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Xie Y, Sinclair C, Hamilton M, Peisah C, Temple J, Anstey KJ. Barriers Experienced by Community-Dwelling Older Adults Navigating Formal Care: Evidence From an Australian Population-Based National Survey. J Aging Health 2024:8982643241263132. [PMID: 38914050 DOI: 10.1177/08982643241263132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVES This study aims to identify the relationship between psychosocial factors and unmet needs among community-dwelling older adults who have received or who expect to receive formal home-based aged care services. METHODS A subsample of the national Survey of Disability, Ageing and Carers was used to examine the prevalence of having any unmet needs among older adults navigating care. We also examined associations between older adults' psychosocial factors and their unmet needs using logistic regression. RESULTS Regression analyses highlighted that perceived social isolation (OR = 1.62, 95% CI: 1.30-2.01), high/very high psychological distress (OR = 2.11, 95% CI: 1.52-2.93), and occasional assistance from informal support (OR = 1.92, 95% CI: 1.22-3.05) were associated with increased odds of having unmet needs, after adjusting for other covariates. DISCUSSION Our study suggests that older adults facing psychosocial difficulties or lacking informal support are more likely to encounter barriers in accessing formal care. Future policy should address the psychosocial needs and support networks of older adults.
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Affiliation(s)
- Yuchen Xie
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Craig Sinclair
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Myra Hamilton
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Carmelle Peisah
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jeromey Temple
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Kaarin J Anstey
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
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Genaro LE, Marconato JV, Tagliaferro EPDS, Pinotti FE, Valsecki Júnior A, Adas Saliba T, Rosell FL. Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:539. [PMID: 38791748 PMCID: PMC11121688 DOI: 10.3390/ijerph21050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.
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Affiliation(s)
- Luis Eduardo Genaro
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - José Victor Marconato
- School of Medicine, San Francisco University, Bragança Paulista 12.916-900, SP, Brazil;
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Felipe Eduardo Pinotti
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Aylton Valsecki Júnior
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Tânia Adas Saliba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
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Wang H, Liu H, Wu B, Hai L. The Association Between Trajectories of Perceived Unmet Needs for Home and Community-Based Services and Life Satisfaction Among Chinese Older Adults: The Moderating Effect of Psychological Resilience. Res Aging 2024; 46:139-152. [PMID: 37768843 DOI: 10.1177/01640275231203608] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
This study examined whether trajectories of perceived unmet needs for Home and Community-Based Services (HCBS) were associated with life satisfaction among Chinese older adults and whether the association was moderated by psychological resilience. Data came from five waves (2005-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent class growth analysis revealed three distinct trajectories of perceived unmet HCBS needs: "increasing" (n = 977, 36.24%), "persistent" (n = 570, 21.14%), and "decreasing" (n = 1149, 42.62%). Multiple regression estimates showed that the increasing group was associated with lower life satisfaction, and the association was moderated by psychological resilience, especially for older adults who were male, living in rural, and oldest-old. Results indicate that inequalities in cumulative exposure to perceived unmet HCBS needs may further lead to increasing inequalities in life satisfaction. Interventions focused on minimizing the provision-need gap of HCBS and enhancing personal resilience should be considered to improve the life satisfaction of older adults.
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Affiliation(s)
- Hui Wang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Huijun Liu
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Lun Hai
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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Woo S, Cui Y, Kim S, Choi M. Gender differences in caregiver attitudes and unmet needs for activities of daily living (ADL) assistance among older adults with disabilities. BMC Geriatr 2023; 23:671. [PMID: 37853319 PMCID: PMC10583335 DOI: 10.1186/s12877-023-04383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND With a rapidly ageing population and a decline in the availability of family caregivers, the number of older adults with disabilities who have unmet long-term care needs is gradually increasing worldwide. However, whether there are gender differences in the association between primary caregivers or their attitudes and unmet needs for activities of daily living (ADL) assistance remains largely unknown. METHODS This study used the latest 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), containing the data of 1187 older adults with disabilities aged 65 and older, to identify gender differences in the attitudes of primary caregivers toward the unmet needs for ADL assistance among with disabilities adults in China. Binary logistic regression analysis was conducted to determine the effects of primary caregivers and their caregiving attitudes on the unmet care experiences of older adults with ADLs. In addition, a gender-stratified analysis was conducted to compare the differences based on older adults' gender. RESULTS The results revealed that the lack of positive attitudes from primary caregivers might create a situation of unmet needs for ADL assistance among older adults. When family members carry the main burden of care, older adults with disabilities, especially older women, have a lower level of unmet needs for ADL assistance. Therefore, it is important to consider gender-specific interventions to improve ADL assistance among older adults. CONCLUSIONS The findings suggest that the presence of a family member as a caregiver has a significant effect on unmet needs for ADL assistance in women, highlighting the importance of developing an emotional bond with the caregiver. Given that the availability of informal caregivers, such as family members, is declining, it is crucial to provide financial assistance and formal services, such as paid home services and community-based care services, and reduce the burden on family caregivers to address the unmet needs for ADL assistance among older adults with disabilities in China.
