Introduction Nearly four million LGBTQ+ adults aged 50 and older live in the U.S., with up to 40,000 currently living with Parkinson's disease (PD). However, little is known about PD-related symptoms in this population.Methods From 2022 to 2025, we conducted a national cross-sectional study using a convenience sample of LGBTQ+ and non-LGBTQ+ individuals living with PD (n = 254). We administered validated PD and health-related measures to examine physical, mental and social health symptoms. Bivariate and regression models examined differences in symptom burden between LGBTQ+ and non-LGBTQ+ participants, as well as associations with sociodemographic characteristics and social determinants of health.Results The sample included 89 LGBTQ+ and 165 non-LGBTQ+ individuals living with PD. On average, LGBTQ+ participants were 5.3 years younger than their non-LGBTQ+ counterparts (mean age: 62.9 vs. 68.3). Compared with non-LGBTQ+ participants, LGBTQ+ individuals living with PD were more likely to report anxiety (53.9% vs. 33.3%, p = 0.002), moderate-to-severe motor impairments (32.2% vs. 19.4% p = 0.024), and loneliness (18.8% vs. 8.5%, p = 0.037). Regarding social determinants of health, younger age, identifying as a person of color, and experiencing healthcare discrimination were associated with higher odds of reporting moderate-to-severe PD-related symptoms.Discussion This study highlights potential disparities in PD-related symptoms, with LGBTQ+ individuals, persons of color, and those experiencing healthcare discrimination being more likely to report physical, mental and social health challenges. There is a need for further research on the health needs of diverse populations living with PD, including LGBTQ+ adults, as well as the development of tailored and inclusive healthcare strategies.
Objective This study used a mixed-methods approach (qualitative and quantitative) to develop the Health Qigong Embodied Experience Scale, code its dimensions, and examine associations between Health Qigong embodied experience and meaning in life among older adults, with particular attention to the mediating roles of psychological capital (optimism, resilience, hope, and self-efficacy). Methods This study first employed thematic analysis to code themes of Health Qigong embodied experience, from which two dimensions were extracted: bodily regulation experience and psychological regulation experience. Next, convenience sampling was used to survey 500 older adults across six communities in Guangzhou. Data were collected using the Health Qigong Bodily Regulation Experience Scale, the Health Qigong Psychological Regulation Experience Scale, the Psychological Capital Scale, and the Meaning in Life Scale. SPSS 27.0 and AMOS 26.0 were used to assess scale reliability and validity and to conduct confirmatory factor analysis (CFA). We then conducted common method bias testing, descriptive statistics, and correlation analyses. Finally, Model 4 of the PROCESS 4.0 macro was applied to examine the mediating roles and the total association hypotheses. Results The results indicated that Health Qigong bodily regulation experience and psychological regulation experience were each associated with older adults' meaning in life (beta = 0.532, p < 0.01; beta = 0.593, p < 0.01). Optimism partially mediated the relationships between bodily regulation experience (beta = 0.048, Bootstrap 95% CI [0.012, 0.086]) and psychological regulation experience (beta = 0.045, Bootstrap 95% CI [0.009, 0.082]) with meaning in life. Resilience partially mediated the relationships between bodily regulation experience (beta = 0.211, Bootstrap 95% CI [0.138, 0.282]) and psychological regulation experience (beta = 0.205, Bootstrap 95% CI [0.139, 0.269]) with meaning in life. Hope partially mediated each of the relationships between bodily regulation experience (beta = 0.076, Bootstrap 95% CI [0.028, 0.130]) and psychological regulation experience (beta = 0.066, Bootstrap 95% CI [0.018, 0.115]) and meaning in life. Notably, self-efficacy did not play a mediating role (beta = 0.025, Bootstrap 95% CI [-0.046, 0.091]; beta = 0.028, Bootstrap 95% CI [-0.024, 0.076]). Conclusion In the qualitative component, this study developed a new scale. In the quantitative component, conservation of resources (COR) theory was applied at the macro level to frame the structural relationships among the mediation pathways, whereas embodied cognition theory was used at the micro level to explain the mechanisms linking Health Qigong embodied experience to older adults' meaning in life, alongside psychological capital playing a mediating role. Among these, optimism, hope, and resilience each played a partially mediating role in these relationships, whereas self-efficacy did not. This indicates that, through Health Qigong embodied experience, older adults' meaning in life is nurtured by process-oriented and acceptance-based psychological resources rather than by outcome-oriented self-efficacy.
