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Release: Aug. 31, 1999

UI College of Nursing wins support to expand gerontological nursing research center

IOWA CITY, Iowa -- A $1.7 million, five-year federal grant to the University of Iowa College of Nursing will allow the college to head a six-state Gerontological Nursing Intervention Research Center (GNIRC). This award expands the scope and function of the current GNIRC, one of six nursing research centers funded nationwide since 1994.

Ultimately, this will mean better health for older adults in Iowa, the Midwest and the nation, said Toni Tripp-Reimer, Ph.D., professor and associate dean for research and director of the GNIRC.

The GNIRC will use the grant, announced recently by the National Institute for Nursing Research, a division of the National Institutes of Health, to develop a regional training and resource facility for gerontological nursing researchers. Initially, the training core will link investigators at the UI, the University of Minnesota, the University of Missouri at Columbia and the University of Wisconsin at Madison. In 2002, faculty at two historically black colleges, Southern University in Baton Rouge, La., and Alcorn State University in Lorman, Miss., will also join the regional center.

"We're particularly excited to have Southern University and Alcorn State join the center," said Meridean Maas, Ph.D., professor of nursing and co-director of the GNIRC. "This will allow us to address the scarcity of research concerning the health care needs of minority elders."

The regional training core will strengthen gerontological nursing research in several ways, Tripp-Reimer said. It will facilitate collaborative and multi-site studies by investigators at the member institutions; give scientists access to a larger and more diverse pool of older adults to participate in studies; foster mentoring relationships between experienced faculty investigators and their junior colleagues; and allow researchers to draw on resources and expertise at institutions other than their own.

The GNIRC also will use the grant to promote the use of scientific knowledge in clinical nursing practice. The center's research dissemination core will coordinate programs to train doctoral students and junior scientists how to translate scientific findings so they can be used by health care practitioners; disseminate scientific information to the health professions and consumers; and facilitate the adoption of new nursing practices that will improve the care of older adults.

"Nursing science is rapidly developing effective practices that improve patient outcomes," said Marita Titler, Ph.D., director of the research dissemination core. "The challenge is to go beyond simply publishing new findings to make sure nurses learn about them and can adopt them in their daily practice. It's also important that consumers have reliable information so they can make appropriate decisions regarding their own health care."

In addition to the regional training and research dissemination cores, the GNIRC also comprises an administrative core and a research support core (RSC) that provides statistical and other consultative services to investigators. The RSC is headed by Frank Kohout, Ph.D., professor of periodontics in the UI College of Dentistry.

The GNIRC was created in 1994 to facilitate gerontological nursing research, to provide a forum for collaboration by UI investigators and to move innovations into professional nursing practice. One of the center's goals is to help junior investigators and graduate students establish programs of research and gain standing with outside funding agencies, and another is to support senior faculty in nursing and other disciplines engaged in research leading to more effective nursing interventions for older adults.

The center currently supports 23 interdisciplinary projects ranging from pilot studies to full scale investigations. It is closely linked with the UI's Center for Nursing Classification, which works to develop standardized terms to describe the work nurses do and the patient outcomes that result from it.

Since its inception, the GNIRC has supported numerous projects resulting in improved patient care, including prevention of dehydration in residents of long-term care facilities; prevention and healing of pressure ulcers; training of family caregivers of persons with Alzheimer's disease and related disorders; improved end-of-life care; improved pain assessment and management; reduced urinary incontinence; decreased risk of osteoporosis; prevention and management of acute confusion; use of music therapy to decrease agitation; use of exercise to improve balance and reduce falls; and facilitation of relocation to long-term care.

"This five-year award to expand the center to a regional area is a testament to the strength of gerontological research in nursing and collaborating disciplines at the University of Iowa," Tripp-Reimer noted. The College of Nursing is currently ranked 11th within the top 60 NIH-funded schools of nursing. This is the only center grant awarded to a school of nursing in the Midwest.

Other large, newly funded centers will be housed at schools of nursing at UCLA, the University of Washington, the University of North Carolina, and the University of Pittsburgh.

According to Kathleen Buckwalter, Ph.D., UI associate provost for health sciences and co-director of the GNIRC, a number of social and economic factors suggest the need for more gerontological nursing research:

• Currently, about 12.7 percent of Americans are 65 or older. The Census Bureau predicts this percentage will rise to almost 18 percent in 2020 and almost 23 percent by 2050. In Iowa, 15.4 percent of the population currently is 65 or older.

• The proportion of Americans who are 85 or older--the "oldest old"--is expected to reach 5 percent by 2050. Iowa currently leads the nation in this age category, at 2 percent.

• More than 80 percent of older adults report having chronic health problems; the most common illnesses are arthritis, high blood pressure, heart disease, hearing loss, cataracts, orthopedic impairments, sinusitis and diabetes. Among people 85 and older, 47 percent of those living at home and more than 60 percent of those living in long-term care facilities experience some degree of cognitive impairment.

• Fifty-two percent of individuals over 65 have at least one disability that affects their ability to perform normal activities of daily living, and almost three in four people 85 or older have difficulty with routine activities. Women, especially those who live alone, report difficulty with daily living activities at a significantly higher rate than men.

• Though they represent 12.7 percent of the U.S. population, individuals 65 and older account for 40 percent of the national health bill. Medicare, the federal health insurance program for older Americans, currently pays about 18 percent of all health expenditures; that figure is expected to reach almost 26 percent by 2030.