The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff train...The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.展开更多
Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing sta...Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.展开更多
Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the ...Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the China Health and Retirement Longitudinal Study conducted in 2011.Multiple logistic regressions were performed to examine the associations between individual characteristics and diabetes treatments.Results:In total,719/993(72.4%)of the respondents received treatment for diabetes;of which<8% used insulin therapy.Urban residents were more likely than rural residents to use insulin therapy[odds ratio(OR)=0.44,confidence interval(CI):0.20-0.99;p<0.05],and more likely to use traditional Chinese medicine than migrants(OR=0.30,CI:0.10-0.96;p<0.05).Overall,rural residents showed lower treatment rates than urban and migrant populations.Conclusion:Efforts to improve and enhance diabetes treatments,particularly among rural residents,are urgently needed in China.展开更多
Older adults faced unique challenges in the pandemic due to their increased vulnerability to coronavirus disease 2019(COVID-19)and its complications.Pandemic-related restrictions such as physical distancing,stay-at-ho...Older adults faced unique challenges in the pandemic due to their increased vulnerability to coronavirus disease 2019(COVID-19)and its complications.Pandemic-related restrictions such as physical distancing,stay-at-home orders,lock-down,and mandatory face cover affected older adults in unique ways.Additionally,older adults experienced psychosocial concerns related to discrimination based on ageism and emotional distress from exposure to conflicting messages in the media.They experienced several forms of loss and associated grief and survivor guilt.Pandemic added to their loneliness and social isolation.Furthermore,older adults experienced the fear and anxiety related to COVID and the fear of contracting the disease and dying from it.Pandemic experience included events potential to generate the desire and capability for suicide.Several studies report varying symptoms such as loneliness,anxiety,and depression among older adults during the pandemic.However,during the initial months of the pandemic,there were reports on coping and resilience among this population.The impact of COVID-19 on older adults’mental health may have long-term implications.This narrative review examines the impact of COVID-19 on older adults’mental health and psychosocial wellbeing.Additionally,the review highlights various factors that affected their psychosocial wellbeing during the COVID-19 pandemic.展开更多
Colorectal cancer(CRC)is the third most diagnosed form of cancer and second most deadly cancer worldwide.Introduction of better screening has improved both incidence and mortality.However,as the coronavirus disease 20...Colorectal cancer(CRC)is the third most diagnosed form of cancer and second most deadly cancer worldwide.Introduction of better screening has improved both incidence and mortality.However,as the coronavirus disease 2019(COVID-19)pandemic began,healthcare resources were shunted away from cancer screening services resulting in a sharp decrease in CRC screening and a backlog of patients awaiting screening tests.This may have significant effects on CRC cancer mortality,as delayed screening may lead to advanced cancer at diagnosis.Strategies to overcome COVID-19 related disruption include utilizing stool-based cancer tests,developing screening protocols based on individual risk factors,expanding telehealth,and increasing open access colonoscopies.In this review,we will summarize the effects of COVID-19 on CRC screening,the potential longoutcomes,and ways to adapt CRC screening during this global pandemic.展开更多
Background Emergency medical services(EMS)is a critical link in the chain of stroke survival.We aimed to assess EMS use for stroke in Singapore,identify characteristics associated with EMS use and the association of E...Background Emergency medical services(EMS)is a critical link in the chain of stroke survival.We aimed to assess EMS use for stroke in Singapore,identify characteristics associated with EMS use and the association of EMS use with stroke evaluation and treatment.Methods The Singapore Stroke Registry combines nationwide EMS and public hospital data for stroke cases in Singapore.Multivariate regressions with the generalised estimating equations were performed to examine the association between EMS use and timely stroke evaluation and treatment.results Of 3555 acute ischaemic patients with symptom onset within 24 hours admitted to all five public hospitals between 2015 and 2016,68%arrived via EMS.Patients who used EMS were older,were less likely to be female,had higher stroke severity by National Institute of Health Stroke Scale and had a higher prevalence of atrial fibrillation or peripheral arterial disease.Patients transported by EMS were more likely to receive rapid evaluation(door-to imaging time≤25 min 34.3%vs 11.1%,OR=2.74(95%CI 1.40 to 5.38))and were more likely to receive intravenous tissue plasminogen activator(tPA,22.8%vs 4.6%,OR=4.61(95%CI 3.52 to 6.03)).Among patients treated with tPA,patients who arrived via EMS were more likely to receive timely treatment than self-transported patients(door-to needle time≤60 min 52.6%vs 29.4%,OR=2.58(95%CI 1.35 to 4.92)).Conclusions EMS use is associated with timely stroke evaluation and treatment in Singapore.Seamless EMS-Hospital stroke pathways and targeted public campaigns to advocate for appropriate EMS use have the potential to improve acute stroke care.展开更多
文摘The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.
