Relationship between physical activity and perceptions of ageing from the perspective of healthy ageing among older people with frailty with chronic disease: a cross-sectional study.

BACKGROUND: In Taiwan, the 2019 Elderly Frailty Assessment found that 11.2% of older people have frailty problems. Some researchers have found that older persons' negative perspectives on ageing aggravate the progression of frailty, thereby increasing their risk of disability. This study aimed to investigate associations of physical activity and perceptions of ageing on perspectives of healthy ageing in older people with frailty and chronic diseases and to compare the differences in their frailty status. METHODS: This study used a descriptive cross-sectional design. Participants were recruited from community long-term care stations. The inclusion criteria were (1) no severe cognitive impairment and ability to communicate in Mandarin and Taiwanese; (2) over 65 years old; (3) at least one chronic disease; and (4) at least one debilitating item in the Study of Osteoporotic Fracture index. A total of 312 participants were recruited. The Brief Ageing Perceptions Questionnaire Chinese version, Healthy Ageing Perspectives Questionnaire, and Physical Activity Scale for the Elderly Chinese Version were used for measurement. RESULTS: The study results found that demographic variables, perceptions of ageing, and physical activity were significantly correlated with perspectives on healthy ageing, including age, Activities of Daily Living, education, all domains of perceptions of ageing, and household- and work-related physical activity. With regard to the frailty status level, prefrailty was better than frailty from the perspective of healthy ageing in older people with chronic disease (t = 5.35, p < 0.05). Hierarchical regression analysis was used to predict the healthy ageing perspectives of older persons with chronic disease involving a chronic time-line, positive control, health-related changes, and work-related activities. Those domains could predict 21% of the variance in healthy ageing perspectives. CONCLUSION: It is suggested that in community long-term care stations, health care providers can arrange activities to improve the perception of ageing that are acceptable for older people with frailty and chronic diseases and encourage older people to participate in service activities to achieve a sense of social participation.

The effectiveness of facilitator-led remote interactive intervention for loneliness, quality of life, and social support among seniors in communities during the COVID-19 pandemic: a randomized controlled experiment.

OBJECTIVE: This study investigated the impact of a 12-week remote interaction intervention on loneliness, quality of life, and social support for seniors living in a community during the COVID-19 pandemic. METHODS: This study adopted a randomized controlled trial design. Participants in the intervention group received a 12-week bidirectional remote interaction intervention, while participants in the control group received a 12-week unidirectional remote interaction intervention. The study's primary assessment tools were the UCLA Loneliness Scale (UCLA) and the World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF). RESULTS: The main findings indicate that the intervention group scored significantly higher than the control group on the WHOQOL-BREF in the physical health and social relationships domains after the intervention. In addition, intervention group participants with low loneliness scored significantly higher than their control group counterparts in the physical health and social relationships domains of the WHOQOL-BREF. Similarly, intervention group participants with high loneliness scored significantly higher than their control group counterparts in the social relationships domain of the WHOQOL-BREF. However, there was no significant difference in loneliness scores between the intervention and control groups. CONCLUSIONS: This result confirms that providing intensive bidirectional interaction benefits seniors' quality of life during the COVID-19 pandemic.

Evaluation of registered nurses' interprofessional emergency care competence through the gamification of cardiopulmonary resuscitation training: a cross-sectional study.

