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This study aimed to investigate the effects of transitional care (TC) programs on the health outcomes of discharged older patients with osteoporotic vertebral compression fractures (OVCFs).A total of 160 older patients were recruited from two campuses of a public teaching hospital in China. Patients were grouped according to the campus to which they were admitted. The TC programs commenced one day before discharge and lasted 6 months after discharge. Repeated-measures analysis of variance was used to analyse the effects of the TC programs.The TC programs improved the discharge of older patients with OVCF in their activities of daily living (ADLs), pain levels and social support, and decreased fracture recurrence rates.This study provides evidence of concurrent clinical improvements and health outcomes in discharged older patients with OVCFs from the effects of TC programs based on social support theory.

This study translated the Positive and Negative Social Exchange (PANSE) scale into Chinese, examined its psychometric characteristics, and explored its feasibility for use among older adults with disabilities from China.A two-stage study procedure was employed. In the first stage, the English version of the PANSE scale was translated and cross-culturally adapted. In the second stage, the reliability and validity of the scale were assessed based on item-total correlation, internal consistency, test-retest reliability, content validity, structural validity, concurrent criterion validity, and known group validity.A total of 357 older adults with disabilities participated in the survey. The Chinese version of the PANSE scale consisted of two parts, the Positive Social Exchange Scale and the Negative Social Exchange Scale. Exploratory factor analysis extracted six communal factors. The cumulative contribution of the two parts of the scale was 69.90% and 77.88%, respectively. The item-total correlation was 0.353 to 0.802, the internal consistency of the PANSE was 0.653 to 0.886. The PANSE demonstrated good content validity and it was correlated with the SSRS scale.The Chinese version of the PANSE is a valid and reliable instrument for assessing social exchange in Chinese older adults with disabilities.Implication for rehabilitationDespite the growing number of older adults with disabilities being a concern in China, the lack of tools to measure the type of social support limits research related to the health status of these people.This study cross-culturally adapted, translated into Chinese and validated the Positive and Negative Social Exchange (PANSE) scale as the measurement tool to be used in the cultural context of China.The two subscales of PANSE were validated in the Chinese population of older adults with disabilities.The PANSE scale measures social exchange among older adults with disabilities in China, which can guide the development of interventions to address issues in the social exchange of these people.

To evaluate the current situation and associated factors of informational support for older adults with chronic diseases in transitional care. Study was conducted in five hospitals of five different cities in Jiangsu Province, China. A random cluster sample of 800 older adults with chronic diseases responded to the informational support questionnaire of transitional care survey. Descriptive analysis, t-tests, variance analysis, and stepwise multiple linear regression were used to analyze data. The STROBE statement for observational studies was applied. Total score of ISQTC for older adults with chronic diseases was (44.05 ± 17.21). Marital status, educational level, past occupation, close friends, medical insurance, complications, and exercise habits were significantly correlated with informational support. The level of informational support in transitional care for older adults with chronic diseases was low. Clinical staff should periodically and primarily assess their informational support, help find information resources for those who have low initial informational support, and identify which information they preferred to carry out accurate transitional care.

To assess and summarize the effects of informational support on depression and quality of life of older patients with cancer. PubMed, MEDLINE, and Web of Science were searched to identify articles written in English and published until March 2021. Studies within 10 years period (2010–2021) were included. Randomized controlled trials were included if they evaluated the impact of informational support on depression and quality of life. All analyses were performed with Review Manager 5.3. Twelve studies with a total of 2374 participants met the inclusion criteria. Our primary outcomes included depression and quality of life. (1) Depression: results indicated no statistically significant difference and low heterogeneity [SMD = 0.28, 95% CI (− 0.24,0.80), p = 0.45; I2 = 0%], (2) Quality of life: in the subgroup analyses of EORTC QLQ-C30, results indicated a significant effect of informational support on quality of life [SMD = 2.84, 95% CI (0.63, 5.05), p = 0.03; I2 = 79%]; in the subgroup analyses of FACT and SF-36, there were no significance. Informational support could reduce depression and did improve the quality of life in older cancer patients with statistical significance. The findings suggested that informational support was an effective approach to improve depression and quality of life in older patients with cancer.

