The elderly form a physiological heterogeneous group. This thesis is concerned with the activity of plasma aspirin esterase and several other plasma esterases in the fit, community-dwelling and frail hospitalized elderly. I, Several studies have produced evidence to suggest that drug metabolism is altered in the frail elderly and some of this work has centred around the plasma esterases. Kinetic analysis of plasma from young people, and fit and frail elderly people showed that the reduced plasma aspirin esterase in the latter group was most likely due to a reduced amount of cholinesterase enzyme (a reduced maximal activity) rather than that of a compromised affinity of the enzyme (increased Km). Purification of whole plasma achieved the removal of 97% of the albumin component of plasma aspirin esterase. Subsequent kinetic analysis confirmed that there was no change in the Km value of plasma aspirin esterase in the three groups as a result of isolating the cholinesterase enzyme. Following this, it was postulated that the reduced activity of several plasma esterases in the frail elderly may be due to their often poor nutritional status. A group of frail elderly people were randomised and half received a supplemented hospital diet. Plasma aspirin esterase, cholinesterase, paraoxonase, phenylacetate esterase, red blood cell intracellular esterase and red blood cell acetylcholinesterase in addition to anthropometric measurements were measured at 0,4 and 8 weeks of the study period. The control group did not gain weight whereas the group who received a supplemented diet gained an average 1.3Kg (non-significant). The post study weight and TSF measurements between the fed and control groups differed signifcantly at p<0.05. There were no significant changes in any of the esterases at 8 weeks however plasma cholinesterase did show a significant increase in activity at 4 week (p < 0.05) and plasma paraoxonase showed a trend towards an improved activity.

BACKGROUND: Constipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients. METHODS: We conducted a retrospective case-control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis. RESULTS: Approximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF. CONCLUSIONS: Approximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.

As inquietações por estudar esta temática apreendendo quais significados atribuem os enfermeiros ao cuidar do paciente idoso, hospitalizado, em fase terminal, surgiu a partir de experiências pessoais. Minha inquietação aumentou com a prática profissional, notando que, o pessoal que atendia aos idosos, em fase terminal, em sua maioria, era auxiliar de enfermagem, sem nenhuma formação específca para este cuidado. Assim, ao surgir a oportunidade de ingressar no doutorado em enfermagem, emergiu, novamente, a inquietação que há muitos anos vinha se instalando: O quê significa para a enfermeira o cuidado do idoso, em seu encontro com a morte, no mundo hospitalar? Desta forma, a proposta foi possibilitar que suas experiências, manifestadas por meio do discurso verbal e não verbal, pudessem aproximar-me do mundo que elas habitam nos hospitais e saber quais significados atribuem a esta experiência para propor um novo pensar sobre este cuidado. Tratou-se de um estudo conduzido segundo uma abordagem qualitativa, pertinente às questões muito particulares de um objeto cuja natureza não pode ser quantificada. A investigação foi desenvolvida com enfermeiros que trabalham nos hospitais públicos, na cidade de Celaya, Guanajuato, pelo fato de atenderem à maioria da população idosa. A coleta de dados foi realizada por meio de 12 entrevistas, conduzidas segundo a abordagem fenomenológica, a partir de uma questão norteadora proposta aos enfermeiros. Durante a investigação, pude apreender que, para eles, a vivência do cuidado do paciente, enquanto profissionais de enfermagem, envolve vários aspectos como as especificidades da pessoa da qual se cuida, como suas características físicas, emocionais, sociais e espirituais. Foi descrito ainda como sendo o ato de ajudar o paciente a morrer. No entanto, muitas vezes, procuram realizá-lo de forma a protelar a morte, como um impulso para conservar a vida daquele que está morrendo. Esse cuidado é proporcionado em um mundo concreto - geralmente, o hospital - e é um desafio manifestado pelos enfermeiros de forma a permitir o respeito às decisões do paciente e de sua família. Da mesma forma, as políticas das instituições de saúde pública necessitam serem revistas para que o familiar possa permanecer próximo do idoso em fase terminal, pois é seu direito morrer em companhia dos seus, de forma a ter uma morte digna. Reconhece-se, cada vez mais, que este cuidado é uma especialidade de enfermagem que requer conhecimentos e capacidades profissionais específicos e uma determinada estrutura de carreira profissional. / The restlessness for studying this theme, and learn about the meanings that nurses assign to caring for dying older patients, aroused from personal experiences. My restlessness increased with professional practice, and I noticed that the majority of the staff who cared for older, terminal patients were auxiliary nurses, with no specific training for this particular health care practice. Hence, when I ran across the opportunity to enter the nursing doctorate program, this restlessness, which had been present for many years, emerged once again: What does it mean, for nurses, to care for older individuals, as they face death, in the hospital environment? Therefore, the purpose was to permit that their experiences, reported both verbally and non-verbally, could bring me closer to the world they inhabit in the hospitals, and learn about the meanings that they assign to this experience. That way, I would be able to propose a new thought concerning this care. This study used a qualitative approach, pertinent to the very specific issues of an object whose nature cannot be quantified. The research was developed with nurses working in public hospitals in the city of Celaya, Guanajuato, because they care for the majority of the elderly population. Data collection occurred