PURPOSE/OBJECTIVES: To deliver evidence-based, high-quality end-of-life care through a collaborative initiative led by geriatric and palliative clinical nurse specialists in partnership with an interdisciplinary team and hospital administration. DESCRIPTION: After identifying inconsistent end-of-life care within an academic medical center, geriatric and palliative clinical nurse specialists synthesized best practices to develop a "comfort care" initiative. Operating across the 3 clinical nurse specialists' spheres of influence, the team collaborated with administrative and interdisciplinary stakeholders to pilot the model on a specialized geriatrics unit. OUTCOMES: Implementation led to consistent use of individualized care plans, accurate pain assessments, and timely execution of EOL orders. In the designated unit, nurses achieved compliance rates of 80% to 100%, significantly outperforming other system settings. This successful pilot served as a catalyst for system-wide improvements, including the standardization of evidence-based nursing care plans, comfort care code status protocols, and end-of-life order sets throughout the hospital system. CONCLUSIONS: This project demonstrates that clinical nurse specialists-led interdisciplinary collaboration can drive sustained, significant improvements in end-of-life care quality and system-wide practice standardization.
Frontiers in public healthTing-Ting Ruan, Ling-Ling Huang, Li-Juan Zhang
BACKGROUND: Global population aging has raised worldwide demand for geriatric care practitioners, including in China. Vocational nursing students are key reserve workforce for geriatric care, yet few enter this sector. Existing studies have explored individual factors shaping geriatric care employment intention, but few examine interactive effects of family support, experiential exposure and personal cognitive factors, or extend Social Cognitive Career Theory (SCCT) to Chinese vocational nursing education. PURPOSE: This study explores how family support, practical care experience and personal cognitive variables interact to shape vocational nursing students' intentions to engage in geriatric care. It expands SCCT application and provides empirical evidence for geriatric care workforce recruitment, nursing curriculum design and may offer insights for other regions of China and aging societies internationally. METHODS: A cross-sectional survey was conducted among 1,537 vocational nursing students in Hunan Province (2024-2025). Questionnaire data were analyzed using binary logistic regression and eXtreme Gradient Boosting (XGBoost) to identify key predictors. Hayes' PROCESS macro was used to test the mediating role of personal factors. RESULTS: Only 53.4% of students reported willingness to work in geriatric care. Family attitudes, prior caregiving experience and personal-factor-related occupational cognitions positively predicted intention, while insufficient curriculum exposure and poor perceived career prospects suppressed it. Personal factors significantly mediated the association between family factors and employment intention, with notable interactive effects across family, experience and cognition-related variables. CONCLUSION: Findings highlight integrating the family-experience-cognition pathway into curriculum optimization and policy interventions. This study enriches SCCT application in Chinese vocational education and offers region specific practical references for strengthening China's geriatric care workforce via talent cultivation and educational reform.
