A new look at successful aging : exploring a mid-range nursing theory among older adults in a low-income retirement community.

The current view of successful aging excludes elders with disease or disability, limits the potential for success among disadvantaged populations, and fails to consider older adults’ own criteria for success, especially in the existential or spiritual domain. This cross-sectional study was a preliminary investigation of a mid-range nursing theory (Flood, 2005) of successful aging. A random, stratified sample (N= 112) was used. Questionnaires were administered to small groups of non-demented older adults. Relationships among study variables were examined using hierarchical multiple regression. Adaptation and transcendence explained 45.4% of the variance in successful aging, independent of age, income, function, and health. Transcendence accounted for 2.5 times the effect of adaptation

Exploring a new theory of successful aging among low-income older adults in an independent and assisted living community.

BACKGROUND: Current successful aging theory excludes individuals with disease or disability, limits the potential for successful aging in minority and lower socioeconomic populations, focuses on behavioral determinants of health rather than social and environmental determinants, and fails to consider older adults\u27 own criteria for successful aging. A recent mid-range nursing theory (Flood, 2005) proposed that two factors - adaptation and gerotranscendence - are primary contributors to a new view of successful aging that may address these problems. PURPOSE: The goal of the study was to investigate relationships among adaptation, transcendence, and successful aging to explore the potential of Flood\u27s (2005) theory to serve as a guide to nursing research, practice, and policy. METHODS: A cross-sectional survey study was conducted among a stratified, random sample (N= 112) of non-demented older adults living independently or receiving assisted living services in an urban low-income continuing care retirement community. Investigator administered surveys were conducted with small groups (n= 5 to 7). Recruitment minimized the number of surveys subsequently excluded due to dementia (6.4%). Data collection, including consent, dementia screening, and administration of surveys was completed in a single session, while preserving participants\u27 privacy and dignity. Efforts were made to accommodate sensory or literacy limitations. RESULTS: The study found significant support for Flood\u27s (2005) theory of successful aging. Adaptation and transcendence explained 45.4% of the variance in successful aging, controlling for age, income, function, and health. Transcendence accounted for two-and-a-half times the effect of adaptation. Ninety-two percent of participants reported they were aging successfully, regardless of age, health, function, income, or objective measures of successful aging. The study also supported the use of the newly developed Successful Aging Inventory (Flood, 2008) as an outcome measure to capture the new definition of successful aging (alpha .82). CONCLUSIONS: Flood\u27s theory of successful aging appears to merit further study of its potential to address the needs of older adults with disease, disability or socioeconomic disadvantages. Transcendence may be an important contributor to a holistic, positive view of aging that has not been previously reported in the successful aging literature

Effective home care nursing : perceptions of clients, nurses, & nurse supervisors.

EducationDoctor of Education (Ed.D.

COMPUTATIONAL STUDIES OF CHEMICAL SYSTEMS: I. A THEORETICAL INVESTIGATION OF CLATHRATE HYDRATESII. CONFORMATIONAL POTENTIAL ENERGY SURFACE OF TRYPTAMINE

Hydrogen clathrates have recently been discovered and considered as storage medium for H2. Hydrogen forms a Type II clathrate structure, with a small and large cage. Multiple guest hydrogen molecules can occupy both cages (up to two in the small cage and four in the large cage), although the number of hydrogen molecules occupying the small cage has been a source of debate in the literature. The goal of this work has been to develop a polarizable force field for use in molecular dynamics simulations of hydrogen clathrates. The resulting force field has been coded in the DLPOLY package and simulations of the system as a function of the number of guest hydrogen molecules have been performed. The development of the force field, and the results of the simulations are discussed.In order for a clathrate structure to form, a 'guest' molecule must be present under ideal conditions. That is, water does not form a so-called 'self' hydrate. In order to elucidate the factors responsible for clathrate formation, emph{ab initio} calculations were performed on (H2O)$_{21}$ and (H2O)$_{20}$*H2S clusters. The results of these calculations have provided insight into why water does not form a self hydrate.Stimulated emission pumping experiments done by the Zwier group have established bounds on the low energy isomerization barriers between specific minima of tryptamine. In order to identify the low energy isomerization pathways, the Becke3LYP and RI-MP2 methods were used to characterize the low-energy minima and the transition states of tryptamine. In general there is good agreement between theory and experiment, but for a subset of the isomerization processes, the calculations give significantly higher barriers than deduced from experiment. Possible causes of this discrepancy are discussed

Multisite recruitment and data collection among older adults : exploring methods to conserve human and financial resources.