through 12 interviews, conducted according to the phenomenological approach, based on a guiding question directed to nurses. During the research, I learned that, for the nurses, the experience of caring for the patients involves various aspects like the specificities of the person being cared for, as well as his or her physical, emotional, social, and spiritual characteristics. Nurses also reported that their work was the act of helping the patient to die. However, nurses often seek to, through their work, postpone death, as an impulse to preserve the life of who is dying. This care is provided in a concrete world - usually the hospital - and nurses state that it is a challenge to respect patients\' and their family\'s decisions. Similarly, public health institution policies should be reviewed so as to permit relatives to stay close to terminal patients, since it is their right to die in the company of their loved ones, as a way of having a dignified death. It has been more and more recognized that his care is a nursing specialty that requires specific professional knowledge and skills, besides a particular professional career structure.

As inquietações por estudar esta temática apreendendo quais significados atribuem os enfermeiros ao cuidar do paciente idoso, hospitalizado, em fase terminal, surgiu a partir de experiências pessoais. Minha inquietação aumentou com a prática profissional, notando que, o pessoal que atendia aos idosos, em fase terminal, em sua maioria, era auxiliar de enfermagem, sem nenhuma formação específca para este cuidado. Assim, ao surgir a oportunidade de ingressar no doutorado em enfermagem, emergiu, novamente, a inquietação que há muitos anos vinha se instalando: O quê significa para a enfermeira o cuidado do idoso, em seu encontro com a morte, no mundo hospitalar? Desta forma, a proposta foi possibilitar que suas experiências, manifestadas por meio do discurso verbal e não verbal, pudessem aproximar-me do mundo que elas habitam nos hospitais e saber quais significados atribuem a esta experiência para propor um novo pensar sobre este cuidado. Tratou-se de um estudo conduzido segundo uma abordagem qualitativa, pertinente às questões muito particulares de um objeto cuja natureza não pode ser quantificada. A investigação foi desenvolvida com enfermeiros que trabalham nos hospitais públicos, na cidade de Celaya, Guanajuato, pelo fato de atenderem à maioria da população idosa. A coleta de dados foi realizada por meio de 12 entrevistas, conduzidas segundo a abordagem fenomenológica, a partir de uma questão norteadora proposta aos enfermeiros. Durante a investigação, pude apreender que, para eles, a vivência do cuidado do paciente, enquanto profissionais de enfermagem, envolve vários aspectos como as especificidades da pessoa da qual se cuida, como suas características físicas, emocionais, sociais e espirituais. Foi descrito ainda como sendo o ato de ajudar o paciente a morrer. No entanto, muitas vezes, procuram realizá-lo de forma a protelar a morte, como um impulso para conservar a vida daquele que está morrendo. Esse cuidado é proporcionado em um mundo concreto - geralmente, o hospital - e é um desafio manifestado pelos enfermeiros de forma a permitir o respeito às decisões do paciente e de sua família. Da mesma forma, as políticas das instituições de saúde pública necessitam serem revistas para que o familiar possa permanecer próximo do idoso em fase terminal, pois é seu direito morrer em companhia dos seus, de forma a ter uma morte digna. Reconhece-se, cada vez mais, que este cuidado é uma especialidade de enfermagem que requer conhecimentos e capacidades profissionais específicos e uma determinada estrutura de carreira profissional. / The restlessness for studying this theme, and learn about the meanings that nurses assign to caring for dying older patients, aroused from personal experiences. My restlessness increased with professional practice, and I noticed that the majority of the staff who cared for older, terminal patients were auxiliary nurses, with no specific training for this particular health care practice. Hence, when I ran across the opportunity to enter the nursing doctorate program, this restlessness, which had been present for many years, emerged once again: What does it mean, for nurses, to care for older individuals, as they face death, in the hospital environment? Therefore, the purpose was to permit that their experiences, reported both verbally and non-verbally, could bring me closer to the world they inhabit in the hospitals, and learn about the meanings that they assign to this experience. That way, I would be able to propose a new thought concerning this care. This study used a qualitative approach, pertinent to the very specific issues of an object whose nature cannot be quantified. The research was developed with nurses working in public hospitals in the city of Celaya, Guanajuato, because they care for the majority of the elderly population. Data collection occurred through 12 interviews, conducted according to the phenomenological approach, based on a guiding question directed to nurses. During the research, I learned that, for the nurses, the experience of caring for the patients involves various aspects like the specificities of the person being cared for, as well as his or her physical, emotional, social, and spiritual characteristics. Nurses also reported that their work was the act of helping the patient to die. However, nurses often seek to, through their work, postpone death, as an impulse to preserve the life of who is dying. This care is provided in a concrete world - usually the hospital - and nurses state that it is a challenge to respect patients\' and their family\'s decisions. Similarly, public health institution policies should be reviewed so as to permit relatives to stay close to terminal patients, since it is their right to die in the company of their loved ones, as a way of having a dignified death. It has been more and more recognized that his care is a nursing specialty that requires specific professional knowledge and skills, besides a particular professional career structure.

