Scope and inclination of voluntary service for urban community-living older adults provided by volunteers with nursing background: A qualitative study.

BACKGROUND: With the growing challenge of an aging population, addressing the needs of elderly individuals who face living difficulties and lack family support becomes increasingly difficult. Volunteer services are crucial in this context, yet their effectiveness is hindered by unclear service scopes and uncertain volunteer inclinations. AIM: To explore the role and specific preference of volunteers with nursing backgrounds in support of older adults living in the urban community. DESIGN, SETTING AND PARTICIPANTS: A descriptive qualitative study was conducted between September and October 2022. Twenty-three participants (hospital nurses [10], community nurses [4], nursing teachers [4] and nursing students [5]) were selected. Data analysis followed conventional content analysis. RESULTS: Nine major themes were identified based on interview data. Four themes described the service scope of nursing volunteers: (1) environment domain, (2) physiological domain, (3) psychosocial domain and (4) health-related behaviours domain. Another five themes highlighted the service inclination of these volunteers: (1) service frequency, (2) service duration per person/time, (3) service coverage, (4) service place and (5) service object. CONCLUSION: This study clarifies the service focus and scope of necessary support for volunteers, exploring the potential service capabilities of scarce volunteers to the greatest extent. Meanwhile, the results of this study also provide a foundation for stakeholders to fully exploit the synergy. The important findings of this study will help the government and relevant authorities better understand the service attributes of nursing volunteers, allowing them to develop detailed training plans and provide nursing volunteers with targeted support and assistance to meet the health expectations of urban community-living older adults in need. PATIENT OR PUBLIC CONTRIBUTION: Developing research questions, participation and conduct and provision and interpretation of evidence.

Nursing assistants' knowledge, attitudes and training needs regarding urinary incontinence in nursing homes: a mixed-methods study.

BACKGROUND: Urinary incontinence is an increasingly common problem, especially among older people in nursing homes. Nursing assistants are the leading workforce in nursing homes, and their knowledge and attitudes regarding urinary incontinence have garnered considerable attention in the context of aging in China. However, most previous studies on this issue have focused on registered nurses. This study aimed to explore nursing assistants' knowledge, attitudes and training needs with regard to urinary incontinence. METHODS: We conducted a two-part mixed-methods study. After institutional manager approval, we surveyed the knowledge and attitudes of 509 nursing assistants regarding urinary incontinence. We carried out semi-structured interviews with 40 nursing assistants to elicit detailed information on training needs. RESULTS: In general, knowledge about urinary incontinence was poor (14.00 ± 4.18), although attitudes were primarily positive (35.51 ± 3.19). Most nursing assistants were very willing to learn more about urinary incontinence (93.9%, 478/509), but time constraints and low educational background may be barriers to learning motivation. The three preferred training styles among nursing assistants were face-to-face guidance from a mentor, training combining theory with practice, and online video training. CONCLUSIONS: Chinese nursing assistants had poor knowledge but positive attitudes toward urinary incontinence. Facility managers should focus on developing training and learning mechanisms regarding urinary incontinence. It is important to adopt diverse training styles according to the actual situation of nursing homes.

Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis.

