Occurrence and Risk Factors for Cognitive Decline Shared by Couples: A Systematic Review and Meta-Analysis.

Background: To date, the magnitude of association and the quality of evidence for cognitive decline (mild cognitive impairment, Alzheimer's disease, and dementia) in couples and risk factors for outcomes have not been reviewed and analyzed systematically. Objective: The aim of this study was to investigate the concordance of cognitive impairment in unrelated spouses and to qualitatively describe potential risk factors. Methods: Eight databases were searched from inception to October 20, 2023. Eligible studies were independently screened and assessed for quality. Statistical analysis was conducted using Stata 15.1 software. The study was preregistered with PROSPERO (CRD42023488024). Results: Eleven studies involving couples were included, with moderate to high evidence quality. Compared to controls, spouses of individuals with cognitive impairment had lower cognitive scores (Cohen's d: 0.18-0.62) and higher risk of cognitive decline (OR = 1.42, 95% CI: 1.15-1.76). The consistency of cognitive impairment between spouses was attributed to three theories: 1) the impact of caregiving stress experienced by the spouse; 2) assortative mating, which suggests that individuals select partners with similar characteristics; and 3) the influence of shared living environments and lifestyles. Conclusions: The cognitive status of one spouse can affect the cognitive function of the other spouse. It is important to consider shared lifestyle, environmental, and psychobehavioral factors, as they may contribute to the risk of cognitive decline by couples. Identifying these factors can inform the development of targeted recommendations for interventions and preventive measures.

Mediterranean diet related to 3-year incidence of cognitive decline: results from a cohort study in Chinese rural elders.

OBJECTIVE: This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up. METHODS: This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0-6 points) and high compliance (7-14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression. RESULTS: During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (ß = -0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (ß = -0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline. CONCLUSIONS: This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function.

Impression life with pulmonary hypertension: clinically relevant characteristics and quality of life among patients in Gansu, China.

BACKGROUND: The adverse effects of pulmonary arterial hypertension (PAH) on physical, emotional, and health-related quality of life (HRQoL) remain primarily unrecognized, especially in resource-limited settings. OBJECTIVES: This study aims to characterize the HRQoL of patients with PAH in this area and also identify the potential role of clinically relevant characteristics, including the 6-min walk distance test (6MWD), WHO-Functional Classification (WHO-FC), and mental health in the occurrence of lowering quality of life. DESIGN: This was a cross-sectional observational study. METHODS: Inpatients with PAH were chosen from a tertiary hospital located in Gansu province, China. All participants were interviewed face-by-face by using questionnaires, including items from the 36-Item Short Form Health Survey (SF-36), the self-rating anxiety scale, and the self-rating depression scale. Data on demographic and clinically relevant characteristics, including WHO-FC and 6MWD, were also collected by tracing medical recorders. Multiple linear regression analysis was used to determine the association between demographic, clinically relevant characteristics data, and physical component summary (PCS) or mental component summary (MCS) in SF-36. RESULTS: Of the 152 participants, SF-36 differed significantly from Chinese norms in all eight domains, with role-physical (21.55 ± 9.87) less than one-third of the norm (88.79 ± 28.49). Multiple linear regression results showed that the factors with the greatest impact on PCS were anxiety scores (ß = -0.22, p = 0.001), followed by WHO-FC (ß = -0.16, p = 0.014) and 6MWD (ß = 0.15, p = 0.036). The factors with the greatest impact on MCS were WHO-FC (ß = -0.30, p < 0.001), followed by anxiety (ß = -0.23, p = 0.001) and depression scores (ß = -0.16, p = 0.013). CONCLUSION: HRQoL was substantially reduced among PAH patients in the resource-limited area, mainly the physiological functions. WHO-FC and anxiety scores were independently associated with both PCS and MCS in SF-36. Clinicians should make reasonable rehabilitation programs and plans for patients according to their cardiac function grade and the severity of clinical symptoms. In addition, psychological interventions should also be taken, especially for those with anxiety symptoms, so as to improve their HRQoL.

