Clinical Interventions in Aging最新文献

{"title":"Exercise Identity and Spiritual Well-Being in Nursing Home Residents: Mediating Roles of Social Support and Exercise Behavior in Hebei Province, China.","authors":"Shan Luo, Li Ming Wu, Yan Wang, Hong Qin Jin, Ya Ning Zhao, Xiao Fei Du","doi":"10.2147/CIA.S520138","DOIUrl":"10.2147/CIA.S520138","url":null,"abstract":"<p><strong>Objective: </strong>With China's rapidly aging population, institutional care for older adults is becoming increasingly common. Spiritual well-being has emerged as a key component of quality elderly care, contributing to emotional resilience, life satisfaction, and positive aging. This study explores the impact of exercise identity on the Spiritual well-being of older adults residing in nursing homes and the mediating roles of perceived social support and exercise behavior.</p><p><strong>Methods: </strong>A survey was conducted on 514 older adults residing in nursing homes using general demographic questionnaires, the Spirituality Index of Well-Being Scale, the Perceived Social Support Scale, the Physical Activity Rating Scale, and the Exercise Identity Scale.</p><p><strong>Results: </strong>The total score of Spiritual well-being among older adults residing in nursing homes was (32.76 ± 7.07). Significant positive correlations were found among exercise identity, perceived social support, exercise behavior, and Spiritual well-being. Perceived social support partially mediated the relationship between exercise identity and Spiritual well-being, with an indirect effect value of 0.237, accounting for 39.6% of the total effect (0.599). Exercise behavior also partially mediated the relationship between exercise identity and Spiritual well-being, with an indirect effect value of 0.201, accounting for 33.5% of the total effect (0.599).</p><p><strong>Conclusion: </strong>Perceived social support and exercise behavior have parallel mediating effects on the relationship between exercise identity and Spiritual well-being of older adults residing in nursing homes. These findings offer a theoretical foundation for developing targeted interventions aimed at enhancing spiritual well-being through improved exercise identity and supportive environments in institutional care settings.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1099-1108"},"PeriodicalIF":3.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Testing a New Online Dynamic Nomogram for Contrast-Induced Acute Kidney Injury in Elderly Patients with ST-Segment Elevation Myocardial Infarction.","authors":"Jingkun Jin, Jiahui Ding, Xishen Zhang, Linsheng Wang, Xudong Zhang, Wenhua Li, Shanshan Li","doi":"10.2147/CIA.S534736","DOIUrl":"10.2147/CIA.S534736","url":null,"abstract":"<p><strong>Background: </strong>ST-segment elevation myocardial infarction (STEMI), the most severe form of acute coronary syndrome (ACS), requires timely percutaneous coronary intervention (PCI) to restore coronary blood flow. However, contrast-induced acute kidney injury (CI-AKI), the third most common cause of hospital-acquired renal failure, remains a critical complication of PCI.</p><p><strong>Objective: </strong>To develop a machine learning model predicting CI-AKI risk in elderly patients with STEMI patients using clinical features.</p><p><strong>Methods: </strong>Data from 2120 elderly patients with STEMI treated with PCI at Xuzhou Medical University Affiliated Hospital (2019-2023) were used for model development and testing. An external validation cohort, comprising 236 individuals, was derived from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database (2008-2019). Lasso regression selected predictors, and nine Machine Learning (ML) algorithms were evaluated via Receiver Operating Characteristic (ROC) analysis. Overlapping top-ranked features from high-performing models (AUC >0.8) informed a nomogram. Performance was assessed using AUC and decision curve analysis (DCA).</p><p><strong>Results: </strong>The final model included five independent predictors: lymphocyte-to-monocyte ratio, diuretic use, residual cholesterol, serum creatinine, and blood urea nitrogen. This model was developed as a simple-to-use online dynamic nomogram. It demonstrated robust discrimination, with C-statistics of 0.782 in the testing dataset and 0.791 in the validation dataset. DCA confirmed its clinical utility across a wide range of risk thresholds.</p><p><strong>Conclusion: </strong>A new online dynamic nomogram was developed to provide a practical tool for CI-AKI risk stratification in elderly STEMI patients, aiding personalized prevention strategies.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1085-1098"},"PeriodicalIF":3.