Higher patient activation is associated with lower odds of functional limitation in older adults with chronic diseases.

Objectives: To investigate the association between patient activation and functional limitation among older adults living with multiple chronic conditions.

Methods: We performed a secondary analysis of a parent study, which examined the relationship between self-efficacy and both inflammatory biomarkers and frailty. We conducted multivariate logistic regression while controlling for the patients' sociodemographic variables and comorbidities to examine the association between self-reported functional limitation and patient activation as measured by the Patient Activation Measure (PAM-10).

Identifying when racial and ethnic disparities arise along the continuum of transplant care: a national registry study.

Background: Fewer minoritized patients with end-stage kidney disease (ESKD) receive kidney transplantation (KT); efforts to mitigate disparities have thus far failed. Pinpointing the specific stage(s) within the transplant care continuum (being informed of KT options, joining the waiting list, to receiving KT) where disparities emerge among each minoritized population is pivotal for achieving equity. We therefore quantified racial and ethnic disparities across the KT care continuum.

Ideal Postdischarge Follow-Up After Severe Pneumonia or Acute Respiratory Failure: A Qualitative Study of Primary Care Clinicians in Diverse Settings.

Background: Most patients discharged after hospitalization for severe pneumonia or acute respiratory failure receive follow-up care from primary care clinicians, yet guidelines are sparse.

Research Question: What do primary care clinicians consider to be ideal follow-up care after hospitalization for severe pneumonia or acute respiratory failure and what do they perceive to be barriers and facilitators to providing ideal follow-up?

Study Design And Methods: We conducted, via videoconferencing, semistructured interviews of 20 primary care clinicians working in diverse settings from five US states and Washington, DC. Participants described postdischarge visits, ongoing follow-up, and referrals for patients recovering from hospitalizations for pneumonia or respiratory failure bad enough to be hospitalized and to require significant oxygen support or seeking treatment at the ICU.

Leveraging community Wi-Fi and spaces for digital health use.

Digital health disparities continue to affect marginalized populations, especially older adults, individuals with low-income, and racial/ethnic minorities, intensifying the challenges these populations face in accessing healthcare. Bridging this digital divide is essential, as digital access and literacy are social determinants of health that can impact digital health use and access to care. This article discusses the potential of leveraging community Wi-Fi and spaces to improve digital access and digital health use, as well as the challenges and opportunities associated with this strategy.

Using Photovoice to Explore the Lived Environment and Experience of Older Adults with Frailty on their Kidney Transplant Journey.

Key Points: Photovoice, a qualitative method, visually depicted the daily lives of participants with frailty, providing insights into independence and symptom management to guide clinicians and researchers. This photovoice study uncovered subthemes of home safety and organization, revealing potential safety hazards like dialysis fluid storage, and suggests its potential use in geriatric nephrology. The findings emphasize the importance of integrating participant values and goals into care decisions and interventional design in the context of kidney transplant journeys for frail adults.

Acceptability and Feasibility of a Pain and Depressive Symptoms Management Intervention in Middle-Aged and Older African American Women.

Background And Objectives: The intersection of race, gender, and age puts older African American women at high risk of experiencing comorbid pain and depressive symptoms. The purpose of this study was to assess the feasibility and acceptability of a 12-week behavioral activation intervention to target self-selected goals related to pain and depressive symptoms in middle-aged and older African American women.

Research Design And Methods: This randomized waitlist control study included 34 self-identified African American women, 50 years of age or older, with moderate-to-severe chronic pain and depressive symptoms.

Life Space and Activity Space Measurement: Making "Room" for Structural Racism.

As we age, the ability to move is foundational to health. Life space is one measure of a person's ability to move and engage in activity beyond the home. A separate but related concept is activity space, a measurement of a person's spatial behaviors and visited locations that include social networks, neighborhoods, and institutions.

Resilient Adaptation Strategies: Unveiling Older Adults' Coping Dynamics Amidst the COVID-19 Pandemic.

Older adults, who are particularly vulnerable to coronavirus disease 2019 (COVID-19), exhibit less stress and greater well-being than their younger peers. However, there have been no in-depth explorations of adaptive coping strategies among this population, nor has the role of frailty status been addressed. The current study examined stress and coping in 30 U.

Age Disparities in Access to First and Repeat Kidney Transplantation.

Background: Evidence suggests that older patients are less frequently placed on the waiting list for kidney transplantation (KT) than their younger counterparts. The trends and magnitude of this age disparity in access to first KT and repeat KT (re-KT) remain unclear.

Methods: Using the US Renal Data System, we identified 2 496 743 adult transplant-naive dialysis patients and 110 338 adult recipients with graft failure between 1995 and 2018.