'Fear, uncertain, tired ...' psychological distress among pulmonary hypertension patients: a qualitative interview study.

BACKGROUND: Patient-centered health care for patients with pulmonary hypertension (PH) is important and requires an understanding of patient experiences. However, there is a lack of approaches to examine what's the effects and how the disease impact patients' psychological well-beings. METHODS: We conducted qualitative interviews with PH patient representatives to understand patient psychological experiences and inform patient-centered research and care. Participants were chosen from a tertiary hospital located in northwest China. 20 patients with PH who be treated at the hospital (13 participants were women, aged 18-74 years) were strategically selected and individually interviewed. We used qualitative analysis to identify themes relating to existential psychological distress that would clarify the nature of such concerns. RESULTS: We found that patients experience tremendous psychological distress throughout the treatment process. Four categories that describe patients' psychological experiences emerged: burden of PH treatment, fear and uncertainty about the disease, frustration in social and family role, and lack of recognition of the condition. CONCLUSIONS: Existential concerns are salient in PH and involve the experience of loss and disruptions to the sense of self and relationships. Healthcare practitioners must work more in collaboration to detect patients' need for support and to develop the patient's own skills to manage daily life. The PH teams should tailor interventions to provide emotional, informational and instrumental support and guidance to patients.

Prevalence and Determinants of Delay in Time-to-Diagnosis for Pulmonary Arterial Hypertension Patients in Gansu China: A Observational Cohort Study.

Current studies of patients with pulmonary arterial hypertension (PAH) have shown a significant diagnostic delay. However, the causes and risk factors for this delay are not been well explored in Chinese population. This study aimed to assess the status of diagnostic delay in patients with PAH in China. Additionally, we identified factors associated with the delay. Demographic and clinical data were collected from 153 PAH patients admitted to three tertiary hospitals in Gansu, China, from March 2020 to October 2022. Based on the recorded date, the diagnostic delay was divided into patient delay and health system delay. For analysis, we divided diagnostic delay into 2 groups (≤3 years and >3 years). Factors associated with delay were identified by binary logistic regression. The median diagnostic delay was 3 years (IQR: 0.25-5.88). Binary logistic regression analysis showed that male (OR = 2.48, 95% CI: 1.10-5.58), those with junior high school or below (OR = 3.65, 95% CI: 1.36-9.78), living far away from the tertiary hospital (OR = 2.66, 95% CI: 1.14-6.18), initially visit hospital before 2018 (OR = 3.82, 95% CI: 1.68-8.71), and visit hospital at county level or below (OR = 3.80, 95% CI: 1.42-10.18) were risk factor for diagnostic delay (>3 years). Despite increased awareness, most patients with PAH in Gansu, China still experienced a delay in diagnosis of more than 3 years. Male sex, lower educational background, and being away from tertiary hospitals are risk factors for delay. Furthermore, factors impacting time-to-diagnosis and its impact should be continuously evaluated as therapeutic strategies continue to evolve and improve.

Self-perceived care needs and quality of life in people with cognitive impairment during routine care at home: cross-sectional results of the interventional study.

BACKGROUND: Cognitive impairment (CI) is one of the most common disabling symptoms in the elderly, and people with CI face a variety of unmet care needs. There is limited evidence on the relationship between unmet needs and quality of life (QoL) of people with CI. The aim of this study is to analyse the current situation of unmet needs and QoL among people with CI, and to explore the correlation between QoL and unmet needs. METHODS: The analyses use baseline data of the intervention trial, which recruited 378 participants to complete the questionnaire including the Camberwell Assessment of Need for the Elderly (CANE), and the Medical Outcomes Study 36-item Short-Form (SF-36). The SF-36 was further gathered into physical component summary (PCS) and mental component summary (MCS). Multiple linear regression analysis was conducted to explore the correlations between unmet care needs and PCS and MCS of SF-36. RESULTS: The mean score of each of the eight domains of SF-36 was significantly lower than the Chinese population norm. The incidence of unmet needs ranged from 0 to 65.1%. Multiple linear regression results showed that living in rural areas (Beta=-0.16, P < 0.001), having unmet physical needs (Beta=-0.35, P < 0.001), and unmet psychological needs (Beta=-0.24, P < 0.001) were associated with lower PCS scores, whereas duration of CI > 2 years (Beta=-0.21, P < 0.001), unmet environmental needs (Beta=-0.20, P < 0.001), and unmet psychological needs (Beta=-0.15, P < 0.001) were associated with lower MCS scores. CONCLUSION: The main results support the important view that lower QoL scores are associated with unmet needs in people with CI, depending on the domain. Given that the more unmet needs can further worsen QoL, it is recommended that more strategies should be taken, especially for those with unmet care needs, so as to improve their QoL.