International journal of older people nursingKatsuma Mieda, Miki Kameyama, Erika Ota, Masako Yamada
INTRODUCTION: Integrated, people-centred care requires continuity and coordination across services, and nurses increasingly contribute to case management; however, evidence on its effectiveness for older adults living at home remains limited. This systematic review aimed to evaluate the effectiveness of nurse-led case management for community-dwelling older adults compared with usual care. METHODS: PubMed, CINAHL, Embase and the Cochrane Central Register of Controlled Trials were searched from inception to 13 August 2025, for randomised controlled trials comparing nurse-led case management with usual care among community-dwelling older adults with frailty or risk of functional impairment. Primary outcomes were institutionalisation, hospital admissions and mortality. Secondary outcomes included quality of life, emergency department visits, physical function, costs, client satisfaction and days living at home. This review was reported in accordance with PRISMA 2020. RESULTS: Fifteen trials involving 7995 participants were included. The evidence was of very low certainty for institutionalisation, mortality and hospital admissions, with pooled estimates indicating little to no difference. Nurse-led case management probably results in a slight improvement in the physical aspect of quality of life (SMD 0.08, 95% CI 0.00-0.15; moderate certainty). It probably also results in a slight improvement in the mental aspect of quality of life, although the confidence interval included no effect and probably results in little to no difference in physical function. Evidence regarding emergency department visits was of very low certainty. CONCLUSION: The evidence for the effects of nurse-led case management on institutionalisation, hospital admissions and mortality was of very low certainty. Nurse-led case management probably results in a slight improvement in the physical aspect of quality of life, although the clinical importance of this effect remains uncertain. Implementation and evaluation should align with the current uncertainty regarding healthcare utilisation outcomes and include patient-reported outcomes alongside utilisation outcomes. Future research and policy evaluation should use frameworks that assess long-term continuity and coordination of care and system-level impacts, in addition to individual health outcomes. IMPLICATIONS FOR PRACTICE: Nurse-led case management may yield a small improvement in physical quality of life for community-dwelling older adults, while effects on institutionalization, hospital admissions and mortality should be interpreted cautiously because the certainty of evidence is very low. Routine evaluation of nurse-led case management should include patient-reported outcomes, such as quality of life, alongside healthcare utilization outcomes. TRIAL REGISTRATION: PROSPERO: CRD420251114141.
Nursing openTing Liao, Jinmei Zou, Min Wang, Yuqing Song, Li Cai, Jin Yin, Yao Chen, Yating Wang
AIM: To investigate the interrelationships of professional identity, educator competence perception and willingness to engage in geriatric nursing among Chinese nursing students. DESIGN: A cross-sectional study design. METHODS: This study involved a cross-sectional descriptive study. A total of 842 nursing students enrolled in online learning were included in this study. We used the Professional Identity Questionnaire for Nursing Students (PIQNS), the Gerontological Nurse Teacher Scale (GeNTS), and the Willingness Engaging in Aged Nursing Scale (WEANS) to measure levels of PI, educator competence perception and willingness to engage in geriatric nursing. The structural equation model and bootstrap method were used to identify the association and interaction among the three variables. RESULTS: The scores of nursing students' PI, educator competence perception and willingness to engage in geriatric nursing were (59.77 ± 10.85), (111.70 ± 19.42), and (71.71 ± 11.17), respectively. After adjusting for age, gender, and academic year, PI was positively associated with educator competence perception (β = 0.70, p < 0.001), and educator competence perception was positively associated with willingness to engage in geriatric nursing (β = 0.33, p < 0.001). In a cross-sectional mediational model, educator competence perception accounted for an indirect association between PI and willingness (standardised indirect effect = 0.230, 95% bootstrap CI [0.164, 0.296]); after model adjustment and controlling for age, gender, and grade, the final structural model yielded good fit (χ2/df = 2.954, p < 0.001, GFI = 0.961, TLI = 0.977, CFI = 0.983, NFI = 0.975, RMSEA = 0.048). CONCLUSION: Professional identity of nursing students and perceived educator competence are positively associated with students' willingness to engage in geriatric nursing. Educational interventions may focus on these areas to address the growing need for geriatric care professionals. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
PloS oneXiufang Hou, Yanglan Wang, Fangfang Wang, Qiuping Li
PURPOSE: This study aimed to explore the willingness and attitudes of undergraduate nursing students enrolled in a geriatric nursing minor program toward pursuing careers in long-term care facilities. METHODS: A qualitative phenomenological approach was adopted. Semi-structured, in-depth individual interviews were conducted with fourteen students minoring in geriatric nursing. Interview transcripts were analyzed using thematic analysis. RESULTS: The analysis identified three primary themes: (1) Nascent Interest in Geriatric Care; (2) Perceived Deficiencies in Professional Competence for Geriatric Care; and (3) The "Government-Society-Family" Collaborative Geriatric Care Ecosystem Remains Underdeveloped. CONCLUSION: While nursing undergraduates recognize strong market demand for geriatric care professionals, their current career preferences favor hospital settings. This inclination is influenced by considerations of the social status associated with long-term care facilities, perceived misalignment between their skills and role requirements, limited career advancement pathways, and high labor intensity in long-term care.
