Aim: To comprehensively assess the quality of current breastfeeding measurement instruments and to recommend instruments. Background: The field of breastfeeding assessment is characterized by a diverse array of measurement tools, yet their application is complicated by heterogeneity in psychometric quality and inconsistent findings. Previous systematic reviews employing the COSMIN (CONsensus-based Standards for the selection of health Measurement INstruments) framework have been limited in scope, highlighting the need for a contemporary and comprehensive evaluation to guide instrument selection. Methods: Following COSMIN guidelines, we systematically searched 10 Chinese and English databases from inception to September 30, 2024. Two reviewers independently conducted study screening, data extraction, and methodological quality assessment. Evidence was synthesized and recommendations were formulated based on predefined criteria. Results: Analysis of 54 studies evaluating 24 instruments revealed substantial evidence gaps in key measurement properties. Reliability data were missing for 52% of instruments, while cross-cultural validity/measurement invariance, criterion validity, and responsiveness were assessed in fewer than 30% of cases. No instrument had established values for minimal important change or smallest detectable change. Seven instruments measuring self-efficacy, support needs, and breastfeeding behavior prediction received Grade A recommendations. Discussion: The review offers a validated evidence base to guide instrument selection. Future research should prioritize closing the identified evidence gaps, particularly establishing reliability and clinically meaningful change parameters for all recommended tools. Conclusions: This review provides an evidence base for instrument selection while identifying critical gaps in measurement property evidence, particularly in reliability and clinically interpretable parameters, directing future validation research priorities.

Background:Dietary behaviour among kidney transplant recipients (KTRs) is a critical factor influencing long-term postoperative outcomes. However, research focusing on the dietary behaviour of KTRs remains limited. The aim of this study was to examine the dietary behaviour and explore the influencing factors of dietary behaviour in KTRs based on a health promotion model. Methods:This was a cross-sectional study. A total of 289 KTRs from four hospitals were recruited from October 2022 to March 2023 by convenience sampling method. Participants completed a survey consisting of a general information questionnaire, the Dietary Self-management Ability Scale, the Perceived Dietary Behaviour Benefit and Barrier Questionnaire, the Self-Rating Depression Scale, and the Adapted Health Eating Cognitive Beliefs Questionnaire. The survey was administered both online and on-site. Data were analysed with Spearman's correlation analysis and path analysis. Results:Dietary behaviour was at moderate level, with an index score of 78%. Depression (β = -0.207, p < 0.001), perceived behaviour benefits (β = 0.220, p < 0.001), perceived behaviour barriers (β = -0.234, p < 0.001), attitude (β = 0.135, p = 0.026), and social support (β = 0.166, p = 0.001) directly predicted dietary behaviour, while depression, attitude, and social support exhibited indirect effect on dietary behaviour. Conclusion:Medical staff could help KTRs change their poor dietary attitude and negative mode, guide them to receive more social support and perceived benefits, reduce their perceived barriers. These positive shifts could ultimately facilitate the emergence of healthy dietary behaviour and enhancement of quality of life.

To evaluate the effects of social network-based health education on self-management, self-efficacy and HbA1c of older adults with type 2 diabetes mellitus (T2DM). A convenience sample of 64 elderly T2DM patients with poor glycemic control was randomly divided into two groups. The intervention group received social network-based health education with their nominated social network member for 12 weeks, while the control group received health education alone. The scores of Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Self-Efficacy Scale (DSES), and HbA1c were compared between groups at the baseline and after 12 weeks by using RM-ANOVA. Sixty older adults with T2DM, 30 cases in each group, completed the study. The diet and blood glucose testing dimensions of C-SDSCA had an interaction effect on group-by-time (F were 4.700 and 4.752, respectively, p < 0.05). The mean diet dimension score increased by 1.55 in the intervention group, while 0.76 in the control group, and the score of blood glucose testing dimension increased by 3.5 in the intervention group, while 0.75 in the control group. No significant group-by-time differences were found in C-DSES (F = 1.667, p > 0.05) and HbA1c (F = 0.553, p > 0.05). Social network-based health education effectively promotes self-management in diet and blood glucose testing of the elderly T2DM patients with poor glycemic control. Trial Registration: China Clinical Trial Registration Center (ChiCTR2000038177).