The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators\u27 time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits. The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen centers and among older adults in independent or assisted living apartments within continuing care retirement communities (CCRCs). 1 In the latest study, a convenience sample (N = 152) was recruited and data collection was completed in 4 weeks at a total cost of less than $5,000. Methods common to qualitative research and those commonly used in community-based research were adapted to reduce time and costs for recruitment, screening, and data collection. Given limited availability of research funding, other nursing researchers may find one or more of these methods useful

The role of transcendence in a holistic view of successful aging : a concept analysis and model of transcendence in maturation and aging.

BACKGROUND: Although successful aging is most often defined by the absence of disease and disability, older adults consistently report aging successfully even in the presence of chronic illness and functional limitations. A more holistic way of looking at old age suggests transcendence may be an important missing criterion for successful aging. AIM: Transcendence, a late life developmental process, appears to have a profound effect within the spiritual domain, but is an abstract, complex and unfamiliar concept. A clear understanding of the meaning of transcendence is necessary to explore the concept’s usefulness as a potential basis for future interventions to increase successful aging. METHODS: Walker and Avant’s (2004) method of concept analysis was adapted to analyze literature from philosophy, theology, developmental psychology, sociology, psychiatry and nursing to gain a thorough understanding of transcendence. RESULTS: Antecedents, attributes, referents and consequences of transcendence were identified then displayed in a conceptual model. A definition of transcendence in relation to successful aging was synthesized from the analysis. CONCLUSION: The concept analysis suggested transcendence may provide a theoretical foundation for development of potentially cost-effective, efficacious interventions to foster a sense of meaning in life, well-being, and life satisfaction. The model under development may prove useful in planning potential interventions

A multidisciplinary concept analysis of empowerment : implications for nursing.

According to the Institute of Medicine, nursing has failed to effectively shape the health care system and to advocate successfully for patients. Empowerment may be a potent tool to fulfill these responsibilities, yet nurses have not benefited from considering application of the concept to the continuum of health care advocacy in their communities, in their relationships with clients, and in their professional roles within health care organizations. This paper uses concept analysis to examine the attributes, characteristics, and uses of empowerment within diverse disciplines to clarify its meaning and explore its potential application to nursing\u27s challenges that cross settings, disciplines, and time

Career Capital Development of Women in the Arab Middle East Context: Addressing the Pipeline Block

Taking a career capital approach, this paper addresses the issue of ‘pipeline block’ frequently experienced by women seeking career advancement. Focusing on the Arab Middle East (AME) region, we take a contextually relevant multi-level approach to examine these issues. The study uses a qualitative, interview-based approach, drawing on data obtained from women leaders from the AME region. Drawing on Bourdieu’s capital-field-habitus framework, we explore how women in the AME developed career capital in particular organizational fields. Our findings show the importance of human and social capital, as well as the influence of habitus for women’s career advancement in specific fields. We also highlight the unique contribution of cultural capital in helping women to navigate organizational fields where it is necessary to both challenge, and conform to, traditional norms. Limitations of the study include assumptions of homogeneity across countries of the AME, whereas differences are known to exist. Future research should consider these contextual differences, and also include a study of women who were not successful in gaining career advancement. Our multi-level approach highlights practical implications for women, organizations, and society. For organizations, we propose some context-relevant coaching strategies that can help women to attain leadership positions. Our multi-level approach highlights practical implications for women, organizations, and society. Focusing on organizations, we propose some context-relevant coaching strategies that can help women to attain advancement in their careers. We demonstrate originality in our findings by showing how women overcome the pipeline block in relation to their career advancement. The use of the Bourdieusian framework, an in-depth qualitative approach, and the AME context also add to the study’s originality

Successful aging in the United States and China : a theoretical basis to guide nursing research, practice, and policy.

Successful aging is an idea gaining increasing attention given the exponential growth in the older adult population. Criteria and definitions within multiple disciplines vary greatly in Western literature, with no consensus on its meaning. Moreover, sociocultural, economic and political differences between the Western view of successful aging and its use in China – with the world’s largest older adult population – add to the confusion. Similarities and differences in the meaning of successful aging in the United States and China are examined and the potential for a common definition that is useful to nursing in both countries is explored. Using the process of concept analysis, shared criteria for successful aging were: decreased or delayed incidence of disease and disability, life satisfaction, a sense of meaning and purpose in life, and the ability to cope effectively to achieve goals based on personal values and priorities. A comprehensive, multidimensional definition of successful aging for nursing, and a mid-range nursing theory of Theory of Successful Aging, were identified and may be useful to guide nursing research, practice and development of aging policy and programs

Assessing the Psychoeducational Approach to Transcendence and Health (PATH) program : an intervention to foster self-transcendence and well-being in community-dwelling older adults.

The late-life developmental process of self-transcendence shapes elders’ perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators’ and participants’ experiences and perceptions, the intervention will be revised and strengthened