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Yupin Aungsuroch,1 Joko Gunawan,1 I Gede Juanamasta,1,2 Jed Montayre3 1Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand; 2Nursing Program, STIKES Wira Medika Bali, Bali, Indonesia; 3School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People’s Republic of ChinaCorrespondence: Yupin Aungsuroch, Email yupin.a@chula.ac.thBackground: Understanding the factors influencing work engagement among nurses is crucial for ensuring high-quality care and positive patient outcomes. Despite numerous factors associated with nurse work engagement, many were explored before the pandemic, potentially overlooking aspects relevant to the current context.Aim: To explore and update factors related to nurse work engagement in the new normal era.Design: Systematic review.Data Sources: The search was restricted to articles published from 2019 to 2024 in CINAHL, PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest, with full English text. The search was conducted from September 13th to 15th, 2023. Quantitative research articles that examined factors related to work engagement were included.Review Methods: Data extraction, quality appraisal, and data analysis were performed in all included studies. Manual content analysis method was used to classify and group the factors.Results: Sixty-one research articles were included in the final review. Five key groups of factors were generated from content analysis, including 1) individual-related factors, 2) organizational-related factors, 3) job and role-related factors, 4) work-life balance, and 5) work environment.Conclusion: Understanding and addressing these multifaceted factors holistically is essential to develop strategies to sustain optimal engagement levels among nursing staff and improve overall patient care outcomes. Further studies are needed to confirm the findings.Keywords: work engagement, nurse, hospital, pandemic, new normal

Introduction: Many patients start to live with a long-term indwelling urinary catheter (IDC) unexpectedly and often find difficulty adjusting their psycho-social life with an IDC insitu2. Patients are often not supported with information and resources to care for and manage their catheter and are forced to rely on the internet or other resources. Complications associated with a long-term IDC contribute to avoidable, costly hospital presentations and increasing healthcare-associated burden3. To minimise catheter-associated complications and improve patients' quality of life, it is essential to enhance catheter self-management by increasing patient and caregiver knowledge and self-efficacy. This study aims to explore the impact of educational interventions for patients living with an indwelling urinary catheter in situ. Materials & methods: A systematic scoping review was undertaken in accordance with PRISMA guidelines and guided by Cochrane methodology, quality appraisal using Centre for Evidence-Based Medicine (CEBM) Joanna Briggs Institute (JBI), GRADE criteria and Quality Improvement Minimum Quality Criteria Set Version 1.0 (QIMQCS V 1.0) tools. Studies (n = 446) published between 2000 and 2020 were retrieved from CINAHL, Cochrane Library, Scopus and Medline. Results: A total of 15 primary research studies were included in the narrative thematic synthesis, nine were from the USA, two from Australia, two from the United Kingdom, one from Italy and one from Turkey. These 15 studies were published between 2003 and 2019 and accounted for 19918 patients with an age range 15 to 99 years. Study design varied; there were 11 quantitative and four qualitative studies. Studies were of low-moderate quality. A total of four themes were identified; (i) information needs of patients living with long-term catheters; (ii) core learning content and educational approaches; (iii) feasibility and effectiveness of educational interventions to reduce complications and improve quality of life; and (iv) common outcome measures. While it is recognised that fear and anxiety were commonly experienced among patients living with indwelling urinary catheters, there is a scarcity of information provided to patients and their caregivers4. Despite the heterogeneity in educational interventions, all studies included in this review reported the specific approach undertaken was effective in minimising catheter-associated complications and improving the quality of life of patients living with a long-term IDC in situ. A care bundle approach, that partners clinicians with the patient and caregiver, was found to be more effective in promoting IDC self-management. Nurses are well positioned to provide opportunistic and structured, planned education related to IDC selfmanagement in both acute hospital and community settings. Future educational intervention approaches need to focus on addressing the educational needs of clinicians, patients, and caregivers. Conclusion: The dissemination of information and the delivery of urinary catheter education to patients is inadequate. Core components of educational interventions should address fluid intake, bowel management, hygiene and self-monitoring/management, including adverse events. There is a need for future robust trials of educational and self-management interventions to improve the quality of life of patients who have a long-term IDC and who live in the community. [ABSTRACT FROM AUTHOR]

Objective: To map evidence on the characteristics, effectiveness, and potential mechanisms of motor imagery interventions targeting cognitive function and depression in adults with neurological disorders and/or mobility impairments., Data Sources: Six English databases (The Cochrane Library, PubMed, Embase, Scopus, Web of Sciences, and PsycINFO), two Chinese databases (CNKI and WanFang), and a gray literature database were searched from inception to December 2024., Review Methods: This scoping review followed the Joanna Briggs Institute Scoping Review methodology. Interventional studies that evaluated motor imagery for cognitive function and/or depression in adults with neurological disorders and/or mobility impairments were included., Results: A total of 24 studies, primarily involving adults with cerebrovascular diseases, multiple sclerosis, and Parkinson's disease, were identified. Motor imagery was typically conducted at home/clinic, occurring 2 to 3 sessions per week for approximately 2 months, with each session lasting 20 to 30 minutes. The 62.5% of studies (n = 10) reported significant improvements in cognitive function, exhibiting