BACKGROUND:Self-management among kidney transplant recipients (KTRs) is crucial for preventing postoperative complications and improving health outcomes. However, challenges such as a lack of physical activity and the frequent consumption of high-calorie foods persist. Therefore, targeted interventions for enhancing post-transplant self-management behaviors are essential. Currently, scientific evidence on effective strategies to improve self-management among KTRs is lacking. Enhancing social support and promoting self-efficacy may be significant approaches. DESIGN AND METHODS:This study employs a meta-analytic structural equation modeling (MASEM) approach to examine the mediating role of self-efficacy in the relationship between social support and self-management behaviors in KTRs. A comprehensive search was conducted across multiple databases, including PubMed, Embase, APA PsycInfo, Cochrane Library, CINAHL, Web of Science, ERIC, Springer, CNKI, VIP, and Wanfang, from the inception of each database until August 9, 2024. Statistical analyses were performed using Comprehensive Meta-Analysis software, Mplus for Mac, and R Studio for Mac. RESULTS:A total of 1990 titles and abstracts were screened in this study, resulting in the inclusion of 19 studies. The MASEM was constructed using a two-stage structural equation modeling approach. The analysis revealed that self-efficacy partially mediated the relationship between social support and self-management behaviors (direct effect: 0.140; indirect effect: 0.299; 95 % CI: 0.268, 0.331). CONCLUSIONS:This study highlights the importance of clinical interventions aimed at enhancing social support and self-efficacy to improve self-management behaviors in KTRs. REGISTRATION:https://doi.org/10.17605/OSF.IO/MXBZY(https://osf.io/).

[This corrects the article DOI: 10.3389/fpubh.2025.1562186.].

AIMS:To develop the core outcome set and identify unique outcomes for the three stages and five types of nursing interventions, respectively, in lactational mastitis. DESIGN:A mixed methods study. METHODS:A systematic literature search, four semi-structured interviews for key stakeholders, two rounds of Delphi surveys and two online consensus meetings were conducted. RESULTS:Thirty-one nursing outcomes were derived from the systematic review (literature research from January 2019 to December 2021) and semi-structured interviews in 2022. Six A-category nursing outcomes and 19 B-category nursing outcomes were determined after Dephi survey and provided in consensus meeting in 2023. The consensus meetings resulted in the agreement on seven core outcomes: Pain Level, Breast Establishment: infant, Breast Establishment: maternal, Breast Maintenance, Client satisfaction: care, Sleep, and Family Support during Treatment. Specifically, the unique outcomes for the three stages were identified as Breastfeeding Maintenance, Infection Severity and Wound Healing: Primary Intention, respectively. The unique outcomes for the five interventions included Pain level, Infection Severity, Wound Healing: Primary Intention, Comfort and Knowledge: breastfeeding, respectively. CONCLUSION:Based on an evidence-based, consensus-driven approach, the core outcome set incorporates the perspectives of key stakeholders. It is recommended that all core outcomes be reported in both lactational mastitis nursing research and clinical quality control and audit. Unique outcomes should be reported based on the stages of lactational mastitis and types of interventions. IMPACT:The core outcome set and unique outcomes developed by our study could provide nursing researchers and clinical practitioners with sensitive outcomes for lactational mastitis, while also promoting standardisation. Utilising these outcomes could enhance comparability among studies, reduce reporting bias and promote standardised evaluation of practice effectiveness. REPORTING METHOD:Findings are reported per Core Outcome Set-STAndards for Reporting: COS-STAR Statement. PATIENT OR PUBLIC CONTRIBUTION:None. TRIAL REGISTRATION:https://www.comet-initiative.org/Studies/Details/1650.

BackgroundDue to aging, the use of antidiabetic drugs, and dietary restrictions following a diagnosis of type 2 diabetes mellitus (T2DM), the social interactions of older adults with T2DM are often limited. As a result, this population experiences a higher incidence of social isolation than the general older adult population. This study aims to analyze the prevalence and influencing factors of social isolation among older adults with T2DM using a structural equation model.Patients and methodsA cross-sectional study was conducted between January and November 2023. A total of 496 older adults with T2DM were recruited from hospitals or community health service centers in Beijing to investigate their social isolation status and related factors. The Lubben Social Network Scale-6, along with related scales, was used for data collection. The effects of different factors on social isolation were determined using a path analysis.ResultsAmong 496 older adults with T2DM, 227 reported social isolation, resulting in a prevalence rate of 45.77%. Activity of daily living, cognitive function, loneliness, exercise management, smoking, social support, and social participation are all directly related to social isolation. Additionally, six factors—activity of daily living, loneliness, depression, diet management, blood glucose monitoring, and social support—were related to social isolation through social participation.ConclusionThe incidence of social isolation among older adults with T2DM is high. For them, activities of daily living, loneliness, and social support are significant factors in their social isolation since they are directly or indirectly related to social isolation. Meanwhile, diabetes self-management, such as diet management, exercise management, blood glucose management, and smoking, is directly or indirectly related to social isolation. For older adults with T2DM, the important intermediary role of social participation between the factors and social isolation should be given due attention.