BACKGROUND: As population aging accelerates, the demand for high-quality end-of-life care for older adults continues to increase. Nurses' death coping ability is essential to the delivery of compassionate end-of-life care and to the maintenance of nurses' psychological well-being. However, in cultural contexts where death is often considered a taboo topic, limited evidence is available regarding geriatric nurses' death coping ability, its associated factors, and appropriate strategies for death education. This study aimed to assess the level of death coping ability among geriatric nurses, identify associated factors, and develop culturally sensitive strategies for death education. METHODS: A cross-sectional mixed-methods study was conducted in a tertiary hospital in Kunming, China. Using convenience sampling, 203 nurses were recruited from nine geriatric medical wards, three geriatric surgical wards, and a geriatric intensive care unit. Quantitative data were collected using a demographic information questionnaire and the Chinese version of the Coping with Death Scale. Semi-structured interviews were also conducted to explore nurses' perceptions of death, end-of-life care, and death education. Quantitative data were analyzed descriptively, and qualitative data were examined using thematic analysis. RESULTS: The mean Coping with Death Scale score was 110.12 ± 24.35, with a standardized score rate of 54.19%, indicating a moderate level of death coping ability. Among the six dimensions, life review ability had the highest score, followed by end-of-life coping ability, death acceptance ability, ability to reflect on and express views about death, ability to discuss one's own death, and ability to discuss others' death. The corresponding scores were 33.22 ± 8.765, 18.82 ± 6.698, 18.62 ± 4.203, 15.66 ± 5.057, 14.22 ± 5.735, and 9.58 ± 3.071, respectively. Interview findings showed that traditional cultural beliefs contributed to nurses' avoidance of death-related conversations. Nurses' attitudes toward death were also closely related to how they communicated with and cared for terminally ill patients and their families. CONCLUSION: Geriatric nurses in this hospital demonstrated a moderate level of death coping ability, which appeared to be closely associated with traditional cultural taboos surrounding death. Death education programs for geriatric nurses should therefore be culturally embedded and systematically designed. Recommended strategies include establishing a dynamic assessment system and developing progressive training modules that address self-acceptance of death, communication skills in end-of-life care, and grief support for family members. Nurses' years of professional experience, previous exposure to end-of-life care, cultural background, and religious beliefs should be considered when tailoring these interventions. This study provides an empirical basis for developing culturally sensitive death education in the Chinese nursing context. Future randomized controlled trials are needed to evaluate the long-term effectiveness of these strategies.
OBJECTIVE: To develop a Knowledge-Attitude-Practice (KAP) questionnaire on geriatric foot care for clinical nurses in China and to evaluate its reliability and validity. METHODS: The questionnaire was developed based on the Knowledge-Attitude-Practice (KAP) framework through a literature review, semi-structured interviews, and two rounds of Delphi expert consultation. After pilot testing, a cross-sectional survey using convenience sampling was conducted among 324 clinical nurses from two tertiary general hospitals in Guizhou Province and Chongqing Municipality, China. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of reliability and validity were performed to examine the psychometric properties of the questionnaire. RESULTS: The final questionnaire comprised 48 items across three dimensions: knowledge, attitude, and practice. Exploratory factor analysis yielded a cumulative variance contribution of 58.314%. Confirmatory factor analysis demonstrated satisfactory model fit (χ²/df = 1.489, GFI = 0.912, AGFI = 0.932, CFI = 0.948, and RMSEA = 0.055). The scale-level content validity index (S-CVI) was 0.93. The overall Cronbach's alpha coefficient was 0.933, and both split-half reliability and test-retest reliability coefficients exceeded 0.80. CONCLUSION: The questionnaire demonstrated satisfactory psychometric properties, with acceptable reliability and validity. It may be useful for assessing clinical nurses' knowledge, attitudes, and practices regarding geriatric foot care and for identifying educational needs in this area.