moderate-to-large effect sizes (Cohen's d  = 0.48-3.41), especially in memory, attention, and executive function, while 53.3% (n = 8) indicated alleviation in depression with moderate-to-large effect sizes (Cohen's d  = -0.72- -2.56). Motor imagery interventions could relieve pain perception and promote beneficial neurological changes in brains by facilitating neurotrophic factor expression and activating neural circuits related to motor, emotional, and cognitive functions., Conclusion: Motor imagery could feasibly be conducted at home, with promising effects on cognitive function and depression. More high-quality randomized controlled trials and neuroimaging techniques are needed to investigate the effects of motor imagery on neuroplasticity and brain functional reorganization, thereby aiding in the development of mechanism-driven interventions., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Sense of coherence (SoC) is a core concept of 'salutogenesis' in positive psychology, correlated with emotional distress and disease development in adults with chronic disease and older adults. A diversity of non-pharmacological interventions (NPIs) has been developed to enhance SoC, but research findings are conflicting and the adequacy of sample sizes is uncertainty., Objective: This paper aimed to explore appropriate interventions, evaluate the effectiveness of these SoC interventions and verify the statistical robustness and reliability of pooled results., Methods: Search terms including 'sense of coherence' and 'randomised controlled trial (RCT)' were performed in nine electronic databases. Publications were written in English from January 1979 to February 2024. A narrative synthesis was performed to determine intervention details, and classical meta-analysis was used to analyse available data on SoC using RevMan. Besides, trial sequential analysis (TSA) was conducted to verify the robustness of pooled effect size., Results: Meta-analysis was carried out with 27 RCTs involving 2178 patients. It showed significant effects on SoC compared to usual care among this population for all NPIs at post-intervention and 3-month follow-up. Of these follow-up durations, the effective NPIs were salutogenic-based intervention, self-management intervention, while no significant difference was observed at 6-month or > 6-month follow-up. TSA showed that the significant finding of meta-analysis in salutogenic-based intervention was stable and reliable, while the pooled sample size on self-management intervention was insufficient., Conclusions: Non-pharmacological (salutogenic-based) interventions could improve SoC among older adults and adults with chronic conditions within 3 months after-intervention. However, its effects were not sustained over a longer period, which further studies will need larger sample sizes to draw definitive conclusions., Implications for Practice: This meta-analysis provided the evidence that salutogenic-based interventions could improve SoC among the target population within 3 months after-intervention, providing a solid foundation for healthcare professionals to base their therapeutic strategies., Reporting Method: The searching results were reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis checklist., No Patient or Public Contribution: This study is a systematic review with meta-analysis and trial sequential analysis, and the aforementioned details are not applicable to our research., Trial Registration: PROSPERO: CRD42023401215., (© 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Nurses play a critical role in supporting patients in self-managing their indwelling urinary catheters and preventing avoidable hospital presentations. This study aimed to explore the effectiveness of a co-designed educational approach developed to enhance nurses' ability to provide optimal care for patients with catheters., Aim: The primary aim of this study was to enhance nurses' knowledge and skills in urinary catheterisation, care, and management. The secondary aim was to transform their current catheter management practices to improve patient outcomes., Setting: Nurses (n = 127) from one New South Wales, Australia region participated in the study. These nurses provided healthcare across various community settings. Ethics approval was received from the Local Health District (HREC/2019/ETH12575) and the study was registered in ANZCTR (ACTRN12621000683831)., Methods: A mixed-methods approach was used, collecting data at baseline and after the intervention. Quantitative data were analysed using descriptive statistics, tests for normality, and bivariate analysis with the Wilcoxon Signed Ranks test to identify differences between variables. Qualitative data were analysed using a directed content analysis approach to categorise occurrences of specific phenomena., Results: The composite mean knowledge score increased from 65.03 to 84.30 following the intervention (p < 0.001). In addition, the magnitude of knowledge score improvement in seven out of eight questions following the intervention were: Financial support: 1.1 %; Bladder spasm/urine leakage: 3.3 %; Blockage: 3.5 %; Catheter-Associated Urinary Tract Infection (CAUTI): 4.4 %; Self-management: 6.1 %; Sexuality: 7.9 %; and Urinary catheterisation: 11.3 %. Qualitative findings confirmed that the eLearning module was effective in transforming participants' clinical practice, towards improving patient outcomes., Conclusions: The co-designed eLearning module effectively addressed the learning needs of nurses, enhancing their knowledge and skills in urinary catheter management. Incorporating a theoretical model and contextual approach in the intervention delivery increased relevance, personalisation, and engagement, facilitating the behaviour change required to transform current practices., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: Older adults aged over 65 are increasingly admitted to hospital for acute care reasons, including surgical procedures. In multicultural societies, the diversity of an ageing population has significant implications for the planning and delivery of culturally responsive perioperative care for older adults from ethnically diverse backgrounds, who are admitted to hospital for surgical intervention., Objective: To explore the perspectives and experiences of perioperative staff when caring for older adult patients from ethnically diverse backgrounds., Design: Exploratory qualitative methodology., Setting(s): Staff working in Australian perioperative care settings were recruited for