Introduction Frailty is one of the most common comorbidities in kidney transplant recipients (KTRs). Physical, psychological and social frailty could be improved by exercise intervention. Baduanjin, also known as Eight-section Brocades, is a type of traditional Chinese medicine exercise characterised by the interplay between physical postures and movements, breathing and mind. It can help frail patients strengthen their upper and lower body muscles, improve their mood, quality of life and frailty. However, the effectiveness of Baduanjin on frail KTRs remains unknown. Therefore, we will conduct a randomised controlled trial (RCT) to evaluate the effectiveness of Baduanjin on frail KTRs.Methods and analysis This protocol describes an assessor and analyst blinded, parallel RCT for frail KTRs comparing Baduanjin group (n=72) with care-as-usual group (n=72). The primary outcomes are frailty assessed by Frailty Phenotype scale and Tilburg Frailty Indicator scale, and muscle strength assessed by a grip strength metre. The secondary outcomes are quality of life assessed by Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) and depression assessed by the Hospital Anxiety and Depression Scale. All these data will be collected at the baseline, after 3, 6, 9 and 12 months, respectively. Two-way mixed analysis of variance (ANOVA) will be used to test the effectiveness of Baduanjin exercise. Qualitative interviews with participants in the intervention group will also be performed after 6 months. Themes will be extracted from interview transcripts using NVivo software.Ethics and dissemination The Ethics Committees of Beijing University of Chinese Medicine (2022BZYLL1018) and China-Japan Friendship Hospital (2022-KY-250) had approved the study. The organ donors were all from China-Japan Friendship Hospital. They provided informed consent and they were not executed prisoners. We have provided BMJ Open with documentation from the hospital that indicates that the organs will be harvested ethically. The findings of this study will be disseminated through peer-reviewed journals, international conferences, media reports and briefings.Trial registration number ChiCTR2100041730

BackgroundHypoglycemic episodes cause varying degrees of damage in the functional system of elderly inpatients with type 2 diabetes mellitus (T2DM). The purpose of the study is to construct a nomogram prediction model for the risk of hypoglycemia in elderly inpatients with T2DM and to evaluate the predictive performance of the model.MethodsFrom August 2022 to April 2023, 546 elderly inpatients with T2DM were recruited in seven tertiary-level general hospitals in Beijing and Inner Mongolia province, China. Medical history and clinical data of the inpatients were collected with a self-designed questionnaire, with follow up on the occurrence of hypoglycemia within one week. Factors related to the occurrence of hypoglycemia were screened using regularized logistic analysis(r-LR), and a nomogram prediction visual model of hypoglycemia was constructed. AUROC, Hosmer-Lemeshow, and DCA were used to analyze the prediction performance of the model.ResultsThe incidence of hypoglycemia of elderly inpatients with T2DM was 41.21% (225/546). The risk prediction model included 8 predictors as follows(named ADOCHBIU): duration of diabetes (OR=2.276, 95%CI 2.097˜2.469), urinary microalbumin(OR=0.864, 95%CI 0.798˜0.935), oral hypoglycemic agents (OR=1.345, 95%CI 1.243˜1.452), cognitive impairment (OR=1.226, 95%CI 1.178˜1.276), insulin usage (OR=1.002, 95%CI 0.948˜1.060), hypertension (OR=1.113, 95%CI 1.103˜1.124), blood glucose monitoring (OR=1.909, 95%CI 1.791˜2.036), and abdominal circumference (OR=2.998, 95%CI 2.972˜3.024). The AUROC of the prediction model was 0.871, with sensitivity of 0.889 and specificity of 0.737, which indicated that the nomogram model has good discrimination. The Hosmer-Lemeshow was χ2 = 2.147 (P=0.75), which meant that the prediction model is well calibrated. DCA curve is consistently higher than all the positive line and all the negative line, which indicated that the nomogram prediction model has good clinical utility.ConclusionsThe nomogram hypoglycemia prediction model constructed in this study had good prediction effect. It is used for early detection of high-risk individuals with hypoglycemia in elderly inpatients with T2DM, so as to take targeted measures to prevent hypoglycemia.Trial registrationChiCTR2200062277. Registered on 31 July 2022.

