Predicting Chinese older adults' intention to live in nursing homes using an integrated model of the basic psychological needs theory and the theory of planned behavior

Determinants of Aging in Place Willingness Among Community-Dwelling Older Adults in Thailand: Results of a National Survey

Aim: The aim of this study was to estimate the prevalence and determinants of aging in place (AIP) willingness among persons 60 years and older in a national cross-sectional community-based study in Thailand in 2022. Methods: Information was taken from the 2022 Health, Aging, and Retirement in Thailand survey. Only community-dwelling individuals aged 60 and above were included in the sample (analytic sample: n = 3648). AIP willingness was measured using established metrics. The factors influencing AIP willingness were evaluated using logistic regression. Results: The prevalence of AIP willingness was 88.3%. Logistic regressions showed that predisposing factors (increasing age, being retired, and female sex), enabling factors (satisfactory support from children), need factors (multimorbidity, fewer depressive symptoms, and fewer pain sites), and psychosocial factors (not agreeing on an elderly home, higher subjective life expectancy, and current non-smoking) were associated with AIP willingness. Conclusions: Our knowledge of the factors influencing AIP willingness in community-living people 60 years of age and older is improved by this national study. Health and welfare strategies to increase enabling factors (satisfactory support from children), decrease need factors (depression and multisite pain), and increase psychosocial factors (positive attitudes towards AIP and smoking cessation) may help in increasing AIP willingness.

Study on the key factors of public participation in low carbon city construction and willingness to pay

The popularity of urban distributed photovoltaics is crucial for building low-carbon cities. Retrofitting roofs with photovoltaic tiles is a new option. However, whether the public supports this initiative needs to be understood. Assessing willingness to pay is a critical way to measure public acceptance. Therefore, this paper assesses Chinese urban households' willingness to pay to support photovoltaic tiles retrofit roofs to promote the construction of low-carbon cities. To obtain factors that better explain the willingness to pay, variables such as personal of interest perception, moral perception and policy perception are added to the initial theory of planned behavior psychological interpretation framework for willingness to pay and the extended theory of planned behavior psychological explanatory framework for willingness to pay is constructed. It is encouraging to note that the expanded framework has increased the explanatory power of willingness to pay, where the personal of interest perception is the dominant variable in explaining willingness to pay. We believe that we should pay attention to the impact of the personal of interest perception on willingness to pay and increase the publicity of the importance of photovoltaic tiles retrofitting roofs to promote low-carbon city construction through Internet means and increase individual personal of interest perception, policy perception, and moral perception, which may help promote better public participation in low-carbon cities.

Frailty as a mediator between sleep quality and cognitive impairment among the rural older adults: a cross-sectional study

BACKGROUND

Cognitive impairment is a common health problem among older adults. Previous studies have proven the association between sleep quality and cognitive impairment, but the specific underlying mechanisms need to be further explored. This study aimed to examine the relationship between sleep quality and cognitive impairment and the mediating effect of frailty in this relationship among the rural older adults.

METHODS

Data from a cross-sectional study conducted in rural areas of Shandong Province from September to December in 2023. A total of 695 rural older adults were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Frailty was defined using the FRAIL scale. We assessed cognitive impairment using the Dementia Screening Interview (AD8). Logistic regression analyse was used to assess the relationship between sleep quality and cognitive impairment. And the Karlson-Holm-Breen (KHB) method was performed to test the mediating role of frailty in this relationship.

RESULTS

After adjusting for all covariates, sleep quality was significantly associated with cognitive impairment (OR = 1.047, 95% CI: 1.005-1.090). Frailty mediated the relationship between sleep quality and cognitive impairment, with a mediation effect value of 0.010 (95% CI: 0.001-0.020), accounting for 17.86% of the total effect.

CONCLUSIONS

We found there was an association between sleep quality and cognitive impairment, and frailty mediated the above relationship. Comprehensive intervention measures should be taken to reduce the incidence of frailty in the older adults and to improve their sleep quality, thereby preventing and delaying the occurrence and development of cognitive impairment.