BACKGROUNDS: Cardiopulmonary resuscitation (CPR) training is generally led by instructors in a classroom; thus, conventional teaching materials used in CPR training are often constrained by spatiotemporal factors, limiting learners' interest and sense of achievement in learning and preventing them from effectively applying what they learn in practice. For greater effectiveness and more flexible application, clinical nursing education has increasingly emphasized contextualization, individualization, and interprofessional learning. This study determined the self-assessed emergency care competencies of nurses who received gamified emergency care training and explored the factors associated with those competencies. METHODS: Quota sampling of nurses working at a certain regional hospital in central Taiwan was conducted, and a structured questionnaire was administered to the recruited nurses. A total of 194 valid responses were collected. The research tool was a scale measuring the participants' emergency care competencies after they received gamified emergency care training. The data were analyzed using descriptive and inferential statistics and multiple regression. RESULTS: Of the recruited participants, 50.52% were ≤ 30 years old; 48.45% worked in the internal medicine department; 54.64% graduated from 2-year university technical programs; 54.12% were N2 registered nurses; 35.57% and 21.13% had ≥ 10 and 1-3 years of work experience, respectively; and 48.45% worked in general wards. User need (r = 0.52, p = 0.000), perceived usefulness (r = 0.54, p = 0.000), perceived ease of use (r = 0.51, p = 0.000), and usage attitude (r = 0.41, p = 0.000) were positively correlated with emergency care competencies. Furthermore, the multiple regression analysis revealed that perceived usefulness was the primary factor associated with the participants' emergency care competencies. CONCLUSIONS: The results of this study may serve as a reference for acute care facility authorities in designing advanced nursing competency standards and emergency care training programs for nurses.

Investigating the effectiveness of online interactive courses on loneliness and quality of life of older adults in the community during the COVID-19 pandemic: A pilot study and a randomized controlled trial.

BACKGROUND: The early stage of the COVID-19 pandemic was a critical time for increasing loneliness, especially for older people. However, there is insufficient existing research on associated interventions and their effectiveness. AIM: This study aimed to investigate the effectiveness of an 8-week online interactive course on the loneliness, depression, social support, and quality of life (QOL) of older adults in the community during the COVID-19 pandemic. METHODS: A single-blind randomized controlled trial was conducted to collect data from a community in Taiwan. Eighty-nine participants recruited from long-term care institutions were randomly divided into an experimental group (n = 44) and a control group (n = 45). Participants in the experimental group received an 8-week (Monday to Friday) intensive online interactive course, whereas those in the control group watched 8 weeks (Monday to Friday) of unidirectional online video programs. RESULTS: Significant differences were observed in the UCLA Loneliness Scale and in both the psychological health and social relationship domains of the WHO Quality of Life-BREF Scale. In other words, compared with those in the control group, participants in the experimental group experienced more significant improvements in the state of their loneliness as well as QOL in the psychological health and social relationship domains (without the physical health/environment domains) after taking the online interactive course. CONCLUSIONS: The results of this study showed that the 8-week online interactive course could effectively improve the loneliness, the psychological health domain, and the social relationship domain of the QOL of the older adults of a particular community during the ongoing pandemic. Geriatr Gerontol Int 2023; 23: 91-97.

Exploring Key Factors Influencing Nursing Students' Cognitive Load and Willingness to Serve Older Adults: Cross-sectional Descriptive Correlational Study.

BACKGROUND: Virtual learning environments (VLEs) use a virtual environment to support learning activities. VLEs are commonly used to overcome the temporal and spatial restrictions of learning activities held in conventional face-to-face classrooms. In VLEs, students can participate in learning activities using the internet, and teachers can provide assistive learning tools during the process. OBJECTIVE: The purpose of this study was to investigate the relationships among nursing students' mental load, cognitive load, and affective learning outcomes in terms of their willingness to serve older adults in an interaction-based educational virtual reality (VR) learning environment. METHODS: This study used a cross-sectional method. A total of 130 students participated in interaction-based VR learning and completed related questionnaires. Descriptive and inferential statistics and stepwise regression for data analysis were used. RESULTS: The research results revealed that in the dimension of willingness to use VR learning materials, perceived usefulness received the highest score (mean 4.42, SD 0.45). In the dimension of nursing ability, students scored the highest in information management and application ability to care for case patients (mean 4.35, SD 0.54). Correlation analysis revealed that cognitive load during learning and willingness to serve older adults were negatively correlated, whereas willingness to use VR learning materials was positively correlated with nursing ability and willingness to serve older adults. Analyzing the regression coefficients of predictor variables revealed that willingness to use VR learning materials (ß=.23; t2=2.89, P=.005) and cognitive load during learning (ß=-.35; t2=-.4.30, P<.001) were predictive factors of nursing students' willingness to serve older adults. CONCLUSIONS: This study demonstrated that students' willingness to use VR learning materials and their cognitive load during learning affected their willingness to care for older adults. Therefore, the components of mental or cognitive load generate inconsistent predictive effects on affective variables and willingness to serve older adults.