BACKGROUND: Person-centered care (PCC) is a critical approach to improving the quality of care for community-dwelling older people. Old-age care services could be provided according to older peoples' choices, needs, and preferences. The purpose of this study was to synthesize research evidence on the experiences of older people, healthcare providers, and caregivers with PCC and to identify the enablers and barriers to implementing PCC for community-dwelling older people. METHODS: A meta-synthesis of qualitative research design was adopted. Data searches were performed using CINAHL (EBSCOhost), PubMed (OvidSP), Embase (Ovid), Cochrane Database, and PsycINFO (Ovid) in published articles and were reviewed from the earliest date to February 2023. The Qualitative Method Appraisal Tool was used to conduct a quality appraisal on selected articles. Data were extracted based on the capacity, opportunity, and motivation-behavior model (COM-B model), and the findings were synthesized using the meta-aggregative approach. RESULTS: Twelve included articles were analyzed to identify 122 findings that were organized into 11 categories and combined into three synthesized findings-capacities of older people, healthcare providers, and caregivers; opportunities in the implementation of PCC; motivation in implementing PCC. Capacities consisted of a lack of person-centered knowledge and skills, negative attitudes toward shared decision-making, and a lack of formal training to enhance capabilities among HCPs. Opportunities included a lack of coordination in resource allocation, strengthening multidisciplinary teamwork, establishing a desirable environment, and time constraints. Motivation in implementing PCC included encouraging self-reflection and regulation, respecting the autonomy of older people, lack of clear reward and empowerment mechanisms, and being resilient and optimistic. CONCLUSIONS: The findings of this research provide a reference for implementing successful PCC in the community. The researchers identified barriers and facilitators of implementing PCC, facilitating through stakeholder's person-centered knowledge and skills being valued and respecting the autonomy of older people. Establishing a positive environment and strengthening multidisciplinary team members also promotes the implementation of PCC. However, additional studies are required to explore the influencing factors and address the barriers.

Nurse managers' perceptions and experiences of caring behavior for clinical nurses: a multicenter survey.

BACKGROUND: Humanistic care management is a necessary measure to improve the motivation and initiative of clinical nurses and is the foundation to improve the quality of nursing. Understanding the current status and identifying the influencing factors that promote or hinder humanistic care behaviors is essential. This study investigated the current status and experiences of nurse managers' caring behaviors toward clinical nurses. METHODS: We conducted a mixed-methods study with an explanatory sequential design. A survey on the nurse managers' caring behaviors in 101 hospitals from 23 provinces and four municipalities in China was investigated (n = 2022). Then, semi-structured interviews were conducted to obtain information about the participants' experiences associated with the performance of caring behaviors (n = 27). RESULTS: Survey data demonstrated that the nurse managers' overall caring behaviors were moderately good. The total scoring rate was 88.55%, and the overall score was 161.19 ± 20.68. Qualitative data revealed that the capacity of nurse managers and clinical nurses, opportunity, and motivation to implement humanistic care are key influencing factors of caring behaviors. CONCLUSIONS: The results suggested that intrinsic motivation, organizational support, and the humanistic care capabilities of clinical nurses and nurse managers are vital to implementing care behaviors. Thus, successful humanistic care management requires a concerted effort at the individual and organizational levels.

Perspectives of older adults, caregivers, healthcare providers on frailty screening in primary care: a systematic review and qualitative meta-synthesis.

BACKGROUND: Screening is often recommended as a first step in frailty management. Many guidelines call to implicate frailty screening into practice in the primary care setting. However, few countries or organizations implement it. Understanding and clarifying the stakeholders' views and issues faced by the implementation is essential to the successful implementation of frailty screening. However, the systematic review on stakeholders' views of frailty screening in primary care is decidedly limited. Our objective was to explore the perspective of older adults, caregivers, and healthcare providers on frailty screening and determine the enablers and barriers to implementing frailty screening in primary care. METHODS: A systematic search of six databases and other resources was conducted following JBI's three-step search strategy. The search resulted in 7362 articles, of which 97 were identified for further assessment according to the inclusion criteria. After the full-text screening, quality assessment and data extraction were carried out using the tools from Joanna Briggs Institute (JBI). Moreover, reviewers used the approach of meta-aggregative of JBI to analyze data and synthesis the findings. RESULTS: Six studies were included. A total of 63 findings were aggregated into 12 categories and then further grouped into three synthesized findings:1) capacity of healthcare providers and older adults; 2) opportunity in the implementation of frailty screening; 3) motivation in the implementation of frailty screening. These themes can help identify what influences the implementation of screening from the perspective of stakeholders. CONCLUSIONS: This meta-synthesis provides evidence on the barriers and enablers of frailty screening in primary care, from the aspects of psychological, physical, social, material, etc. However, stakeholder perspectives of frailty screening have not been adequately studied. More research and efforts are needed to explore the influencing factors and address the existing barriers.

