Exploration of subgroups and predictors of loneliness among older adults in rural China: A latent profile analysis.

BACKGROUND: Loneliness is a negative emotional state that can lead to physical and mental health problems. This study's objective was to acquire an in-depth understanding of the heterogeneity and the predictors of loneliness among older adults in rural China and provide valuable references for practical interventions. METHODS: Older rural adults in China (N = 680) were recruited between January and April 2023. Latent profile analysis (LPA) was employed to identify subgroups of loneliness among participants. Single-factor and multinomial logistic regression analyses were conducted to investigate predictors of loneliness. RESULTS: The loneliness of rural older adults could be divided into three subgroups: low interaction loneliness group (55.0%), moderate emotional loneliness group (31.8%), and high loneliness group (13.2%). The subgroup predictors included age, gender, religious beliefs, marital status, living alone, number of chronic diseases, and smartphone use (P < 0.05). CONCLUSION: This study identified a classification pattern for loneliness among older adults in rural areas of China, revealed the characteristics of different demographic variables in loneliness categories, and highlighted the heterogeneity of loneliness in this population. It serves as a theoretical reference for formulating intervention plans aimed at addressing various loneliness categories for local rural older adults. CLINICAL TRIAL REGISTRATION: ChiCTR2300071591.

Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study.

BACKGROUND: Intensive care nurses experience many difficulties in caring for patients with delirium. Thus, it is valuable to conduct in-depth research on the factors that influence the difficulties faced by intensive care nurses in caring for those with delirium as doing so can result in tangible improvements in patient outcomes. OBJECTIVES: The objective of this study was to explore the difficulties faced by intensive care nurses in caring for patients with delirium in light of the demographic, clinical, and professional and management characteristics of nurses. METHODS: A cross-sectional study involving 360 intensive care nurses from eight general hospitals in Taizhou, Zhejiang Province, China. The participants completed questionnaires assessing the level of difficulty they faced in caring for patients with delirium and their level of delirium-related knowledge. RESULTS: The highest overall mean scores on the difficulty scale subscales were observed for ensuring safety (2.92 ± 0.30), dealing with stress and distress (2.80 ± 0.37), and lack of resources (2.85 ± 0.41). The main factors influencing nurses' difficulty in caring for these patients were title, status as a critical care specialist nurse, training regarding delirium, a standardised delirium management process, the knowledge level regarding delirium, the total number of years working in the intensive care unit, and work communication ability. Likewise, most of these characteristics made it difficult for the nurses to use delirium screening tools. CONCLUSIONS: This study provides insights into factors influencing the difficulties faced by intensive care nurses in caring for patients with delirium and in using delirium screening tools. Our findings suggested that nursing managers could develop targeted improvement strategies and provide more resources to support nurses, thereby improving the quality of delirium care and patient outcomes by using the results from this study. These findings can also provide evidence to support intervention studies in the future.

Efficacy of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community: a randomized controlled trial.

BACKGROUND: This study explores the effect of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community. It provides a practical basis for the in-depth implementation and revision of the community health management model. METHODS: A randomized controlled intervention study was conducted from 2022 to 2023. A total of 72 older adults were recruited and randomly divided into an intervention group (36 individuals) and a control group (36 individuals). Balance ability (measured by the Short Physical Performance Battery and One Leg Stand Test), aging attitudes, and perceived stress were assessed at baseline and at the 12-week and 24-week follow-ups. Repeated-measures ANOVA and generalized estimating equations were used to compare outcome measures. RESULTS: Sensory-based static balance training was beneficial for balance ability and aging attitude among participants in the intervention group. At the end of the intervention, participants in the intervention group showed significant improvements in SPPB scores and OLST scores compared with the control group (FSPPB = 12.347, P = 0.001, Waldχ2OLST = 45.530, P < 0.001), as well as significant differences in aging attitudes (FAAQ = 18.549, P < 0.001). Multiple comparisons at different time points in the intervention group reveal a significant intervention effect (FSPPB = 29.211, Waldχ2OLST = 80.428, FAAQ = 45.981, all P < 0.05). However, the difference in perceived stress before and after the intervention was not significant (FCPSS = 2.876, P = 0.095). CONCLUSIONS: Sensory-based static balance training significantly improved balance ability and aging attitudes among older adults in the community. The effect on perceived stress among older adults in the community was not significant. TRIAL REGISTRATION: Registered in the Chinese Clinic on 04/06/2022. The registration number is ChiCTR2200060541.

