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OBJECTIVE: To evaluate the reliability, validity, responsiveness, importance, and application level of the Core Nursing Outcomes Evaluation System for inpatients with stroke. METHODS: The reliability, validity, responsiveness, importance, and application level were evaluated by expert scoring, clinical measurement, and questionnaire survey. RESULTS: The scale‐level content validity index (S‐CVI) and item‐level content validity index (I‐CVI) were >0.8. The scoring of intraclass coefficient of all indicators was >0.600 (p <.001). There were significant differences in the total scores among patients with different severities (p <.001). Compared with total scores at admission, the total scores at discharge were significantly improved (p <.01). The importance and application level scores of all indexes are >4.5 points. CONCLUSION: The system has higher reliability, validity, responsiveness, and importance, but the application of each dimension is disproportionate. Stroke is an acute cerebrovascular disease characterized by cerebral ischemia and hemorrhagic injury. Epidemiological findings revealed that stroke is the second leading cause of death and the leading cause of disability in the world (Feigin et al., 2014). Epidemiological survey of 600,000 people in China showed that the prevalence of stroke has been increasing over the past 30 years (Sun & Wang, 2018). At present, stroke has become the first cause of death among Chinese residents (Wang, 2018; Zhou et al., 2016). In surviving patients with stroke, more than 60% of patients had different degrees of neurological dysfunction (Wang, Liu, Yang, Peng, & Wang, 2018), about 40% of them had severe disabilities (You & Wu, 2016). About 60% of first onset stroke patients were associated with higher risk of recurrence (Wang et al., 2018). With increasing age, the global burden of stroke is becoming heavier and heavier (Johnston, Mendis & Mathers, 2009). In 2015, the cost of stroke treatment in China reached about 29.2 billion RMB, bringing heavy economic burden to families as well as society (Ma, 2018). From the above data, we deduced that stroke has characteristics of high prevalence rate, high disability rate, high mortality rate, and high recurrence rate. It is one of the important causes of death and disability, seriously threatening human health and has become an important public health problem faced by Chinese society currently. [ABSTRACT FROM AUTHOR]

PURPOSE: To screen and create a core nursing outcomes evaluation index system based on NOC for stroke inpatients in China. METHODS: This study adopted the method of Delphi expert consultation, with the degree of consent >4.0 points and the coefficient of variation <0.25 as the standard for inclusion of indexes. RESULTS: The evaluation index system established in this study includes five first‐grade indexes, 15 second‐grade indexes, and 58 third‐grade indexes. CONCLUSION: The evaluation index system of core nursing outcomes for stroke inpatients in China has good specificity and reliability. PRACTICE IMPLICATIONS: The evaluation index system of core nursing outcomes provides a standardized location‐specific tool for clinical nurses to evaluate the nursing quality and intervention effect for stroke inpatients in China. [ABSTRACT FROM AUTHOR]

Background Aims Design Methods Results Conclusion Implication to Clinical Practice Reporting Method Physical frailty (PF) is highly prevalent and associated with undesirable outcomes in stroke survivors aged 65 years or older. However, the long‐term trajectories of PF are understudied in those older stroke survivors.To identify PF trajectories and relative predictors associated with the PF trajectories in older stroke survivors.This is a secondary analysis of a population‐based cohort study in the United States.Six hundred and sixty‐three older stroke survivors from the National Health and Ageing Trends Study from 2015 to 2021 were included. PF was operationally assessed based on the Fried Frailty Phenotype. Trajectories were identified by group‐based trajectory modelling. The associations between sociodemographic characteristics, clinical factors, symptoms, cognitive factors and PF trajectories were examined using the design‐based logistic regression method.Most older stroke survivors were 75 and older (63.32%), female (53.99%), white (80.54%) and partnered (50.64%). Two PF trajectory groups were identified (Group 1: low risk, robust; 49.47%; Group 2: high risk, deteriorating; 50.53%). Individuals were at a higher risk to be assigned to Group 2 if they were 75–84 years (adjusted odds ratio [aOR]: 2.16, 95% CI: 1.23–3.80) or 85+ years (aOR: 2.77, 95% CI: 1.52–5.04), had fair self‐reported health (aOR: 2.78, 95% CI: 1.53–5.07) or poor self‐reported health (aOR: 3.37, 95% CI: 1.51–7.52), had comorbidities (aOR: 8.44, 95% CI: 1.31–54.42), had breathing problems (aOR: 2.18, 95% CI: 1.18–4.02) and had balance problems (aOR: 1.70, 95% CI: 1.06–2.73).PF trajectories in older stroke survivors were heterogeneous and were associated with age, self‐rated health status, comorbidities, breathing problems and balance problems.Early, routine, dynamic screening for stroke‐related physical frailty (PF) and relative predictors might be beneficial for identifying the most vulnerable individuals. Our findings might help develop strategies to manage PF progression.The reporting followed the STROBE guideline. [ABSTRACT FROM AUTHOR]

