BMC geriatricsMerita Neziraj, Elisabeth Carlson, Malin Sundström, Maria Samuelsson
BACKGROUND: Global demographic ageing trends and changes in healthcare require that nursing students are adequately prepared to care for older people in home care settings. However, many students report insufficient knowledge and feel unprepared for this role. The aim of this study was to describe the variation in nursing students' understanding of caring for older people receiving home care. This study forms part of a broader project aiming at developing a tailored educational intervention in collaboration with nursing students to prepare them for this role. METHODS: A qualitative study with a phenomenographic approach was conducted. Eighteen individual semi structured interviews were conducted with nursing students at three Swedish universities between February and April 2025. The interviews were conducted either via telephone, digitally via Zoom or face-to-face and subsequently analysed. RESULTS: The results comprise three descriptive categories illustrating the variation in nursing students' understanding of caring for older people: Nurses' collaborative role in tailoring person-centred care for older people receiving home care, Challenges to person-centred care for older people receiving home care and Opportunities to person-centred care for older people in the home care setting. Within these understandings, students emphasised that nurses need to collaborate with older people, their family members and colleagues to tailor person-centred care to older people at home. However, students also identified challenges that could hinder person-centred care for older people, inducing factors related to older people, nurses and the organisation. Despite these challenges, students recognised opportunities inherent in the home care setting, such as the potential to develop deeper relationships with older people, support their family members, and engage with the broader community. CONCLUSIONS: The results indicate that students recognised the essential collaborative role nurses play in tailored person-centred for older people in this setting, while also identifying challenges that may hinder its full realisation. At the same time, the students pointed to concrete opportunities for strengthening person-centred approaches within home care. These insights deepen our understanding of how nursing students conceptualise care for older people receiving home care and provide insight into how an educational intervention can be developed to better equip them to meet the complex needs of older people in this setting.
International journal of older people nursingHeeKyung Chang, JuHee Seo, Minji Park, Youngjoo Do
AIMS AND OBJECTIVES: To clarify how Ikigai and closely related meaning constructs are described in literature relevant to older people in Korea and to propose a provisional, context-informed conceptual framework for gerontological nursing. BACKGROUND: Ikigai, often glossed as "a life worth living," has been associated with well-being in later life, yet its meaning and operationalisation vary across settings. Greater conceptual clarity is needed to support culturally responsive nursing assessment and care planning. METHODS: Rodgers' evolutionary method of concept analysis (Rodgers, 2000) was used to examine contemporary scholarly use of Ikigai and related concepts in 13 peer-reviewed studies (published 2002-2024; searched January 2000-June 2025), of which 10 were conducted outside Korea and three in Korea. Data were analysed to identify defining attributes, antecedent contexts, consequences and related concepts. RESULTS: Six defining attributes were identified: psychological equanimity, purposefulness in life, self-worth and personal value, social connectedness, cultural belonging, and reflective wisdom and self-integration. Four antecedent contexts were identified: family and intergenerational change, cultural and value transformation, health and functional challenges, and existential and social disconnection. Four consequence domains were identified: emotional stability and psychological balance, active health orientation and functional preservation, life fulfilment and satisfaction, and community integration and social engagement. In literature relevant to older people in Korea, Ikigai was not presented simply as a list of valued sources, but was provisionally interpreted as a process through which relational sources such as family roles, intergenerational continuity and everyday responsibilities may be internalised as an enduring sense of life's worth. CONCLUSIONS: Ikigai may be understood as a dynamic and context-dependent meaning process in later life that includes both valued sources of worth and a sense of life's worth. This review offers a provisional conceptual framework for gerontological nursing and supports further qualitative and measurement research in Korea. IMPLICATIONS FOR PRACTICE: This framework can support gerontological nurses in assessing meaning, dignity, purpose and relational continuity alongside physical and functional indicators. Nurses may use open-ended questions and observable indicators to identify valued roles, relationships and routines that sustain older people's sense that life is worth living. Meaning-centred and culturally responsive care planning may help support participation, autonomy and continuity during later-life transitions.
