Internet use and difficulties in acquiring health resources among older adults with disabilities during the COVID-19 pandemic: a population-based cross-sectional study.

BACKGROUND: The various restrictions caused by the COVID-19 pandemic may have worsened the digital divide and health inequality. However, research to ascertain the association between Internet use and difficulties in acquiring health resources among older adults with disabilities is scarce. This study aimed to explore the relationship between Internet use and difficulties in acquiring health resources among older adults with disabilities during the COVID-19 pandemic and explore the associated factors by disability severity. METHODS: Data from the 2020 survey of people with disabilities in South Korea were used. This secondary analysis study included 4,871 older adults aged 55 and above among 7,025 total responders. Complex sample logistic regression analyses were conducted to identify the association between Internet use and difficulties in acquiring health resources during the pandemic. RESULTS: Only 23.66% of older adults with disabilities used the Internet. Internet non-users were more likely to experience difficulties in obtaining health resources than Internet users. The relationship between Internet non-use and difficulties in acquiring COVID-19-related information (OR 1.57, 95% CI 1.28-1.92) and buying and using personal protective equipment (OR 1.36, 95% CI 1.11-1.65) were statistically significant in the overall sample. Whereas, difficulties with using medical services were not statistically significantly associated with Internet use. Additionally, factors associated with difficulties in acquiring health resources differed by disability severity. CONCLUSIONS: Considering that older adults with disabilities experience triple the burden amid COVID-19 due to old age, disabilities, and the digital divide, policymakers, healthcare professionals, and engineers should aim to narrow the gaps between Internet users and Internet non-users among this population. Narrowing the gaps will make decreasing health gaps and increasing well-being among older adults with disabilities more attainable.

Transcriptomic Insights into Archaeal Nitrification in the Amundsen Sea Polynya, Antarctica.

Antarctic polynyas have the highest Southern Ocean summer primary productivity, and due to anthropogenic climate change, these areas have formed faster recently. Ammonia-oxidizing archaea (AOA) are among the most ubiquitous and abundant microorganisms in the ocean and play a primary role in the global nitrogen cycle. We utilized metagenomics and metatranscriptomics to gain insights into the physiology and metabolism of AOA in polar oceans, which are associated with ecosystem functioning. A polar-specific ecotype of AOA, from the "Candidatus Nitrosomarinus"-like group, was observed to be dominant in the Amundsen Sea Polynya (ASP), West Antarctica, during a succession of summer phytoplankton blooms. AOA had the highest transcriptional activity among prokaryotes during the bloom decline phase (DC). Metatranscriptomic analysis of key genes involved in ammonia oxidation, carbon fixation, transport, and cell division indicated that this polar AOA ecotype was actively involved in nitrification in the bloom DC in the ASP. This study revealed the physiological and metabolic traits of this key polar-type AOA in response to phytoplankton blooms in the ASP and provided insights into AOA functions in polar oceans.

The Association of Nocturnal Seizures and Interictal Cardiac/Central Autonomic Function in Frontal Lobe Epilepsy: Heart Rate Variability and Central Autonomic Network Analysis.

Purpose: Patients with epilepsy frequently experience autonomic dysfunction, closely related to sudden unexplained death in epilepsy (SUDEP). SUDEP occurs most often at night or during sleep, and frequent nocturnal seizures are an established risk factor. This study investigated the influence of nocturnal seizures on autonomic dysfunction in epilepsy. Patients and Methods: This retrospective study enrolled frontal lobe epilepsy (FLE) patients who performed 24-hour EEG monitoring. All participants were divided into nocturnal FLE (NFLE, > 90% of seizures occurring during sleep) or diurnal FLE (DFLE) groups. EEG and ECG signals were simultaneously obtained during waking and sleep stages. EEG current density source and connectivity analysis of the autonomic network were performed. ECG was analyzed across time and frequency domains heart rate variability (HRV) analysis method was used. The obtained parameters were compared between the NFLE and DFLE groups. Results: Fifteen NFLE and 16 DFLE patients were enrolled with no significant difference in age, sex, disease duration, seizure frequency, or the number of anti-seizure medications between the two groups. During sleep, a decrease in HRV parameters and an increase of the beta-1 (13-22 Hz) current source density power in the bilateral paracentral lobule (BA4,5,6), precuneus (BA7), and cingulate (BA31) were observed in the NFLE group compared to DFLE group. The NFLE group also showed hyperconnectivity in the central autonomic (12 edges distributed over 10 nodes), sympathetic (2 edges distributed over 3 nodes), and parasympathetic (4 edges distributed over 6 nodes) beta-1 frequency band networks during sleep. During wakefulness, central and cardiac autonomic variables were not significantly different between the NFLE and DFLE groups. Conclusion: Interictal cardiac and central autonomic dysfunction occurred simultaneously and can be attributed to the brain-heart autonomic axis. Our findings suggest that nocturnal seizures may contribute to interictal autonomic dysfunction during sleep in people with epilepsy.