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Driven Prediction of One-Year Readmission in HFrEF Patients: The Key Role of Inflammation.","authors":"Fanghui Ma, Yue Hu, Ping Han, Yan Qiu, Ying Liu, Jingjing Ren","doi":"10.2147/CIA.S528442","DOIUrl":"10.2147/CIA.S528442","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with reduced ejection fraction (HFrEF) is a global health issue with high morbidity and frequent hospitalizations. Predicting one-year readmission risk is crucial for optimizing treatment and reducing costs.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study on adult HFrEF patients admitted to the Cardiovascular Department of the First Affiliated Hospital, Zhejiang University School of Medicine on January 2020 and March 2023. Feature selection was performed using LASSO regression, with inflammatory biomarkers (PLR, MLR, NLR, SII, SIRI) prioritized. Seven machine learning (ML) algorithms were trained and validated using a 7:3 dataset split; the metrics of the model included the area under the curve (AUC), accuracy, sensitivity, specificity, F1 score, and Brier score. SHapley Additive exPlanations (SHAP) analysis provided model interpretability. A network-based dynamic nomogram was developed to visualize predictive models.</p><p><strong>Results: </strong>This study included 733 patients, of whom 231 (31.5%) were readmitted within one year. LASSO regression showed that the key predictors included age, BNP, New York Heart Association (NYHA) class, LVEF, PLR, MLR, AF history, and ACEI/ARB/ARNI usage. The Random Forest (RF) model performed best, with an AUC of 0.89 (95% confidence interval (CI): 0.86-0.93), an accuracy of 0.83, a sensitivity of 0.87, and a specificity of 0.80. SHAP analysis showed that BNP was the most influential feature, followed by NYHA class and LVEF, which were also important predictors. In addition, MLR and PLR also played an important role in prediction, once again confirming the important predictive role of MLR and PLR as inflammatory indicators for readmission within one year in HFrEF patients.</p><p><strong>Conclusion: </strong>The ML-based RF model effectively predicted one-year readmission in HFrEF patients, with inflammation indicators playing an important role. Integrating such models into clinical practice could improve risk stratification, reduce readmissions, and enhancing patient outcomes.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1071-1084"},"PeriodicalIF":3.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Cognitive Screening Predicts Postoperative Ambulatory Recovery: A Pilot Study.","authors":"Jake L Cotton, Chiagoziem Anigbogu, Jennifer E Stevens-Lapsley, Hillary D Lum, Yi Su, Michael Bronsert, Thomas N Robinson, Jessica Y Rove","doi":"10.2147/CIA.S517690","DOIUrl":"10.2147/CIA.S517690","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac surgery patients are older adults at risk for postoperative physical impairment. We hypothesize that screening for mild cognitive impairment (MCI) using the Montreal Cognitive Assessment (MoCA) may identify patients at risk for delayed physical recovery.</p><p><strong>Patients and methods: </strong>This is a single center prospective cohort pilot study of patients undergoing elective cardiac surgery. Patients were screened preoperatively for MCI using the MoCA full version 8.1, with scores < 26 defined as a positive screen for MCI. Daily step count, as a practical measure of physical function, was continuously recorded from the preoperative period (baseline) through postoperative day 50 using a commercially available activity tracker.</p><p><strong>Results: </strong>Eighteen patients met inclusion criteria. Eight (44%) screened positive for MCI and 10 (56%) screened non-impaired (NI). Baseline characteristics and operative outcomes were similar between the MCI and NI cohorts. The MCI cohort did not achieve their preoperative daily step count by postoperative day 50, whereas the NI cohort did so by postoperative day 37. There was a difference in median [IQR] postoperative daily step count (MCI: 3662[2292-5704] vs NI: 4497[2532-9216]; p < 0.001).</p><p><strong>Conclusion: </strong>In a cohort of patients older than 60 undergoing cardiac surgery, a preoperative screen for MCI delayed postoperative physical recovery. A brief preoperative cognitive screen tool may identify patients who could benefit from early intervention for recovery of physical function.