Background Traditional methods have limited reach and sustainability and often fail to increase the actual uptake of epidural analgesia. This study explored the impact of health education grounded in the Transtheoretical Model (TTM) on primiparous women's knowledge, attitudes, and practices (KAP) regarding painless delivery, as well as associated delivery outcomes. Materials and methods This quasi-experimental study was conducted at Wuhan Children's Hospital from December 2024 to April 2025. Eligible primiparous women planning vaginal delivery were assigned to the TTM-based intervention group or the routine education group according to enrollment sequence. All participants received epidural analgesia during labor. Baseline and post-intervention assessments measured KAP using a self-developed questionnaire, and childbirth experience using the Chinese version of the Childbirth Experience Questionnaire (CEQ-C). Results A total of 148 women were enrolled (TTM group: n = 77; routine education group: n = 71). All participants received epidural analgesia during labor as part of routine clinical practice. Post-intervention, the TTM group showed greater improvements in KAP scores (all p < 0.001) compared with the routine education group. At follow-up, KAP scores remained higher in the TTM group (all p < 0.001). CEQ-C scores did not differ significantly between groups (2.74 vs. 2.63, p = 0.062). Multivariable linear regression analysis indicated occupational role (beta = -0.113, p = 0.014) and delivery satisfaction (p < 0.001) as independent predictors of CEQ-C scores. Conclusion TTM-based individualized education significantly improves KAP levels in primiparous women. These findings suggest that implementing TTM interventions in clinical practice can optimize perinatal education.
BackgroundDementia is one of the most urgent public health challenges globally. Early screening is indispensable for timely identification and intervention. However, early dementia screening among community-dwelling older adults remains low, and the mechanisms underlying screening barriers remain insufficiently understood.MethodsA qualitative study involving semi-structured interviews was conducted with 23 older adults who were purposively recruited from three communities in Wuhan, China. Interviews were transcribed verbatim and analyzed using thematic analysis that combined deductive coding guided by the social determinants of health framework with inductive coding to capture themes emerging from the data.ResultsFive themes and 12 subthemes were identified: (1) economic stability, comprising economic burden concerns and the lack of material incentives; (2) education access and quality, comprising limited disease-related knowledge, the double effect of educational level, and fixed beliefs about dementia risk; (3) social and community context, comprising perceived stigma, result-related anxiety and family concerns, and late-life values; (4) health care access and quality, comprising insufficient medical trust and service assurance, limited information accessibility, and symptom-oriented healthcare-seeking behavior; and (5) neighborhood and built environment, comprising limitations in convenience and accessibility.ConclusionLow uptake of early dementia screening among community-dwelling older adults in China reflects a system-level behavioral dilemma shaped by social determinants of health. Future screening programs should build integrated, community-embedded pathways that make screening affordable, understandable, trustworthy, connected, and convenient, thereby strengthening the acceptability, equity, and sustainability of dementia prevention and early detection.
BackgroundOlder adults with hypertension commonly experience poor sleep quality and reduced health-related quality of life (HRQoL). Previous studies have mainly examined these associations using total scores, providing limited insight into interactions between specific symptom dimensions. This study aimed to construct a component- and dimension-level network linking sleep quality and HRQoL and to compare network differences across depressive-symptom status.MethodsThis study included 2,257 older adults. Sleep quality, HRQoL, and depressive symptoms were assessed using the B-PSQI, EQ-5D-5L, and PHQ-9, respectively. We estimated a component- and dimension-level network based on the EBICGlasso-regularized Gaussian graph model, calculated centrality and bridge centrality metrics, validated stability using the bootstrap method, and compared network differences between the depressive and non-depressive-symptom groups.ResultsThe final network included 10 nodes and 32 non-zero edges among 45 possible edges, with a density of 0.711. The strongest associations were between sleep efficiency and sleep duration (SE–ST, 0.793), sleep interruption and subjective sleep quality (SW–SQ, 0.583), and self-care and usual activities (SC–UA, 0.560). Usual activities (UA) showed the highest strength centrality and expected influence, followed by subjective sleep quality (SQ), self-care (SC), and sleep efficiency (SE). Sleep efficiency had the highest bridge expected influence, followed by subjective sleep quality. Centrality indices demonstrated good stability (CS = 0.75). No significant differences were found in network structure (M = 0.224, P > 0.05) or global strength (S = 0.119, P > 0.05); repeated 1:1 subsampling broadly supported these findings.ConclusionSleep components and HRQoL dimensions formed a closely connected network in older adults with hypertension. Usual activities showed the highest centrality, while sleep efficiency and subjective sleep quality showed prominent cross-community. These domains may be useful for screening or hypothesis generation but should not be interpreted as confirmed intervention targets.