Care provider interaction and psychological well-being of persons living with dementia in long-term care: a longitudinal observational study.

BACKGROUND: Although social interaction is important for dementia care and well-being of persons living with dementia, a limited number of studies have reported. This study aimed to examine whether the presence, type, and quality of social interaction is associated with psychological well-being among residents with dementia. METHODS: This study analyzed 258 videos of 30 participants living with dementia. Social interaction was assessed by quality, type, and presence of interaction. Psychological well-being was measured by positive and negative emotional expressions. A mixed model was used for data analysis since these repeatedly measured observation data were nested within subjects. RESULTS: Positive and neutral interactions were significantly associated with positive emotional expressions after controlling covariates, while negative interaction was significantly associated with negative emotional expressions. There was no significant relationship found between interaction presence or type and emotional expressions. CONCLUSIONS: This study showed interaction quality is essential to promote psychological well-being in persons living with dementia regardless of presence or type of interaction. This study highlights the importance of positive care provider interactions in dementia care. Additionally, institutional efforts to create an environment to reduce negative interactions appears essential to improve the psychological well-being of persons living with dementia. TRIAL REGISTRATION: The study was reviewed and approved by the Yonsei University Institutional Review Board on October 16, 2020 (ref no: Y-2020-0158).

Association between Visual Impairment and Nutritional Risk among Older Adults with Diabetes: A Population-Based Cross-Sectional Study.

PURPOSE: Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment. METHODS: This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao-Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk. RESULTS: Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk. CONCLUSION: Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.

Sleep, physical activity, and sedentary behaviors as factors related to depression and health-related quality of life among older women living alone: a population-based study.

BACKGROUND: Although the number of older women living alone (OWLA) has risen steadily in aging societies, and research has been conducted on depression and health-related quality of life (HRQoL) among older adults, research is scarce on the health behaviors of OWLA, including their sleep, physical activity, and sedentary behaviors. Hence, we aimed to identify factors related to depression and HRQoL among this subset of the population, focusing on their health behaviors, using Andersen's model as a research framework. METHODS: Data for secondary analysis were from the Korean National Health and Nutritional Examination Survey (2014, 2016, 2018, and 2020). The inclusion criteria were (1) women aged 65 and older and (2) those living alone. We included 794 older South Korean women living alone from 31,051 respondents. We used hierarchical regression analysis, considering sampling weight and a complex sample design, to identify factors related to depression and HRQoL. RESULTS: Among the health behavior factors of Andersen's model as a research framework, sleep was associated with depression, whereas physical activity and sedentary behaviors were related to HRQoL. Subjective health status, limited activity, and perceived stress were associated with both depression and HRQoL. Household income, as an enabling factor, was only associated with HRQoL. The final regression model explained 39% of the variance in depression (p < 0.001) and 37% of the variance in HRQoL (p < 0.001). CONCLUSIONS: Our study highlights the importance of strategies to improve specific healthy behaviors that affect depression and HRQoL in OWLA. Appropriate interventions that target increasing physical activity and quality of sleep, and decreasing sedentary behaviors, will be effective to enhance the well-being of OWLA. Healthcare providers should comprehensively understand the characteristics of OWLA and pay more attention to enabling, need, and health behavior factors.

RNA outperforms DNA-based metabarcoding in assessing the diversity and response of microeukaryotes to environmental variables in the Arctic Ocean.