semi-structured interviews., Participants: Purposive sampling was used to recruit 15 perioperative staff members, who had experience with caring for older adult patients from ethnically diverse backgrounds during their surgical procedure., Methods: Individual, semi-structured interviews were conducted with perioperative staff. Reflexive thematic analysis was used to identify key themes., Results: Two themes were identified. These were 'Organisational barriers in delivering safe and culturally responsive care', and 'Staff experiences in navigating the challenges of providing culturally responsive care'. Staff reported that safety protocols often overshadowed patient-specific needs, especially for patients requiring additional linguistic or cultural support. The lack of formal interpreter services and the pressure to meet efficiency targets were cited as major barriers to delivering culturally responsive care., Conclusions: Delivering culturally responsive care in the fast-paced, high-risk environment of the operating theatre presents complex challenges, as perioperative staff must navigate competing priorities of patient safety, organisational efficiency, and cultural nuances. This article highlights how the emphasis on efficiency can compromise culturally responsive care for older adults, with staff often frustrated by the lack of formalised organisational support, especially those for facilitating effective communication. Current approaches tend to treat cultural care as an "add-on" rather than integrating it into perioperative safety measures. A shift towards pre-emptive planning, with an organisational culture change that embeds culturally responsive care into the broader safety framework, is essential. This proactive approach would enhance both patient outcomes and staff readiness, fostering a perioperative environment where safety and cultural care are synonymous., Tweetable Abstract: Embedding culturally responsive care into safety protocols is essential for enhancing perioperative experiences among older migrant patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This article outlines the use of a co-design methodological approach aimed at optimizing perioperative care experiences for ethnically diverse older adults and their family carers. The research involved three phases. In Phase 1, the foundation was established with the formation of a Core Advisory Group comprising key informants, including health consumers. This initial phase focused on forming relationships and conducting a literature review to inform subsequent stages of the research. Phase 2 progressed to data collection, where a qualitative survey on perioperative experiences was conducted. Semi-structured interviews were held with patients, their family carers, and perioperative staff. Phase 3 advanced the co-design process through a workshop involving patients, family carers, perioperative staff, and key stakeholders. Workshop participants collaborated on potential practice changes, proposing strategies for future clinical implementation. While data analysis and reporting for Phases 2 and 3 are forthcoming, the continued involvement of the Core Advisory Group ensures ongoing consensus-building on health consumer needs. This methodology article adopts a prospective stance, with findings to be presented in subsequent scholarly works. Use of this methodology will help to determine how the use of a co-design approach may impact the development of culturally responsive perioperative nursing care for those from ethnically diverse communities.

The International Council of Nurses (ICN) 2025 Congress, themed "Nursing Power to Change the World," will convene in Helsinki, Finland, from 9 to 13 June 2025. This landmark event celebrates a century of nursing progress and addresses contemporary challenges in healthcare. The Congress emphasises the pivotal role of nurses in enhancing healthcare equity, accessibility, and outcomes, aligning with global health policy goals such as Universal Health Coverage (UHC). It will feature contributions from key international organisations like the WHO and the International Committee of the Red Cross, highlighting the event's global significance. With over 10 000 abstract submissions, the Congress promises a rich scientific programme, fostering knowledge exchange and professional development. Subthemes will explore nursing leadership, healthcare quality, education and the impact of transformative technologies. The Congress will also focus on advocacy, providing a platform for policy discussions on pressing global health issues. Networking opportunities will connect nurses with peers and leaders, promoting collaboration and career advancement. The inclusion of nursing students and early-career professionals underscores the commitment to nurturing the next generation of nurses. The ICN 2025 Congress is a call to action for nurses worldwide to lead transformative change in healthcare, ensuring the profession remains dynamic and influential. Join us in Helsinki to celebrate the power of nursing and explore the many ways in which nurses can lead the change in advancing global health., (© 2024 International Council of Nurses.)

Metaparadigms differentiate disciplines in terms of how each discipline develops its knowledge and its scholarship. Four domains comprise the nursing metaparadigm: environment, person, health, and nursing . Of these domains, the environment domain is the least identified. Relating this domain to the broader substantive meaning of the geographical-landscape setting of nursing encounters requires further explanation . Through a discursive process, the article positions "space and place" by referencing the nursing environment. The article aims to clarify and explain the expanding reach of the environment domain, extending its definition while recognizing its range of influence in nursing and healthcare. Distinguishing the nursing environment as a well-established domain of the nursing metaparadigm makes nursing practice more visible, valuable, and relevant . Characterized by its impact on discipline-related knowledge development guiding professional practice, the environment domain assumes an integral "space and place" in human healthcare practice ., Competing Interests: We declare that two authors are on the editorial board of Belitung Nursing Journal. They have recused themselves from editorial decisions. The manuscript was prepared independently, and we commit to transparency and ethical standards throughout the review process., (© The Author(s) 2024.)

