This study aimed to investigate the association between frailty and self-neglect and to examine the mediating roles of social networks and depression in this relationship among community-dwelling older adults. A cross-sectional descriptive design was employed, with a sample of 521 individuals aged 60 years and older recruited from community settings between July 2021 and February 2022. Analyses were conducted using IBM SPSS Amos 21.0. Structural equation modeling revealed that physical frailty (PE = 0.054) and cognitive frailty (PE = 0.148) were directly associated with self-neglect, as well as indirectly linked through pathways involving social networks and depression. In contrast, overall frailty, psychological frailty, and social frailty exhibited only indirect associations with self-neglect, operating exclusively through these mediators. These findings underscore the importance of early identification of frailty and targeted interventions to strengthen social networks and address depressive symptoms, which may significantly improve the management of self-neglect and enhance well-being in aging populations.

BACKGROUND:In recent years, escape rooms have emerged as a novel pedagogical approach and are increasingly being integrated into nursing education to enhance active learning and engagement. OBJECTIVES:To comprehensively identify and synthesize qualitative evidence regarding nursing students' experiences and perceptions of escape room-based learning, thereby generating collective insights into its educational impact and implementation. METHODS:A comprehensive literature search was conducted across six electronic databases including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, and PsycINFO from their inception to January 19, 2026. Thematic synthesis was employed to analyze and synthesize data from the included studies. The methodological quality of these studies was assessed using the Critical Appraisal Skills Programme qualitative studies checklist. RESULTS:A total of 13 studies were included in this meta-synthesis. From these, four overarching themes emerged with each encompassing a set of underlying sub-themes resulting in eight distinct themes overall. The overarching themes were: the enabling environment-core pedagogical mechanisms, internal gains-foundational learning outcomes, external competencies-observable skills and readiness, and recommendations for improvement-the learner's voice. CONCLUSION:This review enables nursing educators to gain comprehensive insights into students' experiences with escape rooms and their expectations for such educational activities. To maximize the effectiveness of escape rooms in nursing education, future game design may systematically address authenticity, logistical optimization, curricular integration, and feedback mechanisms.

Introduction This cross-sectional study examined the association between sense of coherence and frailty and explored the mediating roles of social support and self-rated health among community-dwelling older adults. Methods Data from 218 older adults were analyzed. Descriptive statistics were used to summarize participant characteristics and study variables, and structural equation modeling with maximum likelihood estimation was performed to test the hypothesized pathways. Indirect effects were evaluated using bias-corrected bootstrap 95% confidence intervals. Results Sense of coherence exerted a direct negative effect on frailty ( β = −0.257, p = 0.005) and an indirect effect through self-rated health, as well as through social support and self-rated health in sequence ( β = −0.136, p = 0.001). Although the direct path from social support to frailty was not statistically significant (p = 0.197), social support was indirectly associated with frailty through self-rated health. The final model showed moderate fit (χ 2 /df = 2.188, SRMR = 0.070, RMSEA = 0.074, CFI = 0.895, TLI = 0.858) and accounted for 35.8% of the variance in frailty. Conclusion These findings suggest that a higher sense of coherence is associated with a lower level of frailty, partly through psychosocial factors. Further longitudinal and interventional studies are warranted to examine whether interventions targeting sense of coherence, social support, and self-rated health may help mitigate frailty and promote healthy aging.

Background:Effective heart failure self-care depends on robust collaboration within patient-caregiver dyads. Health literacy is crucial for illness management, but its patterns and links to dyadic care collaboration and satisfaction are unclear. Objective:This study aimed to identify the latent profiles of health literacy in heart failure patient-caregiver dyads and to examine how these profiles relate to dyadic care collaboration and satisfaction with care type. Methods:A cross-sectional descriptive study was conducted. A total of 231 heart failure patient-caregiver dyads were recruited from four tertiary hospitals in Beijing, China, between September 2023 and August 2024. Health literacy was measured using the Heart Failure-Specific Health Literacy Scale (HFS-HLS), while dyadic collaboration and satisfaction were assessed via the Dyadic Symptom Management Type scale (DSMT). Latent profile analysis was conducted using Mplus 8.3 to identify distinct health literacy profiles. Binary logistic regression analyses were performed to evaluate the associations between dyadic health literacy profiles, dyadic care collaboration, and satisfaction. Results:Latent profile analysis identified two distinct health literacy profiles: a "Low Dyadic Health Literacy" group and a "High Dyadic Health Literacy" group. Binary logistic regression revealed that patient gender, number of hospitalizations, caregiver gender, and caregiver education level were significant independent predictors of profile membership. Dyads classified in the high health literacy profile were significantly more likely to engage in collaborative care and to report higher levels of caregiver satisfaction. Conclusion:Heart failure patient-caregiver dyads with higher levels of dyadic health literacy are more inclined to adopt collaborative care approaches and express greater satisfaction with their care arrangements. These findings suggest that routine assessment of dyadic health literacy in clinical settings may help identify at-risk dyads and guide interventions development.

