OBJECTIVE:The study aimed to examine the impact of a mobile application-based self-management and chronic disease platform in transitional care for older adults with diabetes. METHODS:A prospective non-randomised concurrent controlled clinical trial was adopted from May to November 2023. Participants were allocated based on their scheduled appointment times, received routine outpatient care or 12-week transitional care information and support intervention including chronic disease management platform and Slow Health. Changes in anxiety, depression, diabetes self-management, self-efficacy and the perceived social support scores of the two groups after 1-month and 3-month intervention were compared. RESULTS:A total of 124 participants were enrolled. The experimental group demonstrated a more pronounced decrease in anxiety, exhibited lower levels of diastolic blood pressure (DBP), showed significantly lower levels of depression, higher levels of diabetes self-management and self-efficacy, and comparable levels of perceived social support compared to the control group. CONCLUSIONS:The program has the potential to improve transitional care in older adults with diabetes, warranting further promotion.

ObjectiveTo develop the diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus,and to test its reliability and validity,in order to provide an effective tool for assessing the perception of retinopathy risk.MethodsBased on the protection motivation theory as the theoretical framework,a questionnaire was developed through literature analysis,expert consultation,and pre⁃survey.Using cluster random sampling method,a total of 402 diabetic patients from 3 community health centers were selected for the investigation to test the reliability and validity of the questionnaire.ResultsThe response rates of the two rounds of expert questionnaire inquiries were 90.48% and 100.00%.The expert authority coefficient was 0.93.The total Cronbach's α coefficient of the questionnaire was 0.865.The Cronbach's α coefficients of all dimensions were 0.844,0.892,0.828,0.831,0.845,0.901,and 0.823. The scale⁃level content validity index(S⁃CVI) was 0.968.The item⁃level content validity index(I⁃CVI) ranged from 0.86 to 1.00.Exploratory factor analysis extracted 7 common factors.The cumulative variance contribution rate was 68.589%.Confirmatory factor analysis showed that the model fit was good overall.The diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus was compiled,including 7 dimensions of severity,susceptibility,internal reward,external reward,self⁃efficacy,response efficacy and response cost,with a total of 30 items.ConclusionsThe diabetic retinopathy risk perception questionnaire for patients with diabetes mellitus has good reliability and validity.It could be used to evaluate the level of risk perception of diabetic retinopathy in patients.

BACKGROUND:Nasogastric tube (NGT) insertion is frequently required in patients with stroke and impaired consciousness; however, the procedure is often complicated by swallowing dysfunction. This study assessed the effectiveness of the 1-mL water-swallowing induction method for facilitating NGT placement in this population. METHODS:A total of 102 patients with stroke and impaired consciousness were recruited from Nantong University Affiliated Hospital between 2022 and 2024 and randomly assigned to a control group (traditional neck-flexion technique) or an observation group (1-mL water-swallowing induction method). Primary outcomes included the success rate of NGT insertion, mean duration of the first insertion attempt, and adverse events such as mucosal bleeding, severe coughing, and facial or lip cyanosis. Secondary outcomes included changes in heart rate and oxygen saturation during tube placement. RESULTS:Each group comprised 28 patients in a drowsy state and 23 in a stuporous state (n=51 per group). The observation group achieved a significantly higher success rate of NGT insertion compared with the control group ( P <0.05). Although the mean time required for a successful first insertion attempt was longer in the observation group ( P <0.05), the incidences of mucosal bleeding and severe coughing were significantly lower ( P <0.05). Furthermore, changes in heart rate and oxygen saturation were less pronounced in the observation group than in the control group ( P <0.05). CONCLUSION:The 1-mL water-swallowing induction method improved the success rate of NGT placement in patients with stroke having an impaired consciousness and reduced procedure-related adverse events.