Critical thinking abilities among newly graduated nurses: A cross-sectional survey study in China.

AIM: The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors. DESIGN: A cross-sectional questionnaire survey. METHODS: The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI-CV and nurses' general characteristics. RESULTS: In terms of open-mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession.

Predictors of adherence of enhanced external counterpulsation in patients with coronary heart disease after discharge: A mixed-methods study.

Background: Although enhanced external counter pulsation (EECP) has been included in the cardiac rehabilitation prescription for coronary heart disease (CHD) in China, because the total treatment duration of a course of EECP is 36-36 h, the average hospital stay of CHD patients is short, and the adherence after discharge remains unclear. The purpose of this study is to investigate the adherence to EECP in CHD patients after discharge, and analyze the related influencing factors. Methods: A retrospective mixed method study combining qualitative and quantitative methods. Quantitative component included CHD patients who had received EECP treatment between March 2020 and August 2021. The qualitative component included in-depth interviews with patients who did not adhere to EECP after discharge. Binary Logistic regression was used to analyze the predictors of EECP adherence after discharge. In-depth interviews with patients were conducted to explore the reasons for dropping out of the EECP after discharge. Results: Among 1,304 patients, only 24.23% adhered to EECP treatment after discharge. Binary logistic regression results showed that patients with disease duration < 2 years (OR = 3.13, 95%CI: 2.31-4.24), high school or below (OR = 2.81, 95%CI: 1.98-4.01), distance between residence and hospital more than 20km (OR = 2.08, 95%CI: 1.47-2.96), age over 60 (OR = 2.00, 95%CI: 1.46-2.74), female (OR = 1.64, 95%CI: 1.78-2.29), and angina pectoris (OR = 1.65, 95%CI: 1.16-2.34) were more likely to not adhere to EECP treatment after discharge. However, patients with monthly family income over 8000¥ (OR = 0.46, 95%CI: 0.28-0.75) were more likely to adhere to EECP treatment after discharge than those with household monthly income below 4,000¥. In the qualitative results, the reasons why patients do not adhere to EECP after discharge mainly include insufficient understanding, restricted objective conditions and psychosocial factors. Conclusions: The adherence of CHD patients to EECP treatment after discharge was poor. It is necessary to develop effective intervention measures, such as brochures or videos to improve patients' understanding of the importance of adherence to EECP treatment after discharge. In addition, offering EECP treatment during off-hours and weekends may also improve adherence in more young patients.

Association of adverse childhood experiences with diabetes: A systematic review and meta-analysis.

BACKGROUND: Further clarification is needed regarding the association between adverse childhood experiences (ACEs) and the risk of diabetes. To conduct a systematic review with meta-analysis of studies assessing the association between ACEs and the risk of diabetes. METHOD: We conducted a systematic literature search of PubMed, Embase, and Cochrane Library for published studies describing the association between ACEs and diabetes in December 2021. We examined the overall relationship between ACEs and diabetes and performed a subgroup analysis based on the type of ACEs, number of ACEs, and gender. RESULTS: A total of 17 studies were included. The results of Meta-analysis showed the significant estimated effect of ACEs on diabetes (OR = 1.20, 95%CI: 1.07, 1.35). The subgroup analysis found a significant association between neglect (OR = 1.61, 95%CI: 1.11, 2.33), family dysfunction (OR = 1.14, 95%CI: 1.05, 1.24) and diabetes, respectively. Gender and the number of ACEs were factors that significantly affect the risk of diabetes. CONCLUSION: The results suggest that ACEs were significantly associated with an elevated risk of diabetes, especially for exposure to neglect, family dysfunction, and two or more ACES. Effective ACEs screening for children and intervention among high-risk populations should be taken so as to reduce the incidence of diabetes.