Objective To identify the defining attributes, antecedents, consequences and empirical referents to form an operational definition of social isolation in people with type 2 diabetes. Design The Walker and Avant approach. Data source An electronic search of the literature using China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Web of Science, CINAHL, and PsycINFO informed the analysis. The search included both quantitative and qualitative studies related to social isolation in people with type 2 diabetes published in Chinese and English. Results Of the 2918 articles identified, 21 ultimately met the inclusion criteria. The analysis identified the defining attributes of social isolation in people with type 2 diabetes as objective and subjective. Antecedents included five aspects: personal characteristics, disease-related physiological factors, and psychological, behavioral, and social factors. Consequences were identified as physiological, psychological, behavioral aspects and quality of life. Conclusions The operational definition of social isolation in people with type 2 diabetes is that due to personal characteristics, disease-related physiological factors, and psychological, behavioral, and social factors, people with type 2 diabetes will have limited social networks and social support, reduced social contact and social involvement, and/or negative feelings of disconnection from the outside world, which lead to adverse physiological, psychological, and behavioral outcomes and poor quality of life. Clinicians can further develop tools to measure social isolation in people with type 2 diabetes and analyze the path of the antecedents to social isolation to investigate the interplay between them in order to develop target interventions.

To investigate the status quo and influencing factors of overall frailty and its 3 domains among rural community-dwelling older adults. This is a cross-sectional study. A convenience sample of 195 older adults from 6 villages in Bashang Area of Zhangjiakou City, Hebei Province, China, were recruited from August to September, 2022. The demographic characteristics, the Chinese version of Tilburg Frailty Indicator, Charlson Comorbidity Scale and Hospital Anxiety and Depression Scale were used to investigate frailty and its influencing factors. Univariate analysis and multiple linear regression analysis were employed. The prevalence of overall frailty among the older adults in Bashang Area was 85.13%. Multiple linear regression analysis showed that age, gender, marital status, regular exercise, comorbidity, and anxiety were the influencing factors of overall frailty. While anxiety was the only shared influencing factor for physical frailty, psychological frailty, and social frailty, age, gender, marital status, financial burden, the comorbidity, and regular exercise were factors which influenced 1 or 2 domains of frailty. The prevalence of overall frailty among the older adults in rural areas, Zhangjiakou City is high. It is influenced by many factors. Medical staff and policy makers should work hand in hand to improve frailty among rural community-dwelling older adults in China.

AIM:To identify the latent profiles and predictors of family management styles for children with asthma. DESIGN:This is a secondary data analysis. The demographic data of 506 primary caregivers of children with asthma and their scores of the Family Management Scale in a cross-sectional study were used. Latent profile analysis and multiple logistic regression analyses were employed. RESULTS:Three family management styles were identified: Thriving (Profile 1), Accommodating (Profile 2), and Enduring (Profile 3) Family Management Style. The child's age, gender, mother's education level, family structure, influence of illness on parents' work and family life, whether they had follow-up plans and whether their parents had read disease and health knowledge pamphlets were found to be the predictors of different styles. CONCLUSION:Three distinct family management styles exist for children with asthma. Future interventions designed to enhance family management for children with asthma should be based on their demographic characteristics and family management styles. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE:The precise classification of family management styles in this study can serve as a guide to form multi-disciplinary teams of physicians and nurses to provide individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future. IMPACT:This paper aims to identify the latent profiles and predictors of family management styles of children with asthma. Thriving, accommodating, and enduring family management styles were identified in this paper. Child's characteristics, family and organizational factors were the predictors of different family management styles. Findings of this paper provide guidance for physicians and nurses to offer individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future. REPORTING METHOD:The article was reported according to the STROBE Checklist. PATIENT OR PUBLIC CONTRIBUTION:No Patient or Public Contribution.