Health literacy is a public health issue. Unpaid caregivers of older people with low health literacy may have difficulties providing care, exerting a negative impact on the care process. The aim of the present study was to perform a systematic review of the literature on factors associated with low health literacy in unpaid caregivers of older people. Searches for relevant articles were conducted in the Cochrane Library, Embase, LILACS, PubMed and Web of Science databases. A total of 1440 articles were identified, nine of which met the eligibility criteria and were included in the systematic review, which was registered in PROSPERO (CRD42024522986). A total of 2209 unpaid caregivers participated in the studies selected for this review. Most were women (67.2%). The average frequency of inadequate health literacy was 27.1%. Sociodemographic characteristics (i.e. advanced age, low educational level, the female sex), factors related to the care process (i.e. low acculturation, low empowerment, poor ability to read medication package inserts, lower care capacity, greater disease severity, hospitalization of care recipients), cognitive factors and factors related to quality of life/well-being (i.e. less social support, poorer quality of life, greater cognitive impairment, higher levels of burden) were associated with low health literacy. In conclusion, low health literacy in unpaid caregivers of older people is associated with sociodemographic, care-related and cognitive factors as well as factors related to quality of life/well-being. Low health literacy may exert a negative impact on the health of caregivers and, consequently, the quality of care provided to older people., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: The COVID-19 pandemic has placed a significant pressure on the nursing workforce, leading to an increased risk of infection and work-related issues impacting nurses' mental health. This review aims to explore the workplace challenges faced by older nurses and their impact on mental health., Method: This qualitative systematic review followed the Joanna Briggs Institute methodology., Results: The review included 32 studies and identified three interconnected themes: heavy workload and nature of nursing, lack of recognition and feeling undervalued, and challenges in balancing personal life and work. These themes illustrated the complexity of the workplace challenges faced by older nurses., Discussion and Conclusion: Workplace demands and shift work were common negative contributors to mental health and wellbeing. The physical and cognitive capacity of older nurses may diminish due to age-related changes, making the workload more challenging. Recognition and support from the organisation, especially from management and leadership, played a crucial role in nurses' resilience.

Aim: To develop and test the psychometric properties of a self-administered scale to assess the knowledge, skills, attitudes and behaviour of nurses to support the self-management of patients living with indwelling urinary catheters., Background: Nurses are pivotal in supporting patients with urinary catheter self-management to prevent potentially avoidable hospital presentations. However, no validated scale is available to assess nurses' attitudes and readiness for this task., Design: A quasi-experimental design was used to collect survey data both at baseline and after the completion of the intervention. A total of 128 participants were recruited from the Western Sydney region (New South Wales, Australia), who were working in community healthcare settings. Research Electronic Data Capture (REDCap™) database was used to manage the survey data collected for data analysis purposes. This study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN126210 0 0683831) METHODS: Using a three-stage process of concept identification, item construction and pilot testing to develop the Catheter Assessment, Management and Performance (CAMP) scale, followed by factorial and discriminant validity and reliability testing. This 23-item CAMP scale is theoretically informed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model, recognised for its effectiveness in understanding and influencing behaviour change. The scale was distributed to nurses working in three community health care settings to assess their knowledge, attitude and behaviour regarding catheter management and performance., Results: Four factors were identified using scree plot, accounting for 63.36 % of total explained variance, which reflected the four dimensions of the COM-B model. Cronbach's alpha of the overall CAMP scale (0.93) and subscales (0.92, 0.87, 0.85 and 0.86) indicate good internal consistencies. The CAMP scale was able to detect changes in nurses' self-reported behaviour change following educational intervention (85.53 versus 95.98, p < 0.001)., Conclusion: The CAMP scale is valid and reliable scale, capable of assessing nurses' capability, opportunity and motivation to support patients, through delivery of catheter self-management education that can potentially prevent catheter-related complications and avoid hospital presentations. Future research could explore using CAMP scale among non-specialist nurses and in various clinical settings to enhance its effectiveness and generalisability., Competing Interests: Declaration of Competing Interest No conflict of interest has been declared by the authors., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background and Objectives: Social frailty is an emerging concept characterized by state of vulnerability due to the lack or absence of social resources that enable health and well-being, particularly among older people. However, there is no consensus on how to accurately measure and assess social frailty, given the broad coverage of social dimensions affecting older individuals. This scoping review aimed to identify the existing tools and scales used to measure social frailty in older people., Research Design and Methods: A scoping review methodology was employed. Articles published between January 2014 and April 2024 were searched in 6 electronic databases: PubMed, PsycINFO, ProQuest, Scopus, SocIndex, and CINAHL. The scoping review followed a 5-stage process by Arksey and O'Malley and adhered to the guidelines provided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews., Results: Nine social frailty tools were identified across the 58 papers included in this review. The individual question item commonly used in the scales were classified into main categories based on their conceptual characteristics and intentions. The most common individual questionnaire constructs used to measure social frailty included financial status, social resources, social behaviors and activities, and sense of purpose. The reviewed tools varied in terms of their robustness and the process of scale development., Discussion and Implications: Our review suggested the development of a standardized, psychometrically tested, and accurate screening tool to screen social frailty status. An accurate social frailty assessment can inform the development of useful interventions, which also has implications in preventing the development of physical frailty., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: This study aimed to explore prevalent topics related to integrating ChatGPT into nursing education, specifically focusing on its impact on nursing students., Design: A