Identification of risk factors for 1-year mortality among critically ill older adults with hip fractures surgery: A single medical center retrospective study.

Aim: The purpose of this study was to analyze the potential risk factors for mortality 1 year after hip fracture surgery in critically ill older adults. Methods: We reviewed 591 critically ill older adults who underwent hip surgery at our institution from January 2018 to April 2021. We collected baseline demographics, clinical information, and 1-year survival status of the sample patients by means of medical record systems and follow-up phone calls. Patients were divided into survival and mortality groups based on survival within 1 year after surgery. Results: Based on the results of the 1-year postoperative follow-up of patients, we obtained 117 cases in the death group and 474 cases in the survival group, and this led to a 1-year mortality rate of 19.8% (117/591) after hip fracture in critically ill older adults at our hospital. The risk factors that influenced the 1-year postoperative mortality were identified as advanced age (HR:1.04, 95%, 1.01-1.06), preoperative arrhythmia (HR: 1.95, 95%, 1.26-2.70), high level of NLR (HR:1.03, 95%, 1.01-1.06), respiratory failure (HR: 2.63, 95%, 1.32-5.23), and acute cardiovascular failure. 5.23) and acute cardiovascular events (HR: 1.65, 95%, 1.05-2.59). Conclusion: Advanced age, preoperative arrhythmias, high levels of NLR, postoperative respiratory failure, and acute cardiovascular events were independent risk factors for survival of critically ill older adults with hip fracture at 1 year after surgery. Therefore, laboratory tests such as high levels of preoperative NLR can be an important indicator of patient prognosis.

The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study.

BACKGROUND: Clinical practice is a core component of nurse education. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, satisfaction, as well as influence their choice of future career. To examine nursing students' perception of clinical learning environment and mentoring in hospital where they perform their clinical placement and the connection of these factor with intention to work as a nurse once graduated. METHODS: Nursing students enrolled in clinical practice at least 6 months in hospitals in China were surveyed between January-March 2021. Percentages, frequencies, mean, standard deviation, t-test, ANOVA, and regression analysis were used to analyse the data. RESULTS: Of the five scales in the CLES+T, 'Leadership style of the ward manager' scored the highest mean while 'Pedagogical atmosphere at the ward' scored the lowest. Nursing students with lower educational level, those supervised by fixed preceptor, and those intent to be a nurse in the future were significantly more satisfied with the CLES+T. Most of the nursing students are intent to work as a nurse in the future. CLES+T total scores and sub-dimensions (Premises of nursing on the ward) have significantly effectiveness on the intention to be a nurse in the future. CONCLUSIONS: Given the significant correlation of between learning environments and nursing students intention to be a nurse in the future, ward managers need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections among students through effective feedback mechanisms, which can enable students to experience a better clinical learning environment and meaningful experiences to build their professional roles and competencies, thus helping to enhance students' willingness to pursue nursing careers in the future.

Evaluation of reporting quality of abstracts of randomized controlled trials regarding patients with COVID-19 using the CONSORT statement for abstracts.