INTRODUCTION: Accelerated population ageing has resulted in increasingly diverse and complex care needs among older people, posing a major challenge to healthcare systems worldwide. Nursing personnel represent a core workforce in the delivery of healthcare and nursing services for older people, and their geriatric nursing competence (GNC) is closely associated with the quality of care provided, care outcomes and older people's quality of life. Therefore, accurate assessment of GNC is essential for nursing education, workforce development and quality improvement. Although several instruments have been developed to assess GNC, no systematic review has yet comprehensively evaluated their measurement properties. METHODS AND ANALYSIS: This protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. A comprehensive search will be conducted from 1 October 2026 to 1 December 2026 in seven English-language databases and two Chinese-language databases to identify studies reporting the development or evaluation of instruments assessing geriatric nursing competence among nursing personnel. Two reviewers will independently perform study selection, data extraction and methodological quality appraisal. Any disagreements will be resolved through discussion or, if necessary, consultation with a third reviewer. The measurement properties of included instruments will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. ETHICS AND DISSEMINATION: As this review will include only published or publicly available studies, ethical approval is not required. The findings will be submitted for publication in a peer-reviewed journal and presented at relevant academic conferences. PROSPERO REGISTRATION NUMBER: CRD420261356885.
International journal of environmental research and public healthJingwen Yang, Li Yao, Zhouyuan Peng, Kumiko Kuroda
BACKGROUND/OBJECTIVES: As population ageing accelerates, integrated care has become an important strategy for addressing the complex care needs of older adults. Although gerontological nurse specialists (GNSs) are expected to contribute to integrated care, their roles remain inconsistently defined and insufficiently synthesized across healthcare systems and professional role titles. This scoping review aims to systematically map the roles of GNSs in supporting integrated care for older adults within hospital-based settings. METHODS: This scoping review protocol will follow the JBI methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR guidelines. Searches will be conducted in PubMed, CINAHL, Web of Science, China National Knowledge Infrastructure, and Ichushi-Web, with no date restrictions. Studies published in English, Chinese, and Japanese will be included. The review will consider studies involving nurses with recognized specialist or advanced nursing practice competence in gerontological or older-adult care and will focus on their roles in supporting integrated care for older adults within hospital-based settings and hospital-linked transitional care services. Two independent reviewers will conduct study selection and data extraction. The findings will be synthesized descriptively and presented using tabular, narrative, and diagrammatic formats. CONCLUSIONS: This review is expected to contribute to a clearer understanding of the roles of GNSs in integrated care for older adults and provide evidence to inform future nursing practice, workforce development, education, and research in gerontological integrated care. REGISTRATION: This protocol was registered within the OSF database on 19 May 2026.
BMJ openVeselina Hristova Slavova, Anna Petrova Georgieva
INTRODUCTION: Compassionate care is a core ethical and professional value in nursing, especially in the context of elderly care, where vulnerability, chronic illness and relational dependency are at the forefront. Despite the growing international interest in compassion and narrative medicine, there is limited empirical research examining how nurses experience, construct and sustain compassionate care for older people in everyday practice, especially in Eastern European contexts. Narrative practices offer a valuable methodological lens for capturing the experiences, moral meanings and emotional dimensions of nursing care. The aim of this study is to explore how nurses understand, experience and implement compassionate care for older people and to explore the potential of narrative practices to illuminate facilitators, barriers and professional meaning-making in gerontological nursing. METHODS AND ANALYSIS: A qualitative research design based on narrative inquiry and interpretive phenomenological analysis will be used. Semistructured narrative interviews will be conducted with registered nurses working with older people in institutional care settings. The interview guide is informed by international literature on compassionate care, narrative medicine, gerontological nursing and relational ethics. Data will be analysed using reflexive thematic analysis following Braun and Clarke's six-phase framework supported by NVivo software. Narrative and interpretive elements will be integrated to explore both the content of participants' stories and the meanings they attribute to their experiences. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Medical University of Varna (Approval No. 17, 3 July 2025). All participants will provide informed consent and confidentiality will be assured throughout the study. Findings will be disseminated through peer-reviewed publications, academic conferences and professional forums, with the aim of informing nursing education, practice and policy related to compassionate care for older people.