International journal of older people nursingAnna-Liisa Arjama, Mari Kangasniemi, Riitta Suhonen
INTRODUCTION: Nurses' ethical competence and the ethical climate of healthcare settings are critical in promoting high-quality and individualised care. However, these factors may also contribute to various stereotypes that healthcare professionals hold towards older adults, potentially hindering the recognition of patients' individuality. The aim of this study was to investigate possible associations between nurses' characteristics, ethical competence, perceived ethical climate and stereotypes towards older adults in long-term care settings. METHODS: This was a cross sectional survey study. Nurses working in long-term care settings for older adults in Finland participated in the study between 2024 and 2025. The survey included three self-administered instruments: the Ethical Competence Questionnaire, [Hospital] Ethical Climate Survey and Stereotype Content and Strength Survey. The data were analysed using multiple regression models to identify associations between nurses' characteristics, ethical competence, perceived ethical climate and stereotypes regarding older adults. RESULTS: A total of 409 nurses participated. The participants rated their ethical competence and perceived ethical climate of their workplace as moderate or good. Both factors were statistically significantly associated with positive stereotypes towards older adults but not with negative stereotypes. Most participants (89%) held employee positions and had vocational degrees (65%). Younger age was associated with stronger stereotypes. When the independent variables of ethical competence and ethical climate were tested together, ethical competence alone no longer explained positive stereotypes, but ethical climate did, even after adjusting for age. CONCLUSION: This study confirms that nurses' ethical competence and perceived ethical climate support each other. Strengthening these elements can help alleviate stereotypes about the residents in long-term care settings. Maintaining and developing these factors can promote the delivery of high-quality, individualised care. To mitigate stereotypes regarding LTCS residents, the nurse manager can create structures that strengthen ethical competence and support an ethical climate. Further research is needed to clarify the determinants that inform nurses' assessments of stereotypes towards older adults in long-term care settings. IMPLICATIONS FOR PRACTICE: Ethical climate is associated with the content and strength of stereotypes that nurses have towards older adults. Therefore, maintaining and developing an ethical climate is important. Every nurse can promote an ethical climate by improving their ethical competence and promoting positive relationships with different stakeholders. In addition, it is worth creating structures in organizations that strengthen nurses' ethical competence and ethical climate.
International journal of older people nursingAram Karimian, Afsaneh Sadooghiasl, Mitra Khoobi, Eesa Mohammadi, Anoshirvan Kazemnejad
BACKGROUND: Discriminatory nursing care endangers patient rights, ethical standards and fair access to treatment-yet the lived experiences of nurses who engage in such practices remain understudied. This study seeks to explore Iranian nurses' personal experiences with their own discriminatory behaviours towards vulnerable patients in everyday clinical settings. METHODS: A qualitative conventional content analysis was conducted in 2024, using in-depth, unstructured interviews with 13 nurses from both public and private hospitals in Iran. Participants were purposefully sampled to ensure maximum variation, and data collection continued until saturation was reached. The interviews were analysed using the five-step framework developed by Graneheim and Lundman. RESULTS: A central theme, 'discrimination in service provision for vulnerable patients', emerged, highlighting two main categories: (1) Professional Shortfalls in the Care of Older Adults and (2) Shortfalls in Care for Persons at the End of Life. Nurses reported prioritizing younger patients, delaying or withholding essential care, reducing therapeutic communication and demonstrating inconsistent adherence to professional standards. CONCLUSION: Findings reveal subtle yet widespread discriminatory practices against older adults and end-of-life patients. Combating these disparities requires targeted education, supportive organizational policies and strategies to increase nurses' awareness of unconscious bias. IMPLICATIONS FOR PRACTICE: Reducing discriminatory behaviours promotes equitable, person-centred care. Enhancing empathy, prioritizing the needs of vulnerable patients and strengthening adherence to professional standards foster trust, dignity and a more inclusive clinical environment.