OBJECTIVE: To evaluate the reporting quality of randomized controlled trial (RCT) abstracts regarding patients with coronavirus disease 2019 (COVID-19) and to analyze the factors influencing the quality. METHODS: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to collect RCTs on patients with COVID-19. The retrieval time was from inception to December 1, 2020. The CONSORT statement for abstracts was used to evaluate the reporting quality of RCT abstracts. RESULTS: A total of 53 RCT abstracts were included. The CONSORT statement for abstracts showed that the average reporting rate of all items was 50.2%. The items with a lower reporting quality were mainly the trial design and the details of randomization and blinding (<10%). The mean overall adherence score across all studies was 8.68 ± 2.69 (range 4-13.5). Multivariate linear regression analysis showed that the higher reporting scores were associated with higher journal impact factor (P < 0.01), international collaboration (P = 0.04), and structured abstract format (P < 0.01). CONCLUSIONS: Although many RCTs on patients with COVID-19 have been published in different journals, the overall quality of reporting in the included RCT abstracts was suboptimal, thus diminishing their potential usefulness, and this may mislead clinical decision-making. In order to improve the reporting quality, it is necessary to promote and actively apply the CONSORT statement for abstracts.

Knowledge, Attitude, and Practice Survey of COVID-19 Among Healthcare Students During the COVID-19 Outbreak in China: An Online Cross-Sectional Survey.

Background: The ongoing coronavirus disease (COVID-19) outbreak has placed the healthcare system and student training under considerable pressure. However, the plights of healthcare students in the COVID-19 period have drawn limited attention in China. Methods: A cross-sectional on-line survey was undertaken between January and March 2020 to explore the COVID-19 knowledge, attitude, and practice (KAP) survey among Chinese healthcare students. Demographic information and data on KAP were obtained using a self-reported questionnaire. The percentage KAP scores were categorized as good or poor. Independent predictors of good knowledge of COVID-19 were ascertained to use a logistic regression model. Results: Of the 1,595 participants, 85.9% (1,370) were women, 53.4% were junior college students, 65.8% majoring in nursing, and 29.8% had received training on COVID-19. The overall median percentage for good KAP was 51.6% with knowledge of 28.3%, attitude 67.8%, and practice 58.6%, respectively. Independent predictors of good knowledge of COVID-19 were being students ≥25 (95% CI = 0.27-0.93, P = 0.02), those taking bachelor degrees (95% CI = 1.17-2.07, P = 0.00), and those having participated in COVID-19 treatment training. Conclusions: The result of this study revealed suboptimal COVID-19-related KAP among healthcare students in China. To effectively control future outbreaks of COVID-19, there is a need to implement public sensitization programs to improve the understanding of COVID-19 and address COVID-19-related myths and misconceptions, especially among healthcare students.

Evaluation of reporting quality of randomized controlled trials in patients with COVID-19 using the CONSORT statement.

OBJECTIVE: To evaluate the reporting quality of randomized controlled trials (RCTs) regarding patients with COVID-19 and analyse the influence factors. METHODS: PubMed, Embase, Web of Science and the Cochrane Library databases were searched to collect RCTs regarding patients with COVID-19. The retrieval time was from the inception to December 1, 2020. The CONSORT 2010 statement was used to evaluate the overall reporting quality of these RCTs. RESULTS: 53 RCTs were included. The study showed that the average reporting rate for 37 items in CONSORT checklist was 53.85% with mean overall adherence score of 13.02±3.546 (ranged: 7 to 22). The multivariate linear regression analysis showed the overall adherence score to the CONSORT guideline was associated with journal impact factor (P = 0.006), and endorsement of CONSORT statement (P = 0.014). CONCLUSION: Although many RCTs of COVID-19 have been published in different journals, the overall reporting quality of these articles was suboptimal, it can not provide valid evidence for clinical decision-making and systematic reviews. Therefore, more journals should endorse the CONSORT statement, authors should strictly follow the relevant provisions of the CONSORT guideline when reporting articles. Future RCTs should particularly focus on improvement of detailed reporting in allocation concealment, blinding and estimation of sample size.

Determinants of COVID-19 Vaccine Acceptance and Hesitancy: A Health Care Student-Based Online Survey in Northwest China.