systematic review and text network analysis were conducted., Data Sources: Full-text articles from reputable scientific databases, including PubMed, Scopus, and ScienceDirect, along with relevant articles identified through Google Scholar, were utilized, and the search period ranged from January 20th to January 23rd, 2024., Review Methods: The review centered on the main text of the articles, which were initially converted from PDFs to TXT files. Text cleaning and preprocessing were conducted using Python 3.11, followed by text analysis performed with InfraNodus., Results: Of 145 articles, 46 full-text articles were included in the final analysis. Four key topical clusters were identified: Academic Writing, Healthcare Simulation, Data Modeling, and Personal Development. Sentiments regarding the integration of ChatGPT into nursing education and its impact on nursing students were primarily positive (48 %), with a notable percentage expressing negative views (31 %) and a smaller proportion indicating neutrality (21 %)., Conclusion: This study highlights the transformative potential of ChatGPT in nursing education, advocating for its responsible integration to empower nursing students with advanced skills and uphold ethical standards in artificial intelligence (AI) utilization. The identified four topics and the sentiments are crucial for guiding educators, researchers, and practitioners in nursing education to navigate the integration of AI tools effectively. Further research and exploration in these areas can contribute to the ongoing discourse on the intersection of technology and nursing education., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Sense of coherence (SoC) refers to how individuals cope with stress and maintain health, yet its concept remains no consensus about how it is defined and applied in the context of stroke care. This study aims to clarify the concept of SoC by reviewing its applications in various stroke populations and its changes across different stages of stroke. The adapted steps of Rodger's evolutionary approach of concept analysis were used to explore the attributes, surrogate or related terms, antecedents, and consequences of SoC in stroke. Twenty-five articles were included after evaluating 1065 records and 80 full-text articles. The SoC's attributes, characterized with dynamicity of comprehensibility, manageability, and meaningfulness in stroke, lie within the different stroke phases (acute, sub-acute and chronic). There is no surrogate term to SoC. Related terms included coping, resistance resources, resilience, hardiness, and readiness. Antecedents related to stroke survivors and informal caregivers included sociodemographic factors, body functioning factors, social factors, stroke-related factors, and caring factors. Consequences for stroke survivors, informal caregivers, and dyads included psychological status, health behavior, marital satisfaction, care provision, and perception of rehabilitation needs. The findings of the concept analysis of SoC in stroke reveal that this concept extends beyond survivors experienced stroke, and its comprehensive understanding needs considering various aspects including the SoC of informal caregivers, dyads, and family. This paper serves as a novel perspective for future stroke care, focusing on the needs for dynamic monitoring and adaptations to changes of SoC at different stages of stroke care. A proper understanding of SoC can also contribute to developing assessment tools and theoretical models in stroke care with some emphasis on the phases of strokes (attributes), demographic and functional characteristics (antecedents), and both stroke survivor-caregiver-related outcomes sensitive to SoC., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Aim: To develop and test the psychometric properties of an expanded catheter self-management scale for patients with in-dwelling urinary catheters., Design: A cross-sectional validation study. Despite the utility of the original 13-item catheter self-management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self-management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self-management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self-management., Methods: A total of 101 adult community-dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23-item expanded catheter self-management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales., Results: The 23-item expanded catheter self-management scale yielded a 5-factor solution, labelled as: (i) self-monitoring of catheter function, (ii) proactive, help-seeking behaviour function, (iii) bowel self-care function, (iv) hygiene-related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self-management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self-management scale and catheter-related problems., Conclusion: The 5-factor structure provided a comprehensive assessment of key aspects of urinary catheter self-management essential to reduce the likelihood of catheter-related hospital presentations., Implications: The expanded catheter self-management scale can be used to assess and monitor effective patient-centred interventions for optimal self-management to prevent catheter-related problems and improve the quality of life of patients., Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter. The findings of this study show the correlation between catheter self-management skills and catheter-related problems. The expanded catheter self-management scale (E-CSM) assists with analysing the self-management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients., Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately., Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co-designing interventions. This paper reports the psychometric analysis of the expanded catheter self-management scale (E-CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ-IDC Study' (Alex et al. in Collegian, 29:405-413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aims: To identify and synthesise evidence related to ageism in older regulated nurses' practice settings., Design: A systematic review following Joanna Briggs Institute methodology., Methods: The review included empirical studies that involved older nurses as the primary study population and studies that focused on ageism in older nurses' work environments, including strategies or interventions to address ageism within the workplace. Following the initial screening, all relevant studies were critically appraised by two reviewers to ensure they were appropriate to include in the review. A synthesis without meta-analysis reporting (SWiM) guideline was employed in the review., Data Sources: Medical Literature Analysis and Retrieval Systems Online, Scopus, Psychological Information Database and Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched to identify empirical studies and a range of academic institutional websites were accessed for master's and doctoral dissertations and theses. The search covered the period from January 2022 to May 2022, and only publications in English from 2000 onwards were considered., Results: Nineteen studies were included, ten qualitative studies, seven quantitative studies and two mixed methods secondary analyses. Our results revealed that negative perceptions and beliefs about older nurses' competencies and skills prevail in their practice settings, which influences older nurses' health and well-being