基金Partial support for this project was provided by Grant#66636 from the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative program(Interdisciplinary Mobility Team Approach to Reduction of Facility-Acquired Pressure Ulcers)Tracey L.Yap(PI).Trial Registration:clinicaltrials.gov Identifier:NCT01008254+1 种基金Partial support was also provided by the National Institute for Occupational Safety and Health Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant No.T42/H008432-06Susan Kennerly&Tracey Yap(co-PI’s).
文摘Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.
文摘Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the China Health and Retirement Longitudinal Study conducted in 2011.Multiple logistic regressions were performed to examine the associations between individual characteristics and diabetes treatments.Results:In total,719/993(72.4%)of the respondents received treatment for diabetes;of which<8% used insulin therapy.Urban residents were more likely than rural residents to use insulin therapy[odds ratio(OR)=0.44,confidence interval(CI):0.20-0.99;p<0.05],and more likely to use traditional Chinese medicine than migrants(OR=0.30,CI:0.10-0.96;p<0.05).Overall,rural residents showed lower treatment rates than urban and migrant populations.Conclusion:Efforts to improve and enhance diabetes treatments,particularly among rural residents,are urgently needed in China.
文摘Older adults faced unique challenges in the pandemic due to their increased vulnerability to coronavirus disease 2019(COVID-19)and its complications.Pandemic-related restrictions such as physical distancing,stay-at-home orders,lock-down,and mandatory face cover affected older adults in unique ways.Additionally,older adults experienced psychosocial concerns related to discrimination based on ageism and emotional distress from exposure to conflicting messages in the media.They experienced several forms of loss and associated grief and survivor guilt.Pandemic added to their loneliness and social isolation.Furthermore,older adults experienced the fear and anxiety related to COVID and the fear of contracting the disease and dying from it.Pandemic experience included events potential to generate the desire and capability for suicide.Several studies report varying symptoms such as loneliness,anxiety,and depression among older adults during the pandemic.However,during the initial months of the pandemic,there were reports on coping and resilience among this population.The impact of COVID-19 on older adults’mental health may have long-term implications.This narrative review examines the impact of COVID-19 on older adults’mental health and psychosocial wellbeing.Additionally,the review highlights various factors that affected their psychosocial wellbeing during the COVID-19 pandemic.
文摘Colorectal cancer(CRC)is the third most diagnosed form of cancer and second most deadly cancer worldwide.Introduction of better screening has improved both incidence and mortality.However,as the coronavirus disease 2019(COVID-19)pandemic began,healthcare resources were shunted away from cancer screening services resulting in a sharp decrease in CRC screening and a backlog of patients awaiting screening tests.This may have significant effects on CRC cancer mortality,as delayed screening may lead to advanced cancer at diagnosis.Strategies to overcome COVID-19 related disruption include utilizing stool-based cancer tests,developing screening protocols based on individual risk factors,expanding telehealth,and increasing open access colonoscopies.In this review,we will summarize the effects of COVID-19 on CRC screening,the potential longoutcomes,and ways to adapt CRC screening during this global pandemic.
文摘Background Emergency medical services(EMS)is a critical link in the chain of stroke survival.We aimed to assess EMS use for stroke in Singapore,identify characteristics associated with EMS use and the association of EMS use with stroke evaluation and treatment.Methods The Singapore Stroke Registry combines nationwide EMS and public hospital data for stroke cases in Singapore.Multivariate regressions with the generalised estimating equations were performed to examine the association between EMS use and timely stroke evaluation and treatment.results Of 3555 acute ischaemic patients with symptom onset within 24 hours admitted to all five public hospitals between 2015 and 2016,68%arrived via EMS.Patients who used EMS were older,were less likely to be female,had higher stroke severity by National Institute of Health Stroke Scale and had a higher prevalence of atrial fibrillation or peripheral arterial disease.Patients transported by EMS were more likely to receive rapid evaluation(door-to imaging time≤25 min 34.3%vs 11.1%,OR=2.74(95%CI 1.40 to 5.38))and were more likely to receive intravenous tissue plasminogen activator(tPA,22.8%vs 4.6%,OR=4.61(95%CI 3.52 to 6.03)).Among patients treated with tPA,patients who arrived via EMS were more likely to receive timely treatment than self-transported patients(door-to needle time≤60 min 52.6%vs 29.4%,OR=2.58(95%CI 1.35 to 4.92)).Conclusions EMS use is associated with timely stroke evaluation and treatment in Singapore.Seamless EMS-Hospital stroke pathways and targeted public campaigns to advocate for appropriate EMS use have the potential to improve acute stroke care.