Background: With the spread of COVID-19 around the world, herd immunity through vaccination became a key measure to control the pandemic, but high uptake of vaccine is not guaranteed. Moreover, the actual acceptance of COVID-19 vaccination and associated factors remain uncertain among health care students in Northwest China. Methods: A cross-sectional survey of a sample of 631 health care students was performed using a questionnaire developed through Wen Juan Xing survey platform to collect information regarding their attitudes, beliefs, and acceptance of COVID-19 vaccination. Binary logistic regression analyses were performed to identify the association between vaccination willingness and demographics, attitudes, and beliefs to determine the factors that actually effect acceptance and hesitancy of COVID-19 vaccine among health care students. Results: Overall, 491 (77.81%) students actually received the COVID-19 vaccine, and of the 140 unvaccinated, 69 were hesitant and 71 rejected. Binary logistic regression analysis showed that the actually vaccinated individuals were those who mostly believed in the effectiveness of the COVID-19 vaccine (OR = 2.94, 95%CI: 1.37, 6.29), those who mostly felt it is their responsibility to receive the vaccine to protect others from infection (OR = 2.75, 95%CI: 1.45, 5.23), with less previous experience about other vaccines (OR = 1.70, 95%CI: 1.06, 2.72), students who mostly thought COVID-19 to be very severe (OR = 1.77, 95%CI: 1.07, 2.93), and students who mostly thought the COVID-19 vaccine was one of the best protection measures (OR = 1.68, 95%CI: 1.03, 2.76). Concerns about side effects of vaccines (OR = 0.30, 95%CI: 0.18, 0.51) and the use of personal protective behavior as an alternative to the COVID-19 vaccination (OR = 0.16, 95%CI: 0.06, 0.39) hindered the vaccine acceptance. Conclusions: Our study showed higher COVID-19 vaccine acceptance among healthcare students. However, the individuals with vaccine hesitancy and rejection were still worrying. Vaccine safety and effectiveness issues continue to be a major factor affecting students' acceptance. To expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for those with negative attitudes and beliefs.

Corrigendum: Knowledge, Attitude, and Practice Survey of COVID-19 Among Healthcare Students During the COVID-19 Outbreak in China: An Online Cross-Sectional Survey.

[This corrects the article DOI: 10.3389/fpubh.2021.742314.].

Anxiety and Depression in Patients With Pulmonary Arterial Hypertension in Northwest China: A Cross-Sectional Study.

OBJECTIVE: Pulmonary arterial hypertension (PAH) is a rare life-threatening and incurable disease. Although symptoms of depression and anxiety have been widely reported, these traits and associated factors have not been systematically assessed in Northwest China. METHODS: A cross-sectional study was conducted between March 2020 and February 2021. 106 PAH patients in Northwest China were evaluated by Self-rating Anxiety Scale (SAS) and the Self Rating Depression Scale (SDS) questionnaire. RESULTS: Overall, the included patients had particularly high depressive symptoms (70.09%), while anxiety among them was 17.55%. Multivariate linear regression revealed that patients with lower age (p = 0.04), female (p < 0.01), smoking (p < 0.01), WHO functional class III/IV (p < 0.01), higher mean pulmonary hypertension (p < 0.01), lower left ventricular ejection fraction (p < 0.01), and lower 6-min walking distance (p < 0.01) had higher anxiety scores. Patients who lived in rural areas (p = 0.01), smoking (p < 0.01), WHO functional class III/IV (p < 0.01), higher mean pulmonary hypertension (p = 0.04), lower 6-min walking distance (p < 0.01), and college degree or above had higher depression scores (p = 0.02). CONCLUSIONS: Mental health problems such as depression are common among patients with PAH in Northwest China. Patients' characteristics such as smoking status, WHO functional class, and 6-min walking distance were related to anxiety and depression scores. Thus, early detection of mental health problems such as depression and anxiety should be detected in PAH patients. Meanwhile, interventions against these problems should be used to improve such patients' mental status.

Met and unmet care needs of home-living people with dementia in China: An observational study using the Camberwell Assessment of Need for the Elderly.