Effects of Team-Based Learning on Students' Teamwork, Learning Attitude, and Health Care Competence for Older People in the Community to Achieve SDG-3.

BACKGROUND: Team-based learning (TBL) was studied in several preclinical settings, but evidence for its effectiveness in community nursing education is scant. A community health care nursing course was developed, and nursing students engaged in TBL to achieve Sustainable Development Goal 3. PURPOSE: This study aimed to examine the effect of TBL model integration on students' learning attitude, community understanding, and community care competence for achieving SDG 3 and determine the extent to which the TBL model altered students' nursing competence for providing community health care. We compared the effect of TBL and traditional learning (TL) in terms of community health care knowledge objectives. METHODS: TBL was employed as the teaching strategy to guide students' discussion of community care issues, allowing them to fully utilize the knowledge acquired in their community practice. We used an unblinded crossover design, and 99 students participated in the community health nursing course. RESULTS: The results demonstrated that TBL improved participants' community understanding and enhanced their skills for assessing and fulfilling community needs. The experimental and control groups differed significantly in their TBL performance, learning attitude, and nursing competencies. The performance of those who engaged in TBL was higher than that of those who engaged in TL on all community issues. TBL appears to be a more effective method than TL in terms of achieving nursing students' knowledge objectives. CONCLUSIONS: Regarding practical application, the proposed intervention enables nursing students to acquire professional knowledge related to community aging health care and nursing skills, and establish partnerships with community residents. This facilitates the achievement of the United Nations' sustainable development goal of ensuring healthy living and promoting well-being at all ages.

Does Smartphone Addiction, Social Media Addiction, and/or Internet Game Addiction Affect Adolescents' Interpersonal Interactions?

The purpose of this study is to investigate the correlations that levels of addiction to smartphones, social media, and online games have with levels of real-life and online interpersonal interactions among adolescents. In this cross-sectional study of adolescents in a college in Taiwan, structured questionnaire surveys were used to collect information. The questionnaire included the following: demographic background, Real Interpersonal Interaction Scale (RIIS), Internet Interpersonal Interaction Scale (IIIS), Smartphone Application-Based Addiction Scale (SABAS), Bergen Social Media Addiction Scale (BSMAS), and Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Multiple regression analyses were carried out to investigate the correlations between SABAS, BSMAS, IGDS9-SF, and RIIS/IIIS. We recruited 998 students (413 boys). The average age was 17.18 ± 1.46. The study results show that adolescents with higher levels of addiction to smartphones and social media may have greater interpersonal interaction with friends in real life, but adolescents with high levels of addiction to online games may have less interpersonal interactions with friends in real life. Adolescents with high levels of addiction to smartphones, social media, and online games may have greater interpersonal interactions with friends online.

[Self-Perceived Long-Term Care Competency and Its Related Factors Among Nurses Working in cute Care Facilities].