IntroductionDue to the sexual orientation and HIV diagnosis, young and middle-aged men who have sex with men (MSM) with new HIV-diagnosis may experience more depressive syndromes and face greater psychological stress. The study explored trajectories of depressive symptoms of young and middle-aged MSM within 1 year after new HIV-diagnosis and analyze the related factors.MethodsFrom January 2021 to March 2021, 372 young and middle-aged MSM who were newly diagnosed as HIV-infection were recruited in two hospitals in Beijing. Self-rating Depression Scale was used to measure the participants’ depressive symptom in 1st month, 3rd month, 6th month, 9th month and 12th month after HIV diagnosis. The latent class growth model was used to identify trajectories of the participants’ depressive symptoms. Multinomial logistic regression was used to analyse factors related with the trajectories.ResultsThree hundred and twenty-eight young and middle-aged MSM with new HIV-diagnosis completed the research. Depressive symptom in 328 young and middle-aged MSM was divided into three latent categories: non-depression group (56.4%), chronic-mild depression group (28.1%), and persistent moderate–severe depression group (15.5%). The participants assessed as non-depression (non-depression group) or mild depression (chronic-mild depression group) at the baseline were in a non-depression state or had a downward trend within one-year, and the participants assessed as moderate and severe depression (persistent moderate–severe depression group) at the time of diagnosis were in a depression state continuously within 1-year. Multinomial logistic regression analysis showed that, compared with the non-depression group, monthly income of 5,000 ~ 10,000 RMB (equal to 690 ~ 1,380 USD) was the risk factor for the chronic-mild depression group, and self-rating status being fair/good and self-disclosure of HIV infection were protective factors for the persistent moderate–severe depression group while HIV-related symptoms was the risk factor.ConclusionDepressive symptoms in young and middle-aged MSM is divided into three latent categories. Extra care must be given to young and middle-aged MSM assessed as moderate or severe depression at the time of HIV-diagnosis, especially to those who had poor self-rating health status, did not tell others about their HIV-infection and experienced HIV-related symptoms.

目的 基于交流促发展模型构建2型糖尿病患者运动管理信息化平台,以实施个体化运动处方并进行运动监管.方法 通过查阅文献,结合前期对糖尿病患者运动管理信息化平台使用需求的质性研究结果,形成初步拟定的2型糖尿病运动管理信息化平台整体架构;运用德尔菲法对20名临床医学、临床护理、护理教育和护理管理领域专家进行函询,确定此架构应用层的模块及具体内容,即2型糖尿病运动管理信息化平台各模块及条目.结果 初步拟定2型糖尿病运动管理信息化平台整体架构包括表现层、框架层、应用层、数据层;两轮函询问卷有效回收率分别为90.91％和100％,专家权威系数为0.86和0.87,第1轮重要性评分4.4～5.0分,重要性变异系数为0～0.29,第2轮重要性评分3.9～5.0分,重要性变异系数为0～0.23,Kendall's W值为0.016和0.175(P＜0.01);确定2型糖尿病运动管理信息化平台由医护中心模块和患者中心模块组成,医护中心模块下设5个维度共18条目,患者中心模块下设3个维度共16条目.结论 本研究构建的基于交流促发展模型的2型糖尿病患者运动管理信息化平台的方案科学可行,可为延续性护理中实施2型糖尿病患者运动管理提供客观、可量化的工具.

Background Providing self-management support to kidney transplant recipients is essential. However, a scale to identify the self-management support they have received is lacking. The purpose of this study is to develop a Self-management Support Scale for Kidney Transplant Recipients (SMSSKTR) and test its psychometric properties. Methods This is an instrument development and validation study, which has a three-stage cross-sectional design. In Stage 1, a preliminary item pool was formed using a literature review, semi-structured interviews, and the Delphi method. In Stage 2, six experts were invited to assess content validity. A convenience sample of 313 participants was used to explore the factor structure by using exploratory factor analysis. The test-retest reliability was assessed using the intra-class correlation coefficient (ICC). In Stage 3, two hundred and sixty-five participants were recruited to validate the factor structure by using confirmatory factor analysis. Convergent validity was examined using Spearman’s correlation coefficient. Cronbach’s alpha coefficient and corrected item-total correlation coefficient were used to test the reliability of the entire scale and its dimensions. The study was reported according to the STARD and GRRAS checklists. Results An initial 40-item scale was developed in Stage 1. In Stage 2, three factors with 22 items emerged from the exploratory factor analysis: instrumental support, psychosocial support, and relational support. The content validity index of the scale was 0.97. The intra-class correlation coefficient for the entire scale and the subscales were 0.915, 0.771, 0.896, and 0.832, respectively. In Stage 3, the confirmatory factor analysis indicated that the three-factor model had a good fit. The score of the scale was positively associated with that of the Self-Management Scale of Renal Transplant Recipients ( r = 0.532). Cronbach’s alpha was 0.959 for the entire scale and 0.956–0.958 for the three subscales. The corrected item-total correlation coefficient ranged from 0.62 to 0.82. Conclusion The 22-item SMSSKTR has sufficient psychometric properties to assess the self-management support they have received, which has not been measured before.