Voice biomarkers have been increasingly applied in disease diagnosis and monitoring because of their non-invasive, low-cost, and easily accessible features. This scoping review aimed to summarize existing evidence on voice biomarkers used in heart failure management and to describe their collection, processing, and analysis methods. Four databases (PubMed, CINAHL, Scopus, and IEEE Xplore) were searched from inception to January 10, 2024. Two reviewers independently screened studies and extracted data using a predesigned form. The review followed the Joanna Briggs Institute framework and the PRISMA-ScR guideline. Nineteen studies published between 2010 and 2023 were included. Voice biomarkers were applied for diagnosis or differential diagnosis (9/19) and for assessing or monitoring disease progression (10/19). Voice/speech (11/19) were the most common biomarkers, typically collected via microphones (6/19), phones (3/19), or applications (3/19). Common processing methods included segmentation (9/19), feature extraction (9/19), denoising (8/19), and resampling (7/19). Most studies (12/19) developed new algorithms for data analysis. Model performance was mainly evaluated by accuracy (10/19), sensitivity (7/19), and specificity (6/19). This review highlights the potential of voice/speech biomarkers in heart failure management. Their non-invasive and accessible nature supports their integration into clinical monitoring. However, standardized procedures for data collection, processing, and analysis should be established through multidisciplinary collaboration to enable reliable clinical application.

BACKGROUND:To know the level of health locus of control (HLC) and investigate the factors associated with HLC among community-dwelling older adults. METHOD:A total of 470 older adults completed the Multidimensional Health Locus of Control Scale, the Activities of Daily Living Scale, the Geriatric Depression Scale, and the Lubben Social Network Scale. Hierarchical multiple regression was used to explore the factors associated with HLC. RESULTS:Gender, marital status, income and the number of chronic diseases were associated with internal HLC; age, educational level, income, activities of daily living and social networks were associated with powerful others HLC; social networks were associated with chance HLC (P < 0.05). CONCLUSION:As modifiable factors, physical function and social support are essential for improving HLC in older adults and interventional programs aiming at changing them could help older adults maintain acceptable levels of HLC.

AIMS:To synthesize the evidence of interventions based on salutogenesis for older adults. BACKGROUND:With the increasing tendency of global ageing and the progression of 'healthy ageing', salutogenesis has been adopted as a framework of health promotion for older adults. DESIGN:An integrative review following PRISMA guidelines. DATA SOURCES:Seven databases including PubMed, Cochrane Library, Web of Science, Embase, Scopus, PsycINFO and CINAHL Plus were systematically searched on 29 September 2022 and updated on 18 July 2023. RESULTS:Eighteen eligible studies were included in this review. Salutogenic-based interventions fell into three main categories: dialogue-based, health education courses based, and goal setting and achievement based. The intervention doses: length ranged from 4 weeks to 2 years, with most (n = 12) within 12 weeks; the duration of each session ranged from 30 to 150 min, with the majority (n = 7) within 1 h; the frequency ranged from five times weekly to three times in 10 months, and in six studies was once a week. Intervention providers were mostly multidisciplinary teams, while in four studies were nurses only. Most of the studies reported that salutogenic-based interventions could improve older adults' sense of coherence, quality of life, self-efficacy, self-management, meaning of life and mental health. CONCLUSIONS:This review synthesized the interventions based on salutogenesis for older adults, including salutogenesis application, intervention and its doses, intervention settings and providers, and intervention effects. Future research on the effectiveness of the intervention, the optimal dose of the intervention and the underlying mechanisms are still necessary to understand salutogenic-based interventions. NO PATIENT OR PUBLIC CONTRIBUTION:Not apply as it's a review paper. RELEVANCE TO CLINICAL PRACTICE:Salutogenic-based intervention is effective for older adults in different scenarios to improve their health outcomes. Nurses play a key role in salutogenic-based interventional programs and thus should be essential personnel as the intervention provider.