Background: Depression and cognitive dysfunction are prevalent in the elderly population and have a serious impact on patients' quality of life and social functioning. Nutritional factors play a key role in the prevention and management of these disorders, particularly folate and vitamin D. The aim of this study was to elucidate the association between serum total folate and serum vitamin D concentrations and depressive symptoms and cognitive dysfunction in older adults., Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, 2042 participants aged 60 years and older were analyzed. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Animal Fluency test and the Digit Symbol Substitution Test (DSST). Associations between serum total folate and vitamin D concentrations and depression with cognitive dysfunction were analyzed using multivariate logistic regression models, incorporating stratification and sensitivity analyses., Results: For every 1 nmol/L increase in serum vitamin D concentration, there was a 1% reduction in the risk of depression in older adults (OR=0.99 95% CI 0.98-0.99). Serum total folate showed a significant W-shaped association with depression with cognitive dysfunction: when serum total folate concentration was below 33.00 nmol/L, the risk of depression was reduced by 7.6% for every 1 nmol/L increase in its concentration (OR=0.924 95% CI 0.89-0.959); this association was not significant when the concentration was above 33.00 nmol/L (OR=1.006 95% CI 0.998-1.013)., Conclusions: Adequate levels of vitamin D and folate may help prevent and manage depression and cognitive dysfunction in older adults. The W-shaped association between serum total folate and these conditions suggests that folic acid supplementation could be effective within a specific range, warranting further exploration and validation through clinical studies., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Physical inactivity is a global issue for cancer survivors. Wearable activity trackers are promising to address physical inactivity by providing real-time feedback on physical activity and offering opportunities for self-monitoring and goal setting. Meta-analysis has reported the effects of interventions that incorporate wearable activity trackers on improved physical inactivity and related health outcomes (eg, BMI, anxiety and depression, and self-rated health status). However, wearable activity trackers were often used as an adjunct to physical activity interventions, and the effectiveness of wearable activity trackers alone is unknown., Objective: This study aims to determine the association of wearable activity trackers with physical activity and health outcomes in patients with cancer., Methods: Data from 957 cancer survivors from the Health Information National Trends Survey-Surveillance, Epidemiology, and End Results (HINTS-SEER) were analyzed. The outcome variables examined were time spent in moderate to vigorous physical activity, weekly frequency of strength training, BMI, anxiety and depression levels, and self-assessed health status. The primary independent variable was whether cancer survivors had used wearable activity trackers within the past 12 months. Design-based linear regression for continuous outcome variables and ordinal logistic regression for ordinal outcome variables were conducted to determine the associations after controlling for sociodemographic, cancer-related, and health-related factors. All data analyses accounted for the complex survey design and sample weights., Results: Only 29% of cancer survivors reported wearable activity tracker use. Bivariate analyses showed that younger age (P<.001), higher education (P=.04), higher income (P<.001), and an employed status (P<.001) were significantly associated with wearable activity tracker use. Wearable activity tracker use was significantly associated with higher time spent in moderate to vigorous physical activity (adjusted =37.94, 95% CI 8.38-67.5; P=.01), more frequent strength training per week (adjusted odds ratio [OR] 1.50, 95% CI 1.09-2.06; P=.01), and better self-rated health status (adjusted OR 1.58, 95% CI 1.09-2.29; P=.01), but not with BMI or anxiety and depression., Conclusions: This study suggests that the uptake of wearable activity trackers is low and highlights the digital divide among patients with cancer. This study has confirmed the associations of wearable activity tracker use with physical activity and self-rated health, supporting using wearable activity trackers as a promising tool to facilitate physical activity promotion., (©Weijiao Zhou, Shaomei Shang, Youmin Cho. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.10.2024.)

