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The interaction between dementia and changes in health status accelerates the progression of dementia and health deterioration. Although health indicators exist for older adults, comprehensive ones for dementia are lacking.
To (1) establish core health indicators for older adults with dementia, (2) develop an integrated health assessment toolkit for older adults with dementia, and (3) test the feasibility and applicability of the integrated health assessment toolkit.
This study involved two phases. In the first phase, using the Delphi method, opinions from 10 experts were synthesized to establish core health indicators for older adults with dementia. In the second phase, with a descriptive research approach, an integrated health assessment toolkit was developed, evaluated by 10 daycare case managers for feasibility, and then pilot tested with 50 older adults with dementia across three daycare centers.
The core health indicators for older adults with dementia covered 18 indicators in five domains: (1) cognitive and behavioral impairment, (2) sensory and perceptual impairment, (3) disease and dysfunction, (4) functional fitness deterioration, and (5) social isolation. After two rounds of assessments, experts rated the criteria's importance and clarity at 0.94 and 0.89 on the scale-level content validity index/universal agreement (S-CVI/UA), respectively. In the second phase, the integrated health assessment toolkit was developed, which integrated five observational assessment scales and six physical function measures. The average applicability scores ranged from 7.80 to 9.90 out of 10. In the pilot test, the assessment process proceeded smoothly without any adverse events. However, 10 participants did not comply with wearing the actigraphy device.
The core health indicators and the corresponding health assessment toolkit are feasible to assess the health of older adults with dementia that could provide valuable insights and guide future interventions to enhance their well-being.
In China, nursing information systems (NIS) implementation can face numerous barriers to acceptance, including the attitudes of potential users. However, few studies have evaluated this acceptance.
The aim of this study was to explain the acceptance of NIS utilizing a survey based on unified theory of acceptance and use of technology.
A multi-center cross-sectional study utilizing an online survey was conducted. SPSS AMOS was used to conduct a structural equation modelling analysis. This research followed the STROBE Checklist.
A total of 3973 Nurses participated in the study between January 2023 and March 2023. The acceptance of NIS among nurses was overall moderate to high. The proposed model has been rigorously tested and validated using empirical data, ensuring its credibility and dependability. Performance expectancy (PE), social influence (SI), and attitude significantly and positively affected intentions to use NIS. Effort expectancy (EE) did not show any significant effects in the sample. Facilitating conditions (FCs) was found to have a negative relationship with the intention to use NIS. There was a statistically significant difference BI between the different age groups, working years, and computer training experience. The model demonstrates a good fit with the observed data.
This study identified PE, SI, and attitude as facilitators of nurses' intentions to use NIS. The findings about EE indicates that the ease of using NIS does not seem to be a concern among nurses. Moreover, high FC might be perceived as indicative of a complex system or extensive usage, that can lead to increased workload and reduced behavioural intention (BI). The significant differences in BI among various demographic groups highlight the need for more studies understanding the preferences and barriers faced by different, levels of experience and training backgrounds.
No patient or public contribution.
by Fengying Wei, Ruiyang Zhou, Zhen Jin, Yamin Sun, Zhihang Peng, Shaojian Cai, Guangmin Chen, Kuicheng Zheng
The differences of SARS-CoV-2 variants brought the changes of transmission characteristics and clinical manifestations during the prevalence of COVID-19. In order to explore the evolution mechanisms of SARS-CoV-2 variants and the impacts of variant evolution, the classic SIR (Susceptible-Infected-Recovered) compartment model was modified to a generalized SVEIR (Susceptible-Vaccinated-Exposed-Infected-Recovered) compartment model with age-group and varying variants in this study. By using of the SVEIR model and least squares method, the optimal fittings against the surveillance data from Fujian Provincial Center for Disease Control and Prevention were performed for the five epidemics of Fujian Province. The main epidemiological characteristics such as basic reproduction number, effective reproduction number, sensitivity analysis, and cross-variant scenario investigations were extensively investigated during dynamic zero-COVID policy. The study results showed that the infectivities of the variants became fast from wild strain to the Delta variant, further to the Omicron variant. Meanwhile, the cross-variant investigations showed that the average incubation periods were shortened, and that the infection scales quickly enhanced. Further, the risk estimations with the new variants were performed without implements of the non-pharmaceutical interventions, based on the dominant variants XBB.1.9.1 and EG.5. The results of the risk estimations suggested that non-pharmaceutical interventions were necessary on the Chinese mainland for controlling severe infections and deaths, and also that the regular variant monitors were still workable against the aggressive variant evolution and the emergency of new transmission risks in the future.
This study explored the impact of different care modes on the outcome of hospitalized patients with acute ischaemic stroke (AIS) during hospitalization and 3 months after discharge.
This was a prospective cohort study comparing the outcomes at hospitalization, at discharge, and at 3 months post discharge among AIS patients with different caregiving arrangements from 9, December 2022 to 20, August 2023. The general information questionnaire, Modified Barthel Index, Shortened General Comfort Questionnaire, Perceived Social Support scale, Herth Hope Index, modified Rankin scale and EQ-5D-5L were utilized for the investigation.
The psychological evaluation scores during hospitalization, including comfort, perceived social support, and hope, did not significantly differ between the two groups of AIS patients (p > .05). Moreover, there were no significant impacts observed in terms of length of stay (LOS) at the hospital or hospitalization expense (p > .05). The proportion of patients with intact functionality was greater in the family caregiver group 3 months after discharge (16.5%). However, when stratified based on prognosis, the difference in outcomes between the two groups of patients did not reach statistical significance (p > .05). The analysis of ADL, quality of life and stroke recurrence in 276 surviving ischaemic stroke patients 3 months post discharge indicated no differences between the two groups across all three aspects (p > .05).
Older and divorced or widowed AIS patients tend to prefer professional caregivers. The psychological state during hospitalization, length of hospital stay and hospitalization expenses are not influenced by the caregiving model. Three months post discharge, a greater proportion of patients in the family caregiving group had intact mRS functionality, but this choice did not impact patient prognosis, stroke recurrence, quality of life or independence in ADL.
The aim of this study is to systematically evaluate the effects of quality nursing on wound infections and postoperative complications in patients undergoing cardiothoracic surgery. Computerised searches of the PubMed, Web of Science, Cochrane Library, Embase, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang databases were conducted from database inception to October 2023 for randomised controlled trials (RCTs) on the application of quality nursing to patients undergoing cardiothoracic surgery. The studies were screened and evaluated by two researchers based on the inclusion and exclusion criteria, and data were extracted from the included studies. Stata software (version 17.0) was used for all analyses performed. A total of 18 RCTs and 1742 patients were included, including 972 in the quality nursing group and 870 in the routine nursing group. The analysis revealed that compared with routine nursing, patients undergoing cardiothoracic surgery who received quality nursing care were significantly less likely to experience postoperative wound infections (OR = 0.31, 95% CI: 0.19–0.51, p < 0.001) and complications (OR = 0.24. 95% CI: 0.17–0.33, p < 0.001). The implementation of quality nursing in clinical care after cardiothoracic surgery can effectively reduce the incidence of wound infections and postoperative complications, and is worthy of promotion and clinical application.
The COVID-19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long-term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood.
Describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities.
A scoping review.
A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings.
A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: “The roles of health and care workers evolve with the times”, “The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities” and “The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels”. Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes.
The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers.
Infection prevention efforts within long-term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement.
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