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1063-1069"},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Specific Associations Between Oral Function Impairment and Clinical Outcomes in Hospitalized Older Adults: A Retrospective Observational Study.","authors":"Yen-Yang Lee, Shuo-Chun Weng, Yu-Shan Lee, Yin-Yi Chou, Fu-Hsuan Kuo, Shu-Hui Yang, Ya-Hui Yeh, Wei-Min Chu, Chiann-Yi Hsu, Shih-Yi Lin, Cheng-Fu Lin","doi":"10.2147/CIA.S524802","DOIUrl":"10.2147/CIA.S524802","url":null,"abstract":"<p><strong>Purpose: </strong>Oral functional impairment is a critical factor influencing clinical outcomes in hospitalized older adults. Notably, sex disparities in oral health on clinical outcomes remain an often underappreciated aspect.This study aims to investigate the association between oral function, assessed using the bedside oral examination (BOE), and in-hospital mortality, with an emphasis on sex-specific differences.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted involving 1,141 patients aged 65 years and older who were admitted to a medical center in Taiwan between 2018 and 2023. The BOE was a standardized clinical tool that evaluated eight domains of oral health, including swallowing, lips, tongue, saliva, mucous membranes, gingiva, teeth or dentures, and oral odor. Patients were classified into normal, moderate, or severe oral impairment groups. Cox proportional hazards models and Kaplan-Meier survival analysis were used to examine mortality risk, with results stratified by sex.</p><p><strong>Results: </strong>Overall, greater oral functional impairment was associated with higher in-hospital mortality and poorer physical, nutritional, and psychological status. In the sex-stratified analysis, severe oral impairment remained an independent predictor of mortality in male patients (hazard ratio 1.77, 95% confidence interval 1.05 to 2.99, p = 0.032), but not in female patients. Survival differences were statistically significant among men based on oral function levels, as shown by Kaplan-Meier curves (log-rank p = 0.014), while no significant difference was found among women (log-rank p = 0.376).</p><p><strong>Conclusion: </strong>Severe oral functional impairment significantly predicts in-hospital mortality among older men, but not women. These findings underscore the importance of sex-specific approaches to risk assessment and intervention. Incorporating oral health screening into routine geriatric care, especially for men, may enhance early identification of high-risk patients and inform targeted strategies to improve clinical outcomes. Further research is warranted to understand the mechanisms underlying these sex differences.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1049-1061"},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Glycated Hemoglobin and Diabetic Retinopathy in Individuals with Diabetes: A Focus on the Modifying Effect of Ambulatory Blood Pressure.","authors":"Shenglan Yang, Hui Liu, Yao Liang, Lijing Wu, Qidong Zheng, Jing Wu","doi":"10.2147/CIA.S514622","DOIUrl":"10.2147/CIA.S514622","url":null,"abstract":"<p><strong>Background: </strong>Suboptimal glycemic control in individuals with diabetes is one of the major contributors to the development of diabetic retinopathy (DR). However, the role of ambulatory blood pressure (ABP) in this association remains unclear. The purpose of this research was to assess the associations among ABP, glycosylated hemoglobin (HbA1c), and DR in a diabetic population, with an emphasis on individuals exhibiting suboptimal glycemic and BP control.</p><p><strong>Methods: </strong>This study included 498 diabetic patients with comprehensive ABP data. The assessment of diabetes is based on the criteria of the American Diabetes Association (ADA). We adopted Least Absolute Shrinkage and Selection Operator (Lasso) regression to identify key variables and used logistic regression to investigate associations, followed by subgroup analyses.</p><p><strong>Results: </strong>After adjustment for covariance variables, HbA1c showed a strong correlation with DR (OR: 1.228, 95% CI: 1.010-1.368). Among participants with low ABP, the prevalence of DR rises significantly with higher HbA1c levels (OR: 1.217,95% CI:1.057-1.402), whereas in those with elevated ABP (OR:1.366,95% CI:1.122-1.662), this relationship was markedly stronger, particularly in the context of Awake systolic blood pressure (SBP). Comparable findings were noted in both categorical models, as well as in subgroup analyses. However, heterogeneity was observed in subgroup analyses stratified by age.</p><p><strong>Conclusion: </strong>ABP may modify the relationship between HbA1c and DR; specifically, suboptimal glycemic management in patients at elevated ABP levels exacerbates the risk of DR. Therefore, it is imperative for diabetic patients to prioritize both BP regulation and glycemic management in their comprehensive disease management strategy.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1029-1038"},"PeriodicalIF":3.