Cross-cultural adaptation and validation of the Chinese version of the intensive care oral care frequency and assessment scale.

Objectives: The objective of this study was to translate the Intensive Care Oral Care Frequency and Assessment Scale into Chinese and to evaluate its reliability and validity in Chinese ICU patients. Methods: This study was conducted using a cross-sectional survey design in ICUs of three tertiary hospitals in Huai'an and Taizhou from October 2022 to April 2023. The Chinese version of the Intensive Care Oral Care Frequency and Assessment Scale (C-ICOCFAS) was developed by expert consultation and cultural adaptation according to the two-person verbatim translation-back translation criteria described in the Brislin model. Item analysis was conducted using correlation analysis, and validity analysis included content validity, construct validity, and criterion validity. Reliability analyses included Cronbach's alpha coefficient, Guttman split-half reliability, and interrater reliability. Results: The Chinese version of the scale consisted of one dimension and nine items, consistent with the original version. Exploratory factor analysis showed KMO = 0.891, and the cumulative variance contribution reached 65.534 %. The confirmatory factor analysis indicated a good fit, χ2/df = 2.124, NFI = 0.950, GFI = 0.942, IFI = 0.973, CFI = 0.973, SRMR = 0.037, and RMSEA = 0.073. The content validity of the scale was 0.97, and the content validity of the items ranged from 0.83 to 1.00; the criterion validity was 0.969; the Cronbach's alpha coefficient was 0.919; the total item correlation coefficient was 0.725-0.831; the Guttman split-half reliability was 0.919; and the interrater reliability was 0.885. Conclusion: The C-ICOCFAS has good reliability and validity and can effectively guide nurses in the frequency of oral care for ICU patients. Implications for clinical practice: This tool can significantly improve the level of oral care among ICU patients and further promote the health and safety of patients. These findings can help clinical nursing experts to better understand and master the use of scales and standards to improve nursing.

The Chinese version of the self-efficacy scale for daily life activities among older adults: translation, validity and reliability.

OBJECTIVE: To translate and cross-culturally adapt the Self-efficacy Scale for Daily Life Activities among Older Adults (SSDLAOA) into Chinese, as well as to examine the psychometric properties of the Chinese version of the SSDLAOA (C-SSDLAOA) in a Chinese community-based older adult population. METHODS: This study used a cross-sectional survey. The psychometric properties of the C-SSDLAOA were evaluated among 355 older adults recruited from three communities in Huzhou, including internal reliability, test-retest reliability, face validity, content validity, construct validity, and concurrent validity. RESULTS: The C-SSDLAOA was consistent with the original version, which consisted of five dimensions and 23 items. The confirmatory factor analysis indicated a good fit for each indicator (χ2 /df=1.387, RMSEA = 0.043, CFI = 0.967, TLI = 0.962, and SRMR = 0.042). The Cronbach's alpha was 0.909, and the test-retest reliability was 0.966, with good internal consistency and stability. The content validity index of the items ranged from 0.83 to 1.00, while the content validity index of the scale was 0.96. The correlation between the C-SSDLAOA and GSES was 0.886, with good concurrent validity. CONCLUSIONS: The C-SSDLAOA is a reliable and valid instrument for assessing self-efficacy for daily life activities in Chinese community-dwelling older adults.

Effects of reminiscence therapy on psychological outcome among older adults without obvious cognitive impairment: A systematic review and meta-analysis.