Impact of Pain and Psychosocial Factors on Frailty Among Older Adults With Physical Functional Limitations: A Cross-Sectional Study.

AIMS: The objective of this study was to determine the prevalence of frailty and pain among older adults with physical functional limitations in China. We also assessed the impact of pain and psychosocial determinants on frailty among this vulnerable population. DESIGN: This study was a cross-sectional study. SETTING AND PARTICIPANTS: Totally, 2,323 Chinese elders with physical functional limitation were enrolled. METHODS: Physical functioning was assessed by the Barthel Index, participants who reported "often troubled with pain" were further asked about the intensity of their pain using a 1-10 numeric rating scale, and frailty was assessed by the Assessment of frailty FRAIL scale. The impact of pain and psychosocial factors on frailty was assessed by multivariable binary logistic regression. RESULTS: The prevalence of frailty and pain were 30.9% and 46.1%, respectively. Compared with subjects who reported no pain, those who reported mild (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.21-2.31), moderate (OR = 2.10, 95% CI = 1.53-2.82), or severe pain (OR = 2.31, 95% CI = 1.56-3.40) tended to be more vulnerable to frailty. Furthermore, compared with participants with positive psychosocial determinants, those with negative psychosocial determinants seemed more likely to be frail. CONCLUSIONS: These findings suggest that the incidence of pain, negative psychosocial status, and frailty were prevalent, and the presence of pain and negative psychosocial factors increased the risk of frailty among older adults with physical functional limitation.

Malnutrition and its associated factors among elderly Chinese with physical functional dependency.

OBJECTIVE: To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency. DESIGN: Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment-Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition. SETTING: China. PARTICIPANTS: A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme. RESULTS: The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82). CONCLUSIONS: The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.

Enablers and barriers to implementing care quality improvement program in nursing homes in China.

OBJECTIVE: To explore the perspectives of key stakeholders on necessary factors to implement care quality improvement program. METHODS: We conducted qualitative descriptive research in eight nursing homes in four major prefecture-level cities of Changsha, Xiangtan, Zhuzhou, and Yueyang. Data of 50 clinical nurses and 64 nurse assistants were included and analyzed. Ethical approval was given by the medical ethics committee of Chinese Clinical Trial Registry (No. ChiCTR-IOC-17013109, https://www.chictr.org.cn/index.aspx ). One-to-one interviews were used with the nursing managers, and separate focus group discussions were used with the clinical nurses and nurse assistants. All of the interviews were audio recorded and later transcribed verbatim. In addition, the first author documented the responses of every participant in the field notes during the interviews and focus groups. RESULTS: The participants' perspectives were characterized by two main themes: (1) enablers, with four subthemes of "organizational support", "the evidence-based practice ability", "proactivity", "nursing supervision and feedback;" and (2) barriers, with five sub-themes of "low educational background", "the limitations of self-role orientation", "resistance to change", "lack of job motivation", and "organizational constraints". CONCLUSION: These findings recognize factors at the organizational level, staff level and societal level that are necessary to implement effective mentoring. The results of this study can provide reference for nursing home in improving nursing management quality, formulating, implementing and revising training policies.

Nursing home staff perceptions of challenges and coping strategies during COVID-19 pandemic in China.

BACKGROUND: First-line nursing staff are responsible for protecting residents, the most vulnerable population, from COVID-19 infections. They are at a high risk of being infected with COVID-19 and experience high levels of psychological distress. AIMS: To explore the challenges and coping strategies perceived by nursing staff during the COVID-19 pandemic in China. METHODS: In April,2020, we conducted a qualitative study using in-depth semi-structured interviews with nursing staff. Participants were selected from seven nursing homes in three cities in Hunan Province, China. RESULTS: A total of 21 nursing staff participated in the study, including seven nurse managers, seven registered nurses and seven nursing assistants. Three main themes were identified. Different groups encountered different sources of stress and adopted various coping strategies to fulfil their responsibilities. CONCLUSIONS: Nursing home staff were underprepared for dealing with COVID-19-related challenges. Educational programs to improve the ability to deal with COVID-19 prevention and control are needed.