The Arctic Ocean (AO) has a harsh environment characterized by low temperatures, extensive ice coverage, and periodic freezing and melting of sea ice, which has provided diverse habitats for microorganisms. Prior studies primarily focused on microeukaryote communities in the upper water or sea ice based on environmental DNA, leaving the composition of active microeukaryotes in the diverse AO environments largely unknown. This study provided a vertical assessment of microeukaryote communities in the AO from snow and ice to sea water at a depth of 1670 m using high-throughput sequencing of co-extracted DNA and RNA. RNA extracts depicted microeukaryote community structure and intergroup correlations more accurately and responded more sensitively to environmental conditions than those derived from DNA. Using RNA:DNA ratios as a proxy for relative activity of major taxonomic groups, the metabolic activities of major microeukaryote groups were determined along depth. Analysis of co-occurrence networks showed that parasitism between Syndiniales and dinoflagellates/ciliates in the deep ocean may be significant. This study increased our knowledge of the diversity of active microeukaryote communities and highlighted the importance of using RNA-based sequencing over DNA-based sequencing to examine the relationship between microeukaryote assemblages and the responses of microeukaryotes to environmental variables in the AO.

Experiences of implementing person-centered care for individuals living with dementia among nursing staff within collaborative practices: A meta-synthesis.

BACKGROUND: Person-centered care is considered standard care in long-term care for individuals living with dementia. However, qualitative reviews that synthesize the staff experiences of the implementation of person-centered care are lacking. OBJECTIVE: This review aims to synthesize the experiences of nursing staff members after the implementation of person-centered care for individuals living with dementia. DESIGN: A meta-synthesis was conducted. DATA SOURCES: Overall, five electronic databases (i.e., PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO, and Cochrane Library) were searched for the following terms: "dementia," "person-centered care," and "qualitative." The search was limited to articles published in English from January 1998 to December 2021, considering the period when person-centered care was applied in dementia care. REVIEW METHODS: Qualitative content analysis was conducted using a person-centered nursing framework. Meta-data analysis, meta-method, and meta-theory analysis were used to synthesize the results of the included studies. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. RESULTS: Altogether, 19 studies were included in this review. Through meta-synthesis, 12 themes, including professionally competent, perspective shift, shared decision-making among staff, appropriate supportive system, understanding and respecting individuals living with dementia, interaction with persons living with dementia and their family members, collaboration among staff members, concern about the well-being of an individual living with dementia, meaningful relationship between staff members and individuals living with dementia, quality care, reflections for maintenance, and barriers to overcome, emerged. CONCLUSIONS: A person-centered nursing framework could be implemented in person-centered care for individuals living with dementia. However, the framework should be modified based on the characteristics of individuals living with dementia. Additionally, reflection strategies for maintenance and barriers are added to facilitate successful person-centered care implementation. REGISTRATION: The study was registered with PROSPERO (International prospective register of systematic reviews) in May 2022 (registration number: CRD42022316097).

Evaluating a theory-based intervention for improving eHealth literacy in older adults: a single group, pretest-posttest design.

BACKGROUND: The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS: Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. RESULTS: Participants' computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. CONCLUSION: The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.

Factors Associated With Diabetes Self-Care Behaviors of People With Visual Impairment: A Cross-Sectional Study.

PURPOSE: The purpose of the study was to examine the factors associated with diabetes self-care behaviors (DSCB) in people with visual impairment (PVI), including demographics, disease-related characteristics, and psychosocial factors (self-efficacy, depression, and family support). METHODS: A descriptive cross-sectional study was conducted. Adults with visual impairment and diabetes were recruited online and through posting notices, and a total of 141 participants were included. Measurements were completed using email and telephone surveys. Multiple linear regression analysis was performed to examine the factors associated with DSCB. RESULTS: Higher self-efficacy and positive family support were significant predictors of better DSCB, whereas higher negative family support was a significant predictor of worse DSCB. Diabetes medication regimen was another major influencing factor on DSCB. However, depression was not associated with DSCB. CONCLUSION: Diabetes interventions for the visually impaired should have strategies to improve vulnerable areas of diabetes self-care, such as blood glucose monitoring. Health care providers are needed to consider diabetes education programs focused on improving self-efficacy or include family members in interventions to promote DSCB in PVI. Further studies are required to understand the problems and solutions for diabetes self-care in this population.

The Moderating Effects of Disability on Mobile Internet Use Among Older Adults: Population-Based Cross-sectional Study.

