ObjectiveTo develop an intervention program based on a shared mental model to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards. MethodsUsing the shared mental model as the theoretical framework, the intervention program was preliminarily drafted through literature review to establish a theoretical foundation and qualitative research to identify clinical needs. The Delphi method was then used to revise and refine the program. ResultsBased on literature review and qualitative research, intervention elements were extracted across four dimensions: equipment, tasks, team interaction and team members, forming the initial draft of the intervention program. Two rounds of consultations were conducted with 18 experts, achieving a 100% valid response rate in both rounds. The expert authority coefficients were 0.87 and 0.90, respectively. In the second round of consultation, the variation coefficients for the importance scores of each item ranged from 0 to 0.20 (overall Kendall's W = 0.272, P < 0.001), and the variation coefficients for feasibility scores ranged from 0 to 0.21 (overall Kendall's W = 0.275, P < 0.001). The final intervention program included five first-level indicators, eight second-level indicators, and 29 third-level indicators, aligning with the four dimensions of the shared mental model. ConclusionThe intervention program was developed to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards based on the shared mental model.

Objective To explore the potential categories and influencing factors of cognitive function trajectories in elderly hemodialysis patients.Methods A convenience sampling method was used to select elderly patients undergoing hemodialysis in the blood purification center of a tertiary hospital in Beijing,China,from June 2022 to June 2024.A general information questionnaire,the Short Physical Performance Battery,the Patients Health Questionnaire-9,the Impact on Participation and Autonomy Questionnaire,the Hemodialysis Self-Management Instrument,and the Mini-Mental State Examination,were used to collect data at the time of enrollment.Cognitive function was evaluated at the time of enrollment and 6,12,18,and 24 months after enrollment,using latent category growth model to identify trajectory categories,and logistic regression,and decision tree models to analyze the influences on cognitive function trajectories.Results Finally,304 patients were included.A total of 2 trajectories of cognitive function in elderly hemodialysis patients were identified,namely,high-level stable group(63.2％)and low-level declining group(36.8％).Both logistic regression and decision model results showed that the type of dialyzer,body mass index,physical function,and depression status were the factors influencing potential categories of cognitive function for elderly hemodialysis patients.The areas under the receiver operating characteristic curves for logistic regression and decision tree models were 0.823[95％CI(0.775,0.870)]and 0.816[95％CI(0.765,0.867)],respectively.Conclusion There is heterogeneity in the cognitive function trajectories of elderly hemodialysis patients,and healthcare professionals can develop targeted interventions according to the influencing factors of the trajectory categories to improve their cognitive function.

Objective:To explore the value of immature platelets and thromboelastography (TEG) in evaluating bleeding tendency in patients bitten by blood venomous snakes.Methods:In December 2023, a bleeding scoring system was used to grade the bleeding score and degree of bleeding in 147 patients with blood venomous snake bites. Immature platelets and TEG were also tested to analyze the correlation between the bleeding degree of patients and indicators such as TEG, immature platelet ratio (IPF), and absolute value of immature platelets (A-IPF). The measurement data were represented by Mean±SD, and ANOVA was used for comparison among groups. Statistical data were analyzed using χ2 test. Spearman correlation was used to analyze the correlation between bleeding degree and the platelet count (PLT), immature platelet and TEG. Pearson linear correlation was used to analyze the correlation of PLT, immature platelets and TEG. The indexes of immature platelets and TEG were analyzed by receiver operating characteristic curve. Results:The 147 patients were graded for bleeding severity based on their bleeding scores, and divided into mild (22 cases), moderate (119 cases), and severe groups (6 cases), and the clinical data such as age, gender and the time from bite to visit were compared among the three groups. The differences were not statistically significant ( P>0.05). The coagulation reaction time (R), clot formation time (K), and immature platelet parameters (IPF, A-IPF) in TEG parameters increased with the degree of bleeding. PLT decreased with the degree of bleeding, and the difference was statistically significant ( P<0.05). Blood venomous snake bite patients have a negative correlation between PLT and IPF ( r=-0.301, P=0.012), but no correlation with A-IPF ( r=0.072, P=0.461) ; PLT was positively correlated with coagulation Angle (αAngle) and maximum thrombus amplitude (MA) of TEG ( r=0.220、0.243, P=0.028、0.015), but negatively correlated with R value and K value ( r=-0.368、-0.362, P<0.001). IPF is positively correlated with R and K values ( r=303、271, P=0.0020、0.035) ; IPF is not correlated with MA value and Angle angle, while A-IPF is positively correlated with R value ( r=0.162, P<0.001). The degree of bleeding in patients is positively correlated with R value ( r=0.237, P<0.001), but not with K value, MA value, and Angle angle ( P>0.05) ; The degree of bleeding in patients is correlated with PLT ( r=-0.411, P<0.001). The ROC curve analysis results show that the R value, K value, and MA value are effective in evaluating the bleeding risk of blood venomous snake bites in patients, and the PLT combined with A-IPF has the best efficacy in evaluating the bleeding risk of blood venomous snake bites in patients. Conclusion:The combination of PLT and A-IPF, TEG's R value, K value, MA value indicators can accurately evaluate the bleeding risk of blood venomous snake bites, and can be widely used in clinical practice as an important prediction method for bleeding tendency in patients bitten by blood venomous snakes.