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Expectations Regarding Aging and Related Influencing Factors in Older People with Type 2 Diabetes Mellitus: A Cross-Sectional Study.","authors":"Ting Yao, Qiuxia Jiang, Feng Zhang, Hong Cao, Dan Li, Jiai Yan, Yingyu Wang, Ju Yang, Ruijuan Zhuang, Jing Sun","doi":"10.2147/CIA.S530212","DOIUrl":"10.2147/CIA.S530212","url":null,"abstract":"<p><strong>Purpose: </strong>Improving the health behaviors of older type 2 diabetes mellitus (T2DM) patients is crucial for promoting healthy aging worldwide. Given the significant role of expectations regarding aging (ERA) in fostering healthy behaviors and improving disease outcomes, understanding its status and influencing factors in this population is essential.</p><p><strong>Patients and methods: </strong>The cross-sectional study was conducted from December 2023 to February 2024 at a tertiary hospital in China, where 289 elderly T2DM patients were surveyed. Self-reported questionnaires were used to assess sociodemographic and clinical data, ERA, depression, social support, diabetes self-efficacy. Data were analyzed using SPSS 26.0 software, employing Pearson correlation analysis, univariate analysis, and multiple stepwise linear regression.</p><p><strong>Results: </strong>The ERA score in older T2DM patients was 39.72 ± 9.53, which was at a medium-low level. The level of ERA is negatively correlated with depression (r = -0.549, <i>p</i> < 0.01) and positively correlated with social support (r = 0.625, <i>p</i> < 0.01) and diabetes self-efficacy (r = 0.514, <i>p</i> < 0.01). Age, family monthly income, type of daily medication, number of sources for diabetes-related knowledge, as well as depression, social support, and diabetes self-efficacy are factors that influence ERA and can explain 59.2% of the total variance.</p><p><strong>Conclusion: </strong>Efforts should be made to promote ERA in older patients with T2DM. Healthcare providers should develop intervention strategies based on identifying the factors that influence the ERA in elderly T2DM patients to improve their health outcomes and enhance their health management awareness, thereby improving the quality of their later years.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1039-1048"},"PeriodicalIF":3.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Diagnostic Nomogram Model for Predicting Cognitive Frailty in Acute Coronary Syndrome.","authors":"Shan Wang, Ying Sun, Wen Tang, Shangxin Lu, Feng Feng, Xiaopei Hou, Lihong Ma, Runzhi Li, Jieqiong Hu, Bing Liu, Yunli Xing","doi":"10.2147/CIA.S527085","DOIUrl":"10.2147/CIA.S527085","url":null,"abstract":"<p><strong>Background: </strong>Cognitive frailty (CF) is strongly associated with major adverse cardiovascular events, yet its assessment requires specialized equipment, limiting clinical practicality. This study aimed to develop and validate a nomogram model for predicting CF in patients with acute coronary syndrome (ACS) to enhance early identification and intervention.</p><p><strong>Methods: </strong>Patients with ACS (N=547) were enrolled and randomly split into a training set (70%) and a testing set (30%). The training set was used to construct the nomogram, while the testing set was used for validation. Model performance was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to assess discrimination, accuracy, and clinical utility, respectively.</p><p><strong>Results: </strong>The nomogram included six predictors: education level, age, systolic blood pressure (SBP), Charlson Comorbidity Index (CCI), Short Physical Performance Battery (SPPB), and nutritional status. The model demonstrated strong discriminatory power, with an area under the ROC curve of 0.854 (95% CI: 0.741-0.861) in the training cohort and 0.733 (95% CI: 0.500-0.898) in the testing cohort. Calibration analysis confirmed high accuracy, and DCA indicated significant net benefits across both cohorts, supporting its clinical applicability.</p><p><strong>Conclusion: </strong>The nomogram effectively predicts CF in ACS patients by considering education, age, SBP, CCI, SPPB, and nutritional status, serving as a visual aid for healthcare providers to facilitate the early identification and intervention of CF. Future research is needed to validate the nomogram's efficacy in diverse populations and explore standardized assessment methods that enhance its clinical applicability in mitigating CF in ACS patients.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1015-1027"},"PeriodicalIF":3.