as well as their continuation of practice. Further, older nurses' continuation of practice can be facilitated by having a positive personal outlook on ageing, meaningful relationships in their practice settings and working in an environment that is age-inclusive., Conclusion: To combat ageism in older nurses' practice settings and support their continuation of practice, effective interventions should be organisational-led. The interventions should focus on fostering meaningful relationships between older nurses and their colleagues and managers. Further, healthcare institutions should implement initiatives to promote an age-inclusive work environment that supports an age-diverse nursing workforce., Implications for the Profession And/or Patient Care: The review findings offer insights for healthcare managers, policymakers and researchers, emphasising the need for anti-ageism policies in healthcare organisations. According to WHO (2021), educational activities such as role-playing and simulation during in-service training may also be effective interventions. Additionally, incorporating anti-ageism initiatives into staff meetings and mandating anti-ageism training could support the continuation of practice for older nurses while fostering a more age-diverse nursing workforce., Impact: We found evidence on the presence of ageism in older nurses' workplace and the detrimental effects of ageism on older nurses' well-being and continuation of practice. Importantly, we identified a lack of organisational initiatives to address ageism and support older nurses. These findings should encourage healthcare organisations to address ageism in older nurses' practice settings and prompt policymakers to develop age-inclusive policies that support older nurses' continuation of practice., Reporting Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis Without Meta-analysis checklists were used to report the screening process., Trial and Protocol Registration: The PROSPERO registration number for the review was CRD42022320214 (https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42022320214). No Patient or Public Contribution., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: Construction and nursing are critical industries. Although both careers involve physically and mentally demanding work, the risks to workers during the COVID-19 pandemic are not well understood. Nurses (both younger and older) are more likely to experience the ill effects of burnout and stress than construction workers, likely due to accelerated work demands and increased pressure on nurses during the COVID-19 pandemic. In this study, we analyzed a large social media data set using advanced natural language processing techniques to explore indicators of the mental status of workers across both industries before and during the COVID-19 pandemic., Objective: This social media analysis aims to fill a knowledge gap by comparing the tweets of younger and older construction workers and nurses to obtain insights into any potential risks to their mental health due to work health and safety issues., Methods: We analyzed 1,505,638 tweets published on Twitter (subsequently rebranded as X) by younger and older (aged <45 vs >45 years) construction workers and nurses. The study period spanned 54 months, from January 2018 to June 2022, which equates to approximately 27 months before and 27 months after the World Health Organization declared COVID-19 a global pandemic on March 11, 2020. The tweets were analyzed using big data analytics and computational linguistic analyses., Results: Text analyses revealed that nurses made greater use of hashtags and keywords (both monograms and bigrams) associated with burnout, health issues, and mental health compared to construction workers. The COVID-19 pandemic had a pronounced effect on nurses' tweets, and this was especially noticeable in younger nurses. Tweets about health and well-being contained more first-person singular pronouns and affect words, and health-related tweets contained more affect words. Sentiment analyses revealed that, overall, nurses had a higher proportion of positive sentiment in their tweets than construction workers. However, this changed markedly during the COVID-19 pandemic. Since early 2020, sentiment switched, and negative sentiment dominated the tweets of nurses. No such crossover was observed in the tweets of construction workers., Conclusions: The social media analysis revealed that younger nurses had language use patterns consistent with someone experiencing the ill effects of burnout and stress. Older construction workers had more negative sentiments than younger workers, who were more focused on communicating about social and recreational activities rather than work matters. More broadly, these findings demonstrate the utility of large data sets enabled by social media to understand the well-being of target populations, especially during times of rapid societal change., (©Weicong Li, Liyaning Maggie Tang, Jed Montayre, Celia B Harris, Sancia West, Mark Antoniou. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 05.06.2024.)

Aims: To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing., Design: A convergent parallel mixed-method study., Methods: A national survey was conducted (July-September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting., Results: Undergraduate nursing students (n = 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) 'This is a very misandristic viewpoint'; (2) 'Compassion and intelligence are distributed in men and women equally'; (3) 'Men bring a different quality to nursing' (4) 'Anyone can be whatever they want to be'., Conclusion: Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society., Impact: Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Objectives: To examine loneliness in old age and whether intergenerational reciprocity and WHO functional ability predicted loneliness., Methods: Using the China Health and Retirement Longitudinal Study Wave 4 (2018) database (CHARLS), logistic regression models were adopted to investigate the relationships., Results: The prevalence of loneliness was 28% in older people in China. Corresponding to the five domains of functional abilities, providing financial support to adult children (adj. OR 0.83, 95% CI 0.70-0.99), self-perceived health (adj. OR 1.30, 95% CI 1.19-1.41), having a retirement pension (adj. OR 0.73, 95% CI 0.57-0.93), the ability to decide on taking medications (adj. OR 1.32, 95% CI 1.10-1.58), as well as being able to get up from a chair (adj. OR 1.15, 95% CI 1.02-1.3), and having paid work (adj. OR 0.72, 95% CI 0.54-0.95) were associated with less loneliness. On the contrary, infrequent contact (once a month) with adult children (adj. OR 1.18, 95% CI 1.01-1.38), troubling body pain (adj. OR 1.16, 95% CI 1.10-1.23) and falling since the last interview (adj. OR .23, 95% CI 1.04-1.45) were positively associated with loneliness., Conclusions: In this study, functional abilities of meeting basic needs, making decisions, being mobile and contributing to the support of adult children and society were protective factors for experiencing loneliness in late life. We need to rethink interventions for addressing loneliness in the context of healthy ageing and specific cultural values, taking into account not only providing services to older adults but also supporting them to gain values by contributing to society., (© 2023 AJA Inc’.)