BACKGROUND: In response to the promotion of long-term care policies, nurses in hospitals must not only have professional knowledge related to disease care but also be equipped with care competencies related to long-term care. PURPOSE: The purpose of this study was to explore the self-perceived competencies of nurses working in acute care facilities with regard to long-term-care and related factors. METHODS: A cross-sectional research design with quota sampling was used. The participants were recruited from registered nurses employed at a medical center in southern Taiwan, and data from 159 valid, returned questionnaires were used in the analysis. The research instruments used included the long-term care competency scale and long-term care-related knowledge, and care intention. T test, Chi-square, ANOVA, and Pearson correlation coefficient were used to examine the relationship between the targeted variables and long-term care competency. Regression analysis was used to determine the important determinants of long-term care competency. RESULTS: The average age of the participants was 30.86 years (± 3.38). Most currently worked in the internal medicine department, 93.1% were educated to the university level, 44% had worked for fewer than 5 years, and 32.7% were N3 level nurses. Long-term care competency was found to be significantly and positively correlated with gender (t = 2.06, p = .041), seniority at the facility (F = 2.49, p = .046), job satisfaction (r = .28, p < .001), and long-term care service practices (r = .227, p < .001). After the regression analysis, self-perceived long-term care competency was found to be positively related to job satisfaction and long-term care service practices. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study suggest that a long-term care training should be incorporated into the regular in-service education program to improve the knowledge and attitudes of nurses with regard to older and disabled patients and to develop their professional role in long-term care. Furthermore, the results may be referenced by nursing supervisors in acute care facilities when making arrangements for nurses to participation in the Clinical Nursing Ladder Program and when arranging nursing staff training and setting the direction of long-term care-related education and training in healthcare facilities.

Improving the care stress, life quality, and family functions for family-caregiver in long-term care by home modification.

This study examined whether interventions through barrier-free home environment improvements could reduce family caregivers' care stress, improve their family functions, and increase their quality of life. This study recruited family caregivers of older people with disabilities from a long-term care management center in central Taiwan. These older people required improvements related to a barrier-free home environment. A pretest was conducted before and a post-test was conducted 2 months after the improvements. The content of the pretest and the post-test questionnaires included: demographic characteristics, Caregiver stress scale, Family functions scale, World Health Organization Quality of Life-BREF (WHOQOL-BREF) Questionnaire. This study recruited 72 family caregivers; the average age was 56.25 ± 12.99 years. The results indicated that interventions through barrier-free home environment improvements could significantly reduce the family caregivers' care stress, improve their family functions (e.g., reducing conflicts), and enhance their quality of life. Additionally, after intervention, the family cohesion of family caregivers caring for those with mild disability improved to a greater extent than did that of those caring for people with other disease severities. This study revealed that interventions involving barrier-free home environment improvements have positive effects on family caregivers.

Association between work content and musculoskeletal disorders among home caregivers: a cross-section study.

In Taiwan, over 80% of home caregivers have experienced musculoskeletal disorders (MSD) in the past year. Although MSDs in health care workers have been discussed in existing literature (e.g., in nursing staff), there is limited understanding of the association between MSD and the work content of home caregivers. This study aimed to investigate the correlation between the work content and MSD of home caregivers. This cross-sectional study was conducted in long-term care units in central Taiwan. A structured questionnaire was used to collect data, including basic information, work content survey, and information from the Nordic Musculoskeletal Questionnaire. Logistic regression analysis was used to examine the association between work content and MSD. A total of 149 home caregivers with a mean age of approximately 50.97 ± 9.80 years were recruited for the study. The frequency of transfer of toilet and wheelchair was significantly associated with shoulder discomfort, upper back discomfort, and wrists/hands discomfort. In addition, the frequency of passive range of motion exercise was significantly associated with elbows discomfort. The results of this study indicated that the highest risk factor for MSD was transfer of toilet and wheelchair followed by passive range of motion exercise.

Growth of CeO2 nanocubes showing size-dependent optical and oxygen evolution reaction behaviors.

CeO2 nanocubes with average sizes of 9, 13, and 18 nm have been synthesized by preparing a slightly basic aqueous mixture of Ce(NO3)3, Na2SO4, and NH4OH and heating the solution to 100 to 150 °C in 4 or 9 h. The nanocubes possess high crystalline quality. Their band gaps decrease gradually beyond the quantum confinement regime from 3.57 eV to 3.45 eV with increasing particle sizes. The 9 nm CeO2 nanocubes have the most positive valence band energy and correspondingly they exhibit the best electrochemical oxygen evolution reaction activity. Since band gaps of semiconductor nanocrystals can be tuned substantially through particle size control to yield different band energies, this fact can be utilized to enhance the electrochemical and photocatalytic properties.