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Chronic Pain, Coping Strategies, and Sleep Quality in Rural Chinese Older Adults: A Cross-Sectional Study.","authors":"Xin Tao, Cheng Cheng, Jie Bai","doi":"10.2147/CIA.S533869","DOIUrl":"10.2147/CIA.S533869","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the current status of sleep quality and explore the associations between chronic pain, sleep quality, and coping strategies in older adults living in rural areas of China, a topic of growing interest and importance in gerontology and public health.</p><p><strong>Patients and methods: </strong>This was an observational, cross-sectional study with a convenience sample of Chinese older adults from a rural community in Northern Anhui, China, conducted from September to December 2023. A self-reported questionnaire was used to collect data on socio-demographic items, chronic pain (visual analogue scale, VAS), coping strategies (Coping Strategies Questionnaire-Revised, CSQ-R), and sleep quality (Athens Insomnia Scale, AIS). Descriptive statistics, Pearson correlation, Stepwise multiple linear regression, and mediation analysis were used to analyze the data.</p><p><strong>Results: </strong>A total of 158 participants (48.7% female) were included in the study. Most participants (73.4%, n = 116) reported poor sleep quality. The regression model revealed significant associations between sleep quality and chronic pain (Beta = 0.599, t = 9.99, p < 0.001) and praying as a way of coping (Beta = 0.165, t = 2.72, p = 0.007). The model explained 46.5% of the variance in sleep quality (p < 0.01). Mediation analysis indicated that chronic pain had an indirect effect on sleep quality via praying, even after controlling for covariates (B = 0.137, 95% CI = 0.0614, 0.2227).</p><p><strong>Conclusion: </strong>This study displayed a significant association between chronic pain, coping strategies, and sleep quality in Chinese older adults living in rural areas. Chronic pain directly affects sleep quality, while praying as a coping strategy may mitigate this effect. Nurses should prioritize pain management and promote adaptive coping strategies to improve sleep quality.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"1005-1014"},"PeriodicalIF":3.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Centered Care in Family Medicine: Strategies for Continuity and Comprehensive Care for Older Adults - A Mixed-Methods Study.","authors":"Abdulaziz M Alodhialah, Ashwaq A Almutairi, Mohammed Almutairi","doi":"10.2147/CIA.S513624","DOIUrl":"10.2147/CIA.S513624","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-centered care (PCC) is a crucial approach in family medicine, particularly for older adults with complex health needs. This study evaluates the implementation of PCC strategies and their impact on health outcomes for older adults in family medicine settings.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods study was conducted, involving 47 healthcare providers and 126 older adult patients in Riyadh, Saudi Arabia. Quantitative data were collected using structured surveys, while qualitative data were obtained through semi-structured interviews. Statistical analyses included chi-square tests, ANOVA, and effect size calculations to assess the impact of PCC strategies.</p><p><strong>Results: </strong>Healthcare providers identified continuity of care programs (48.9%) and patient education (44.7%) as the most effective PCC strategies. Key challenges included time constraints (74.5%) and lack of resources (59.6%). Patients in the high PCC implementation group demonstrated significantly better health outcomes, including lower hospital readmission rates (15.9% vs 36.5%, p=0.002), improved chronic disease management (87.3% vs 66.7%, p=0.014), higher adherence to care plans (82.5% vs 60.3%, p=0.008), and increased patient satisfaction scores (mean 4.6 vs 3.9, p=0.001). Qualitative findings highlighted key themes, including communication challenges, patient empowerment, and the role of multidisciplinary teams.</p><p><strong>Discussion: </strong>PCC strategies significantly enhance health outcomes and patient satisfaction among older adults in family medicine. However, implementation barriers such as time constraints, resource limitations, and coordination challenges must be addressed. The study underscores the need for systemic healthcare reforms to improve PCC delivery.</p><p><strong>Conclusion: </strong>This study highlights the benefits of PCC in improving patient outcomes and satisfaction while identifying barriers that must be addressed for effective implementation. Greater investment in PCC initiatives, improved healthcare coordination, and professional training are essential to enhancing care quality for older adults.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"985-1003"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}