Background: Older Chinese immigrants constitute the largest older Asian ethnic population in New Zealand. Aging in a foreign land can be complex, presenting increasing challenges for gerontology scholars, practitioners, and policy makers. Older Chinese immigrants are more susceptible to experiencing loneliness and social isolation compared to native older people, primarily due to language, transportation, and cultural barriers. These factors subsequently impact their physical and mental health. With advancements in robotic technology, aged care robots are being applied to support older people with their daily living needs. However, studies on using robots with older immigrants living in the community are sparse. Their preferences for the appearance and function of aged care robots are unclear, which impacts the acceptance and usability of robots, highlighting the need for a user-centered design approach., Objective: This study aims to explore older Chinese immigrants' needs and preferences toward the appearance and function of aged care robots and to examine their relationships with the demographic characteristics of participants., Methods: A cross-sectional design was used in this study, which was undertaken between March and May 2020. A total of 103 participants completed a web-based survey., Results: The average age of participants was 68.7 (SD 5.5) years. The results suggest that 41.7% (n=43) of the 103 participants preferred a humanlike adult appearance, while 32% (n=33) suggested an animallike appearance. These participants reported higher scores in both rigorousness and friendliness compared to others who preferred different robot appearances. Participants expressed a greater preference for the functions of housework assistance (n=86, 83.5%), language translation (n=79, 76.7%), health monitoring (n=78, 75.7%), facial expressions (n=77, 74.8%), news reading (n=66, 64.1%), and security monitoring (n=65, 63.1%). These preferences were found to be significantly associated with marital status, financial status, and duration of immigration., Conclusions: To support immigrant populations to age well in a foreign country and address the growing shortage of health and social professionals, it is important to develop reliable robotic technology services that are tailored based on the needs and preferences of individuals. We collected and compared the perspectives of immigrant and nonimmigrant participants on using robots to support aging in place. The results on users' needs and preferences inform robotic technology services, indicating a need to prioritize older Chinese immigrants' preference toward aged care robots that perform housework assistance, language translation, and health and safety monitoring, and robots with humanlike features., (© Ching-Ju Chiu, Yi-Hsuan Lo, Jed Montayre, Hammoda Abu-Odah, Mei-Lan Chen, Ivy Yan Zhao. Originally published in JMIR Aging (https://aging.jmir.org).)

Background: Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population., Objective: This literature review seeks to explore the association between family visits and depression among those living in residential aged care., Methods: An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895)., Results: Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement., Conclusion: Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families., Tweetable Abstract: Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background and Objectives: The age-friendly university (AFU) initiative embodies the collaborative efforts of promoting age inclusivity and diversity in higher education, embracing lifelong learning and civic participation in older people. This scoping review aims to explore the conceptualization of AFU, the experiences, and the strategies used in operationalizing the AFU principles of participating universities in becoming members of the age-friendly university network., Research Design and Methods: A search of peer-reviewed papers published from 2012 to July 2021, conducted in nine databases using JBI scoping review methodology, found 1,752 articles. Of these, 13 papers were eligible for inclusion., Results: Three themes were identified as key to becoming an AFU: (a) interdisciplinary collaboration within the university; (b) strong partnership with the community; and (c) alignment with global priorities and initiatives. Furthermore, identifying barriers to physical access in universities, such as signage, walkways, and transportation, addressing the less tangible issues of ageism and promoting intergenerational learning were essential to promote engagement of older people., Discussion and Implications: This review underscores the need for a multidisciplinary approach within the university, the reciprocal benefits of authentic university-community collaborations, and the advantages of harnessing international resources and global influence to becoming an AFU. Although the principles of the AFU remain aspirational, the ideals championed by the pioneering universities in the AFU network brought the mutual benefits of intergenerational learning, the challenges and support required for older learners to the fore, propelling the AFU agenda forward., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Being in direct contact with COVID-19 patients for long periods increases the risk of infection among frontline workers. The purpose of this study was to identify levels of empathy and psychological concern among medical students during the COVID-19 pandemic., Methods: An online cross-sectional study was conducted among medical interns divided into two groups: those who worked on the frontline (n = 87) and those who did not (n = 63) during the COVID pandemic. The students completed the Interpersonal Reactivity Index, Maslach Burnout Inventory, Perceived Stress Scale, and Patient Health Questionnaire., Results: The majority of respondents were women (70.7%), and the mean age was 25.45 ± 3.93 years. In unadjusted analyses, those who worked with COVID-19 patients had a higher level of empathy, stress, burnout symptoms, and depressive symptoms. In the logistic regression analyses, students who worked on the frontline during the COVID-19 pandemic had a higher level of empathy (OR: 1.27; 95% CI: 1.16-1.14), higher perceived stress levels (OR: 1.21; 95% CI: 1.05-1.39), and greater burnout symptoms (OR: 1.19; 95% CI: 1.10-1.30)., Conclusion: Medical students in the internship period who worked on the frontline during the COVID-19 pandemic had more psychological concerns and higher levels of empathy compared to those who did not work on the frontline.

