Actual and Virtual Parks Benefit Quality of Life and Physical Activity: A Cluster Trial.

Urban parks provide connectedness to nature as a health resilience environment for promoting health. Virtual reality can provide opportunities for urban citizens to be exposed to natural elements with health benefits. The purpose was to explore the effects of actual and virtual parks on the quality of life and physical activity of urban residents. The study design was a cluster trial. Participants were healthy adults aged 20-50 years, recruited from three college campuses, and randomly assigned to two experimental groups (n = 30, 32) and one control group (n = 30). The intervention with virtual or actual parks was conducted for 30 min a session once a week for 12 weeks. Outcomes were measured using self-reported questionnaires, including the World Health Organization Quality-of-Life Scale-BREF and International Physical Activity Questionnaire-Short Form. In total, 84 participants completed the interventions and post-intervention measures. Results showed that participants who experienced actual parks had significant increases in the social quality of life and light-intensity physical activity and had decreased body weight. Participants who experienced the virtual parks experienced a significant increase in their mental quality of life. Participants in the experimental groups of both kinds of parks had significant improvements in their self-rated health, physical and environmental quality of life, and sedentary time after the intervention. Urban parks are an important natural resource for citizens' health and physical activity promotion. Virtual parks can simulate actual parks and have similar health benefits and are thus are recommended for citizens who lack opportunities and motivation to go to actual parks.

Leisure Participation for Mental Health Promotion in Later Life: A Six-Year Longitudinal Study.

Engaging in leisure activities is essential for mental health in older adults. This longitudinal study (n = 1,101, mean age = 69.20 ± 6.23 years at baseline) examined the associations between leisure participation and mental health over 6 years in three waves: 2016, 2018, and 2020. Pearson's correlation analyses and generalized estimating equations were performed for data analyses. The frequency of participation in physical and social activities was significantly positively associated with happiness, life satisfaction, and self-rated health, and significantly negatively associated with depression. Passive activities were significantly positively associated with happiness, life satisfaction, and self-rated health but not with depression. The time effect had no significant association with any mental health outcomes. These findings highlight the importance of leisure activities in promoting mental health among older adults. Policy makers should encourage older adults to engage in physical and social leisure activities.

Awareness of and subjective needs for post-discharge healthcare services among older adult patients.

BACKGROUND: Increasing patient awareness of post-discharge care resources is an effective strategy to reduce rehospitalization rates and medical costs. Therefore, the purpose of this study was to explore hospitalized older adult patients' awareness of and subjective demands for post-discharge healthcare services. METHODS: A cross-sectional study design was conducted from November 2018 to May 2020. STROBE statement was completed. Participants were inpatients over 65 years of age in the general ward of a medical center in northern Taiwan. A questionnaire was used to collect data by face-to-face interviews. Two hundred and twelve participants were recruited. Home nursing care, home rehabilitation, home respiratory therapy, home services, assistive devices rental, and transportation were the main post-discharge healthcare services in this study. RESULTS: Overall, 83.5% of older adult patients were aware of and 55.7% of the older adult patients demanded at least one post-discharge healthcare services. Logistic regression results found that, patients experiencing moderate to severe disability and cognitive impairment, and those hospitalized in the past year had significantly higher demands for services. CONCLUSIONS: Developing post-discharge healthcare services for older adult patients provides continuous patient-centered services for assisting patients and their families in adapting to the transition period of the post-acute stage. Satisfying these demands is beneficial for older adult patients and their families, as well as for reducing readmissions and medical costs.

Effects of discharge planning services and unplanned readmissions on post-hospital mortality in older patients: A time-varying survival analysis.

BACKGROUND: Older patients often encounter negative health outcomes after discharge from the hospital. The purpose of this study was to explore the effects of discharge planning services and unplanned readmissions on the risk of death within 1 year after discharge in older patients. METHOD: A prospective observational study was conducted from November 2018 to May 2020. Participants were inpatients aged over 65 years in 13 general wards of a medical center in Taiwan. Data were collected by interviews and patients' medical records, including the offer of discharge planning services, the occurrence of unplanned readmissions, and death which occurred within 1 year after discharge. A proportional hazard regression model with a time-varying covariate was performed for data analysis. RESULTS: In total, 300 patients completed the interview and medical records, and 297 were assessed for eligibility; 42.1% of participants received discharge planning services, 43.4% of participants had an unplanned readmission, and 34 (11.4%) participants died from all causes within 1 year after discharge. After controlling for age, operation, tube use, physical and mental disabilities or major illnesses, body-mass index, incontinence, muscle weakness, malnutrition problems, and length of stay in the hospital, older patients who had received discharge planning services had a significantly lower risk of death within 1 year after discharge (adjusted hazard ratio (aHR)=0.08, p<0.001). Older patients who experienced an unplanned readmission had a significantly higher risk of death within 1 year after discharge (aHR=12.78, p = 0.001). CONCLUSIONS: After being discharged from the hospital, patients experiencing an unplanned readmission may have an increased chance of death. Therefore, the development of continuous hospital discharge planning services and the achievement of a collaborative partnership are recommended to improve patients' compliance and positive health outcomes after discharge from the hospital.

Social engagement for mental health: An international survey of older populations.

BACKGROUND AND PURPOSE: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. MATERIALS AND METHODS: An international cross-sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. RESULTS: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self-placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self-accomplishment, and life satisfaction, but negatively predicted loneliness and depression. CONCLUSIONS: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICIES: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies.

Smart Wearable Device Users' Behavior Is Essential for Physical Activity Improvement.

BACKGROUNDS: This study aimed to explore the effect on physical activity and sedentary behavior of users of wearable devices, and understand the association between physical activity and behavior. METHODS: This study conducted a three-arm, randomized controlled trial for 12 weeks. Healthy adults without experience of using a wearable device were recruited and were randomly assigned to a control group with a mobile app and two experimental groups with different smart wearable devices. Data were collected through questionnaires. RESULTS: No significant effect of group, time, or group-by-time interaction among groups for physical activity, sedentary time, or sleep quality was found. Wearing duration significantly positively predicted changes in low-intensity and total physical activity. The number of times the device was checked negatively predicted a change in sedentary time. CONCLUSIONS: The behavior of wearable device users is an essential factor for successfully increasing physical activity and decreasing sedentary time.

Comparisons of physical activity and sedentary behavior between owners and non-owners of commercial wearable devices.

AIMS: Wearable devices are a new strategy for promoting physical activity in a free-living condition that utilizes self-monitoring, self-awareness, and self-determination. The main purpose of this study was to explore health benefits of commercial wearable devices by comparing physical activity, sedentary time, sleep quality, and other health outcomes between individuals who used and those that did not use commercial wearable devices. METHODS: The research design was a cross-sectional study using an Internet survey in Taiwan. Self-administered questionnaires included the International Physical Activity Questionnaire-Short Form, Pittsburgh Sleep Quality Index, Health-Promoting Lifestyle Profile, and World Health Organization Quality-of-Life Scale. RESULTS: In total, 781 participants were recruited, including 50% who were users of wearable devices and 50% non-users in the most recent 3 months. Primary outcomes revealed that wearable device users had significantly higher self-reported walking, moderate physical activity, and total physical activity, and significantly lower sedentary time than non-users. Wearable device users had significantly better sleep quality than non-users. CONCLUSION: Wearable devices inspire users' motivation, engagement, and interest in physical activity through habit formation. Wearable devices are recommended to increase physical activity and decrease sedentary behavior for promoting good health.