Effect of Elastic-band Baduanjin exercise on older adults with type 2 diabetes mellitus in China: protocol for a randomised controlled trial.

INTRODUCTION: In China, older adults have the highest incidence of type 2 diabetes mellitus (T2DM). Bone, joint and physical endurance limit the types of exercise available to older adults with T2DM. Baduanjin is recommended and encouraged as an exercise option. However, Baduanjin exercise alone cannot account for the loss of muscle mass. Resistance training is recommended in the guidelines and offers new options for increasing muscle strength. The purpose of this study is to compare the effects of Elastic-band Baduanjin exercise training with those of Baduanjin alone. METHODS AND ANALYSIS: This study is a reworking exercise programme, consisting of Baduanjin combined with elastic band resistance exercise training. A 12-week randomised controlled trial will be conducted. Patients aged 60-80 years with T2DM will be assigned to the Elastic-band Baduanjin (intervention) and Baduanjin (control) groups using cluster random sampling. A sample of 70 participants will be conducted. Indicators of muscle strength, body composition, blood glucose and balance function will be collected before and after the intervention. Meanwhile, exercise will be monitored using the International Physical Activity Questionnaire. ETHICS AND DISSEMINATION: The trial was approved by the Chinese Ethics Committee of Registering Clinical Trials on 19 June 2022 (ChiECRCT20220210). The research results will be published in peer--reviewed publications. TRIAL REGISTRATION NUMBER: Chinese Clinical Trials Registry (ChiCTR2200062424).

Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study.

BACKGROUND: Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population. METHODS: The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network and node characteristics, and factor analysis was used to examine symptom clusters. RESULTS: A total of 167 participants were included in this study. The participants included 111 men and 56 women with a mean age of 70.05 ± 7.40. The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen that feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness. CONCLUSIONS: Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms.

Effectiveness of continuous subcutaneous insulin infusion versus multiple daily injections on glycaemic control among older adults with type 2 diabetes: protocol for systematic review and meta-analysis.

INTRODUCTION: Insulin therapy plays an irreplaceable role in glycaemic control among older adults with type 2 diabetes mellitus (T2DM) and can be administered by either multiple daily injections (MDI) of insulin or by a continuous subcutaneous insulin infusion (CSII) pump. Many clinical trials have compared the effects of CSII pumps and MDI in various diabetic populations, but there has been no systematic review and meta-analysis focusing on older adults with T2DM. This study aims to determine whether the CSII pump is associated with better glycaemic control relative to the MDI in older adults with T2DM. METHODS AND ANALYSIS: PubMed, Medline, Cochrane Library, Web of Science core collection, China National Knowledge Infrastructure (CNKI), Wan Fang Database, Chinese Science and Technology Journal Database (VIP) and Chinese Biomedical Literature Database (SinoMed) will be searched from inception to December 2021. Only randomised controlled trials will be included, and the language of the selected studies will be restricted to English and Chinese. Two researchers will independently screen the studies, extract data, assess the risk of bias and evaluate the quality of evidence. Any disagreement will be resolved by consensus or by a third researcher. Data analysis and synthesis will be conducted using RevMan V.5.3. Subgroup analysis, sensitivity analysis and publication bias assessment will be performed, as necessary. ETHICS AND DISSEMINATION: As this study will not contain personal information, ethical approval will not be required. The results of the study will be published in a peer-reviewed journal or at relevant conference. PROSPERO REGISTRATION NUMBER: CRD42021283729.

Exercise Adherence and Compliance and Its Related Factors Among Elderly Patients with Type 2 Diabetes in China: A Cross-Sectional Study.

Purpose: To explore exercise adherence and compliance as well as its related factors among elderly patients with type 2 diabetes mellitus (T2DM) to provide a basis for clinical intervention strategies. Patients and Methods: The present study was a cross-sectional study of 205 elderly patients with T2DM who regularly visited a Shanghai community health center from August 2020 to July 2021. Exercise adherence and compliance was measured using an exercise adherence and compliance questionnaire, and potential correlates were explored using multiple linear regression analysis. Results: The mean total score of the exercise adherence and compliance questionnaire was 16.72±5.08. The stepwise regression results revealed that exercise adherence and compliance was positively correlated with self-monitoring (F=3.510, P=0.005), exercise knowledge (r=0.784, P<0.001), exercise willingness (r=0.556, P<0.001), professional support (r=0.426, P<0.001), and self-efficiency (r=0.5, P<0.001). There was a negative correlation between hypoglycemia and exercise adherence and compliance (F=-3.672, P<0.001). Conclusion: Low exercise adherence and compliance was related to low glucose self-monitoring frequency, increased hypoglycemia, less exercise knowledge, less exercise willingness, less professional support, and less self-efficiency. When developing exercise instructions adapted to the cognitive and volitional needs of diabetic patients, it is essential to focus on their daily self-management habits and extrinsic motivation to improve exercise adherence and compliance.

Perceptions of Chinese older adults with type 2 diabetes mellitus about self-management mobile platform: A qualitative study.

