Tania T. Von Visger

Background: While both older adults receiving assistance with daily living tasks for health or functioning reasons and the family members or kin-like friends who help them are affected by the context of caregiving, little is known about how their interactions might simultaneously affect each other’s well-being. Objective: This study aimed to determine the influence of intrapersonal factors on health outcomes for dyads of older adults and their family caregivers and examine the moderating effect of dementia status on these associations. Methods: Cross-sectional dyadic data were obtained from the National Health and Aging Trends Study (NHATS; Round 12, 2022) linked to the National Study of Caregiving (NSOC; IV, 2022), yielding a sample of 1,560 older adults paired with their respective primary family caregiver, defined as the person providing the greatest number of hours of care. A series of actor–partner interdependence models (APIMs), which statistically account for nonindependent observations, examined associations between older adults’ and caregivers’ positive affect, negative affect, and self-realization on both their own and each other’s mental health (depression and anxiety) and perceived general health. A second series of APIMs explored interactions between predictors and dementia status of the care recipient. All models controlled for dyad members’ own age, gender, race/ethnicity, and dementia status. Results: Dyad members’ positive affect, negative affect, and self-realization were significantly associated with their own depression, anxiety, and perceived general health. Additionally, caregivers’ negative mood was associated with their care recipients’ symptoms of depression, and older adults’ self-realization was associated with their caregivers’ perceived general health. Dementia status of the older adult was also found to moderate the relationship between older adults’ positive affect and their own depression. Probing revealed that this relationship was stronger for older adults with dementia than for those without dementia. Discussion: Considering caregiving dyads together provides a more holistic perspective. Intrapersonal factors are potentially modifiable aspects of caregiving contexts, and addressing older adults and their family caregivers simultaneously could be synergistically beneficial.

Aim: To examine older persons' experiences and participation in life‐enhancement activities in a long‐term care facility. Design: Convergent mixed‐methods design. Methods: Naturalistic observations of 20 life‐enhancement activity sessions were conducted in a single long‐term care facility that includes 111 older persons in September 2024. Data were collected through guiding questions and fieldnotes for systematic observation. We used Kruskal‐Wallis and Mann–Whitney U tests for quantitative analysis. Fieldnotes were analyzed using a six‐phase reflexive thematic analysis approach. Results: Engagement levels (self‐initiative, assistance‐seeking frequency, and social interaction frequency) significantly differed across 16 different life‐enhancement activities. Social interaction frequency also varied by mobility status (wheelchair, walker, independent). Participants displayed significantly more distractions in the TV Room than in the Activity Room. Four themes emerged from thematic analysis: (1) participation barriers, (2) activity contextual factors, (3) facilitator support strategies, and (4) social interactions and emotional well‐being. Conclusion: Structural elements (purposefully designed rooms, activity design and complexity, and the resident‐preferred music), relational elements (facilitators' hands‐on support, conflict resolution, and positive reinforcement), and individual factors (mobility status) influence older persons' participation in life‐enhancement activities. Life‐enhancement activities benefit older persons when they are provided with choices and adaptive equipment. Implication: Findings support allocating distraction‐free spaces for life‐enhancement activities, incorporating resident‐preferred music and game‐layered physical exercises, and providing facilitator training in adaptive coaching, hands‐on support, and conflict resolution. Impact: Life‐enhancement programs can promote psychosocial well‐being among older persons in long‐term care facilities by transforming routine recreational activities into personalized and socially engaging experiences that may reduce feelings of loneliness. Reporting Method: Journal Article Reporting Standards for Mixed Methods Research. Patient or Public Contribution: No Patient or Public Contribution.