AIM: The goal of the study was to investigate the patterns of needs in older individuals with mild-to-moderate dementia living at home using the Camberwell Assessment of Need for the Elderly questionnaire. METHODS: This was a cross-sectional study. A total of 378 home-living residents served as the sample. The Camberwell Assessment of Need for the Elderly questionnaire was used to analyze the needs of those receiving adequate interventions (met needs) and those without appropriate supports (unmet needs). Thereafter, the factors that correlated with total needs were determined using demographic characteristics. RESULTS: Persons with dementia (PWD) had a mean care needs of 18.5 ± 5.4 (range 5-35). Unmet needs were most common in caring for someone (65.1%), looking after the home (63.5%), self-care (58.7%) and intimate relationships (44.4%) domains. Higher needs were significantly related to living with others than a spouse, longer length of diagnosis, older age and higher cognitive function. CONCLUSION: Unmet needs are common in home-living PWD. Home-based dementia care can identify and address PWD's unmet needs by focusing on care recipients and caregivers to enable PWD to remain safely at home and improve their quality of life. Geriatr Gerontol Int 2021; 21: 102-107.

Analysis of the status quo of the Elderly's demands of medical and elderly care combination in the underdeveloped regions of Western China and its influencing factors: a case study of Lanzhou.

BACKGROUND: This study aims to analyse the current demand by senior citizens in Lanzhou, China for a combination of medical and elderly care services and to identify the factors influencing their needs. METHODS: 7500 participants aged 60 or above living in Lanzhou, China, were recruited, a unified questionnaire concerning elderly people's demand for a service combining medical and elderly care has been adopted to survey these subjects. The status quo of the demand of the service combining medical and elderly care and its influencing factors were analysed with the single-factor Chi-square test and multi-factor binomial logistic regression method. RESULTS: 3772 of 7320 older people have the demand for the service combining medical and elderly care, accounting for 53.15% of survey respondents. Many factors are in play, including gender, marital status, degree of education, occupation before retirement, number of children, monthly income, health self-assessment status, endowment insurance type, medical insurance type, current nursing arrangements, old-age demands, self-care ability and the knowledge of combining medical and elderly care and the willingness to pay for the combination of medical and elderly care have statistical significance (P < 0.05) with the elderly's needs, different ages, living styles and the prevalence of chronic diseases, have no statistical significance (P > 0.05) with the elderly's care needs in Lanzhou. The number of children, type of medical insurance and willingness to pay for the combination of medical treatment and nursing care are major influencing factors among the complex factors influencing the elderly's demand for the proposed service. CONCLUSIONS: The low knowledge rate and demand rate, the number of children, the type of medical insurance, and the willingness to pay for the medical-nursing combination service for the elderly in Lanzhou have a great impact on the elderly's demand rate for combining medical and elderly care. Meanwhile, relevant government departments should focus more on the promotion of the endowment model of combining medical and elderly care and provide integrated medical care services by integrating multiple resources, and improving social security.

Inpatient satisfaction with nursing care in a backward region: a cross-sectional study from northwestern China.

OBJECTIVES: The aim of the study was to examine the level of patient satisfaction with nursing care and identify the factors affecting satisfaction from the inpatient's perspective in a backward region of China. DESIGN: This was a cross-sectional study. SETTING: The study was conducted at a tertiary hospital located in northwest China. PARTICIPANTS: Patients admitted to the ward for at least 48 hours were chosen to participate in the survey. PRIMARY OUTCOME MEASURE: The Newcastle Satisfaction with Nursing Care Scale was used. Data were collected from 219 patients. RESULTS: The overall inpatient satisfaction with nursing care was 78.15±4.74. Patients were more satisfied with nurses who respected their privacy and treated them as individuals (67.7%). Patients were least satisfied with the type of information nurses gave them (11.7%) and with the sufficient awareness of their needs. Patients who were married, had a history of hospitalisation, surgery and were taken charge of by junior nurses had higher satisfaction. CONCLUSIONS: The overall level of patient satisfaction was moderate. Patient-centred individualised care and providing sufficient information model of care are needed. There was a need for nurses to be aware of patients' individualised care needs and to provide them with more information. This study may suggest/urge hospital administrators, policymakers and nurses to be more sensitive with patients' married status, history of hospitalisation and surgery, the professional title of in charged nurses when care is provided. Ultimately to achieve better outcome of patients' hospitalisation.