BACKGROUND: The preferred devices to access the internet are changing from personal computers to mobile devices, and the number of older adults with or without disabilities is rapidly increasing in an aging society. However, little is known about the moderating effects of disability on mobile internet use among older adults. OBJECTIVE: This study aimed to examine the levels of mobile internet use and factors associated with this use among older adults according to their disabilities. In addition, moderating effects of disability on mobile internet use were investigated. METHODS: This study consisted of a secondary data analysis using the 2020 Digital Divide Survey conducted in South Korea. The single inclusion criterion was participants being aged 55 years or older; accordingly, 2243 people without disabilities and 1386 people with disabilities were included in the study. Multiple regression analyses considering complex sample designs were conducted to identify mobile internet use factors and to test the moderating effects of disability on mobile internet use. RESULTS: Older adults with disabilities used mobile internet less than older adults without disabilities. However, disability status had moderating effects on the relationships between mobile internet use and (1) operational skills regarding mobile devices (B=0.31, P=.004), (2) internet use skills (B=1.46, P<.001), (3) motivation to use digital devices (B=0.46, P=.01), and (4) attitude toward new technology (B=0.50, P=.002). The results revealed that these positive relationships were stronger among older adults with disabilities than among adults without disabilities. CONCLUSIONS: Although older adults and people with disabilities are considered vulnerable populations regarding technology adoption, disability creates a stronger association between several determinants and actual mobile internet use. Therefore, policy makers and practitioners should pay attention to older adults with disabilities to deliver appropriate information-literacy education. Older adults with disabilities could be the primary beneficiaries of mobile services and new technology.

Spatial dynamics of active microeukaryotes along a latitudinal gradient: Diversity, assembly process, and co-occurrence relationships.

Recent global warming is profoundly and increasingly influencing the Arctic ecosystem. Understanding how microeukaryote communities respond to changes in the Arctic Ocean is crucial for understanding their roles in the biogeochemical cycles of nutrients and elements. Between July 22 and August 19, 2016, during cruise ARA07, seawater samples were collected along a latitudinal transect extending from the East Sea of Korea to the central Arctic Ocean. Environmental RNA was extracted and the V4 hypervariable regions of the reverse transcribed SSU rRNA were amplified. The sequences generated by high throughput sequencing were clustered into zero-radius OTUs (ZOTUs), and the taxonomic identities of each ZOTU were assigned using SINTAX against the PR2 database. Thus, the diversity, community composition, and co-occurrence networks of size fractionated microeukaryotes were revealed. The present study found: 1) the alpha diversity of pico- and nano-sized microeukaryotes showed a latitudinal diversity gradient; 2) three distinct communities were identified, i.e., the Leg-A, Leg-B surface, and Leg-B subsurface chlorophyll a maximum (SCM) groups; 3) distinct network structure and composition were found in the three groups; and 4) water temperature was identified as the primary factor driving both the alpha and beta diversities of microeukaryotes. This study conducted a comprehensive and systematic survey of active microeukaryotes along a latitudinal gradient, elucidated the diversity, community composition, co-occurrence relationships, and community assembly processes among major microeukaryote assemblages, and will help shed more light on our understanding of the responses of microeukaryote communities to the changing Arctic Ocean.

Contrasting Community Composition and Co-Occurrence Relationships of the Active Pico-Sized Haptophytes in the Surface and Subsurface Chlorophyll Maximum Layers of the Arctic Ocean in Summer.

Haptophytes (Hacrobia: Haptophyta), which can perform phototrophic, phagotrophic, or mixotrophic nutritional modes, are critical for element cycling in a variety of aquatic ecosystems. However, their diversity, particularly in the changing Arctic Ocean (AO), remains largely unknown. In the present study, the biodiversity, community composition, and co-occurrence networks of pico-sized haptophytes in the surface water and subsurface chlorophyll maximum (SCM) layer of the AO were explored. Our results found higher alpha diversity estimates in the surface water compared with in the SCM based on high-throughput sequencing of haptophyte specific 18S rRNA. The community composition of the surface water was significantly different from that of the SCM, and water temperature was identified as the primary factor shaping the community compositions. Prymnesiales (mostly Chrysochromulina), uncultured Prymnesiophyceae, and Phaeocystis dominated the surface water communities, whereas Phaeocystis dominated the SCM communities, followed by Chrysochromulina, uncultured Prymnesiophyceae, and the remaining taxa. The communities of the surface water and SCM layer developed relatively independent modules in the metacommunity network. Nodes in the surface water were more closely connected to one another than those in the SCM. Network stability analysis revealed that surface water networks were more stable than SCM networks. These findings suggest that SCM communities are more susceptible to environmental fluctuations than those in surface water and that future global changes (e.g., global warming) may profoundly influence the development, persistence, and service of SCM in the AO.