OBJECTIVE: To explore the perceptions of Chinese older adults with type 2 diabetes mellitus (T2DM) about the WeChat-based self-management mobile health (mhealth) platforms. METHODS: A semi-structured interview was conducted with a purposive sample of 20 older adults with T2DM. Interview data were summarized and refined with the NVivo 11.0 software. Content analysis was used for qualitative research. RESULTS: Three themes emerged from the interviews: Perception One: Better experience when using a self-management mobile platform; Perception Two: More practical functions of the platform; and Perception Three:Trust and assistance from others. CONCLUSION: Older adults with T2DM have a high willingness to use the WeChat-based self-management mhealth platform. To encourage them to use the platform more frequently, the following factors should be taken into consideration: the perceived experience, fundamental demand for self-management, and need for others' support and assistance. These age-appropriate approaches to self-management health reform may benefit older adults with T2DM.

Effect of bilevel continuous positive airway pressure for patients with type II respiratory failure due to acute exacerbation of COPD: A protocol for systematic review and meta-analysis.

BACKGROUND: The purpose of this study is to determine the therapeutic efficacy of bi-level continuous positive airway pressure (BIPAP) intervention in patients with type II respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (COPD). METHODS: This review will only include randomized controlled trials (RCTs). The search strategy will be applied to 4 Chinese databases: China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Science and Technology Journal Database (VIP), and Chinese Biomedical Literature Database (SinoMed); and 5 foreign literature databases: PubMed, Cochrane Library, Springer, EBSCO, and Web of Science. RCTs published from inception to October 2020 will be included. The 2 researchers will independently screen and extract the data and assess quality. The main results obtained through blood gas analysis and equipment observation, heterogeneity assessment, sensitivity analysis, funnel chart synthesis, data synthesis, and grouping analysis will be carried out using Review Manager 5.4 software. The trial sequential analysis will be completed using TSA v0.9 developed by the CTU at the Copenhagen Clinical Trial Center. RESULTS: In the current meta-analysis, we will provide more practical and targeted results for the therapeutic efficacy of BIPAP in patients with type II respiratory failure due to acute exacerbation of COPD. CONCLUSION: This study will provide new evidence for the therapeutic efficacy of BIPAP in patients with type II respiratory failure due to acute exacerbation of COPD. REGISTRATION NUMBER: INPLASY2020110003 (DOI:10.37766/inplasy2020.11.0003).

Cross-cultural adaptation, validity, and reliability of the Chinese version of the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC).

BACKGROUND: In recent years, disasters occurred frequently all over the world, and the role of nurses in public health emergencies and disaster emergencies was highlighted under the background of the covid19 epidemic. However, there was a lack of education and evaluation. Our study aims to cross-cultural adapt the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC) and evaluate the reliability and validity of the Chinese version. METHODS: We translated the scale following the translation-integration-back translation-expert review procedure, adapted according to Chinese culture. We evaluated the reliability and validity of the scale, and a total sample of 911 nurse data from the Yangtze River Delta Regional Nursing Alliance Hospital was gathered. RESULTS: The Chinese version of NPDCC included 45 items, 5 factors (critical thinking skills, special diagnostic skills, general diagnostic skills, technical skills, and communication skills) were extracted from the analysis, which could explain the 68.289% of the total variance. The content validity index was 0.925. The Cronbach's α of the total NPDCC score was 0.978, and 0.884-0.945 for every factor. The split-half for the scale was 0.930, and every factor was 0.861-0.894. CONCLUSIONS: The Chinese version of NPDCC has excellent reliability and validity, and it is suitable to measure nurses' perceptions of disaster core competencies in China. The next step is to promote the application in a large scale.

Effect of Self-Acupoint Massage on Blood Glucose Level and Quality of Life in Older Adults With Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

The current study aimed to explore the effect of self-acupoint massage (SEAM) on blood glucose level and quality of life in community-dwelling older adults with type 2 diabetes mellitus (T2DM). Sixty-six older adults with T2DM were enrolled and randomly divided into observation and control groups. Participants in the control group received routine nursing interventions, whereas participants in the observation group received a SEAM intervention in addition to routine nursing interventions. After 12 weeks of SEAM, glycosylated hemoglobin (HbA1c) levels in the observation group decreased from 8.35% (SD = 1.84%) at baseline to 7.29% (SD = 1.38%) (p < 0.01). Total score of the Diabetes-Specific Quality of Life Scale (DSQLS) in the observation group improved from 45.96 (SD = 4.29) at baseline to 41.3 (SD = 3.89) (p < 0.01). The physiological dimension of the DSQLS in the observation group improved from 49.65 (SD = 7.33) at baseline to 38.54 (SD = 4.68) (p < 0.01). As SEAM effectively decreased older adults' HbA1c level and improved their quality of life, it can be used as a complementary approach to routine nursing interventions for community-dwelling older adults with T2DM. [Journal of Gerontological Nursing, 45(8), 43-48.].