Introduction: Reminiscence therapy has been a high-benefit and low-cost measure of psychosocial intervention for older adults in recent years. It has attracted much attention in the intervention study of older adults without obvious cognitive impairment. This study aimed to evaluate the effects of reminiscence therapy on psychosocial outcomes among older adults without obvious cognitive impairment and analyze the divergences of different intervention programs (form, duration, and setting) on outcomes. Methods: We searched the commonly used databases and used RevMan 5.4 in the meta-analysis (PROSPERO-ID: CRD42022315237). All eligible trials used the Cochrane Risk of Bias Tool and the Effective Public Health Practice Project quality assessment tool to identify the quality and determine the bias risk grade. Results: Twenty-seven studies were included, involving 1,755 older adults. Meta-analysis showed that reminiscence therapy has a significant effect on both depression and life satisfaction. Group reminiscence played a significant role in improving life satisfaction. Depression symptoms were not affected by the intervention duration (P = 0.06), while life satisfaction was significantly improved after more than 8 weeks of intervention (P < 0.00001). Intervention settings drove differences in depressive symptoms (P = 0.02), and the effect size of the community was larger. Conclusion: Reminiscence therapy can significantly reduce depressive symptoms and improve life satisfaction. There are different effects of reminiscence therapy in different intervention schemes on psychological outcomes among older adults. More well-designed trials with large sample sizes and long-term follow-ups are necessary to confirm and expand the present results. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315237, identifier: CRD42022315237.

Mental health service needs and mental health of old adults living alone in urban and rural areas in China: The role of coping styles.

This study aimed to explore the level and relationship between the mental health service needs (MHSN), coping styles (CS), and mental health (MH) of old adults living alone in urban and rural, and to explore the moderating effects of coping styles. A cross-sectional study was conducted with 717 older adults living alone. The survey measured MHSN, CS, and MH. Data were analyzed using a structural equation and bootstrapping method. There were significant differences in the MHSN, CS, and MH between urban and rural old adults living alone (P < 0.05). The model of the impact of MHSN on MH in urban and rural old adults living alone showed a good fit. These findings highlighted the importance of high MHSN and positive CS as potential protective factors of mental health in old adults living alone. This provides a theoretical basis for psychological nursing for old adults living alone in the community.

Cross-cultural adaptation and validation of the Chinese version of the loneliness scale for older adults.

Loneliness is emerging as a public health problem. Due to the social and emotional attributes of loneliness, there is a lack of multidimensional-related research and an effective scale with which to evaluate the loneliness of older adults in China. We intend to translate and psychometrically validate the Chinese version of the loneliness scale for older adults (C-LSOA). A cross-sectional study was conducted with a sample of 415 older adults in Huzhou, China. Content validity, construct validity, concurrent validity, and reliability were used to assess the scale's psychometric properties. Exploratory factor analysis of the C-LSOA extracted five common factors, and confirmatory factor analysis fit well. The model fit parameter values were X2/df = 2.060, CFI = 0.912, TLI = 0.902, RMSEA = 0.064, and SRMR = 0.060. The scale's content validity index was 0.93. The Cronbach's α for the total scale was 0.868, and the test-retest result was 0.854. The correlation between the C-LSOA and UCLA was 0.886, with good concurrent validity. The results indicated that the C-LSOA could be used to measure the loneliness of older adults in Chinese communities.

Improved sulfide mitigation in sewers through on-line control of ferrous salt dosing.

Water utilities worldwide spend annually billions of dollars to control sulfide-induced corrosion in sewers. Iron salts chemically oxidize and/or precipitate dissolved sulfide in sewage and are especially used in medium- and large-size sewers. Iron salt dosing rates are defined ad hoc, ignoring variation in sewage flows and sulfide levels. This often results in iron overdosing or poor sulfide control. Online dosing control can adjust the chemical dosing rates to current (and future) state of the sewer system, allowing high-precision, stable and cost-effective sulfide control. In this paper, we report a novel and robust online control strategy for the dosing of ferrous salt in sewers. The control considers the fluctuation of sewage flow, pH, sulfide levels and also the perturbation from rainfall. Sulfide production in the pipe is predicted using auto-regressive models (AR) based on current flow measurements, which in turn can be used to determine the dose of ferrous salt required for cost-effective sulfide control. Following comprehensive model-based assesment, the control was successfully validated and its effectiveness demonstrated in a 3-week field trial. The online control algorithm controlled sulfide below the target level (0.5 mg S/L) while reducing chemical dosing up to 30%.