Objective:To explore the role positioning and job responsibilities of integrated care managers in China, with a view to providing reference for policy formulation and career development.Methods:The qualitative study was conducted. From December 2023 to July 2024, 18 frontline workers and managers working in integrated care in two hospitals, two community health service centers and seven elderly care institutions in Beijing were selected by purposive sampling method to conduct semi-structured interviews. Colaizzi 7-step analysis was used to analyze the data.Results:A total of six core roles and seven responsibilities of the integrated care managers were identified, including the role of the comprehensive assessor and the responsibility of conducting comprehensive health assessments, the role of the team collaborator and the responsibility of organizing interdisciplinary discussions, decision-making and collaboration, the role of the case manager and the responsibility of developing and implementing integrated care plans, the role of the resource integrator and the responsibility of coordinating and integrating resources, the role of the service controller and the responsibility of supervising and optimizing care services, the role of professional leader and communicator and the responsibility of promoting team building and development, and the responsibility of leading professional innovation and growth.Conclusions:As an emerging complex professional talent to cope with population aging, clarifying their roles and responsibilities is of great significance in realizing the goal of healthy aging and building an integrated healthcare service system in China. Integrated care managers should be based on personalized, multi-level, and whole-process care service needs, flexibly adapt to diversified role changes, and stimulate their own intrinsic motivation and innovation ability to provide high-quality care services.

Objective:To understand the usability evaluation indicators for intelligent caregiving robots in elderly care from the perspectives of stakeholders, and provide a reference for constructing a usability evaluation indicator system for these robots.Methods:This study was a qualitative study. From November 2023 to May 2024, purposive sampling was used to select eight intelligent robot developers from three engineering universities and one medical technology company, seven intelligent product usage managers from three elderly care institutions in Beijing, and seven elderly users who have used intelligent caregiving robots at Xuanwu Hospital of Capital Medical University. Semi-structured interviews were conducted with these participants. The content analysis method was employed to organize and analyze the interview data, and themes were extracted.Results:A total of four themes and eleven sub-themes were identified: safety and reliability (mechanical safety, sensory safety, privacy safety) , performance (effectiveness, fault tolerance, intelligence) , user experience (learnability, ease of use, comfort) , and cost-effectiveness (cost-performance ratio, usage cost) .Conclusions:The usability evaluation indicators for intelligent caregiving robots in elderly care, extracted from multiple perspectives, provide a reference for constructing a scientific, reasonable, and comprehensive usability evaluation indicator system for intelligent caregiving robots in elderly care.

Objective:To explore the impact of community environment on the functional ability in the elderly based on a person-environment fit perspective.Methods:The descriptive qualitative research method was used. Applying the purposive sampling method, elderly people attending two community health centers and their subordinate health stations in Beijing were selected as respondents from January to May 2024. An interview outline was developed based on the person-environment fit theory, and semi-structured interviews were used to collect information. Thematic analysis was used for data analysis.Results:A total of 16 community elderly people were interviewed, and four themes were finalized, including multidimensional compensation of the environment for individual competence (accessible and convenient environments compensate for declining motor abilities, supportive physical environments compensate for declining vision and vitality, social support compensates for declining cognitive abilities, and age-friendly environments enhancing a sense of belonging and security) , congruence of personal preferences with the community environment (diversity of activities to meet individualized needs, environmental stability to ensure a sense of control over life, age-friendly digital environments to meet the digital needs of the elderly) , personal influencing factors of the perceived environment (length of residence, personal health status, personal social relations) , and coping styles with person-environment mismatches (enhancement of individual capabilities, use of assistive devices for self-empowerment, proactive home age-friendly adaptation, self-psychological adjustment) .Conclusions:Community healthcare workers should emphasize the role of the environment and give full consideration to the individual characteristics, needs and preferences of the elderly people, and pay special attention to the elderly people who have a poor perception of the environment and encourage them to take positive coping styles to adapt to the environment.