The advent of the era of biomedical big data has helped promote the development of precision nursing. Precision nursing for chronic diseases in older adults is an interdisciplinary research field in which accurate individualized data are utilized to carry out early screening and health management of older adult populations at high risk for chronic diseases and early intervention of diseases, which plays an important role in improving the prognosis of diseases and the health level of the older adult population. Herein, we introduced the concept of precision nursing, and discussed the latest research findings in the key areas of precision nursing for chronic diseases in older adults, including precision symptom management in cancer patients and precision nursing in older patients with multimorbidity. At present, research concerning precise symptom management of cancer patients is mainly focused on prediction modelling for risks of symptoms, longitudinal change trajectories, core symptom identification, etc. Investigations in the precise nursing of cancer patients are conducted in the following areas, risk prediction, the timing of interventions, and intervention targets. Research on precision nursing for multimorbidity is mainly focused on assessment of chronic disease multimorbidity, multimorbidity pattern recognition, and health management of multimorbidity. We also discussed potential opportunities and challenges of precision nursing in the future, in order to provide a scientific basis for the improving the practice and theories of precision nursing. In the future, precision nursing will play an ever more important role in uncovering pathogenic information, the diagnosis and treatment of diseases, the health of the research population, and the promotion of medical research., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Background: Despite the benefits of digital health technology use, older adults with cancer (ie, aged 65 years) have reported challenges to technology adoption. However, there has been a lack of a good understanding of their digital health technology use patterns and the associated influential factors in the past few years., Objective: This study aimed to examine the trends in and factors associated with digital health technology use among older adults with cancer., Methods: The National Health and Aging Trends Study (NHATS) data set is a national longitudinal cohort study with annual survey waves of Medicare beneficiaries 65 years and older. Participants were community-dwelling older adults who self-reported previous or current cancer diagnoses in each round. The study sample size of each round ranged from 1996 (2015) to 1131 (2021). Digital health technology use was defined as using the internet or online in the last month to order or refill prescriptions, contact medical providers, handle Medicare or other insurance matters, or get information about their health conditions. The association of sociodemographics, clinical factors (self-rated health, chronic conditions, difficulties in activities of daily living, dementia, anxiety, and depression), and physical function (Short Physical Performance Battery and grip strength) with digital health technology use was examined using design-based logistic regression. All statistical analyses accounted for the complex sample design., Results: The prevalence of any digital health technology use increased from 36% in 2015 to 45% in 2019. In 2020-2021, which was amid the COVID-19 pandemic, it ranged from 51% to 52%. In terms of each digital health technology use behavior, in 2015, overall, 28% of older cancer survivors used digital health technology to obtain health information, followed by contacting clinicians (19%), filling prescriptions (14%), and handling insurance (11%). Greater use of digital health technology was associated with younger age, being White, having a college or higher education, having a higher income, having more comorbidities, nondementia, and having a higher gait speed., Conclusions: Digital health technology use in older adults with cancer has gradually increased, particularly during the COVID-19 pandemic. However, socioeconomic and racial disparities have remained in older cancer survivors. Additionally, older adults with cancer may have some unique features associated with digital health technology use; for example, their use of digital health may be increased by their comorbidities (ie, health care needs) and reduced by their frailty., (©Weijiao Zhou, Youmin Cho, Shaomei Shang, Yun Jiang. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 31.05.2023.)

Objective: To investigate patients' attitudes towards cancer pain management and analyze the factors influencing these attitudes., Methods: The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form (BQT), and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China., Results: The average patient score for attitudes towards pain management was 2.96±0.49. The dimension scores indicated good attitudes in three areas (scores <2.5), "Desire to be good" (2.22±1.04), "Fatalism" (2.08±0.81) and "Religious fatalism" (1.86±1.00), and poor attitudes in six areas (scores ≥2.5), "Tolerance" (3.83±0.96), "Use of analgesics as needed ( p.r.n. )" (3.73±1.01), "Addiction" (3.44±1.05), "Disease progression" (3.28±1.26), "Distraction of physicians" (3.16±1.07) and "Side effects" (2.99±0.68). Two factors were entered into the regression equation: the caregivers' attitudes towards cancer pain management and the patients' pain knowledge. These two factors explained 23.2% of the total variance in the patients' average scores for their attitudes towards cancer pain management., Conclusions: The patients' attitudes towards cancer pain management were poor and could be influenced by the caregivers' attitudes and the patients' pain knowledge, and thus need to be improved., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.