Objective: Wearing face masks is believed to mitigate coronavirus disease 2019 (COVID-19) virus transmission by filtering respiratory droplets. This study was to explore the factors influencing wearing face masks in public in China during COVID-19 outbreak. Methods: This study was a qualitative semi-structured interview research design and was guided by the Protection Motivation Theory. Participants from Jiangxi Province China were interviewed by means of WeChat video call. Thematic analysis was used to analyze the data. Results: Recruitment efforts were suspended when 21 participants (aged 23 to 72 y) were successfully enrolled and the data reached thematic saturation. Four themes were identified when participants described factors influencing them to wear face masks: knowledge of disease (subthemes were severity of disease, and individual vulnerability to disease), environmental facilitators and constraints (subthemes were government recommendations, public opinion, and affordability and availability of face masks), understanding of protection effectiveness (subthemes were protection effectiveness of wearing face masks, and selection of protective measures), and past experiences. Conclusions: Individuals’ decision to wear face masks was influenced by the combination of factors identified. Identification of these factors provides guidance for explaining wearing face masks in public and helps policy-makers develop feasible recommendations for wearing face masks during COVID-19 outbreak.

This study aimed to examine the feasibility and validity of an emotional support programme developed for older adults living in nursing homes, using a quasi-experimental design. Older adults in the intervention group attended a 12-week emotional support programme while those in the control group received usual care. Outcome variables, assessed at baseline and at 1-month and 3-month follow ups, included nursing home adjustment, perceived social support, and quality of life. Group-by-time interaction effects were found concerning nursing home adjustment and perceived social support. Significant improvements in the two variables were observed in the intervention group, but no significant difference was found in quality of life. The emotional support programme based on social learning theory resulted in significant improvements in nursing home adjustment and perceived social support. To respond to the demands of an ageing society, further studies are needed on this topic.

Background Instrumental support, which is defined as practical, tangible, and informational assistance extended to patients, is crucial for older people in transition. However, little is known about instrumental support in transitional care. Thus, the aim of this study was to evaluate the instrumental support of older people in transitional care. Methods This cross-sectional study was conducted using the Questionnaire of Instrumental Support in Transitional Care (QISCT) to collect data from 747 older people in China from September to November 2020. Survey items consisted of a sociodemographic characteristics questionnaire and the QISCT. Multiple regression analyses were conducted to examine the association between independent variables and the QISCT scores. Results The total score of the QISCT was 39.43 (± 9.11), and there was a significant gap between the anticipated support and received support. The satisfaction of instrumental support was low. Multiple regression analyses showed that educational level, the number of intimate relationships, monthly family income, monthly costs of transitional care, diabetes, and chronic obstructive pulmonary disease were associated with instrumental support in transitional care. Conclusions To cope with the burden caused by chronic disease, the government and transitional care teams should establish a demand-oriented transitional care service model and pay more attention to helping older people obtain adequate and satisfactory instrumental support.

Aim Most studies on nursing home quality focus on developed countries, with little coverage in developing countries. Our study aimed to compare the differences between Chinese public and private non-profit nursing homes using the latest national standard. Methods A cross-sectional study was conducted including 232 nursing homes in Jiangsu and Zhejiang provinces, China. We conducted statistical analyses (chi-square and independent sample t test) to investigate differences in public and private non-profit nursing homes. We fitted a binary logistic regression model with whether or not the nursing home received a 3-star or higher rating as the dependent variable, and the ownership type as explanatory variable, after adjusting for nursing home characteristics. Results Of the 232 nursing homes included in the study sample, 44.8% were public nursing homes and 55.2% were private non-profit nursing homes. The t test analysis comparing the measures of nursing homes yielded significant results for 4 measures, 3 of which (overall rating, environment, and services) favored private non-profit nursing homes. A regression analysis using whether or not the nursing home received a 3-star or higher rating as the dependent variable showed that when adjusting for nursing home characteristics, private non-profit nursing homes were more likely to have a 3 or higher star compared with public nursing homes (odds ratio = 1.961, 95% confidence interval: 1.056-3.643). Conclusion These results suggested that private non-profit nursing homes performed better than public nursing homes when using the Chinese national standard for nursing homes.

With great interest, we read the recent original article written by Zihan Chang et al1 , which was published in European Journal of Neurology. In this multicenter retrospective case-control study, the authors found that elevated serum Cystatin C may be associated with unfavorable clinical outcomes after intravenous tissue plasminogen activator therapy, independently. The results of receiver operating characteristic curves also showed that model 1 (combining baseline Cystatin C, hypertension, early infarct signs on admission CT scan, WBC and smoking) was able to predict good&sustained benefit (Area under the curve is 0.75). What is more, model 2 (combining baseline Cystatin C, NIHSS on admission, hypertension, early infarct signs on admission CT, and TOAST subtype large-artery atherosclerosis) can be used to forecast good functional outcome (Area under the curve is 0.86). Nevertheless, I still have comments.