Quality of care in Hunan Province nursing homes: relationship to staffing and organizational climate.

Our objective was to examine the quality of care perceived by nursing staff and its relationship with the staffing and organizational climate in nursing homes. The participants in this cross-sectional study included 358 nursing staff from 26 nursing homes in Hunan Province, China. This study found that the interaction effect between nursing staff to resident ratio and physician to resident ratio exerted a significant effect on quality of care (p < 0.05). Higher scores on the relationships and communication scale (OR = 4.771, p = 0.002) and lower scores on the work stress scale (OR = 0.980, p = 0.050) were also associated with better quality of care. More work experience was related to lower quality of care (OR = 0.944, p = 0.048), and work experience was associated with relationships and communication (Beta = 0.172, p = 0.002) and work stress (Beta= = 0.259, p = 0.000). Staffing level, work experience, work stress, relationships and communication are key factors in providing higher quality of care in nursing homes.

Evaluation of quality improvement intervention with nurse training in nursing homes: A systematic review.

INTRODUCTION: Quality improvement may be a promising approach to improve the quality of care in nursing homes, and nurse training is a key step in a successful quality improvement practice. The implementation of training measures may be related to the quality of quality improvement practice. Little is known about the quality of quality improvement practice or effective nurse training measures that affect the quality of quality improvement interventions in nursing homes. AIMS: The aim of this review was to assess the quality of available quality improvement intervention designs and present effective nurse training measures that contribute to a high-quality quality improvement intervention. METHODS: We searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and the Cochrane Library for articles published before March 2019. quality improvement intervention quality was evaluated using a standardised assessment tool. Descriptive synthesis was used for the analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Checklist was used for transparency. RESULTS: We included 12 articles, 1 was rated as perfect quality and 7 good quality. Out of these 8 studies, 3 features primarily reflected differences in quality: compliance, sustainability and replication ability of the interventions. They were affected by measures included provision of advanced training, available training resources, feedback process, building quality improvement teams, setting up mentors and nursing leadership training. Other recommended measures included external cooperation and leadership empowerment. CONCLUSION: A high-quality quality improvement intervention should consider how to improve compliance, sustainability and replication ability. Adapting measures that are compatible with nurse training may ensure a successful implementation of quality improvement programmes that are conducive to the effective improvement of service quality. RELEVANCE TO CLINICAL PRACTICE: Quality improvement programmes should take into account measures that are compatible with nursing staff training. These measures should help improve the quality of interventions and promote care service of nursing homes.

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta-synthesis.

AIM: To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes. BACKGROUND: Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes. METHODS: A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta-aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses. RESULTS: The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes. CONCLUSIONS: There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable. IMPLICATIONS FOR NURSING MANAGEMENT: Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high-quality care for residents.

Web-Based Interventions to Improve Mental Health in Home Caregivers of People With Dementia: Meta-Analysis.

BACKGROUND: Dementia is a major cause of disability and dependency in older adults worldwide. It is often accompanied by general psychological distress, such as depression and anxiety symptoms, among caregivers of people with dementia (PwD). The physical and mental health of the caregiver is a prerequisite and a promise to help PwD continue to live as long and as well as possible. Web-based interventions can provide convenient and efficient support and an education tool to potentially reduce the negative outcomes associated with providing care. OBJECTIVE: The aim of this study was to examine the effect of internet-based interventions on the mental health outcomes of family caregivers of PwD and to explore which components of the Web-based interventions play an important role. METHODS: A comprehensive literature search was conducted in PubMed, Excerpta Medica dataBASE, PsycINFO, Cochrane Database, and the Cumulative Index to Nursing and Allied Health Literature using relevant terms such as Web-based and caregiver as keywords, covering all studies published before June 2018. A total of 2 reviewers independently reviewed all published abstracts, according to established inclusion and exclusion criteria. We extracted information about the participants, interventions, and results and reviewed article quality in terms of the randomized trial methods, using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: A total of 815 caregivers participated in 6 studies, with 4 of the studies using depression as an outcome. The analysis found that depression scores dropped an average of 0.23 (95% CI -0.38 to -0.07; P<.01) after Web-based interventions. In 2 studies of caregivers who were experiencing anxiety symptoms, the average score for anxiety dropped by 0.32 points (95% CI -0.50 to -0.14; P<.01). However, in terms of coping, pain, and stress, the Web-based interventions showed a poor effect. On the whole, the addition of professional psychological support on the basis of education can improve caregivers' mental health. CONCLUSIONS: Internet-based interventions were generally effective at reducing anxiety and depression in dementia caregivers, although negative results were found in some studies. As for burden and stress, further research is required.