Geriatric nursing (New York, N.Y.)Mette Merete Pedersen, Pia Søe Jensen, Susanne Mortensen, Maria Belling Worm, Hassana Hakkouni, Sarah Ellehave, Ingrid Poulsen, Barbara Rubek Nielsen
BACKGROUND: Preventing adverse outcomes in older hospitalized adults requires gerontological and geriatric knowledge, including care approaches tailored to their complex needs. To improve geriatric care standards, it is important to gain knowledge of hospital-employed staff's knowledge about care of older adults and their patterns of care. This study aimed to assess Danish hospital-employed nursing staff's general knowledge about older adults, their clinical geriatric knowledge and their perceptions of the geriatric care environment using the Geriatric Institutional Assessment Profile (GIAP). METHODS: An exploratory, cross-sectional survey was conducted at a large university hospital in Denmark. Nursing staff from medical, surgical, emergency, and other clinical departments were invited to complete the GIAP via REDCap between March 23 and May 1, 2024. RESULTS: Fifty nurses and nursing assistants (94% female) participated. General knowledge about older adults was moderate (mean 6.88, SD 1.33 out of 10). Highest knowledge areas included falls, pain, and incontinence; lowest were nutrition, ADL assessments, and skin issues. Participants reported providing person-centered care and treating older adults with respect but noted poor continuity of care and resource constraints. Institutional support for geriatric education and practice change was rated poorly. CONCLUSIONS: The study highlights strengths and critical gaps in geriatric care, including limited resources, staffing, continuity, and formal training support. Targeted education, improved staffing models, and stronger organizational backing are needed to enhance care quality and prevent hospital-associated complications in older adults.
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.
Journal of nursing managementThuy Thi Ngo, Lydia T Manahan, Edreck D Estioko, Huong Thi Thu Pham
BACKGROUND: Global healthcare systems face increasing pressure from rapidly ageing populations and persistent nursing workforce shortages. These challenges are particularly pronounced in geriatric care, where nurses must meet complex clinical demands while sustaining long-term, emotionally intensive care. AIM: This study aimed to examine the relationship between the nursing work environment and resilience among nurses working in geriatric facilities in Hanoi, Vietnam. METHODS: A descriptive, cross-sectional correlational design was employed. Data were collected from 222 nurses across six geriatric facilities in Hanoi. The Practice Environment Scale of the Nursing Work Index (PES-NWI, short version) and a standardised resilience measurement tool were used. Pearson's correlation coefficient was applied to assess associations between variables. RESULTS: Nurses perceived their work environment as generally supportive, particularly regarding leadership and care quality, despite lower ratings for resource adequacy. A statistically significant moderate positive correlation was found between the overall work environment and nurse resilience (r = 0.534, p = 0.001). Subdomain analyses revealed a nuanced pattern: while a strong focus on nursing care was positively associated with stress management capacities, it was inversely related to aspects reflecting personal balance, suggesting potential tensions between professional adaptability and personal boundary maintenance. CONCLUSION: A supportive work environment is fundamentally associated with higher resilience among geriatric nurses. However, resilience in this context appears multidimensional, whereby professional coping strengths may coexist with challenges in maintaining personal balance. Organisational support is therefore essential not only for enhancing resilience but also for sustaining the long-term well-being of the geriatric nursing workforce. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should prioritise culturally responsive leadership and participatory decision-making while addressing structural factors such as staffing and resource allocation. Organisational interventions that balance professional demands with personal sustainability are critical to fostering resilient geriatric nursing practice.