Objective:This study aims to assess the current utilization status of transitional care service among older adults with chronic diseases and identify factors influencing their use. Methods:Utilizing Andersen's Behavioral Model, a cross-sectional survey was conducted in a specific region from October 2023 to December 2023 using convenience sampling. The survey aimed to analyze the impact of predisposing factors, enabling factors, and need factors on the utilization of transitional care services by older adults with chronic diseases. Results:Disease guidance had the highest utilization rate at 61.92% among various types of professional guidance on transitional care, while other professional guidance and services had utilization rates below 50%. Regarding predisposing factors, older adults with chronic diseases who were unmarried, employed part-time or full-time, or previously unemployed indicated lower utilization of transitional care services. In terms of enabling factors, those with a primary caregiver, high monthly family income, and medical insurance were more likely to use transitional care. With respect to need factors, older adults with a higher number of chronic diseases and impaired activities of daily living were less likely to use transitional care services. Conclusion:Older adults with chronic diseases tend to underutilize transitional care services. Based on Andersen's Behavioral Model, factors influencing the utilization of these services include marital status, employment status, previous occupation, primary caregiver presence, monthly family income, method of medical expense payment, number of chronic diseases, and Activities of Daily Living score.

Purpose:To investigate the interaction between metabolic and behavioral factors in non-proliferative diabetic retinopathy (NPDR) among elderly patients with type 2 diabetes mellitus (T2DM). Patients and Methods:A cross-sectional study was conducted from October 2023 to May 2024 using cluster random sampling to recruit elderly patients with T2DM from two tertiary hospitals in Nantong. A self-designed questionnaire was utilized to collect lifestyle and behavioral data. Non-mydriatic fundus photography was used for DR screening, and biochemical indicators were extracted from electronic medical records. Descriptive statistics were applied to analyze demographic characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors influencing NPDR. Interaction models evaluated multiplicative and additive effects between metabolic indicators (low-density lipoprotein cholesterol [LDL-C], urine albumin-to-creatinine ratio [UACR]) and weekly fish consumption frequency on NPDR. Receiver operating characteristic (ROC) curves assessed the diagnostic value of elevated UACR, low fish consumption, and their interaction for NPDR. Results:Among 978 eligible elderly patients with T2DM, 794 were included, with 306 (38.5%) diagnosed with DR, including 246 (31.0%) with NPDR. Multivariable logistic regression identified diabetes duration, LDL-C, UACR, and weekly fish consumption as independent risk factors for NPDR. Interaction analysis demonstrated significant positive multiplicative (OR=8.89, 95% CI=2.87-9.52, P<0.001) and additive interactions (RERI=2.77, API=0.31, SI=1.54) were observed between low fish consumption (<2 times/week) and severe UACR (>33.9 mg/mmol). No interactions were found with moderate UACR (3.4-33.9 mg/mmol) or elevated LDL-C (>1.8 mmol/L). ROC analysis demonstrated AUC values of 0.840, 0.816, and 0.893 for severe UACR, low fish consumption, and their combined effect, respectively, indicating enhanced diagnostic utility for NPDR. Conclusion:The synergistic interaction between severe UACR and infrequent fish consumption significantly elevates NPDR risk in elderly patients with T2DM, highlighting its potential as a predictive marker for early intervention.

Introduction With an increasing number of older adults in China, the number of people with cognitive impairment is also increasing. To decrease the risk of dementia, it is necessary to timely detect mild cognitive impairment (MCI), which is the preliminary stage of dementia. The prevalence of MCI is relatively high among older adults with diabetes mellitus (DM); however, no effective screening strategy has been designed for this population. This study will construct a nurse-led screening system to detect MCI in community-dwelling older adults with DM in a timely manner.Methods and analysis A total of 642 participants with DM will be recruited (n=449 for development, n=193 for validation). The participants will be divided into MCI and none-MCI groups. The candidate predictors will include demographic variables, lifestyle factors, history of diseases, physical examinations, laboratory tests and neuropsychological tests. Univariate analysis, least absolute shrinkage and selection operator regression screening, and multivariate logistic regression analysis will be conducted to identify the outcome indicators. Based on the multivariate logistic regression equation, we will develop a traditional model as a comparison criterion for the machine learning models. The Hosmer-Lemeshow goodness-of-fit test and calibration curve will be used to evaluate the calibration. Sensitivity, specificity, area under the curves and clinical decision curve analysis will be performed for all models. We will report the sensitivity, specificity, area under the curve and decision curve analysis of the validation dataset. A prediction model with better performance will be adopted to form the nurse-led screening system.Ethics and dissemination This prospective study has received institutional approval of the Medical Ethics Committee of Qidong Hospital of TCM (QDSZYY-LL-20220621). Study results will be disseminated through conference presentations, Chinese Clinical Trial Registry and publication.Trial registration number ChiCTR2200062855.