Full-Duplex Multi-Hop Wireless Networks Optimization with Successive Interference Cancellation.

In wireless network communication, in-band full-duplex technique is a useful and important technique that can enlarge the whole throughput of the wireless networks. However, its use needs harsh environment. The successive interference cancellation can make several transmitters' data be received simultaneously by the receiver, and can make the in-band full-duplex technique be used easily in reality. In this paper, we try to propose an optimal algorithm for increasing the throughput of full-duplex multi-hop wireless networks with successive interference cancellation, which we call the full-duplex successive interference cancellation (FD-SIC) wireless networks. We first describe the mathematical model for the FD-SIC wireless networks and show it is NP-hard in general. Then, we propose a heuristic algorithm, namely the use-up-link-capacity iterative (UULC-iterative) algorithm, for each node's routing and transmitting scheme. Simulation results show that the proposed algorithm for FD-SIC wireless networks can achieve better throughput compared with SIC-only networks and the interference avoidance networks.

Isoprenoid emissions from Schima superba and Cunninghamia lanceolata: Their responses to elevated temperature by two warming facilities.

Isoprenoids (including isoprene (ISO) and monoterpenes (MTs)) are the majority of biogenic volatile organic compounds (BVOCs) which are important carbon-containing secondary metabolites biosynthesized by organisms, especially plant in terrestrial ecosystem. Results of the warming effects on isoprenoid emissions vary within species and warming facilities, and thus conclusions remain controversial. In this study, two typical subtropical tree species seedlings of Schima superba and Cunninghamia lanceolata were cultivated under three conditions, namely no warming (CK) and two warming facilities (with infrared radiators (IR) and heating wires (HW)) in open top chamber (OTC), and the isoprenoid emissions were measured with preconcentor-GC-MS system after warming for one, two and four months. The results showed that the isoprenoid emissions from S. superba and C. lanceolata exhibited uniformity in response to two warming facilities. IR and HW both stimulated isoprenoid emissions in two plants after one month of treatment, with increased ratios of 16.3 % and 72.5 % for S. superba, and 2.47 and 5.96 times for C. lanceolata. However, the emissions were suppressed after four months, with more pronounced effect for HW. The variation in isoprenoid emissions was primarily associated with the levels of Pn, Tr, monoterpene synthase (MTPS) activity. C. lanceolata predominantly released MTs (mainly α-pinene, α-terpene, γ-terpene, and limonene), with 39.7 % to 99.6 % of the total isoprenoid but ISO was only a very minor constituent. For S. superba, MTs constituted 24.7 % to 96.1 % of total isoprenoid. It is noteworthy that HW generated a greater disturbance to physiology activity in plants. Our study provided more comprehensive and more convincing support for integrating temperature-elevation experiments of different ecosystems and assessing response and adaptation of forest carbon cycle to global warming.

Identification of formation mechanism and key elements of quality geriatric care behavior of nursing assistants in nursing homes: a grounded theory study.