Made available in DSpace on 2016-04-27T18:47:04Z (GMT). No. of bitstreams: 1 Cleber Silvestre Leoncio.pdf: 1645872 bytes, checksum: edc84bfa9f34ed7c86f3a777d4772e35 (MD5) Previous issue date: 2010-10-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The study it aims at to investigate the nurse front to the systematization of the assistance of nursing (SAE) of the hospitalized elderly. One searched to identify to the perception of the nurses front to the systematization of the nursing assistance, and as it identifies and it recognizes the necessities of the hospitalized elderly. With regard to the methodological delineation, one was about an exploratory, descriptive study and with qualitative boarding. The research was developed in a hospital institution characterized as hospital of education, filantrópico, and generality, located in the city of São Paulo. The citizens of the study had been 43 nurses who act in the units of internment of the institution study field. The criterion of choice of the units occurred for the elderly occupation hospitalized, defining the units of choice of the study. The data had been collected by means of composed questionnaire twopiece, where the first one identifies to the citizen of the research and some questions of multiple choice fronts to the thematic one of the elderly. The second composed part for one asks opened noted, where the citizen discourses its perception in carrying through the SAE of the hospitalized elderly. The nurses consider that he has contact with the elderly in the daily development of its work, but express difficulty to carry through the systematization of the nursing assistance, for believing that the phase of the formation, that is, the graduation presents a gap of formation in regards to the assistance specifies for elderly. In the perception of the majority of the nurses the graduation was imperfection in the learning to subsidize knowledge to attend the elderly. The answers of the citizens had been analyzed through the content considered for Bardin (1977), disclosing that the searched citizens present difficulties in attending the hospitalized elderly. After analysis of the contents we group the results of the answers gotten for similarity in dimensions proposals for Dellors (1996), structuralizing abilities for superior education in the sources of knowing to be, to know to make, to know to know and to know to coexist. The pointers of this study that could be enclosed as suggestion in the superior formation. Promoting a multidimensional assistance when taking care of the hospitalized elderly / O estudo visa investigar o enfermeiro frente à sistematização da assistência de enfermagem (SAE) da pessoa idosa hospitalizada. Buscou-se identificar a percepção dos enfermeiros frente à sistematização da assistência de enfermagem, e como identifica e reconhece as necessidades da pessoa idosa hospitalizada. Com relação ao delineamento metodológico, tratou-se de um estudo exploratório, descritivo e com abordagem qualitativa. A pesquisa foi desenvolvida em uma instituição hospitalar caracterizada como hospital de ensino, filantrópico, geral, localizado no município de São Paulo. Os sujeitos do estudo foram 43 enfermeiros que atuam nas unidades de internação da instituição campo de estudo. O critério de escolha das unidades ocorreu pela ocupação de pessoa idosas hospitalizadas, definindo as unidades de escolha do estudo. Os dados foram coletados por meio de questionário composto de duas partes, onde a primeira identifica o sujeito da pesquisa e algumas questões de múltipla escolha frente à temática da pessoa idosa. A segunda parte composta por uma pergunta norteadora aberta, onde o sujeito discorre sua percepção em realizar a SAE da pessoa idosa hospitalizada. Os enfermeiros consideram que tem contato com a pessoa idosa no desenvolvimento diário de seu trabalho, mas expressam dificuldade de realizar a sistematização da assistência de enfermagem, por acreditarem que na fase da formação, ou seja, a graduação apresenta uma lacuna de formação no tocante à assistência especifica para pessoa idosa. Na percepção da maioria dos enfermeiros a graduação foi falha na aprendizagem de subsidiar conhecimentos para assistir a pessoa idosa. As respostas dos sujeitos foram analisadas através do conteúdo proposto por Bardin (1977), revelando que os sujeitos pesquisados apresentam dificuldades em assistir a pessoa idosa hospitalizada. Após análise dos conteúdos agrupamos os resultados das respostas obtidas por similaridade em dimensões propostas por Dellors (1996), estruturando competências para o ensino superior nas vertentes do saber ser, saber fazer, saber conhecer e saber conviver. Os indicadores deste estudo que poderão ser incluídos como sugestão na formação superior. Promovendo uma assistência multidimensional ao cuidar da pessoa idosa hospitalizada