Investigating the Relationship between Media Usage, Depression, and Quality of Life among Older Adults.

BACKGROUND: The uses and gratifications theory suggests that various types of media can greatly affect people's lives. This is especially true among older adults who tend to use media for leisure. However, there is insufficient research regarding the relationship between media usage, depression, and quality of life among older adults. PURPOSE: The purpose of this study was to explore the association between media usage (traditional and internet media), depression, and quality of life among older adults. METHODS: Using a cross-sectional design, this study recruited individuals aged 65 years and older in central Taiwan and collected data via a structured questionnaire. Contents of the questionnaire included demographic details, a media usage behavior questionnaire, the Brief Symptoms Rating Scale (BSRS-5), and the Quality of Life Scale developed by the World Health Organization (WHOQOL-BREF). Subsequently, multiple regression analyses were conducted to investigate the association between media usage, depression, and quality of life of older adults. RESULTS: The average age of the 252 participants (107 males) was 70.0 ± 5.4 years. Regression analysis revealed a significant, negative relationship between the number of hours spent watching television and the degree of depression. Additionally, the number of hours spent watching television was significantly negatively related to the quality of life in terms of both the psychological health and social relationships categories. In contrast, the number of hours spent reading newspapers and magazines was significantly positively related to quality of life in the categories of psychological health, social relationships, and environment. Finally, the number of hours spent browsing internet media was significantly positively related to the quality of life in the psychological health category. CONCLUSION: Media usage may affect the degree of depression and quality of life of older adults depending on the type of media and amount of usage.

Community Health Nursing Competency and Psychological and Organizational Empowerment of Public Health Nurses: A Cross-Sectional Survey.

AIM: This study explored the effect of public health nurses' current community care nursing competency on the psychological and organizational empowerment of public health services in Taiwan. DESIGN: A cross-sectional nationwide survey design was used. METHODS: A self-developed structured questionnaire was administered to public health nurses. They were recruited using a purposive sampling technique, and they participated in community healthcare workshops. RESULTS: The mean score of Community Care Nursing Competence (CCNC) was 3.92 ± 0.83. The mean score in Community Empowerment (CE) was 3.66 ± 0.90. The study revealed that age and communication competence were crucial factors in public health nurses working in the community. With age and through the accumulation of practical experience, public health nurses' communication competence may also improve, which can further enhance their psychological and organizational empowerment in the nursing workplace.

Distinct Carrier Transport Properties Across Horizontally vs Vertically Oriented Heterostructures of 2D/3D Perovskites.

Two-dimensional-on-three-dimensional (2D/3D) halide perovskite heterostructures have been extensively utilized in optoelectronic devices. However, the labile nature of halide perovskites makes it difficult to form such heterostructures with well-defined compositions, orientations, and interfaces, which inhibits understanding of the carrier transfer properties across these heterostructures. Here, we report solution growth of both horizontally and vertically aligned 2D perovskite (PEA)2PbBr4 (PEA = phenylethylammonium) microplates onto 3D CsPbBr3 single crystal thin films, with well-defined heterojunctions. Time-resolved photoluminescence (TRPL) transients of the heterostructures exhibit the monomolecular and bimolecular dynamics expected from exciton annihilation, dissociation, and recombination, as well as evidence for carrier transfer in these heterostructures. Two kinetic models based on Type-I and Type-II band alignments at the interface of horizontal 2D/3D heterostructures are applied to reveal a shift in balance between carrier transfer and recombination: Type-I band alignment better describes the behaviors of heterostructures with thin 2D perovskite microplates but Type-II band alignment better describes those with thick 2D microplates (>150 nm). TRPL of vertically aligned 2D microplates is dominated by directly excited PL and is independent of the height above the 3D film. Electrical measurements reveal current rectification behaviors in both heterostructures with vertical heterostructures showing better electrical transport. As the first systematic study on comparing models of 2D/3D perovskite heterostructures with controlled orientations and compositions, this work provides insights on the charge transfer mechanisms in these perovskite heterostructures and guidelines for designing better optoelectronic devices.