Studies in health technology and informaticsJeton Iseni, Felix Holl, Daniel Houben, Walter Swoboda
Digital technologies can support nursing in geriatric long-term care (LTC), but successful implementation depends on acceptance by nursing staff. Our systematic review synthesizes empirical evidence on technology acceptance in inpatient geriatric LTC, identifying individual (digital competence, perceived usefulness), organizational (leadership support, training), and technological (usability, relevance) determinants. A limited number of eligible studies were found, indicating a substantial evidence gap. A modified Delphi study is planned to validate and prioritize acceptance drivers, forming the basis for subsequent quantitative research and context-specific implementation guidance.
Scandinavian journal of primary health careGabriella Caleres, Sarah Thelin, Elisabeth Persson, Veronica Milos Nymberg, Sara Modig
BACKGROUND: To improve care for community-dwelling older individuals, Swedish primary care has implemented nurse-led elderly care units targeting this group. AIM: To explore how primary care nurses working in elderly care units view their role regarding medication safety and gain their perspectives on the work model. METHODS: This was a qualitative focus group study with 14 strategically sampled primary care nurses working at elderly care units. Data were collected through three focus groups and two individual interviews between September 2024 and June 2025, audio-recorded and transcribed verbatim. Content analysis was applied, and the person-centred nursing framework was used to interpret the results. Triangulation and reflexivity were pursued, and an audit trail was maintained to ensure trustworthiness. RESULTS: Five categories emerged (1), diverse conditions for elderly care units (2), preventing and managing drug-related problems (3), bridging the gap - a vital function for medication safety (4), the comprehensive geriatric perspective, and (5) perceptions of the nurse's role. CONCLUSION: This study found that nurses in elderly care units recognize their potentially significant role in medication safety. Their comprehensive geriatric perspective enables them to impede or intervene on drug-related problems, compensate for fragmented care and resolve issues as a central coordinator. However, the absence of guidelines leads to inconsistent and inequitable care, insights important for further development of the work model.
Frontiers in public healthWei Zhang, Xueke Hui, Lili Wei, Yunhua Wang, Zhirui Li, Xihao Zhang, Mengting Li
BACKGROUND: Global population aging has precipitated an increased demand for professional geriatric care while facing a shortage of nursing personnel and inconsistent attitudes toward older adults care among nursing students. A systematic review and meta-analysis were conducted to examine nursing student's attitudes toward older adults care and the factors that influence these attitudes in order to optimize the education of geriatric nurses. METHODS: This meta-analysis was reported following the PRISMA 2020 Checklist. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang data, VIP, and Chinese Biomedical Literature Service System were systematically searched from inception to July 4, 2024, to identify cross-sectional surveys reporting nursing student's attitudes toward older adults. Meta-analysis was performed using Stata 17.0 software after two researchers independently screened the literature, extracted information, and evaluated the risk of bias in the included studies. Subgroup and sensitivity analyses were performed to address heterogeneity. Funnel plots and Egger's test were used to assess the publication bias. RESULTS: Sixty-four studies of nursing student's attitudes toward geriatric care from 11 countries, 47 using KAOP 34-238 and 17 using KAOP 34-204, involved 19,933 and 4,399 nursing students, respectively. Fifty-six studies were assessed as being of high or moderate quality, while eight studies were classified as low quality. Regarding nursing students' attitudes toward older adults, the results of the meta-analysis showed that the KAOP 34-238 score was 146.41 (95% CI: 141.16-151.66, I 2 = 99.8%), and the KAOP 34-204 score was 130.95 (95% CI: 125.53-136.39, I 2 = 99.5%). Subgroup analyses of these predictor variables revealed that nursing students showed statistically significant differences in the following factors (p < 0.05): gender, having lived with and caring for an older person, having taken a course in geriatric care, selecting nursing as their first choice, and student grade level. CONCLUSION: The attitude of nursing students toward older adults is generally positive. Future studies should be designed with higher quality to explore the relationship between attitudes toward older people and nursing students' willingness to work in geriatric care. SYSTEMATIC REVIEW REGISTRATION: CRD42022348244.