Nursing home adjustment in China: mediating and moderating effects.

PURPOSE: Adjusting to nursing homes contributes to successful aging in older adults. However, the effect of stress on psychological adjustment in nursing home residents is unclear. Therefore, this study aimed to explore the relationship between stress and psychological adjustment among nursing home residents. METHODS: This was a cross-sectional, multicenter survey. A total of 386 residents from 11 nursing homes were included in the study. Bootstrapping with resampling strategies was used to examine multiple mediators and the moderator effect. This research conforms with the STROBE checklist. RESULTS: Path analysis demonstrated that stress directly negatively predicted the psychological adjustment of nursing home residents. It also indirectly predicted psychological adjustment through the mediating role of learned resourcefulness and self-efficacy, as well as the chain mediating role of both. Social support played a moderating role in the path of stress to learned resourcefulness. CONCLUSION: This study revealed the mechanism underlying the effect of stress on psychological adjustment in nursing home residents without cognitive impairment and walking difficulties. It further suggests that health providers could enhance older adults' learned resourcefulness, self-efficacy, and social support to assist them in adjusting to nursing home life.

Psychometric properties of the Chinese version of quality of life in life-threatening illness-family carer version.

Background: The Quality of Life (QOL) in Life-threatening Illness-Family Carer Version (QOLLTI-F) has been proven to be a brief, reliable, and valid instrument for measuring the caregivers' QOL in western cultures. However, whether it is suitable to be used in Chinese culture is unclear. This study aimed to test the reliability and validity of the Chinese version of (QOLLTI-F-CV). Materials and methods: A total of 202 family caregivers (FCs) of advanced cancer patients from Fujian Provincial hospice care center were investigated using the Chinese version of QOLLTI-F-CV from September 2019 to August 2020. The questionnaire was evaluated using an exploratory structural equation model. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, internal consistency, and test-retest reliability. Results: Differently from the seven-domain original QOLLTI-F, its Chinese version had only three domains including caregiver's self-feelings, caregiver's stress, and caregiver's outlooks. The total variance explanation rate for the domains was 55.4%. The Chinese version fitted well with the structure model (χ2 = 153.932, df = 75, P < 0.001); its comparative fit index (CFI) was 0.971; Tucker-Lewis index was 0.954; and the root mean square error of approximation (RMSEA) was 0.072. The success rate of its convergent and discriminant validity calibration test was 100%. Its Cronbach's alpha coefficient of the whole questionnaire and three domains was from 0.650 to 0.874, and test-retest reliability was 0.836. Conclusion: The 3-domain QOLLTI-F-CV is a valid and reliable instrument for identifying QOL concerns of FCs of advanced cancer patients in China. The refactoring structure optimally matches Chinese culture and value system well.

Factors associated with nursing home adjustment in older adults: A systematic review.

BACKGROUND: An ageing population has resulted in increased numbers of older adults moving to a nursing home, and the challenges triggered by relocation are highlighted. Various factors are identified to be associated with relocation and psychological adjustment to living in a nursing home. However, no systematic review has synthesised the evidence, and its associated factors remain unclear. OBJECTIVE: To examine and synthesise the best available evidence on the factors associated with adjustment to living in a care facility. DESIGN: Systematic review. DATA SOURCES: Nine electronic databases were searched from database inception to March 2020: Pubmed, Embase, CINAHL, PsycINFO, Cochrane library, China National Knowledge Infrastructure, China Wanfang Database, Chinese Biomedical Literature Database, Chinese Periodical Full-text Database. REVIEW METHODS: The references listed in the included studies were manually checked. The quality of the eligible studies was assessed using the 11-item checklist of the Agency for Healthcare Research and Quality. RESULTS: A total of 20 studies were included in this review, with 17 cross-sectional studies, and three longitudinal study. 19 studies were rated as moderate quality and the other one was high quality. 17 measures were used to assess nursing home adjustment. Six distinct categories of the associated factors for nursing home adjustment were identified: demographic characteristics (n = 11), physiological factors (n = 3), psychological factors (n = 9), social factors (n = 9), relocation factors (n = 6), and facility factors (n = 5). CONCLUSIONS: Decision-making control, self-efficacy, social support, activities of daily living, and length of stay should all be taken into account when assisting resident scoping with a relocation to a nursing home. Infuture research, multiple areas can be considered when improving the level of nursing home adjustment, as well as interventions and health policies. REGISTRATION NUMBER: PROSPERO CRD 42018115935. TWEETABLE ABSTRACT: A systematic review of the factors associated with adjustment to living in a care facility.

An Edge Based Multi-Agent Auto Communication Method for Traffic Light Control.

With smart city infrastructures growing, the Internet of Things (IoT) has been widely used in the intelligent transportation systems (ITS). The traditional adaptive traffic signal control method based on reinforcement learning (RL) has expanded from one intersection to multiple intersections. In this paper, we propose a multi-agent auto communication (MAAC) algorithm, which is an innovative adaptive global traffic light control method based on multi-agent reinforcement learning (MARL) and an auto communication protocol in edge computing architecture. The MAAC algorithm combines multi-agent auto communication protocol with MARL, allowing an agent to communicate the learned strategies with others for achieving global optimization in traffic signal control. In addition, we present a practicable edge computing architecture for industrial deployment on IoT, considering the limitations of the capabilities of network transmission bandwidth. We demonstrate that our algorithm outperforms other methods over 17% in experiments in a real traffic simulation environment.

A psychometric evaluation of the Chinese version of the Nursing Home Adjustment Scale.

PURPOSE: For older adults, psychological adjustment has a great impact on successfully making the transition to living in a nursing home. However, a tailored Nursing Home Adjustment Scale (NHAS) for Chinese nursing home residents is not available. The aim of this study was to develop and psychometrically test properties of the NHAS for Chinese residents. METHODS: A total of 425 residents were recruited from 10 nursing homes from September 2017 to February 2018 in Fujian, China, to examine the psychometrics of the NHAS Chinese version. exploratory structural equation modeling (ESEM) was applied to evaluate the NHAS scale. Internal consistency, test-retest reliability, and construct validity were examined. RESULTS: The final structure for the NHAS was categorized into five domains, including emotional distress, relationship development, acceptance of new residence, depressed mood, and feeling at home. The goodness-of-fit indices of ESEM supported the five-factor model with satisfactory internal consistency (Cronbach's α = 0.87) and test-retest reliability of 0.72 for the entire scale. CONCLUSIONS: The Chinese version of the NHAS is a reliable and valid instrument to assess the level of nursing home adjustment among nursing home residents in China.