Background: Racism against Asian Americans escalated during the COVID-19 pandemic. About 31%‐91% of Asian American adults and children reported experiencing various types of racism during the pandemic. According to the Federal Bureau of Investigation hate crime statistics, anti-Asian hate crime incidents increased from 158 in 2019 to 279 in 2020 and 746 in 2021. In 2022, the incidents decreased to 499, corresponding to the downward trend of the pandemic. The degree of impact racism has on mental health and wellness among Asian Americans requires investigation, specifically during the COVID-19 pandemic. Objective: We aim to describe racism-related mental health problems experienced by Asian Americans living in the United States and propose implementation strategies for mitigating their consequences. Methods: We conducted an integrative review of peer-reviewed publications in English reporting anti-Asian sentiments and racism’s impacts on mental health among Asian Americans in the United States. Results: The 29 eligible articles report on studies that utilized cross-sectional survey designs with various sample sizes. Racism is directly correlated with the prevalence of depression and anxiety experienced by victims of racist acts. The prevalence of in-person direct racism (racist expression aimed directly at the victim) is lower than in-person indirect racism (racist expression aimed at the ethnic group the victim belongs to). During the COVID-19 pandemic, the incidence of explicit online racism was lower than online indirect racism. Conclusions: COVID-19–related racism exacerbated preexisting racism, contributing to worse depression and anxiety among Asian Americans. To address this issue, we propose 2 main approaches: increase public awareness and education about recognizable racist sentiments/acts and systematized reporting of racially motivated crimes to guide political action. At an individual level, culturally responsive, trauma-informed interventions promoting cultural support and cohesion for various Asian American groups will foster this empowerment. These proposed actions will help alleviate racism by reducing stereotypes, empowering victims, and chipping away at the systemic racism structure.

Background: The American Association of Colleges of Nursing promotes competency-based education (CBE) to foster learning, producing competent graduates. Effective CBE necessitates innovative teaching strategies to optimize academic performance. Purpose: The purpose of this study was to initiate early clinical reasoning and clinical judgment competency development while enhancing the academic performance and engagement of undergraduate nursing students through collaborative learning and digital engagement strategies. Methods: We conducted a retrospective academic records review of nursing students in the undergraduate program enrolled in fall 2023 and spring 2024 in an online statistic course. Results: Ninety-six student records were included in the review. Student engagement predicted academic success as measured by collaborative exam generation (r = .50, p < .001), time spent in course content (B = 5.22, SE = 1.55, t = 3.34, p = .001), and student discussion posts (B = 7.22, SE = 1.42, t = 5.11, p < .001). Conclusions: Active, collaborative learning approaches can be introduced in nursing prerequisite courses to develop competency in critical reasoning, clinical judgment, and respectful communication strategies to build interprofessional partnerships.

BACKGROUND Background: Racism against Asian Americans (AAs) escalated during the COVID-19 pandemic. The degree of impact racism has on mental health and wellness among Asian Americans requires investigation, specifically during the COVID-19 pandemic. OBJECTIVE Background: Racism against Asian Americans (AAs) escalated during the COVID-19 pandemic. The degree of impact racism has on mental health and wellness among Asian Americans requires investigation, specifically during the COVID-19 pandemic. METHODS Methods: We conducted an integrative review of peer-reviewed publications in English reporting anti-Asian sentiments and racism’s impacts on mental health among Asian Americans in the US. RESULTS Results: The 28 eligible articles utilized cross-sectional survey designs with various sample sizes. Racism is directly correlated with the prevalence of depression and anxiety experienced by victims of racist acts. The prevalence of in-person direct racism (racist expression aimed directly at the victim) is lower than in-person indirect racism (racist expression aimed at the ethnic group the victim belongs to). During the COVID-19 pandemic, the incidence of explicit online racism was lower than online indirect racism. CONCLUSIONS Conclusions: COVID-19-related racism exacerbated preexisting racism, contributing to worse depression and anxiety among Asian Americans. To address this issue, we propose two main approaches: increase public awareness and education about recognizable racist sentiments/acts, and systematized reporting of racially motivated crimes to guide political action. At an individual level, culturally responsive trauma-informed interventions promoting cultural support and cohesion for various Asian American groups will foster this empowerment. These proposed actions will help alleviate racism by reducing stereotypes, empowering victims, and chipping away at the systemic racism structure. CLINICALTRIAL Not applicable. Not a clinical trial.