Cette recherche visait à développer, mettre à l’essai et évaluer les effets d’une intervention de pratique réflexive (IPR) avec des infirmières œuvrant auprès d’aînés hospitalisés. Fondée sur la théorie du Human Caring de Watson (1979) et sur le modèle de réflexion structurée de Johns (2006), l’étude a été réalisée au moyen d’un devis mixte. Le développement et la mise à l’essai de l’IPR ont été réalisés au moyen d’une approche qualitative de type recherche-action. L’évaluation de l’intervention a été effectuée à l’aide d’une approche qualitative et d’une approche quantitative de type quasi-expérimental avec groupe de comparaison (GC). Au terme de l’IPR, les infirmières étaient invitées à décrire les retombées perçues de cette intervention, soit les habiletés et les savoirs infirmiers développés suite à une pratique réflexive (PR), ainsi que leur perception de la PR comme moyen d’amélioration de leur pratique professionnelle. De plus, comparativement à un GC, trois hypothèses étaient formulées : les infirmières du groupe expérimental (GE) ayant bénéficié d’une IPR amélioreraient significativement leurs attitudes et leurs connaissances à l’égard des aînés; identifieraient davantage d’interventions infirmières adaptées à la clientèle âgée hospitalisée, et obtiendraient un niveau de réflexion supérieur. L’étude a été effectuée auprès de 43 infirmières (GE = 22; GC = 21) travaillant dans un centre hospitalier universitaire. L’IPR s’est déroulée sur une période de 22 semaines. Elle comprenait huit ateliers thématiques d’une durée de 75 minutes chacun, dispensés aux trois semaines, combinés à des lectures et à des exercices individuels. L’IPR portait sur trois thèmes centraux du séjour hospitalier des aînés : la médication, la mobilisation et la planification du congé. Des données qualitatives et quantitatives ont été colligées par le biais de questionnaires ouverts (vignettes, écrit réflexif) et standardisés (Kogan’s Attitudes Toward Old People Scale, Palmore’s Facts on Aging Quiz) pré et post intervention pour les deux groupes. Les infirmières du GE ont également complété un questionnaire sur l’expérience de la PR et certaines d’entre elles ont participé à des groupes de discussion focalisée. Une analyse de contenu thématique, selon l’approche de Miles et Huberman (2003), a été réalisée sur les données qualitatives, alors que des tests de classement de Wilcoxon ont été effectués sur les données quantitatives. Les résultats soulignent que les infirmières ont développé différentes habiletés nécessaires à une PR telles que l’introspection, l’ouverture aux autres et l’analyse critique. Les participantes reconnaissent que l’IPR leur a notamment permis de développer des savoirs empirique, éthique, esthétique, personnel et émancipatoire. De plus, elles perçoivent que l’IPR est un moyen d’amélioration de la pratique professionnelle puisqu’elle peut, entre autres, contrer la routinisation des soins. Par ailleurs, comparativement au GC, les infirmières du GE ont amélioré significativement leurs attitudes et leurs connaissances à l’égard des aînés. Cependant, aucune différence significative entre le GE et le GC n’a été révélée suite à l’IPR quant au nombre d’interventions adaptées aux situations vécues par les aînés hospitalisés et au niveau de réflexion atteint. Les hypothèses de recherche ont ainsi été partiellement soutenues. Cette étude démontre le potentiel d’une IPR comme approche de développement professionnel novateur qui valorise l’expérience des infirmières, tout en leur permettant de modifier positivement leurs attitudes à l’égard des aînés et d’ajuster leurs connaissances aux besoins de cette clientèle hautement fragile et vulnérable. / The purpose of this research was to develop, field-test and evaluate the effects of a reflective practice intervention (RPI) with nurses who care for hospitalized elders. Based on the theory of Human Caring put forth by Watson (1979) and on the Model for Structured Reflection developed by Johns (2006), the study used a mixed design. A qualitative action-research approach was used for the development and testing of the RPI. The evaluation of the intervention used a qualitative approach and a quantitative quasi-experimental approach with a comparison group (CG). Upon completion of the RPI, the nurses were invited to identify the benefits of the intervention on their skills and nursing knowledge and on their perception of the RP as a way of improving their professional practice. Three hypotheses were advanced: following this RPI and compared with the CG, nurses