The SARS-CoV-2 vaccination rate and hesitation in Shanghai older adults with dementia.

Background: Older adults, particularly those with dementia, are at the greatest risk for being affected by SARS-CoV-2. Despite the Chinese government's efforts to encourage older adults to receive SARS-CoV-2 vaccines, the vaccination rate, especially among older adults with dementia, remains low. Objective: This study aimed to examine the willingness and attitudes towards vaccination among guardians of older adults with dementia and to uncover the factors that may have influenced attitudes towards vaccination during the 2022 Omicron Variant of SARS-CoV-2 outbreak in Shanghai, China. Methods: We conducted a cross-sectional study using self-administered anonymous questionnaires to guardians of dementia patients in three settings: psychogeriatric inpatient wards, long-term care facilities, and home settings from April to May 2022. The primary outcome was participants' willingness to allow dementia patients to receive SARS-CoV-2 vaccines. Logistic regression analyses were used to identify factors associated with vaccination willingness. Results: A total of 327 valid questionnaires were collected. The vaccination rate among participants from long-term care facilities (12.9%) was lower than those in the psychiatric ward (19.3%) or community-dwelling settings (27.1%) (p < 0.05). The guardians' primary concern was that vaccination would aggravate the health conditions of dementia patients [adjusted odds ratio (OR) = 5.11; 95% confidence interval (CI): 1.86-14.05]. Additionally, negative reports about the vaccination [OR = 3.94; 95% CI: 1.68-9.24], and adverse reactions [OR = 2.50; 95% CI: 1.13-5.52] were related to higher odds of vaccine hesitancy. Conclusion: Our results showed that low vaccination rates in older adults with dementia were mainly due to their guardians' concerns about vaccine safety. Our findings first uncovered the actual SARS-CoV-2 vaccination rates among older adults with dementia and may provide potential interventions to reduce unjustified worries towards vaccination.

Efficacy of comprehensive cognitive health management for Shanghai community older adults with mild cognitive impairment.

Background: The management of modifiable risk factors and comorbidities may impact the future trajectory of cognitive impairment, but easy-to-implement management methods are lacking. Aims: This study investigated the effects of simple but comprehensive cognitive health management practices on the cognitive function of older adults in the community with normal cognition (NC) and mild cognitive impairment (MCI). Methods: The comprehensive cognitive health management programme included a psychiatric assessment of the cognitive risk factors for those in the intervention groups and individualised recommendations for reducing the risks through self-management supported by regular medical professional follow-up. The intervention groups for this study included 84 elderly participants with NC and 43 elderly participants with MCI who received comprehensive cognitive health management. The control groups included 84 elderly participants with NC and 43 elderly participants with MCI who matched the intervention group's general characteristics and scale scores using the propensity matching score analysis. The Montreal Cognitive Assessment (MoCA) scale and Geriatric Depression Scale (GDS) scores were compared after a 1-year follow-up. Results: For older adults with MCI in the intervention group, MoCA scores were higher at the 1-year follow-up than at baseline (24.07 (3.674) vs 22.21 (3.052), p=0.002). For the MoCA subscales, the intervention group's abstract and delayed memory scores had significantly increased during the 1-year follow-up. Furthermore, in a generalised linear mixed model analysis, the interaction effect of group×follow-up was statistically significant for the MCI group (F=6.61, p=0.011; coefficients=5.83). Conclusions: After the comprehensive cognitive health management intervention, the older adults with MCI in the community showed improvement at the 1-year follow-up. This preliminary study was the first to demonstrate an easy-to-implement strategy for modifying the cognitive risk factors of elderly individuals with MCI in the community, providing new insight into early-stage intervention for dementia.

Professional identity and its work-related factors among psychiatric nurses: A cross-sectional study.

OBJECTIVE: To investigate the level of professional identity among psychiatric nurses and to explore what work-related factors may affect their professional identity. METHODS: Four hundred and twelve nurses were investigated. Two self-report questionnaires were used: (a) Nursing Professional Identity Scale (NPIS, range: 30 ~ 150); and (b) Practice Environment Scale of Nursing Work (PESNW, range: 0 ~ 100) with six dimensions: nursing-related hospital affairs, high-quality nursing care, ability of nursing manager, manpower and material resources, cooperation between nurses and doctors, and salary and social status. Higher scores indicated higher professional identities and better work environments. RESULTS: Three hundred and ninety-one of the participants completed the questionnaires and were analyzed. The mean age of the participants was 32.53 years, and 93.3% of them were female. The mean score of NPIS was 100.03 (SD: 17.44). Multiple linear regression showed that professional identity was significantly and positively associated with two dimensions of PESNW: salary and social status and ability of nursing manager. CONCLUSIONS: Professional identity among psychiatric nurses was at a moderate level. Salary and social status and ability of nursing manager positively contributed to their professional identity. These results may indicate the directors to construct better work environments for psychiatric nursing to improve professional identity.