Objective:To explore latent categories of trajectories in intrinsic capacity in elderly hemodialysis patients and to analyze their influencing factors.Methods:Elderly hemodialysis patients in the Blood Purification Center of Beijing Tongren Hospital affiliated with Capital Medical University from September 2022 to January 2023, were selected for the study using a convenience sampling method. A baseline survey was conducted using the General Information Questionnaire, Hemodialysis Self-Management Instrument, Social Environmental Factor Scale, and Intrinsic Capacity Scale. The Intrinsic Capacity Scale was used to investigate the intrinsic capacity of patients at 6 and 12 months after baseline. The latent class growth model was used to identify latent categories of intrinsic capacity trajectories of elderly hemodialysis patients. Ordered multiclass Logistic regression was used to analyze the influencing factors of latent categories.Results:A total of 317 elderly hemodialysis patients were investigated at baseline, and finally, 309 completed follow-ups. Among the 309 elderly hemodialysis patients, the trajectory of intrinsic capacity was categorized into a low-level slow-decline group (26.2%, 81/309) , a medium-level smooth-decline group (39.8%, 123/309) , and a high-level slow-decline group (34.0%, 105/309) . Ordered multiclass Logistic regression analysis showed that gender, age, mode of residence, per capita monthly income, type of dialyzer, C-reactive protein, score of hemodialysis self-management scale, housing conditions score, transportation condition score, and environmental condition score were the influencing factors of the latent categories of the trajectory in intrinsic capacity of elderly hemodialysis patients, and the difference was statistically significant ( P<0.05) . Conclusions:There is population heterogeneity in the intrinsic capacity trajectory of elderly hemodialysis patients. Healthcare professionals can provide targeted interventions based on the factors influencing the trajectory.

Objective:To investigate the current status and trajectory of intrinsic capacity in community-dwelling older adults and to analyze its influencing factors.Methods:A longitudinal study was conducted from September 2022 to March 2024. A total of 360 older adults were selected by convenience sampling from the Desheng community, Xicheng District of Beijing City and Liucun Community of Xingtai City, Hebei Province. The Intrinsic Capacity Assessment Scale and the Influencing Factors Questionnaire were administered at three-time points: baseline (T1), 6 months (T2), and 12 months (T3). Binary Logistic regression analysis revealed that age, grip strength, the number of geriatric syndromes, and types of social activities were significant influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Results:A total of 360 participants were assessed at T1, with 58 and 30 lost to follow-up at T2 and T3, development respectively. Ultimately, 272 older adults completed the follow-up. The growth mixture modeling identified two trajectory types: a high-score stable group (92.3%, 251/272) and a low-score declining group (7.7%, 21/272). Binary Logistic regression analysis showed that age, grip strength, number of geriatric syndromes, and types of social activities were influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Conclusions:Intrinsic capacity development trajectories in community-dwelling older adults are heterogeneous. Healthcare professionals should focus on older adults with advanced age, lower grip strength, more geriatric syndromes, and fewer types of social activities to assess and manage their intrinsic capacity and formulate targeted interventions at an early stage.

Objective To explore the potential categories and influencing factors of cognitive function trajectories in elderly hemodialysis patients.Methods A convenience sampling method was used to select elderly patients undergoing hemodialysis in the blood purification center of a tertiary hospital in Beijing,China,from June 2022 to June 2024.A general information questionnaire,the Short Physical Performance Battery,the Patients Health Questionnaire-9,the Impact on Participation and Autonomy Questionnaire,the Hemodialysis Self-Management Instrument,and the Mini-Mental State Examination,were used to collect data at the time of enrollment.Cognitive function was evaluated at the time of enrollment and 6,12,18,and 24 months after enrollment,using latent category growth model to identify trajectory categories,and logistic regression,and decision tree models to analyze the influences on cognitive function trajectories.Results Finally,304 patients were included.A total of 2 trajectories of cognitive function in elderly hemodialysis patients were identified,namely,high-level stable group(63.2％)and low-level declining group(36.8％).Both logistic regression and decision model results showed that the type of dialyzer,body mass index,physical function,and depression status were the factors influencing potential categories of cognitive function for elderly hemodialysis patients.The areas under the receiver operating characteristic curves for logistic regression and decision tree models were 0.823[95％CI(0.775,0.870)]and 0.816[95％CI(0.765,0.867)],respectively.Conclusion There is heterogeneity in the cognitive function trajectories of elderly hemodialysis patients,and healthcare professionals can develop targeted interventions according to the influencing factors of the trajectory categories to improve their cognitive function.

Objective:To explore the role positioning and job responsibilities of integrated care managers in China, with a view to providing reference for policy formulation and career development.Methods:The qualitative study was conducted. From December 2023 to July 2024, 18 frontline workers and managers working in integrated care in two hospitals, two community health service centers and seven elderly care institutions in Beijing were selected by purposive sampling method to conduct semi-structured interviews. Colaizzi 7-step analysis was used to analyze the data.Results:A total of six core roles and seven responsibilities of the integrated care managers were identified, including the role of the comprehensive assessor and the responsibility of conducting comprehensive health assessments, the role of the team collaborator and the responsibility of organizing interdisciplinary discussions, decision-making and collaboration, the role of the case manager and the responsibility of developing and implementing integrated care plans, the role of the resource integrator and the responsibility of coordinating and integrating resources, the role of the service controller and the responsibility of supervising and optimizing care services, the role of professional leader and communicator and the responsibility of promoting team building and development, and the responsibility of leading professional innovation and growth.Conclusions:As an emerging complex professional talent to cope with population aging, clarifying their roles and responsibilities is of great significance in realizing the goal of healthy aging and building an integrated healthcare service system in China. Integrated care managers should be based on personalized, multi-level, and whole-process care service needs, flexibly adapt to diversified role changes, and stimulate their own intrinsic motivation and innovation ability to provide high-quality care services.