in the experimental group (EG) would improve their attitudes and knowledge regarding elders, identify a larger number of nursing interventions adapted to the hospitalized elder clientele, and achieve a higher level of reflection. The study was carried out with 43 university-hospital nurses (EG = 22; CG = 21). The RPI spanned a 22-week period. It included eight thematic workshops each 75 minutes long, delivered at three-week intervals, combined with reading assignments and individual exercises. The RPI focused on three themes central to elder hospitalization: medication, mobilization, and discharge planning. Qualitative and quantitative data were collected through questionnaires, both open-ended (vignettes, reflective essays) and standardized (Kogan’s Attitudes Toward Old People Scale, Palmore’s Facts on Aging Quiz), completed pre- and post intervention by both groups. Nurses form the EG also completed a questionnaire on the RP experience and some took part in focus groups. A thematic content analysis was carried out on the qualitative data using the approach proposed by Miles and Huberman (2003), and Wilcoxon rank tests were run on the quantitative data. Results show that the nurses developed different skills and abilities required for a RP, including introspection, openness to others, and critical analysis. The participants recognized that the RPI allowed them, among other things, to develop empiric, ethical, esthetic, personal and emancipatory knowledge. Moreover, they saw the RPI as a means of improving professional practice, particularly thanks to its potential for countering the routinization of care. Furthermore, compared with their CG counterparts, the EG nurses significantly improved their attitudes and knowledge regarding elders. However, no significant inter-group differences emerged following the RPI in terms of either the number of interventions adapted to situations experienced by hospitalized elders or the level of reflection achieved. Research hypotheses were partly supported. This study demonstrates the potential of a RPI as an innovative professional development approach that valorizes the experience of nurses while allowing them to change their attitudes towards elders in a positive fashion and to adjust their knowledge according to the needs of this frail and vulnerable clientele. Possible avenues of pursuit are proposed for clinical practice, training, management and research.

Cette recherche visait à développer, mettre à l’essai et évaluer les effets d’une intervention de pratique réflexive (IPR) avec des infirmières œuvrant auprès d’aînés hospitalisés. Fondée sur la théorie du Human Caring de Watson (1979) et sur le modèle de réflexion structurée de Johns (2006), l’étude a été réalisée au moyen d’un devis mixte. Le développement et la mise à l’essai de l’IPR ont été réalisés au moyen d’une approche qualitative de type recherche-action. L’évaluation de l’intervention a été effectuée à l’aide d’une approche qualitative et d’une approche quantitative de type quasi-expérimental avec groupe de comparaison (GC). Au terme de l’IPR, les infirmières étaient invitées à décrire les retombées perçues de cette intervention, soit les habiletés et les savoirs infirmiers développés suite à une pratique réflexive (PR), ainsi que leur perception de la PR comme moyen d’amélioration de leur pratique professionnelle. De plus, comparativement à un GC, trois hypothèses étaient formulées : les infirmières du groupe expérimental (GE) ayant bénéficié d’une IPR amélioreraient significativement leurs attitudes et leurs connaissances à l’égard des aînés; identifieraient davantage d’interventions infirmières adaptées à la clientèle âgée hospitalisée, et obtiendraient un niveau de réflexion supérieur. L’étude a été effectuée auprès de 43 infirmières (GE = 22; GC = 21) travaillant dans un centre hospitalier universitaire. L’IPR s’est déroulée sur une période de 22 semaines. Elle comprenait huit ateliers thématiques d’une durée de 75 minutes chacun, dispensés aux trois semaines, combinés à des lectures et à des exercices individuels. L’IPR portait sur trois thèmes centraux du séjour hospitalier des aînés : la médication, la mobilisation et la planification du congé. Des données qualitatives et quantitatives ont été colligées par le biais de questionnaires ouverts (vignettes, écrit réflexif) et standardisés (Kogan’s Attitudes Toward Old People Scale, Palmore’s Facts on Aging Quiz) pré et post intervention pour les deux groupes. Les infirmières du GE ont également complété un questionnaire sur l’expérience de la PR et certaines d’entre elles ont participé à des groupes de discussion focalisée. Une analyse de contenu thématique, selon l’approche de