Background Hypoglycemia is one of the most common complications in patients with DN during hemodialysis. The purpose of the study is to construct a clinical automatic calculation to predict risk of hypoglycemia during hemodialysis for patients with diabetic nephropathy. Methods In this cross-sectional study, patients provided information for the questionnaire and received blood glucose tests during hemodialysis. The data were analyzed with logistic regression and then an automated calculator for risk prediction was constructed based on the results. From May to November 2022, 207 hemodialysis patients with diabetes nephropathy were recruited. Patients were recruited at blood purifying facilities at two hospitals in Beijing and Inner Mongolia province, China. Hypoglycemia is defined according to the standards of medical care in diabetes issued by ADA (2021). The blood glucose meter was used uniformly for blood glucose tests 15 minutes before the end of hemodialysis or when the patient did not feel well during hemodialysis. Results The incidence of hypoglycemia during hemodialysis was 50.2% (104/207). The risk prediction model included 6 predictors, and was constructed as follows: Logit ( P ) = 1.505×hemodialysis duration 8~15 years ( OR = 4.506, 3 points) + 1.616×hemodialysis duration 16~21 years ( OR = 5.032, 3 points) + 1.504×having hypotension during last hemodialysis ( OR = 4.501, 3 points) + 0.788×having hyperglycemia during the latest hemodialysis night ( OR = 2.199, 2 points) + 0.91×disturbance of potassium metabolism ( OR = 2.484, 2 points) + 2.636×serum albumin<35 g/L ( OR = 13.963, 5 points)-4.314. The AUC of the prediction model was 0.866, with Matthews correlation coefficient (MCC) of 0.633, and Hosmer-Lemeshow χ 2 of 4.447( P = 0.815). The automatic calculation has a total of 18 points and four risk levels. Conclusions The incidence of hypoglycemia during hemodialysis is high in patients with DN. The risk prediction model in this study had a good prediction outcome. The hypoglycemia prediction automatic calculation that was developed using this model can be used to predict the risk of hypoglycemia in DN patients during hemodialysis and also help identify those with a high risk of hypoglycemia during hemodialysis.

BACKGROUND Frailty has become a worldwide public health concern, and the elderly are at high risk of frailty. However, research regarding frailty to date tend to focus on the elderly in cities, communities, or nursing homes rather than in rural areas. OBJECTIVE To investigate the status quo and influencing factors of overall frailty and its dimensions among the elderly in rural areas, so as to provide reference for the development of target interventions. Moreover, the number of rural elderly in China is huge and they differ more from those living in urban areas. METHODS A convenience sample of 195 elderly from six natural villages in Bashang Area of Zhangjiakou City, Hebei Province, China, were recruited from August to September, 2022. The demographic information, the Chinese version of Tilburg Frailty Assessment Scale, Charlson Comorbidity Index (CCI) and the Hospital Anxiety and Depression Scale were used to investigate frailty and its influencing factors of the elderly. Univariate analysis and multiple linear regression analysis were employed. RESULTS The incidence of overall frailty among elderly in Bashang Area was 85.13%. Multiple linear regression analysis showed that anxiety, age, gender, marital status, regular exercise and CCI score were the influencing factors of overall frailty. Anxiety was significantly associated with physical frailty, psychological frailty, and social frailty. Age, gender, marital status, financial burden, CCI score, and regular exercise were associated with one or two dimensions of frailty among the elderly in rural areas. CONCLUSIONS The incidence of frailty among the elderly in rural areas, Zhangjiakou City is high. The frailty is influenced by many factors. Medical staff should pay more attention to the frailty of the elderly in rural areas and take multidisciplinary interventions. CLINICALTRIAL N/A

This paper expounds the origin and development of systems engineering initiative for patient safety (SEIPS) model, summarizes the research progress on application of this model in the nursing field at home and abroad in recent years and proposes relevant suggestions for the future research and application of this model in the nursing field, with a view to providing a reference for the application of systems engineering initiative for patient safety model in China.

To explore the status quo of self‐management among young adults with type 2 diabetes mellitus (T2DM) and the determinants of self‐management under the guidance of social cognitive theory.