Lifestyle activity engagement is a modifiable factor for cognitive decline. We aimed to identify lifestyle patterns (LPs) among community-dwelling older adults in the pre-dementia stages and to explore the links between LPs, cognitive function, and individual characteristics. 702 older Chinese adults were recruited. Three LPs were identified by latent class analysis: active aging lifestyle pattern (AALP), leisure lifestyle pattern (LLP), and work-centered lifestyle pattern (WLP). AALP refers to participation in various activities that are meaningful to individuals and benefit their well-being. LLP is the pattern of activities aimed at recreation. WLP refers to the LP where individuals are most likely to engage in work-related activities. However, only AALP is protected against mild cognitive impairment (MCI). Multinomial logistic regression models revealed the differences in individual characteristics among participants with different LPs, indicating the importance of tailored intervention strategies. As a protective factor against MCI, AALP should be highlighted in community-based care.

Purpose This study translated the Positive and Negative Social Exchange (PANSE) scale into Chinese, examined its psychometric characteristics, and explored its feasibility for use among older adults with disabilities from China.Materials and methods A two-stage study procedure was employed. In the first stage, the English version of the PANSE scale was translated and cross-culturally adapted. In the second stage, the reliability and validity of the scale were assessed based on item-total correlation, internal consistency, test-retest reliability, content validity, structural validity, concurrent criterion validity, and known group validity.Results A total of 357 older adults with disabilities participated in the survey. The Chinese version of the PANSE scale consisted of two parts, the Positive Social Exchange Scale and the Negative Social Exchange Scale. Exploratory factor analysis extracted six communal factors. The cumulative contribution of the two parts of the scale was 69.90% and 77.88%, respectively. The item-total correlation was 0.353 to 0.802, the internal consistency of the PANSE was 0.653 to 0.886. The PANSE demonstrated good content validity and it was correlated with the SSRS scale.Conclusion The Chinese version of the PANSE is a valid and reliable instrument for assessing social exchange in Chinese older adults with disabilities.Implication for rehabilitationDespite the growing number of older adults with disabilities being a concern in China, the lack of tools to measure the type of social support limits research related to the health status of these people.This study cross-culturally adapted, translated into Chinese and validated the Positive and Negative Social Exchange (PANSE) scale as the measurement tool to be used in the cultural context of China.The two subscales of PANSE were validated in the Chinese population of older adults with disabilities.The PANSE scale measures social exchange among older adults with disabilities in China, which can guide the development of interventions to address issues in the social exchange of these people.