Context Matters: A Qualitative Synthesis of Adherence Literature for People on Hemodialysis.

Background: Patients with ESKD treated with hemodialysis in the United States have persistently higher rates of nonadherence compared with patients in other developed countries. Nonadherence is associated with an increased risk of death and higher medical expenditure. There is an urgent need to address it with feasible, effective interventions as the prevalence of patients on hemodialysis in the United States continues to grow.

COVID-19: Implications for Nursing and Health Care in the United States.

Purpose: COVID-19 and other recent infectious disease outbreaks have highlighted the urgency of robust, resilient health systems. We may now have the opportunity to reform the flawed health care system that made COVID-19 far more damaging in the United States (U.S.

Loneliness is Associated With Lower Coping Self-Efficacy Among Older Adults.

To address the gap of lacking research on the association between coping self-efficacy and loneliness, this study examined this relationship to inform future research and intervention on loneliness. Using data from 151 community-dwelling older adults ages 65 and older, we estimated multivariate logistic regression models with age, race/ethnicity, sex, body mass index, chronic disease composite score, social support, coping self-efficacy, and depression symptoms. Loneliness was reported in 32.

Physical Resilience Phenotype Trajectories in Incident Hemodialysis: Characterization and Mortality Risk Assessment.

Introduction: Although life-saving, the physiologic stress of hemodialysis initiation contributes to physical impairment in some patients. Mortality risk assessment following hemodialysis initiation is underdeveloped and does not account for change over time. Measures of physical resilience, the ability of a physiologic state to overcome physiologic stressors, may help identify patients at higher mortality risk and inform clinical management.

Strengths-building through life purpose, self-care goal setting and social support: Study protocol for Caregiver Support.

Background: For caregivers of people with heart failure, addressing a range of care recipient needs at home can potentially be burdensome, but caregivers may also gain meaning from caregiving. The Caregiver Support Program, a multicomponent strengths-based intervention, is designed to improve outcomes of heart failure caregivers.

Objectives: 1) Test the feasibility and gauge an initial effect size of the Caregiver Support Program to improve caregiver quality of life (primary outcome), and fatigue and burden (secondary outcomes) from baseline to 16 weeks, 2) test whether fatigue and caregiver burden are associated with objective measures of resilience (sweat inflammatory cytokines (Il-6 and IL-10) and self-reported resilience, 3) evaluate changes in heart rate variability, IL-6 and IL-10, pre- and post-intervention.

Associations of perceived stress, depressive symptoms, and caregiving with inflammation: a longitudinal study.

Objectives: Higher inflammation has been linked to poor physical and mental health outcomes, and mortality, but few studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers in a longitudinal design.

Design: Longitudinal Study.

Setting: REasons for Geographic And Racial Differences in Stroke cohort study.

Home-based primary care visits by nurse practitioners.

Background: With rapidly growing numbers of homebound older adults, the need for effective home-based health interventions is increasingly recognized. Advanced practice registered nurses (NPs) are one of the most common providers of home-based primary care. Limited information is available to address the scope and nature of NP-led home-based primary care and associated outcomes.

Self-efficacy proxy predicts frailty incidence over time in non-institutionalized older adults.

Background: Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable. Self-efficacy is associated with improved health behavior and decreased chronic disease burden.

Comparison of Traditional Videos With Telenovelas for Hospice Family Caregivers Education.

Background: While research has shown that hospice family caregivers (HFCG) seek additional information related to patient care, pain and symptom management, and self-care, it is unknown how the use of telenovela videos for education in hospice would be received by HFCG.

Objective: To explore HFCG perceived benefits and challenges with the use of telenovelas as compared to traditional educational videos during online support group.

Methods: A mixed methods study with a concurrent triangulated design that analyzed qualitative interviews and YouTube analytics report to identify how viewers responded (number of views and their feedback) to telenovela videos as compared to traditional educational videos.

Pilot Outcomes of a Multicomponent Fall Risk Program Integrated Into Daily Lives of Community-Dwelling Older Adults.

To evaluate whether a fall prevention intervention reduces fall risk in older adults who have previously fallen. Randomized controlled pilot trial. Participants' homes.

High coping self-efficacy associated with lower odds of pre-frailty/frailty in older adults with chronic disease.

Objectives: Frailty affects an estimated 15% of community dwelling older adults. Few studies look at psychosocial variables like self-efficacy (confidence to perform well at a particular task or life domain) in relation to frailty. The purpose of this study was to evaluate associations between pre-frailty/frailty and self-efficacy.