Objectives To identify the associated factors of self-neglect in older adults from a salutogenic perspective. Methods A cross-sectional correlational study was conducted in two communities in Beijing with 486 older adults recruited from April to December 2022. Data were collected by a set of questionnaires. Results Sense of coherence (β=-0.138), socio-demographic generalized resistance resources (GRRs) (smoking: β=0.156), social GRRs (living alone: β=0.093), psychological GRRs (self-esteem: β=-0.126), and motivational GRRs (powerful others locus of control: β=-0.199, chance locus of control: β=0.119) were all associated with self-neglect among older adults (p<0.05). Conclusions Sense of coherence and GRRs are vital to improve self-neglect in older adults. It is suggested to increase the level of self-esteem and the tendency of the health locus of control to largely facilitate self-neglect management in older adults.

BACKGROUND:Growing evidence shows that metabolic syndrome and frailty are significantly associated. Screening and assessing frailty in patients with metabolic syndrome is important to help improve their clinical outcomes and quality of life. Therefore, understanding the prevalence of frailty in patients with metabolic syndrome is the first critical step, however, the prevalence reported in the literature varies widely. AIM:To pool the overall prevalence of frailty among patients with metabolic syndrome. DESIGN:Systematic review and meta-analysis. METHODS:The Cochrane Library, PubMed, Web of Science, Embase, APA PsycINFO, Scopus, CINAHL Complete, CNKI, Wan Fang, SinoMed, and VIP databases were searched from the inception to March 6, 2024. Statistical analysis was performed using STATA15 software. The prevalence was pooled using the random-effects model. The sources of heterogeneity were investigated by using meta-regression and subgroup analyses. RESULTS:A total of 22 original studies published between 2007 and 2023 were included in this systematic review and meta-analysis, involving 19,921 metabolic syndrome patients. The prevalence of frailty and pre-frailty among patients with metabolic syndrome was 20% (95% CI: 16% to 25%, I2 = 99.44%) and 45% (95% CI: 36% to 53%, I2 = 99.20%). Subgroup analyses revealed differences in prevalence by frailty instruments, geographic regions, study settings, publication years, study quality, study design, and different components of metabolic syndrome. CONCLUSIONS:This systematic review and meta-analysis showed the high prevalence of frailty and pre-frailty in patients with metabolic syndrome. In the future, more high-quality longitudinal studies and exploration of other potential demographic characteristics that may influence frailty are needed to understand more information on frailty in patients with metabolic syndrome.

Objective: To systematically review studies and explore the association between loneliness and sleep quality among older adults. Methods: A comprehensive literature search was conducted in 8 databases from their inception to February 28, 2022. Studies that investigated the association between loneliness and sleep quality among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze data in the included studies. Results: In total, 16 studies with 23,485 participants were included in this review, and 6 of these studies were included in the meta-analysis. The meta-analysis showed that older adults who were lonely were signifi-cantly more likely to suffer from low sleep quality than their counterparts without loneliness (pooled OR =1.750, 95% CI: 1.511-2.026, p < 0.01). Conclusions: Loneliness is associated with poor sleep quality among older adults. Loneliness reduction meas-ures should be considered as one of the essential elements in sleep management programs for older people with low sleep quality.(c) 2022 Elsevier Inc. All rights reserved.

目的 系统评价抗阻运动对老年骨质疏松性骨折患者不同健康结局的改善效果.方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL Plus、中国知网和万方数据库从建库至2022年9月1日发表的随机对照临床试验,采用随机对照试验偏倚风险评估工具2.0(version 2.0 of the Cochrane tool for assessing risk of bias in randomized trial,RoB 2.0)对纳入研究进行质量评价,使用元分析V3软件进行Meta分析.结果 纳入15项随机对照研究,共1055例患者.Meta分析显示,抗阻运动可以有效改善老年骨质疏松性骨折患者的肌肉力量[SMD=0.746,95％CI(0.152,1.339),P=0.014]、平衡能力[SMD=0.439,95％CI(0.086,0.792),P=0.015]和移动能力[SMD=0.240,95％CI(0.074,0.407),P=0.005];在行走速度测试方面的差异无统计学意义[SMD=0.203,95％CI(-0.008,0.415),P=0.059].结论 抗阻运动能够有效提高老年骨质疏松性骨折患者肌肉力量、总体平衡能力和移动能力.在进行抗阻训练时,护理人员应针对患者的身体情况给予科学、高效的抗阻运动康复建议,指导患者完成运动计划,确保患者安全的同时促进患者健康结局的改善.