Factors Related to Care Competence, Workplace Stress, and Intention to Stay among Novice Nurses during the Coronavirus Disease (COVID-19) Pandemic.

The outbreak of coronavirus (COVID-19), a public health emergency of international concern, has made healthcare staff preparation and the nurturing of high-quality and adequate nursing professionals critical issues. This study aimed to explore registered nurses' competence in nursing care and their intention to stay in their current workplace. In this study, participants who had graduated from different nursing education systems were recruited. The results indicated that nurses' level of commitment to the workplace and clinical stress were positively correlated with the experience of working with patients. Stepwise regression analysis revealed the following significant predictors for intention to stay: clinical stress, frequency of caring for people with infections, and taking a course on infectious nursing. The novice nurses' competencies in the areas of pandemic disease care and care for infectious adults depended on the experience of nursing care and nursing competence in their professional careers, which may have impact on the nurses' intention to stay. Therefore, clinical stress, frequency of caring for patients, and taking nursing courses were correlated with novice nurses' intention to stay in their professional careers.

Formation of size-tunable CuI tetrahedra showing small band gap variation and high catalytic performance towards click reactions.

Tetrahedral CuI crystals with broadly tunable sizes from 56 to 645 nm have been synthesized by adjusting the reaction temperature, addition of different amounts of Na2SO4, or the reagent selection. The crystal growth process can be easily scaled up for catalysis applications. Bulk and surface compositions have been determined to be CuI using various characterization methods. Although larger tetrahedra show gradually decreasing band gap values, the changes are quite small. Optical facet effect should also be present for CuI by comparing the band gaps of size-tunable CuI tetrahedra to that of commercially available CuI powder. Emission band also becomes red-shifted for larger tetrahedral samples. The 56 nm CuI tetrahedra exhibit a far better catalytic performance than that of commercially available CuI powder toward click reactions of aromatic alkynes and benzyl azide for the formation of triazoles, attributed to their large surface area and exposed {111} faces. The small CuI tetrahedral nanocrystals should be explored for use in other CuI-catalyzed reactions.

Factors affecting preregistered nurses' willingness to serve in geriatric long-term care.

AIM: Rapidly ageing population leads to increased demands for long-term care. Taiwan's preparation for its ageing population focuses on engaging healthcare professionals. This study explored pre-registered nurses' current knowledge, experience in geriatric long-term care (GLTC) and willingness to serve in GLTC. DESIGN: A cross-sectional survey design and a self-developed structured questionnaire were used. METHODS: A probability proportionate to size sampling strategy was used to collect data from students in junior college and bachelor of nursing science programmes in Taiwan in 2017. Multiple regression was adopted to predict significant factors that influence nursing students' willingness to serve in GLTC. RESULTS: The willingness to serve in GLTC was positively correlated with their experience of living with older adults, practicum experience, taking GLTC-related courses and interest in GLTC. Willingness to serve older/disabled patients can be enhanced through school courses and practicum experiences, indicating the importance of GLTC-related courses in the training of the professional nursing workforce.

Inactive Cu2O Cubes Become Highly Photocatalytically Active with Ag2S Deposition.