Miles et Huberman (2003), a été réalisée sur les données qualitatives, alors que des tests de classement de Wilcoxon ont été effectués sur les données quantitatives. Les résultats soulignent que les infirmières ont développé différentes habiletés nécessaires à une PR telles que l’introspection, l’ouverture aux autres et l’analyse critique. Les participantes reconnaissent que l’IPR leur a notamment permis de développer des savoirs empirique, éthique, esthétique, personnel et émancipatoire. De plus, elles perçoivent que l’IPR est un moyen d’amélioration de la pratique professionnelle puisqu’elle peut, entre autres, contrer la routinisation des soins. Par ailleurs, comparativement au GC, les infirmières du GE ont amélioré significativement leurs attitudes et leurs connaissances à l’égard des aînés. Cependant, aucune différence significative entre le GE et le GC n’a été révélée suite à l’IPR quant au nombre d’interventions adaptées aux situations vécues par les aînés hospitalisés et au niveau de réflexion atteint. Les hypothèses de recherche ont ainsi été partiellement soutenues. Cette étude démontre le potentiel d’une IPR comme approche de développement professionnel novateur qui valorise l’expérience des infirmières, tout en leur permettant de modifier positivement leurs attitudes à l’égard des aînés et d’ajuster leurs connaissances aux besoins de cette clientèle hautement fragile et vulnérable. / The purpose of this research was to develop, field-test and evaluate the effects of a reflective practice intervention (RPI) with nurses who care for hospitalized elders. Based on the theory of Human Caring put forth by Watson (1979) and on the Model for Structured Reflection developed by Johns (2006), the study used a mixed design. A qualitative action-research approach was used for the development and testing of the RPI. The evaluation of the intervention used a qualitative approach and a quantitative quasi-experimental approach with a comparison group (CG). Upon completion of the RPI, the nurses were invited to identify the benefits of the intervention on their skills and nursing knowledge and on their perception of the RP as a way of improving their professional practice. Three hypotheses were advanced: following this RPI and compared with the CG, nurses in the experimental group (EG) would improve their attitudes and knowledge regarding elders, identify a larger number of nursing interventions adapted to the hospitalized elder clientele, and achieve a higher level of reflection. The study was carried out with 43 university-hospital nurses (EG = 22; CG = 21). The RPI spanned a 22-week period. It included eight thematic workshops each 75 minutes long, delivered at three-week intervals, combined with reading assignments and individual exercises. The RPI focused on three themes central to elder hospitalization: medication, mobilization, and discharge planning. Qualitative and quantitative data were collected through questionnaires, both open-ended (vignettes, reflective essays) and standardized (Kogan’s Attitudes Toward Old People Scale, Palmore’s Facts on Aging Quiz), completed pre- and post intervention by both groups. Nurses form the EG also completed a questionnaire on the RP experience and some took part in focus groups. A thematic content analysis was carried out on the qualitative data using the approach proposed by Miles and Huberman (2003), and Wilcoxon rank tests were run on the quantitative data. Results show that the nurses developed different skills and abilities required for a RP, including introspection, openness to others, and critical analysis. The participants recognized that the RPI allowed them, among other things, to develop empiric, ethical, esthetic, personal and emancipatory knowledge. Moreover, they saw the RPI as a means of improving professional practice, particularly thanks to its potential for countering the routinization of care. Furthermore, compared with their CG counterparts, the EG nurses significantly improved their attitudes and knowledge regarding elders. However, no significant inter-group differences emerged following the RPI in terms of either the number of interventions adapted to situations experienced by hospitalized elders or the level of reflection achieved. Research hypotheses were partly supported. This study demonstrates the potential of a RPI as an innovative professional development approach that valorizes the experience of nurses while allowing them to change their attitudes towards elders in a positive fashion and to adjust their knowledge according to the needs of this frail and vulnerable clientele. Possible avenues of pursuit are proposed for clinical practice, training, management and research.