Objectives: To identify the role of frailty, social networks, and depression in self-neglect in an older Chinese population. Methods: The study was conducted in 521 older adults recruited from four community healthcare centers in a district in Beijing, China. Participants were investigated by a set of questionnaires. Results: Frailty (0=0.150, p=0.759) was not associated with self-neglect of older adults. Social isolation (0=1.980, p<0.001) and depression (0=3.606, p<0.001) were both factors associated with self-neglect in older adults. Conclusion: Management of depression and improvement of social networks of older adults should be incorporated into interventional strategies to effectively control self-neglect. Understanding self-neglect and its associated factors will ultimately contribute to the intervention development and well-being of older adults. (c) 2023 Elsevier Inc. All rights reserved.

PurposeGiven the global trajectory toward an aging population, renewed interest in the phenomena of self-neglect is needed if relevant stakeholders are to be adequately prepared for an expected increase in the number of elder self-neglect cases. This current study is designed to systematically review and synthesize the qualitative literature on the perspectives and experiences of older adults living with self-neglect. DesignA narrative meta-synthesis was used. MethodsSix English databases (PubMed, Web of Science, CINAHL Plus, Scopus, Embase, and PsycINFO) were comprehensively searched from inception to May 2022. The thematic synthesis method was applied to analyze and synthesize the findings of the included studies. The Critical Appraisal Skills Programme qualitative checklist was applied to evaluate the quality of the included studies. FindingsA total of six qualitative studies were finally included with four studies conducted in the United States, one in Israel, and one in Ireland. Through meta-synthesis, five analytical themes were identified: attributes of self-neglect, life shaped by misery, insufficient social networks and resources, self-protection and preservation, and anchoring beliefs and practices. ConclusionsThis qualitative synthesis provides profound insights into the self-neglect phenomenon from the standpoint of older adults with self-neglect and can provide guidance to relevant stakeholders on how to address elder self-neglect cases with respect to its assessment, reporting and management. Future research across geographical locations on the experiences of older adults with self-neglect are needed to provide a more global understanding of this significant and emerging public health issue. Clinical relevanceThe development of future self-neglect management practices based on medical and sociocultural models of care can focus on supporting self-neglecters with positive coping mechanisms and supporting service providers with spiritual care competencies to ensure interventions achieve ethical principles of autonomy, beneficence, and nonmaleficence.

Abstract Pain is the main symptom of arthritis. Microneedling is a new method of transdermal drug delivery that relives the pain in arthritis according to the mechanisms of pain in arthritis. This paper provides a review of the mechanisms of pain in arthritis and the use of different types of microneedles (MNs) in pain relief in arthritis. The mechanism of pain in arthritis is primarily a joint tissue lesion that causes the release of inflammatory factors by pro-inflammatory cells, resulting in pain. MNs can carry various drugs to reduce inflammatory factors, cartilage destruction and thus the symptom of pain. MNs can be classified into five types, which are solid MNs, hollow MNs, coated MNs, dissolving MNs, and swelling MNs. Among them, dissolving MNs and swelling MNs have better prospects for application in long-term management of pain in arthritis due to the biosafety of their materials and its convenience brought by the sustained-release design.

Abstract Objective: The objective of this study was to systematically review evidence of the association between the sense of coherence (SOC) and health outcomes in community-dwelling older adults. Methods: Six databases, including PubMed, Web of Sciences, Scopus, CINAHL Plus with full text (EBSCO), OVID, and the Cochrane Library, were thoroughly searched. The checklist developed by the Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used to assess the quality of the relevant studies. Results: Twenty-nine studies were included in this review. Generally, higher SOC levels are associated with better physical health (less symptom reporting, better functional status, less disability, better daily activity ability, less pain, better sleep quality, and better oral health) and better psychological health (less perceived stress, more positive self-perception of aging, less depression, and less posttraumatic stress reaction) in older adults. Higher SOC levels are also correlated with greater preventive/self-management behaviors ability, subjective well-being, adjustment to aging later in life, cumulative survival, quality of life, life satisfaction, and self-perceived health. Higher SOC levels are a vital mediators or moderators of health in older adults. Conclusions: The SOC is a protective factor for the health of community-dwelling older adults. Interventions targeting improvement in SOC levels should be developed and implemented to facilitate active aging in older adults.