Characterization and Health-Related Quality of Life in Older Adults With Disabilities According to Timing of Disability Onset.

The current study examined characteristics of early-onset and late-onset disability in older adults and identified predictors of health-related quality of life (HRQoL). This is a secondary data analysis of the 2017 national survey in South Korea. Participants were 4,014 older adults with disabilities, who were divided into an early-onset group (n = 2,229) and late-onset group (n = 1,785). Data were analyzed using complex sample analyses. Difficulties during outdoor activity and transportation use, self-rated health, and stress were common predictors in both groups. Comorbidity was a significant predictor only in the early-onset group. Use of information technology devices, household income, and perceived social discrimination were significant predictors in the late-onset group. Characteristics and predictors of HRQoL were different between groups, despite sharing common characteristics. It is necessary to improve support systems and health care services for older adults with disabilities. [Journal of Gerontological Nursing, 48(3), 37-47.].

Factors Related to Smartphone Overdependence in Mothers of Preschoolers: A Systematic Review and Meta-Analysis.

Smartphone overdependence (SO) in mothers of preschoolers (MPs) reduces the parenting capacity of MPs. The current study aimed to identify associated factors of SO in MPs through a systematic review and meta-analysis conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using 10 electronic databases. A total of 18 studies met the inclusion criteria. It was confirmed that SO in MPs is a coping strategy used to manage stress during childrearing. Parenting stress, depression, unemployment, and low household income were identified as risk factors that increased SO in MPs. Protective factors that reduced SO in MPs included resilience and parental intelligence. Findings emphasize the need to assess risk factors to prevent SO in MPs. It is suggested that programs to prevent SO in MPs be developed based on results of this study. [Journal of Psychosocial Nursing and Mental Health Services, 60(3), 40-47.].

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study.

BACKGROUND: Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automatic alerting system (AAS) based on electronic medical records (EMRs). METHODS: We retrospectively analyzed clinical data of patients for whom the RRS was activated in the surgical wards of a tertiary university hospital. We compared the code rate, in-hospital mortality, unplanned intensive care unit (ICU) admission, and other clinical outcomes before and after applying RRS and AAS as follows: pre-RRS (January 2013-July 2015), RRS without AAS (August 2015-November 2016), and RRS with AAS (December 2016-December 2017). RESULTS: In-hospital mortality per 1000 admissions decreased from 15.1 to 12.9 after RRS implementation (p < 0.001). RRS activation per 1000 admissions increased from 14.4 to 26.3 after AAS implementation. The severity of patients' condition calculated using the modified early warning score increased from 2.5 (± 2.1) in the RRS without AAS to 3.6 (± 2.1) (p < 0.001) in the RRS with AAS. The total and preventable code rates and in-hospital mortality rates were comparable between the RRS implementation periods without/with AAS. ICU duration and mortality results improved in patients with RRS activation and unplanned ICU admission. The data of RRS non-activated group remained unaltered during the study. CONCLUSIONS: Real-time AAS based on EMRs might help identify unstable patients. Early detection and intervention with RRS may improve patient outcomes.

Importance of seasonal sea ice in the western Arctic ocean to the Arctic and global microplastic budgets.

Arctic sea ice entraps microplastics (MP) from seawater and atmosphere and is recognized as sink and transport vector of MPs. However, ice-trapped fraction in the global MP budget, contribution of atmospheric input, and linkage among Arctic basins remain unclear. To assess them, we investigated the number- and mass-based data separated by size and shape geometry for MPs in sea ice, snow, and melt pond water from the western Arctic Ocean (WAO). A significant dependency of MP data on measured cutoff size and geometry was found. For the same size range and geometry, sea ice MPs in WAO ((11.4 ± 9.12) × 103 N m-3 for ≥ 100 µm) were within comparable levels with those in other Arctic basins, but showed closer similarity in polymer and shape compositions between WAO and Arctic Central Basin, indicating the strong linkage of the two basins by the Transpolar Drift. Our budgeting shows that a significant amount of plastic particles ((3.4 ± 2.6) × 1016 N; 280 ± 701 kilotons), which are missed from the global inventory, is trapped in WAO seasonal sea ice, with < 1% snowfall contribution. Our findings highlight that WAO ice zone may play a role as a sink of global MPs as well as a source of Arctic MPs.