Background: To assess the effectiveness of the nurse-led individualised self-care model on myocardial infarction (MI) patients with diabetes. Methods: A total of 120 MI patients were enrolled from May 2020 to December 2021. The intervention group received the nurse-led individualised self-care model (n = 60), whereas the control group only received routine health education (n = 60). The Myocardial Infarction Dimensional Assessment Scale (MIDAS), Coronary Heart Disease Self-Management Behavior Scale (CSMS), Self-Rated Abilities for Health Practices (SRAHP) scale, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), blood glucose and nursing satisfaction in both groups were observed and recorded. Results: The six MIDAS subscales except for insecurity, and all dimensions of the CSMS, SRAHP, GSES and HADS scores, of the intervention group were significantly improved compared to those of the control group (p < 0.05). Compared with the control group (5.69 ± 1.43 mmol/L), the intervention group showed a decrease in the serum levels of fasting blood glucose (4.83 ± 1.57 mmol/L; p < 0.01). Conclusions: Our pilot study provides preliminary evidence supporting the feasibility of implementing nurse-led individualised self-care, suggesting its preliminary effects in improving health-related quality of life, self-care ability, health behaviours, self-efficacy, social support and nursing satisfaction among MI patients with diabetes. However, considering the unblinded and pilot nature of this study, these positive results should be interpreted with caution. Clinical Trial Registration: OSF Registration number: DOI 10.17605/OSF.IO/DVW95 (https://archive.org/details/osf-registrations-dvw95-v1).

This study aimed to explore the association between chronic pain, sleep quality, and frailty, and whether sleep quality will mediate the relationship between chronic pain and frailty. A cross-sectional study was conducted between June 2020 and July 2021 among 308 patients in Nantong city. The relationship between chronic pain and frailty was tested using linear regression. The bootstrap method was used to examine mediating effect of sleep quality. Chronic pain was significantly correlated with frailty (r=0.271, P<.001). Sleep quality played a partially mediating role between chronic pain and frailty (β=0.160, R2=32%, P<.001). Interventions to scientifically manage chronic pain and improve sleep quality may be effective in reducing the incidence of frailty in elderly cancer patients.

目的:基于循证和德尔菲法构建膝关节镜下前交叉韧带重建术后的本体感觉康复护理训练方案.方法:按照循证理论,基于筛选的证据构建膝关节镜下前交叉韧带重建术后本体感觉康复护理训练方案初稿.通过2轮德尔菲专家函询,对推荐证据进行论证后,形成膝关节镜下前交叉韧带重建术后本体感觉康复护理训练方案的终稿.结果:形成了包括评估、干预实施、监测与评价3个一级条目、10个二级条目、32个三级条目的膝关节镜下前交叉韧带重建术后本体感觉康复护理训练方案.2轮函询问卷的有效回收率均为100％,对应的权威系数(Cr)分别为0.91和0.90,肯德尔协调系数分别为0.629和0.611(均P<0.01).结论:本研究建立的膝关节镜下前交叉韧带重建术后本体感觉康复护理训练方案,具有科学性、可行性、安全性、临床适用性,其对于临床护理实践工作具有一定的参考价值.

Many studies have revealed the effect of medical history on dementia. The aim of this study was to explore the relationship between the history of disease and onset of dementia. This was a multi-center, cross-sectional study, with 2595 older adults enrolled. The onset of dementia was evaluated with Revised Hasegawa Dementia Scale (HDS-R). The diagnosed diseases after the age of 40 of the participants were investigated, including respiratory system diseases, digestive system diseases, cardiovascular diseases, endocrine disorders, genitourinary system diseases, nervous system disease, sensory system diseases, dental/oral diseases, bone/joint diseases and mental illnesses. Data of 2458 older adults were analyzed. Univariate analysis showed that diabetes, thyroid disease, mental illness, hearing loss, stroke, dental/oral disease, Denture use, fracture/osteoporosis, kidney disease and number of diseases were risk factors for dementia. After controlling for demographic sociological variables, diabetes, dental/oral disease, and denture use were independent risk factors for dementia. Thyroid disease (P = 0.313), mental illnesses (P = 0.067), hearing loss (P = 0.595), stroke (P = 0.538), fractures/osteoporosis (P = 0.069), kidney disease (P = 0.168) were no longer significant to dementia. Diabetes, dental/oral disease and denture use were main risk factors for dementia.

