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The aim of this study is to explore whether subjective cognitive decline and frailty were related to each other and whether nutrition mediated their association.
From January 2025 to May 2025, a total of 194 middle-aged and elderly MHD patients were selected by convenience sampling method. Cross-sectional data on patients' subjective cognitive decline, nutrition, and frailty were collected using questionnaires. Data were analysed using SPSS 27.0 and PROCESS macros.
The frailty score of middle-aged and elderly MHD patients was 4.00 (range 3.00 to 9.00), and 69 (35.57%) were identified as frailty. Spearman correlation analysis showed that subjective cognitive decline (SCD) was positively correlated with frailty. Nutrition was positively associated with SCD and frailty. When controlling for covariates, nutrition was observed to mediate a relationship between SCD and frailty. The intermediate effect value accounted for 31.29% of the total effect.
Nutrition plays a partial mediating role in the relationship between SCD and frailty in middle-aged and elderly MHD patients in this cross-sectional study with a one-way correlational model. The negative effects of SCD on frailty can be mitigated by improving nutritional status. Considering the bidirectional interaction among SCD, nutrition and frailty, this mediating pathway needs to be further verified by longitudinal studies.
Our findings indicate that nutrition plays a mediating role in the association between SCD and frailty. Routine screening for SCD and nutritional status could be considered in clinical practice to detect those at elevated risk of frailty at an early stage. Targeted nutritional and cognitive interventions may help alleviate frailty progression, reduce adverse clinical outcomes, and enhance self-management ability and quality of life, thus supporting the establishment of comprehensive strategies for frailty prevention and management in haemodialysis settings.
This article follows the STROBE guidelines for the reporting of cross-sectional studies.
No patient or public contribution.
To synthesise stakeholders' experiences and perceptions of animal-assisted intervention (AAI) for people with dementia in community care settings.
Qualitative evidence synthesis.
We systematically searched Medline, CINAHL, Embase, Scopus, Web of Science, PsycINFO and AgeLine for potentially eligible studies. Thematic synthesis was used to analyse the data from included studies. We assessed the methodological limitations of included studies using an adaptation of the Critical Appraisal Skills Programme checklist and used Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) tool to assess confidence in review findings. This review is reported using the ENTREQ checklist.
We included 14 reports from 11 studies and developed three analytical themes incorporating a gardening analogy: planting–connecting with animals, growing–engaging in AAI and nurturing–making AAI work; and six subthemes: willingness to connect, building relationships, a rich experience, the benefits of AAI, individualised and holistic approach and training and support, with 15 key findings.
This review describes people's experiences and perceptions of AAI for people with dementia, and provides recommendations on the development and implementation of AAI, with moderate to high confidence. Nurses need to consider the factors that influence the implementation of AAI identified in this review, to facilitate engagement and long-term impacts while adopting AAI in community care settings.
This review may enhance healthcare professionals' understanding of AAI for people with dementia in community care settings. AAI is a complex intervention that can be delivered in varied manner. A multicomponent, flexible and individualised AAI is important. Additional training and education for staff are needed.
A man with dementia and his wife who share a love of dogs, advised at each step of the review, providing insights and perspectives and contributing as co-authors.
Examine the relationships between workplace trust, interpersonal trust, and nurses' physical and mental health, and specifically investigate the mediating role of resilience.
Nurses are central to healthcare delivery but frequently experience workplace violence, adversely affecting their well-being. Trust represents a higher-order mechanism that fosters positive attitudes and professional growth, potentially safeguarding nurses' resilience in coping with adversity. However, research elucidating how trust influences nurses' health via resilience remains limited.
A cross-sectional study was conducted using convenience sampling. A total of 2855 clinical nurses from general hospitals in Fujian Province, China, were surveyed between August and October 2022. Workplace trust and interpersonal trust were served as independent variables, Physical Component Summary and Mental Component Summary scores as dependent variables, and resilience as a mediator. Mediation analysis was performed using Mplus 8.3. The study was prepared and reported according to the STROBE checklist.
Mean scores were Physical Component Summary: 51.12 ± 8.90, and Mental Component Summary: 48.20 ± 10.18. Workplace trust had significant direct effects on both Physical Component Summary and Mental Component Summary. Interpersonal trust had no significant direct effects on Physical Component Summary or Mental Component Summary. Resilience demonstrated significant mediating effects: for workplace trust on Physical Component Summary and on Mental Component Summary; and for interpersonal trust on Physical Component Summary and on Mental Component Summary.
Workplace trust directly enhances nurses' physical and mental health. While interpersonal trust lacks a direct link to health outcomes, both workplace and interpersonal trust significantly improve nurses' health indirectly by bolstering resilience. Resilience serves as a critical pathway through which trust fosters well-being.
No patient or public contribution.
Nurse managers and healthcare administrators should prioritise interventions to cultivate workplace trust (e.g., fostering trust among colleagues, and between nurses and the organisation/management) and strengthen interpersonal trust and psychological resilience. Enhancing these protective factors will better equip nurses to manage occupational and personal stressors, ultimately safeguarding and improving their physical and mental health.
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