Previously, Cu2O cubes have been shown to remain photocatalytically inert toward methyl orange degradation even after surface decoration with ZnO, ZnS, CdS, and Ag3PO4 nanostructures. Surprisingly, when Ag2S nanoparticles are lightly deposited on Cu2O cubes as seen through scanning electron microscopy (SEM) images, the heterostructures become highly photocatalytically active. X-ray diffraction (XRD) patterns show mainly Cu2O diffraction peaks due to lightly deposited Ag2S, but Ag2S peaks can emerge with increased Ag2S deposition. X-ray photoelectron spectroscopy (XPS) analysis also supports Ag2S formation on Cu2O crystals. The Ag2S-deposited Cu2O octahedra and rhombic dodecahedra show the expected activity enhancement. Electron paramagnetic resonance (EPR) measurements, as well as electron, hole, and radical scavenger tests, all confirmed the emergence of photocatalytic activity from the Ag2S-Cu2O cubes. Photoluminescence lifetimes are shortened after Ag2S deposition. Electrochemical impedance measurements revealed a large decrease in charge transfer resistance for Cu2O cubes after the Ag2S deposition. Unexpectedly, the separately synthesized Ag2S particles are also photocatalytically inactive. No specific lattice planes of Ag2S are formed directly over the {100} face of Cu2O. Diffuse reflectance and ultraviolet photoelectron spectral data were used to construct band diagrams of different Cu2O crystals and Ag2S nanoparticles. A Z-scheme charge transfer mechanism may be involved at the heterojunction interface to promote charge carrier separation. However, to explain the sudden appearance of photocatalytic activity from the Ag2S-deposited Cu2O cubes, a large change in the {100} surface band bending after Ag2S deposition should be used. This work illustrates that an unusual photocatalytic outcome is possible to semiconductor heterojunctions, where two photocatalytically inert components can become highly active when joined together.

Continuity of Care and the Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan.

BACKGROUND: Understanding factors associated with the quality of life (QoL) of patients with type 2 diabetes (T2DM) is an important health issue. This study aimed to explore the correlation between continuity of care and quality of life in patients with T2DM and to probe for important explanatory factors affecting quality of life. METHODS: This study used a cross-sectional correlation research design. Convenience sampling was adopted to recruit 157 patients, aged 20-80 years and diagnosed with T2DM in the medical ward of a regional hospital in central Taiwan. RESULTS: The overall mean (standard deviation, SD) QOL score was 53.42 (9.48). Hierarchical regression linear analysis showed that age, depression, two variables of potential disability (movement and depression), and the inability to see a specific physician or maintain relational continuity with medical providers were important predictors that could effectively explain 62.0% of the variance of the overall QoL. CONCLUSIONS: The relationship between patients and physicians and maintaining relational continuity with the medical providers directly affect patients' QoL during hospitalization and should be prioritized clinically. Timely interventions should be provided for older adult patients with T2DM, depression, or an inability to exercise to maintain their QoL.

The Difficulties and Needs of Organ Transplant Recipients during Postoperative Care at Home: A Systematic Review.

With recent advances in surgery and immunosuppressive drugs, organ transplantation has become a major treatment for irreversible organ failure. However, organ transplant recipients returning home after operation may face ongoing physiological, psychological, and social difficulties. To increase recipients' quality of life, postoperative care at home is critical. Thus, the aim of this systematic literature review was to explore recipients' difficulties and needs during postoperative care at home. Our search conformed to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and returned 23 relevant articles published from 1997-2020 in PubMed, MEDLINE, EBSCO, Cochrane, ProQuest, and CEPS, which were assessed using the Modified Jadad Scale or the 32 Consolidated Criteria for Reporting Qualitative Research (COREQ) appraisal indices and then synthesized through narration. The most common difficulties faced were psychological difficulties, followed by physiological, social, and other difficulties; the most common needs were psychological needs, followed by education and information training, social, and other needs. These results demonstrated that healthcare professionals can do more to provide patients with comprehensive care and promote successful self-management and quality of life at home. They also confirmed that collaboration between transplant teams, caregivers, and patients is necessary to optimize postoperative outcomes. We suggest that customized care may promote postoperative patients' self-management and quality of life at home.