Abstract Background Previous studies indicated that poor quantity and quality of instrumental support are one of the main barriers in the application of transitional care. Instrumental support, as one common function of social support, is the provision of financial assistance, material goods, or services. The purpose of our study is to develop an Instrumental Support in Transitional Care Questionnaire (ISTCQ) and use this questionnaire to make an assessment among older adults with chronic diseases. Methods The draft questionnaire was examined by 18 experts from different professional fields performing three rounds of content validity testing with the Delphi method. Afterward, we conducted a pilot test recruiting 174 participants as a convenience sample in Nantong, China. The construct validity was confirmed via exploratory factor analysis and reliability was assessed using Cronbach's alpha. Results The authority coefficient of experts was 0.74–0.99 and Kendall harmony coefficient W was 0.381. The exploratory factor analysis indicated that the questionnaire can be interpreted by three factors: namely, anticipated support (items 1, 2, 3, 4), received support (items 5, 6, 7, 8) and support satisfaction (items 9, 10, 11, 12). These three factors (eigenvalues > 1 and factor loading > 0.4) explained 69.128% of the total variance. Furthermore, the calculation of Cronbach's alpha and test–retest reliability have shown good reliability among each dimension of the 12-item questionnaire (Cronbach's alpha 0.711–0.827, test–retest reliability 0.704–0.818). Conclusion Results from the pilot test demonstrated excellent reliability and validity of ISTCQ through each dimension and as an entire.

Background Instrumental support, which is defined as practical, tangible, and informational assistance extended to patients, is crucial for older people in transition. However, little is known about instrumental support in transitional care. Thus, the aim of this study was to evaluate the instrumental support of older people in transitional care. Methods This cross-sectional study was conducted using the Questionnaire of Instrumental Support in Transitional Care (QISCT) to collect data from 747 older people in China from September to November 2020. Survey items consisted of a sociodemographic characteristics questionnaire and the QISCT. Multiple regression analyses were conducted to examine the association between independent variables and the QISCT scores. Results The total score of the QISCT was 39.43 (± 9.11), and there was a significant gap between the anticipated support and received support. The satisfaction of instrumental support was low. Multiple regression analyses showed that educational level, the number of intimate relationships, monthly family income, monthly costs of transitional care, diabetes, and chronic obstructive pulmonary disease were associated with instrumental support in transitional care. Conclusions To cope with the burden caused by chronic disease, the government and transitional care teams should establish a demand-oriented transitional care service model and pay more attention to helping older people obtain adequate and satisfactory instrumental support.

Objective. This study evaluated the impact of a novel venipuncture method on vascular parameters of vena basilica to provide a new technical option for the clinical management of difficult venipuncture. Methods. 32 volunteers examined by ultrasound at the Medical Imaging Center of The First People’s Hospital of Nantong, Jiangsu province, from February 2020 to April 2020 were randomly selected. One hand of each patient was ligated with the traditional single tourniquet and the new ligation method for 20 seconds. Then, the distance between the left or right vena basilica and the skin and the diameter of blood vessels were measured by ultrasound. 98 patients with peripheral venipuncture difficulty who were examined by ultrasound of a third-grade hospital from April 2019 to March 2020 were selected and randomly divided into control group ( n = 49 ) and experimental group ( n = 49 ). The traditional method was used in the control group, and the new peripheral venipuncture was used in the experimental group. The success rate of single puncture, preparation time before puncture, time required for puncture operation, pain reaction during puncture, intravascular congestion after puncture, subcutaneous tissue injury, and vascular reuse rate after puncture were compared between the two methods. Results. The new ligation and puncture method increased the diameter of peripheral superficial vein vessels by 0.51 ± 0.04 mm , and the change of vena basilica diameter was not significantly associated with gender and age of patient. The success rate of single puncture and the vascular reuse rate were significantly higher in the experimental group than in the control group, while the preparation time and venipuncture time, as well as the patient’s pain response, were significantly lower in the experimental group compared to the control group, and the intravascular congestion and subcutaneous tissue injury were lower. In addition, the mean satisfaction score of patients in the experimental group was higher than that of the control group. Conclusion. The new ligation and puncture method was an effective vena basilica dilation technique for filling the peripheral superficial veins, improving puncture success rate of peripheral difficult vein, and reducing patient pain, which was worth popularizing and applying in clinic.

