Estimated prevalence of multiple chronic conditions throughout adulthood using data from the Research Program.

Estimation of multiple chronic condition (MCC) prevalence throughout adulthood provides a critical reflection of MCC burden. We analyzed electronic health record codes for 58 conditions to estimate MCC prevalence for () Research Program adult participants (N=242,828). Approximately 76% of participants were diagnosed with MCCs, with over 40% having 6 or more conditions and prevalence increasing with age; the most frequently occurring MCC combinations varied by age category (i.

The perspectives of older adults related to transcatheter aortic valve replacement: An integrative review.

Background: Aortic Stenosis (AS) is a common syndrome in older adults wherein the narrowing of the aortic valve impedes blood flow, resulting in advanced heart failure. AS is associated with a high mortality rate (50 % at 6 months if left untreated), substantial symptom burden, and reduced quality of life. Transcatheter aortic valve replacement (TAVR) was approved in 2012 as a less invasive alternative to surgical valve repair, offering a treatment for older frail patients.

Intersection of social determinants of health with ventricular assist device therapy: An integrative review.

Background: Social determinants of health (SDOH) may influence the clinical management of patients with heart failure. Further research is warranted on the relationship between SDOH and Ventricular Assist Device (VAD) therapy for heart failure.

Objectives: The purpose of this integrative review was to synthesize the state of knowledge on the intersection of SDOH with VAD therapy.

Using mHealth to Improve Communication in Adult Day Services Around the Needs of People With Dementia: Mixed Methods Assessment of Acceptability and Feasibility.

Background: Adult day services (ADS) provide community-based health care for older adults with complex chronic conditions but rely on outdated methods for communicating users' health information with providers. CareMOBI, a novel mobile health (mHealth) app, was developed to address the need for a technological platform to improve bidirectional information exchange and communication between the ADS setting and providers.

Objective: This study aims to examine the feasibility and acceptability of CareMOBI in the ADS setting.

An Evolutionary Concept Analysis of the "Fighter" in the Intensive Care Unit.

The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on Rodger's evolutionary method were performed to identify surrogate terms, antecedents, attributes, and consequences pertaining to the "fighter" in the ICU. Thirteen articles with a focus on "the fighter" were included in this analysis.

Career development in pragmatic clinical trials to improve care for people living with dementia.

The growing number of people living with dementia (PLWD) requires a coordinated clinical response to deliver pragmatic, evidence-based interventions in frontline care settings. However, infrastructure to support such a response is lacking. Moreover, there are too few researchers conducting rigorous embedded pragmatic clinical trials (ePCTs) to make the vision of high quality, widely accessible dementia care a reality.

Place of Death From Cancer in US States With vs Without Palliative Care Laws.

Importance: In the US, improving end-of-life care has become increasingly urgent. Some states have enacted legislation intended to facilitate palliative care delivery for seriously ill patients, but it is unknown whether these laws have any measurable consequences for patient outcomes.

Objective: To determine whether US state palliative care legislation is associated with place of death from cancer.

Complex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic Conditions.

Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary data analysis of a multisite randomized clinical trial in palliative care was to elucidate the clinical profile and complex care needs of seriously ill adults with multiple chronic conditions and to highlight key differences among those with and without cancer at the end of life. Of the 213 (74.

Measuring Palliative Care-Related Knowledge, Attitudes, and Confidence in Home Health Care Clinicians, Patients, and Caregivers: A Systematic Review.

Integrating palliative care services in the home health care (HHC) setting is an important strategy to provide care for seriously ill adults and improve symptom burden, quality of life, and caregiver burden. Routine palliative care in HHC is only possible if clinicians who provide this care are prepared and patients and caregivers are well equipped with the knowledge to receive this care. A key first step in integrating palliative care services within HHC is to measure preparedness of clinicians and readiness of patients and caregivers to receive it.

Clinicians' views on the use of triggers for specialist palliative care in the ICU: A qualitative secondary analysis.

Purpose: To understand clinicians' views regarding use of clinical criteria, or triggers, for specialist palliative care consultation in the ICU.

Materials And Methods: Secondary analysis of a qualitative study that explored factors associated with adoption of specialist palliative care in the ICU. Semi-structured interviews with 36 ICU and palliative care clinicians included questions related to triggers for specialist palliative care.

An Adapted Conceptual Model Integrating Palliative Care in Serious Illness and Multiple Chronic Conditions.

Objective: Seriously ill adults with multiple chronic conditions (MCC) who receive palliative care may benefit from improved symptom burden, health care utilization and cost, caregiver stress, and quality of life. To guide research involving serious illness and MCC, palliative care can be integrated into a conceptual model to develop future research studies to improve care strategies and outcomes in this population.

Methods: The adapted conceptual model was developed based on a thorough review of the literature, in which current evidence and conceptual models related to serious illness, MCC, and palliative care were appraised.

End of Life Decision-Making: Watson's Theory of Human Caring.

The phenomenon of end-of-life (EOL) decision-making is a lived experience by which individuals or families make decisions about care they will receive prior to death. A postmodern philosophical approach suggests EOL decision-making is a varied contextual phenomenon that is highly influenced by subjectivity. Thus, there is no specific definition for the phenomenon of EOL decision-making.

A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program.

Background And Objectives: The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment.

Research Design And Methods: Six databases were searched to identify NICHE-related articles between January 1992 and April 2019.

Service Use, Participation, Experiences, and Outcomes Among Older Adult Immigrants in American Adult Day Service Centers: An Integrative Review of the Literature.

Older adult immigrants are often socially isolated and vulnerable to poor health. Adult day service (ADS) centers could potentially facilitate social integration and address their long-term health care needs. The current review (a) identifies barriers to and facilitators of ADS use among immigrants, (b) explores how ADS programs impact older adult immigrants' health and well-being, and (c) isolates the most effective culturally based components of ADS programs.