Efficacy of wooden toy training in alleviating cognitive decline in elderly individuals with cognitive impairment: A cluster randomized controlled study

BACKGROUND

With the increasing global aging population, the health and welfare of elderly individuals, especially individuals with prevalent mild cognitive impairment (MCI) living in nursing homes, have become critical concerns. These concerns highlight the urgency of developing effective interventions to address the cognitive and psychological needs of elderly individuals, ensuring their well-being and alleviating the burden on their caregivers.

OBJECTIVE

This study investigates the impact of wooden toy training on mitigating cognitive decline in elderly individuals with cognitive impairment. It evaluates how this training influences cognitive functions and psychological well-being, exploring whether it can slow or reverse the progression of cognitive decline. This outcome will be assessed in a randomized controlled trial, in which changes in cognitive ability and psychological health indicators among the participants will be measured.

DESIGN

A two-arm, open-label, cluster-randomized controlled trial.

SETTING(S)

The study was conducted in two nursing homes, which served as both the recruitment sites for participants and the intervention locations. These nursing homes were selected for their ability to facilitate the intervention and for their representative demographic characteristics of the elderly population. The settings provided a controlled environment that was conducive to implementing the wooden toy training program and observing its effects on the participants.

PARTICIPANTS

A total of 76 elderly participants with mild cognitive impairment but functional independence were recruited.

METHODS

Participants were randomized into an intervention group and a control group. The intervention group engaged in an 8-week wooden toy training program, whereas those in the control cohort received customary nursing care. Standardized cognitive and psychological well-being measures were used to assess improvements in cognitive performance and mental health.

RESULTS

Significant improvements were observed in the cognitive functions of the intervention group from a baseline score of M = 13.11 to M = 16.29 postintervention (95% CI [-4.44, -1.93]), along with reductions in depressive symptoms from a baseline score of M = 8.63 to M = 7.18 (95% CI [0.38, 2.51]). Additionally, engagement in activities with wooden toys significantly satisfied their need for competence, increasing from a baseline of M = 16.29 to M = 20 postintervention (95% CI [-5.92, -1.51]), and relatedness, which improved from a baseline of M = 20.32 to M = 22.95 (95% CI [-4.73, -0.53]).

CONCLUSIONS

This study underscores the potential of a wooden toy intervention in nursing homes that combines cognitive challenges with traditional cultural elements to improve cognitive functions in elderly individuals with mild cognitive impairment. Our findings suggest a novel method of promoting the cognitive and psychological health of nursing home residents through emotional comfort and social interaction.

It starts at home: non-economic factors influencing consumer acceptance of battery storage in Australia

Homeowners play a critical role in the uptake of low-carbon technologies, yet little is known about the factors that underlie market acceptance of residential battery storage. This research integrates social-psychological, demographic and behavioural factors into a holistic model that predicts market acceptance. Previous research has indicated that social factors play a crucial role in the adoption of rooftop solar. Still, the influence of subjective norms on battery storage, a relatively invisible technology, has yet to be fully understood. An online survey from homeowners in Australia, a mature renewable energy market, is used to provide insights into market acceptance that are relevant to international energy markets. A two-step econometric model, using factor analysis and ordered logistic regression, was used for data analysis. The results show that subjective norms, moral emotions and an environmental self-identity are positively associated with market acceptance. Demographic factors, such as younger age and higher levels of education, predict market acceptance. Motives such as technical interest, autarky and load-shifting behaviours are also relevant. Several recommendations for policymakers and practitioners are offered to improve the acceptance of battery storage, including interventions that exploit social parameters and appeal to consumer psychology.