This study aimed to examine the feasibility and validity of an emotional support programme developed for older adults living in nursing homes, using a quasi-experimental design. Older adults in the intervention group attended a 12-week emotional support programme while those in the control group received usual care. Outcome variables, assessed at baseline and at 1-month and 3-month follow ups, included nursing home adjustment, perceived social support, and quality of life. Group-by-time interaction effects were found concerning nursing home adjustment and perceived social support. Significant improvements in the two variables were observed in the intervention group, but no significant difference was found in quality of life. The emotional support programme based on social learning theory resulted in significant improvements in nursing home adjustment and perceived social support. To respond to the demands of an ageing society, further studies are needed on this topic.

Objective:Wearing face masks is believed to mitigate coronavirus disease 2019 (COVID-19) virus transmission by filtering respiratory droplets. This study was to explore the factors influencing wearing face masks in public in China during COVID-19 outbreak. Methods:This study was a qualitative semi-structured interview research design and was guided by the Protection Motivation Theory. Participants from Jiangxi Province China were interviewed by means of WeChat video call. Thematic analysis was used to analyze the data. Results:Recruitment efforts were suspended when 21 participants (aged 23 to 72 y) were successfully enrolled and the data reached thematic saturation. Four themes were identified when participants described factors influencing them to wear face masks: knowledge of disease (subthemes were severity of disease, and individual vulnerability to disease), environmental facilitators and constraints (subthemes were government recommendations, public opinion, and affordability and availability of face masks), understanding of protection effectiveness (subthemes were protection effectiveness of wearing face masks, and selection of protective measures), and past experiences. Conclusions:Individuals' decision to wear face masks was influenced by the combination of factors identified. Identification of these factors provides guidance for explaining wearing face masks in public and helps policy-makers develop feasible recommendations for wearing face masks during COVID-19 outbreak.

OBJECTIVES:This study aimed to investigate the effects of transitional care (TC) programs on the health outcomes of discharged older patients with osteoporotic vertebral compression fractures (OVCFs).METHODS:A total of 160 older patients were recruited from two campuses of a public teaching hospital in China. Patients were grouped according to the campus to which they were admitted. The TC programs commenced one day before discharge and lasted 6 months after discharge. Repeated-measures analysis of variance was used to analyse the effects of the TC programs.RESULTS:The TC programs improved the discharge of older patients with OVCF in their activities of daily living (ADLs), pain levels and social support, and decreased fracture recurrence rates.CONCLUSIONS:This study provides evidence of concurrent clinical improvements and health outcomes in discharged older patients with OVCFs from the effects of TC programs based on social support theory.

Purpose: To assess and summarize the effects of internet-based interventions on diabetes control and self-management of older adults with diabetes. Methods: PubMed, Web of Science and three Chinese databases were searched to identified articles published in until December 2021. Clinical trials if they covered the effects of internet-based interventions on diabetes control and self-management of older adults with diabetes were included. All data analysis were performed by Review Manager 5.3. Results: Sixteen studies with a total of 5604 participants met the inclusion criteria. Our primary outcomes included HbA1c control and self-management. (1) HbA1c control: results indicated statistically difference and high heterogeneity [Q = 112.9, df = 8, p < 0.001, I-2 = 93%], in the subgroup analysis of studies in China, results showed a significant influence of internet-based interventions on HbA1c control [Q = 21.31, df = 5, p = 0.03, I-2 = 77%]; (2) self-management: in the subgroup analysis of study duration < 6 months [Q = 84.62, df = 2, p < 0.001, I-2 = 98%]. Conclusion: Internet-based interventions are promising on diabetes control and self-management of older adults with diabetes, but still preliminary due to the heterogeneity of intervention components and the limited number of higher methodological quality trials.