of older adults. Blogs were identified using purposive sampling. Bloggers were American, middle-aged, and caring for an older adult with dementia. Caregivers reported “a world upside down” and change that contributed to uncertainty; the need for support; and how isolation, depressive symptoms, and threat contributed to negative psychological well-being. Managing and struggling in response to caregiving challenges and wishing for resolution were also reported. Blogs of caregivers of older adults with chronic illness yielded important information that may be useful to clinicians

Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-being

Objectives: Existing scholarship in social gerontology has paid relatively little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later-life psychological well-being outside a family framework. Method: Drawing from a 3-wave longitudinal survey of community-dwelling older residents (n = 334) of Miami, Florida, we utilized generalized estimating equation models to examine the influence of changes in compassionate love (i.e., feeling love toward other persons and experiencing love from others) on depressive symptoms over time. We also explored cross-sectional relationship between compassionate love and positive and negative affects. Results: An increase in the feeling of being loved (beta = -0.77, p \u3c .001) and feeling love for others (beta = -0.78, p \u3c .001) led to a decline in odds of reporting greater levels of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (beta = .63, p \u3c .001) and expressed love for other people (beta = 0.43, p \u3c .05). Older adults who felt loved and expressed love for other people, respectively, had 0.71 and 0.54-point lower ordered log odds of reporting higher negative affect than those who reported lower levels of love. The statistically significant impact of feeling loved on all well-being outcomes was maintained even after adjustment for altruistic attitudes and emotional support. Except for depressive symptoms, such adjustments explained the positive influence of love for others on well-being outcomes. Discussion: Our findings underscore the powerful influence of both receiving and giving loving emotions for the maintenance of later-life psychological well-being

Undergraduate nursing students’ knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal

Objectives: This study aims to examine Nepalese undergraduate nursing students’ knowledge of aging, attitudes towards older adults and perceptions of working with older adults, and to assess differences in these outcomes by socio-demographic characteristics as well as type of nursing program. Methods: A cross-sectional study was conducted among 385 undergraduate nursing students in six nursing colleges located in the Kathmandu Valley. Knowledge of aging, attitudes toward older adults and perceptions of working with older adults were assessed using standardized tools, the Palmore Facts on Aging Quiz, Kogan's Attitudes towards Older People Scale, and Nolan's Intent to Work with Older People Questionnaire, respectively. Results: The mean knowledge scores on older adults and aging were relatively low; participants scored an average of 26.9 out of 50. Scores assessing attitudes towards and perceptions of working with older adults were more favorable. Compared to students pursuing a Bachelor of Science in Nursing (BSN), students pursuing a Bachelor of Nursing (BN) had a significantly higher score on the knowledge, attitudes and perception of aging scales. Linear regression analyses showed that the students’ knowledge of aging (β = 0.55; 95% CI = 0.25–0.86) and perceptions of working with older adults (β = 0.22; 95% CI = 0.05–0.38) had a significant positive association with their attitudes toward older adults. Conclusions: Undergraduate nursing students in the Kathmandu Valley of Nepal displayed a relatively low level of knowledge, but a positive attitude towards older adults, and a positive perception of working with older adults. Observed differences in knowledge, attitude, and perception scores between students in BSN and BN programs needs further investigation; closing this gap may be important for bolstering undergraduate gerontological preparation in Nepal. Keywords: Aged, Attitudes, Knowledge, Perceptions, Students, Nursing, Nepa