Background: Knowledge of the barriers and facilitators in the adoption of digital health interventions (DHI) is sparse yet crucial to facilitate chronic obstructive pulmonary disease (COPD) management. Objectives: This scoping review aimed to summarize patient-and healthcare provider-level barriers and facil-itators in the adoption of DHIs for COPD management.Methods: Nine electronic databases were searched from inception up till October 2022 for English language evidence. Inductive content analysis was used.Results: This review included 27 papers. Frequent patient-level barriers were poor digital literacy (n = 6), impersonal care delivery (n = 4), and fear of being controlled by telemonitoring data (n = 4). Frequent patient-level facilitators were improved disease understanding and management (n = 17), bi-directional communication and contact with healthcare providers (n = 15), and remote monitoring and feedback (n = 14). Frequent healthcare provider-level barriers were increased workload (n = 5), lack of technology interoperability with existing health systems (n = 4), lack of funding (n = 4), and lack of dedicated and trained manpower (n = 4). Frequent healthcare provider-level facilitators were improved efficiency of care delivery (n = 6) and DHI training programmes (n = 5).Conclusion: DHIs have the potential to facilitate COPD self-management and improve efficiency of care deliv-ery. However, several barriers challenge its successful adoption. Attaining organizational support in develop-ing user centric DHIs that can be integrated and are interoperable with existing health systems is crucial if we are to witness tangible return on investments at the patient-, healthcare provider-and healthcare sys-tem-level.(c) 2023 Elsevier Inc. All rights reserved.

Purpose To systematically review and synthesize the findings on various professionals' perspectives of elder self-neglect (ESN) and/or their experiences with ESN. Design A systematic qualitative review was used. Methods Primary qualitative studies published either in English or Chinese until August 2020 were systematically searched in the following databases: PubMed, Web of Science, Embase, CINAHL Plus, PsycINFO, Wanfang Data, and China National Knowledge Infrastructure (CNKI). Findings Eleven studies were included. Five subthemes including retaining a sense of normalcy/identity, service refusal, isolation, contributing factors in ESN, and manifestations and consequences of ESN were included in the overarching theme of ESN features. Another two subthemes, emotional and ethical dilemmas in caring for self-neglecters and management strategies, were included under the second overarching theme of complicated experiences managing cases of ESN. Conclusions This qualitative synthesis provides a deep and comprehensive insight into professionals' perspectives and experiences of self-neglect in older adults. Understanding professionals' perspectives of ESN can help with the knowledge and theory development pertinent to this particular phenomenon. Clinical relevance Findings are valuable in informing the provision of funds and structural, informational, and emotional support systems development for professionals managing ESN cases. Establishing a strong link between ESN case management and improved outcomes in older self-neglecters is essential to establish a definite need for the provision of support, resource, and stardardized guidelines for these professionals.

Objective:To explore the research hotspots and frontiers of heart failure nursing in the past 10 years in the Web of Science database.Methods:The studies on heart failure nursing included in the Web of Science database from January 1, 2011 to December 31, 2020 were eligible for the study. The CiteSpace visualization software was used to analyze the included articles to determine the development context and research hotspots of heart failure nursing.Results:A total of 1 949 articles were included. In the past 10 years, the number of articles published in the field of heart failure nursing maintained an upward trend year by year. The United States had the most publications, highest importance and centrality of heart failure nursing. In the past 10 years, the research hotspots of heart failure nursing focused on the quality of life, self-care and palliative care in patients with heart failure. Research frontiers focused on readmissions of heart failure patients, symptom clusters, and caregivers.Conclusions:Heart failure nursing developed rapidly. Research efforts should be further intensified, the areas of cooperation should be broadened, and research hotspots and frontiers of heart failure nursing should be focused, so as to promote the development of heart failure nursing research in China.

目的 了解护理本科生为精神疾病病人提供护理服务的意愿和影响因素.方法 采用自行设计的护理服务意愿的评估问题、与精神疾病病人接触程度的评估方法、精神卫生知识调查问卷和歧视精神疾病病人评估量表对南京市某校839名护理本科生进行问卷调查.结果 护理本科生服务意愿的得分为(5.26±1.91)分.多元线性回归分析显示,与病人接触程度高、对病人歧视态度弱的学生更愿意为精神疾病病人提供护理服务(可解释总变异的15.9％).结论 护理本科生为精神疾病病人提供护理服务的意愿并不强烈.护理教育者在培养学生的过程中,应当通过各种综合干预措施,增加学生与病人的接触程度、减少歧视态度,以有效提升学生的护理意愿.