Sex-based factors influencing perceived relocation stress and glycemic control among older adults with diabetes

This study investigated sex differences perceived relocation stress and glycemic control among older adults with type 2 diabetes in long-term care facilities. A cross-sectional correlation design was used to recruit 120 residents during their first year after moving into the facilities in southern Taiwan. The results showed that almost two-thirds of the participants (64.2%) were women. The mean age was 79.62 (SD = 1.71). Older women with diabetes were reported to have significantly lower levels of education and poor glycemic control but higher levels of perceived relocation stress than men; however, functional independence was significantly higher in men. Although perceived relocation stress significantly predicted HbA1c levels in both women and men, length of stay was also significant in predicting HbA1c levels in women. These findings indicate the need for effective physical and psychological measures to improve glycemic control during the first year of stay in long-term care facilities.

Influencing factors of health screening among retirees: an extended TPB approach

Background

Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE).

Methods

This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE.

Results

A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively.

Conclusion

This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.

Using the theory of planned behavior model to predict factors influencing breastfeeding behavior among preterm mothers at week 6 postpartum: the mediating effect of breastfeeding intention

Background

Exclusive breastfeeding (EBF) in the first 6 weeks postpartum is key to continued breastfeeding. This study aimed to explore the role of EBF-related predictors (particularly breastfeeding intention) in breastfeeding behavior among preterm mothers at week 6 postpartum based on the theory of planned behavior (TPB).

Methods

A total of 352 mothers of preterm infants were recruited, 340 of whom participated in this study. Prior to discharge, participants completed the Chinese versions of the modified Breastfeeding Attrition Predictive Tool, the Breastfeeding Knowledge Questionnaire (BKQ), the Infant Feeding Intention, and the Edinburgh Postnatal Depression Scale. Responses to the items of the Breastfeeding Behavioral Questionnaire (BBQ) were also collected by telephone at week 6 postpartum. The final analyses included 321 participants who completed the full two-wave data collection.

Results

The fitness indices of the modified TPB model were acceptable. Breastfeeding knowledge and EBF before discharge positively impacted breastfeeding intention, whereas depression had a negative impact. Before discharge, breastfeeding intention fully mediated the impacts of breastfeeding attitude, social and professional support, knowledge, depression, and EBF on breastfeeding behavior and partially mediated the influence of perceived breastfeeding control on breastfeeding behavior.

Conclusion

These findings indicate that TPB accurately predicts breastfeeding behavior among preterm mothers at week 6 postpartum, and breastfeeding intention is key to the above-mentioned EBF-related factors and breastfeeding behavior. The findings underline the need for further longitudinal studies and corresponding interventions for preterm mothers with a high risk of EBF attrition.

System dynamics simulation of occupational health and safety management causal model based on NetLogo

The occupational health and safety management factors of construction enterprises are critical influencing factors in their training management, and their causal principles are topics that warrant profound exploration. Drawing upon the conventional five factors, this study initially posited and authenticated a causal model among them, subsequently employing system dynamics on the NetLogo platform to dynamically simulate the model, and ultimately scrutinizing the interrelations and dynamic influence degree among the factors. The results show that the direct causes of management factors include human factors (weight coefficient of 0.583) and method factors (weight coefficient of 0.405), and environmental factors directly affect human factors (weight coefficient of 0.994), whereas material factors directly affect method factors (weight coefficient of 0.918). At the same time, it can be seen from the dynamic simulation results that the influence of human factors and method factors on management factors increases sharply in the nascent phase of the simulation cycle (the highest slope is .90), gradually decreases in the intermediary phase (the slope of the inflection point is .11), and is relatively stable in the final phase (the slope is less than 0.11). Three main conclusions have been drawn from this. Firstly, management factors are directly and positively affected by human factors and method factors respectively. Secondly, the interplay between diverse factors evinces a confluence of periodicity and exponential attributes. Thirdly, in each management cycle (set at 381 steps), the main focus is on controlling the causal factors in the early stages of management, with pivotal control points in steps 25 and 100, and the principal management factors comprising the management organization, operating procedures, and protective measures.