ObjectivesWe developed an informational support questionnaire of transitional care (ISQTC) for aged patients with chronic disease and investigated its reliability and validity.SettingThis study was conducted in three large general hospitals in Nantong, Jiangsu Province, China.ParticipantsA total of 130 aged patients with chronic diseases, admitted into outpatient and inpatient departments from three hospitals in China, participated in the study. The inclusion criteria were: (1) patients must provide consent to participate; (2) being 60 years and above; (3) being diagnosed with at least one chronic disease and hospitalised more than two times within the last 1 year; (4) being able to listen, speak, read and write. The exclusion criteria were: (1) refusing to participate; (2) language expression and communication barriers (and having no caregiver to assist in participation); (3) being in intensive care or long-term hospitalisation.Primary and secondary outcome measuresThe developed questionnaire was validated and tested for reliability. The content validity of the questionnaire was determined through experts’ interviews and Delphi expert consultation, and the structure validity of the questionnaire was determined by performing exploratory factor analysis. The coefficient of reliability of the questionnaire was measured using Cronbach’s alpha.ResultsThrough Delphi expert consultation and exploratory factor analysis, the questionnaire was reduced from four dimensions and 12 items to three dimensions and 11 items. A total of 130 patients responded to the questionnaire. The alpha coefficient was 0.747.ConclusionThe ISQTC is a reliable and valid instrument for evaluating aged patients with chronic disease in transitional care.Trial registration detailsChiCTR1900020923. The trial was registered on 22 January 2019.

Background: Transitional care (TC) has been shown to improve stroke rehabilitation in discharged stroke patients. Previous TC interventions did not report satisfactory stroke rehabilitation outcomes or risk management. Incorporating a health behavior theory in interventions can effectively improve health behaviors and metabolic indicators.Objectives: This study was a clinical controlled trial to investigate the impact of the Integrated Behavioral Model (IBM)-based 3-month TC on health behaviors, clinical outcomes, and stroke knowledge in discharged elderly stroke patients.Methods: Sixty elderly patients were recruited from two wards of a public teaching hospital in China. To prevent potential treatment contamination, patients were allocated into either a control or intervention group depending on which wards they were admitted to. The TC intervention considered all the IBM constructs to provide patients assistance in implementing health behaviors as recommended by the Chinese stroke guidelines. The TC intervention commenced one day before discharge and lasted three months after discharge. A linear mixed model was used to measure the impact of the intervention.Results: The TC intervention improved the discharged elderly stroke patients' health behaviors, activities of daily living, quality of life, and stroke knowledge. The intervention also controlled the patients' systolic blood pressure, body mass index, total cholesterol, triglycerides, and low-density lipoprotein cholesterol.Conclusions: This study provided evidence of concurrent self-reported and objective clinical indicators in discharged elderly stroke patients for the impact of the IBM-based 3-month TC intervention, which can be recommended for clinical practice.

Background Limited studies are available on health behavior knowledge among the elderly and the interaction between the elderly and their children living with them. Using a survey of the elderly in the community and their children living with them, we explored the characteristics that determine health behavior knowledge. We also identified the influencing factors affecting such knowledge. The relationship between the health behavior knowledge of the elderly and that of their children was also investigated. Methods A total of 1207 elderly people were selected by multistage probability sampling (number of children of the elderly = 201). We used a self-designed behavior knowledge questionnaire (38 questions) to survey the participants. After the 38 questions were answered, the total score was determined. The group with adequate health behavior knowledge (score ≥ 24) and that with inadequate knowledge (score < 24) were distinguished by logistic regression to explain the influencing factors affecting health knowledge. Results On the basis of the responses to 38 questions in the survey, approximately 46.7% of elderly people were identified as having a good knowledge of health. Knowledge of the proper amount of certain foods and liquids as well as that of psychological disorder among the elderly recorded a low percentage at < 60%. Factors related to health behavior knowledge among the elderly were as follows educational attainment, past occupation, and location of residence. Participants who finished high school or higher had 6, 4, and 3 times greater odds of possessing adequate health knowledge than those who attained below primary school, primary school, and junior high school levels, respectively. Those with experience as administrative and technical personnel, workers, migrant workers, and farmers had 2.5, 2.3, 3.9, and 2.1 times greater odds of possessing adequate health knowledge, respectively, than those who were unemployed. Respondents living in the city had 3.7 times greater odds of possessing adequate health knowledge than those living in the countryside. In the stem family, the health knowledge of the elderly was significantly lower than that of their children (P < 0.001). However, the influence of their children’s knowledge upper their elder’s was relatively weak. Conclusion The need to improve health behavior knowledge among the Chinese elderly remains high. Medical personnel in the community should provide health education related to proper diet and alcohol intake, as well as psychological health, particularly for those elderly who only reached primary school and below, used to be unemployed, and are living in rural areas. Children of stem families should be guided to enhance their health education and contribute to the health knowledge of their elderly parents.