Aim and Objective: To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement., Background: Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition., Design: Survey capturing both quantitative and qualitative data., Methods: Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement., Results: Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment., Conclusion: Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention., Relevance to Clinical Practice: Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce., (© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aims and Objectives: To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff., Background: Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered., Design: An integrative review of literature., Methods: Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework., Results: Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia., Conclusions: Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia., Relevance to Clinical Practice: Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care., (© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background and Objectives: Age-related hearing loss (ARHL) is the third leading cause of years lived with disability. Connections among ARHL, depressive symptoms, social engagement and cognitive status are increasingly reported but the underlying mechanisms leading to these relationships are largely unknown. Exploring these mechanisms is a worthy goal, especially in older adults. This study aimed to examine the mediating effect of social engagement and depressive symptoms on the relationship between ARHL and cognitive status., Methods: Structural equation modeling (SEM) with path analysis were performed with data from a cross-sectional study conducted in 11 community centers in 2021, which assessed older adults' intrinsic and sensory capacities using the WHO ICOPE framework. Demographic information, health profile, a binary measure of hearing capacity, depressive symptoms, social engagement, and cognitive status of participants were gathered., Results: A total of 304 participants were included. ARHL was positively associated with depressive symptoms (β = 0.18, p = 0.009) and negatively related to social engagement (β = -0.13, p = 0.026). Social engagement was positively associated with cognitive status (β = 0.17, p = 0.005) and negatively associated with depressive symptoms (β = -0.23, p < 0.001). Greater depressive symptoms were negatively associated with the participants' cognition (β = -0.13, p = 0.009). Both social engagement (β = -0.02, p = 0.029) and depressive symptoms (β = -0.02, p = 0.032) mediated the negative associations between ARHL and cognitive status., Conclusions: Addressing hearing loss, depressive symptoms, and enhancing social engagement should be investigated as a potential means of minimizing cognitive decline. Well-designed studies are needed to comprehensively inform the clinical practice development, particularly large prospective studies that will facilitate further elucidate possible causal mechanisms behind these observed associations., (© 2023 John Wiley & Sons Ltd.)

Background: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over., Methods: Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed., Results: A total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted., Linking Evidence to Action: This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments., (© 2023 The Authors. Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International.)

Background: World Health Organization (WHO) has defined healthy ageing by highlighting five functional ability domains to (meet basic needs, make decisions, be mobile, build and maintain relationships, and contribute to society), which also emphasized the importance of addressing loneliness as priorities within United Nations Decade of Healthy Ageing initiative. However, the level and determinants of healthy ageing and its association with loneliness are rarely examined. This study aimed to construct a healthy ageing index to verify the WHO healthy ageing framework, measure five domains of functional ability of older adults and examine the relationship between functional ability domains and loneliness., Methods: A total of 10,746 older adults from the 2018 China Health and Retirement Longitudinal Study (CHARLS) were included. A healthy ageing index ranging from 0 to 17 was constructed using 17 components related to functional ability domains. Univariate and multivariate logistic regression analyses were utilized to determine the association between loneliness and healthy ageing. The STROBE guidelines with the RECORD statement for observational studies using routinely collected health data were observed., Results: The factor analysis verified the five functional ability domains for healthy ageing. After adjusting for confounders, being mobile, building and maintaining relationships, and learning, growing and making decisions were significantly associated with lesser loneliness among participants., Conclusions: The healthy ageing index of this study can be utilized and further modified with respect to large-scale research with relevant healthy ageing topics. Our findings will support healthcare professionals to provide patient-centered care when identifying their comprehensive abilities and needs., (© 2023. The Author(s).)

Significance: Due to caregiving commitments, caregivers of older adults may not have the time to make use of the onsite community services available to them during the day. With the support of advanced technology, telecare could be a convenient and easily accessible channel for providing individualized caregiving advice to caregivers., Objective: The aim of the study is to describe a research protocol that highlights the development of a telecare-based intervention program for reducing stress levels in informal caregivers of community-dwelling older adults., Methods: It is a randomized controlled trial. The study is supported by two community centers. The study participants will be randomly assigned to either the telecare-based intervention group or the control group. The former will receive a 3-month program comprised of three components: online nurse case management supported by a health and social care team, an online resource center, and a discussion forum. The latter will receive the usual services that provided by the community centers. Data will be collected at two time points - pre-intervention (T1) and post-intervention (T2). The primary outcome is stress levels, while secondary outcomes include self-efficacy, depression levels, quality of life, and caregiving burden., Discussion: Besides taking care of one or more older adults, informal caregivers have to deal with work, chores, and take care of their children. This study will add valuable information to the knowledge gap on whether telecare-based interventions with the support of an integrated health-social team can alleviate the stress levels of informal caregivers of community-dwelling older adults. If successful, policymakers and healthcare professionals should consider incorporating telecare modalities in a primary health setting for informal caregivers to correspond with them, to relieve their caregiving stress and promote a healthy life., Clinical Trial Registration: https://www.clinicaltrials.gov/, NCT05636982., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wong, Ng, Hui and Montayre.)