Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community.

Objective: This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings. Background: Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established. Methods: A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI). Results: The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI. Conclusion: The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.

Differences in regional distribution and inequality in health workforce allocation in hospitals and primary health centers in China: A longitudinal study.

BACKGROUND: In 2009, China launched a new round of healthcare reform to provide households with secure, efficient, convenient, equitable and affordable healthcare services. Healthcare reform is underpinned by three critical pillars: the health workforce, funding, and infrastructure, with reform of the health workforce being particularly significant. OBJECTIVE: This study analyses the disparities in regional distribution and the inequity of healthcare workforce allocation across hospitals and primary health centers in China over twelve years. DESIGN: Retrospective longitudinal data from the National Health Statistics Yearbook 2011-2022 and National Statistical Yearbook in China from 2011 to 2022 were collected for analysis. PARTICIPANTS: The focus was on hospitals and primary health centers, explicitly examining their health technician and nursing workforce. METHODS: The research utilized four key indicators of the healthcare workforce to evaluate the distribution of health resources between hospitals and primary health centers. Furthermore, the Gini coefficient and Theil index were employed to assess the inequality in allocating the health workforce. RESULTS: Between 2010 and 2021, there was a nationwide increase in the ratio of health workers per 1000 population in hospitals and primary health centers. It is noted that rural districts had higher ratios than urban districts in terms of the number of health technicians and nurses per 1000 population, whether in hospitals or primary health centers; western districts had higher ratios than eastern and central districts did. In the same year, at different levels of medical institutions, the Theil indices of health technicians and nurses in hospitals were lower than those in primary health centers in terms of both demographic and geographical dimensions. Regarding the allocation of the health workforce by population, the Gini coefficient remained below 0.3, while for geographical allocation, it exceeded 0.4. CONCLUSIONS: This study analyzed the temporal trends and inequality of health-resource allocation at the hospital and primary health center levels in China, noting trends of improvements in the quantity and inequality in health workforce allocation from 2010 to 2021, suggesting the success of the government's efforts to advance healthcare reform since 2009. The allocation of health workforce based on population exhibits greater fairness compared to geographical distribution.

Psychometric Properties of the Chinese Version of the Occupational Fatigue Exhaustion/Recovery Scale: A Test in a Nursing Population.

BACKGROUND: The Occupational Fatigue Exhaustion/Recovery Scale (OFER) was designed to assess occupational fatigue in nurses. Although the original English version of this instrument has shown high degrees of reliability and validity, a Chinese version of this scale has yet to be verified. PURPOSE: The aim of this study was to evaluate the psychometric properties of the OFER in a population of Chinese nurses. METHODS: The scale was translated using translation and back-translation. The validities and reliabilities were evaluated on 923 qualified participants using content validity index, concurrent validity, factorial validity, internal consistency reliability, and test-retest reliability. RESULTS: The content validity index for the OFER was .92. The correlation coefficients between the scores of the OFER subscales and the criteria in this study (varying from -.498 to .705) verified that the OFER has acceptable concurrent validity. Principal component analysis and confirmatory factor analysis revealed that three factors correspond to the structure of the original instrument and that recovery mediates the relationship between acute and chronic fatigue. The Cronbach's alpha for the chronic fatigue, acute fatigue, and intershift recovery subscales were .83, .85, and .86, respectively. Test-retest reliabilities with correlation coefficients from .61 to .78 were found in the three subscales. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: OFER is a reliable and valid instrument for assessing work-related fatigue in Chinese nurses. However, further improvement of the acute fatigue subscale is recommended. The OFER has the potential to elicit information that is useful for assessing fatigue in nurses in China. Furthermore, as it differentiates between acute and chronic fatigue, OFER may be an effective tool for guiding the development and implementation of various, related intervention measures.

[Correlation Between Job Characteristics and Occupational Fatigue in Nurses].

BACKGROUND: Occupational fatigue in nurses has earned much attention in recent years. This phenomenon affects the health of nurses and threatens the safety of patients. However, few studies have reported on the correlation between job characteristics and occupational fatigue in China. PURPOSE: The present study describes the nursing job characteristics and nursing occupational fatigue situation at general hospitals in Chengdu in China and explores the correlations between job characteristics and occupational fatigue. METHODS: A cross-sectional descriptive correlation design with systematic sampling was used to recruit 923 nurses from general hospitals in Chengdu. The structural questionnaires used in this study included a personal data-sheet, Occupational Fatigue Exhaustion Recovery Scale (OFER), and Job Content Questionnaire (JCQ). Mean, percentage, independent t test, Chi-square test, Pearson correlation, and multiple linear regression analysis were employed to analyze data. RESULTS: Nurses' acute fatigue level and chronic fatigue level were high, with average scores of 60.30 ± 22.02 and 46.44 ± 23.33, respectively. All dimensions (with the exception of colleague support) correlated significantly with job characteristics and occupational fatigue. Job control, job demand, and amount of shiftwork were important predictors of both acute fatigue and chronic fatigue. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of the study may help the managers better understand the current situation of nurses' occupational fatigue and formulate effective measures that consider the individual characteristics of nurses and the differences in perceived job control and job demand. Furthermore, the results may help nurses better assess the causes of their work-related fatigue and facilitate coping measures in order to reduce acute and chronic fatigue.