Objectives: This study aimed to identify the key elements and develop a formation mechanism model of quality geriatric care behavior for nursing assistants. Methods: This qualitative research employed the strategy of grounded theory proposed by Strauss and Corbin. Furthermore, the data was collected by participatory observation and semi-structured interviews. A total of 12 nursing managers, 63 nursing assistants, and 36 older people from 9 nursing homes in 6 cities were interviewed, whereas for the observatory survey, participants were recruited from 2 nursing homes. Results: The comparative and analysis process revealed 5 key elements of quality geriatric care behavior, including holistic care, personalized care, respect, positive interaction, and empowerment. Based on the Capability-Opportunity-Motivation-Behavior (COM-B) model, key elements and the 3 stages of quality geriatric care behavior (negative behavior cognition stage, practice exchange run-in stage, and positive behavior reinforcement stage), the theoretical framework of the formation mechanism was established. Conclusion: The results indicated that nursing assistants' capabilities, motivation, and organizational and environmental support are vital for quality care behaviors. The theoretical framework established in this study provides theoretical support and practical reference to policymakers, institutional administrators, and healthcare professionals for improving nursing assistant's care behaviors.

Transient interaction effects of temperature and light intensity on isoprene and monoterpene emissions from Schima superba and Phoebe bournei.

Biogenic volatile organic compound (BVOC) (such as isoprene (ISO) and monoterpenes (MTs)) emissions from plants play a great role in the atmospheric chemistry. Now frequency of dramatic changes of weather such as transient temperature changing increases, most current studies focus on the effects of simulating climate change (long-term) on BVOC emissions. While studies of transient effects on that are less reported. This study aimed to identify the ISO and MT emissions and the related physiological processes in the short-term scale at different temperature (T) and light intensity (PAR), in seeding stage of Schima superba and Phoebe bournei belonging to typical subtropical tree species. The results showed that the ISO and MT emissions were significantly affected by T and PAR, either independently or interactively. With the increase of T and PAR, the ISO and MT emissions increased, with the maximum rates of ISO and MTs of 39.39 and 1042.35 pmol m-2 s-1 for S. superba under 40 °C × 500 µmol m-2 s-1 condition, while the maximum rates reached 18.73 and 6737.41 pmol m-2 s-1 at 30 °C × 1500 µmol m-2 s-1 for P. bournei. The increase of ISO and MT emissions with T and PAR increasing that was related to the promotion of Pn and gs in plants. Regarding MT components, the proportion of α-pinene decreased with T and PAR increasing, with the lowest ratios of 4.91 % and 21.16 % for S. superba and P. bournei under 40 °C × 1500 µmol m-2 s-1 condition. However, the proportion of ß-pinene significantly increased, with the highest ratios of 67.42 % and 57.93 % for S. superba and P. bournei under 30 °C × 1500 µmol m-2 s-1 condition, which is attributed to differences in light tolerance between the two plants. Our study provides basis for evaluating the transient changes of environmental factors on BVOC emissions and optimizing regional BVOC emission models.

Nursing Home Residents' Perceptions of Challenges and Coping Strategies during COVID-19 Pandemic in China.

Older people in nursing homes are at a high risk of being infected by coronavirus disease 2019 (COVID-19). They also experienced nursing home lockdowns that harm their psychological wellbeing. Better support for this vulnerable population requires understanding their perceptions of challenges and coping strategies during the COVID-19 pandemic. A qualitative descriptive study was conducted using semi-structured interviews. Thematic analysis approach was used to analyze the data. Participants were recruited from six nursing homes in three cities in Hunan Province, China. Fourteen nursing home residents participated in the study. Four themes were identified from interviews and described as: mental stress and coping strategies, self-regulation to respond to lockdown, the lack of social connection and coping strategies, and the need for medical care services and coping strategies. This study revealed that nursing home residents perceived stress during the nursing home lockdown, but they reported initiating activities to maintain health and connections with their families and peers. Resilience improvement interventions are necessary to enable residents' autonomy and develop their resilience in coping with difficulties and hardship during crises. The findings also indicate that a supportive environment with interactions from families, peers, and staffs played a key role in enabling residents' positive health and wellbeing during the lockdown.