Chronic disease interventions for people with visual impairment: A systematic review.

AIM: To identify the characteristics of chronic disease interventions for people with visual impairment (PVI) and provide suggestions for future interventions. BACKGROUND: Chronic diseases are more common in PVI than people without visual impairment, and PVI have difficulty managing chronic diseases due to physical, social, and psychological problems associated with visual impairment. However, evidence regarding chronic disease intervention for PVI is limited. METHODS: This review was guided by the PRISMA methodology. Data were extracted and checked, and each study was evaluated to ensure their methodological quality using appropriate tools based on the study design. Findings were described through a qualitative synthesis, and the above process was carried out by all four researchers. RESULTS: 28 studies were selected. The intervention for mental disorders was the most common with about 39.3%, followed by stroke (25.0%), diabetes (17.8%), various chronic diseases (10.7%), chronic pain (3.6%), and scoliosis (3.6%). Most of the intervention was delivered individually, and the place of intervention often depends on the preference or convenience of PVI. A wide range of intervention materials was used, from large print, audio, or braille version reading materials to technology products. Based on the results, the main areas of the outcomes were daily living function, psychological conditions, and quality of life. CONCLUSIONS: This review identified the components of interventions for PVI and provided intervention strategies. In particular, chronic disease interventions for PVI should be planned by considering how and where appropriate interventions are provided, various available materials, and the problems to be addressed.

[Diabetes Self-Management Experience of Patients with Diabetes: Focused on the Visually Impaired].

PURPOSE: This study aimed to understand and describe the diabetes self-management experience of visually impaired people with diabetes. METHODS: Ten participants were recruited through a website used by the visually impaired from February to March 2020. Data were collected through two focus group interviews conducted in June 2020; each group consisted of five participants. All interviews were recorded with the consent of the participants and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. RESULTS: Seven categories were as follows; a two-faced, lifelong companion, an unprepared encounter, struggle to live, love-hate relationship with family, strategies to adapt, lessening attention to self-management, the desire to learn properly. CONCLUSION: It can be concluded that the visually impaired have fewer opportunities for receiving diabetes self-management education than general diabetic patients. Consequently, plans to improve the education available to such patients are required. Additionally, psychological counseling and diabetes education for patients' families are necessary, and improving the perception of medical workers regarding the visually impaired will be prove useful.

Psychometric comparisons of measures of eHealth literacy using a sample of Korean older adults.

AIMS: This study aimed to compare the psychometric properties of two measures of eHealth literacy, namely, the Korean versions of the Digital Health Literacy Instrument (K-DHLI) and eHealth Literacy Scale (K-eHEALS), among older adults in South Korea. BACKGROUND: Given the usefulness of eHealth information, measures of eHealth literacy have been developed. It is necessary to examine the validity of such tools among older adults who are likely to experience difficulties in using eHealth resources. METHODS: A validation study was conducted using the secondary data of 180 older adults in South Korea. Two weeks after they had responded to the K-DHLI and K-eHEALS, 89 of them completed the assessments a second time so that the assessments' test-retest reliability could be examined. Using the collected data, their reliability (i.e. internal consistency, test-retest reliability) and validity (i.e. construct validity and criterion validity) were examined. RESULTS: Both tools demonstrated satisfactory internal consistency (α ≥ 0.90, item-total correlation coefficients = .39-.76) as well as good test-retest reliability with intraclass correlation coefficients .77 and .84, respectively. The 21 items of the K-DHLI loaded onto five factors, which accounted for 71% of the variance. The 10 items of the K-eHEALS loaded onto a single factor, which explained 58% of the total variance. The scores of both tools were strongly correlated (r = .63) and positively related to attitudes towards internet health information and subjective health status (r = .23-.50). CONCLUSIONS: The findings suggest that the K-DHLI and K-eHEALS are reliable and valid tools that can be used to assess the utilisation of eHealth resources by older adults. IMPLICATIONS FOR PRACTICE: The findings can help healthcare providers choose a suitable measure of eHealth literacy when working with older adults.