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Affiliation(s)
- Selin Woo
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Ying Cui
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Suyeon Kim
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Mankyu Choi
- School of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, South Korea
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Jiang M, Zeng J, Liao M, Li Q. The work status of nurses in long-term care institutions in elderly care: A qualitative descriptive study. Nurs Open 2023; 10:6428-6434. [PMID: 37332177 PMCID: PMC10416048 DOI: 10.1002/nop2.1892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/14/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023] Open
Abstract
AIM To understand the work status of nurses in long-term care institutions in China for elderly care to provide a reference for further formulating management strategies and promoting the development of long-term care teams. METHODS Using qualitative descriptive research methods, 31 nurses from three long-term care institutions were selected through purposive sampling for in-depth interviews, and a three-week participatory observation was conducted on the daily work of nurses in the above three long-term care institutions. Content analysis was used to analyse data. RESULTS In our sample, nurses in long-term care institutions had insufficient manpower, generally had low academic qualifications, and lacked professional ability. Their work enthusiasm and initiative need to be further improved. Long-term care nurses were moderately paid, and their salary satisfaction was lower than in other trades. At the same time, the social understanding of the long-term care industry was insufficient, and the social identity of nurses in long-term care institutions was low. CONCLUSION The development of long-term care requires the joint efforts of nurses, medical institutions, and society. By improving the system, cultivating talents and building a harmonious atmosphere, we aim to enhance the work enthusiasm of long-term care nurses and promote the stable and orderly development of the long-term care team. IMPLICATIONS FOR NURSING MANAGEMENT Nurses in long-term care institutions are at the core of the ageing age and play a vital role in coping with the ageing problem, meeting long-term care needs, improving the quality of life of old people and reducing the cost of long-term care. The training and management of nurses in long-term care institutions and the construction of the entire long-term care system should be based on China's national conditions and actual needs.
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Affiliation(s)
- Menglin Jiang
- West China Xiamen Hospital of Sichuan UniversityAmoyChina
- Chengdu Medical CollegeChengduChina
| | | | | | - Quanlei Li
- School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
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Sun C, Meng D. Factors associated with perceived caregivers' willingness to provide care among older adults with disabilities in China. Front Public Health 2023; 11:1170594. [PMID: 37342270 PMCID: PMC10277793 DOI: 10.3389/fpubh.2023.1170594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023] Open
Abstract
Objective The aim of this study was to analyze the status quo and associated factors of care recipients' perceptions of caregivers' willingness to provide care among disabled older adults in China. Thus, this study contributes to our understanding of vulnerable older populations who are at a high risk of receiving support from informal caregivers who are unable or unwilling to take the caregiver role. Methods We analyzed the cross-sectional data of 3,539 disabled older adults who received informal care at home from the seventh wave of the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Multiple logistic regression models were used to examine the variables associated with the respondents' perceived caregivers' willingness to care from five aspects: respondents' sociodemographic attributes, health-related data, family endowment, access to health care services and community-based long-term care services (CBLTCS). Results This study found that the majority of disabled older adults (90.9%) had a positive attitude toward their caregivers' willingness to care and the care they received; however, 7.0% of the adults were concerned about their caregivers' ability to handle the care. Moreover, there was a small number of disabled older people (2.1%) who felt that their caregivers were reluctant to care or lacked patience. The results from the multiple logistic regression showed that disabled older adults with socioeconomic disadvantages (living in rural areas, being poor and with no children who frequently visited) or high demand (with severe disabilities or cognitive impairment) were more likely to consider that their caregivers needed respite care. Those adults with anxiety symptoms, a lower amount of care time, poor self-rated financial status and poor accessibility to health care services were more likely to report that their caregivers were reluctant to administer care. Conclusion This study found that living in rural areas, being poor, with no children who frequently visited, severe disabilities or CI were positively associated the care recipients' perception that caregivers needed respite care. While anxiety symptoms, a lower amount of care time, poor self-rated financial status and poor accessibility to health care services were significantly associated with care recipients' perception of caregivers' reluctance to care. Our findings highlight the awareness of monitoring informal carers' willingness to care or capability to enact caring tasks.
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Song H, Sun H. Association of unmet long-term care needs with depression and anxiety among older adults in urban and rural China. Geriatr Nurs 2023; 49:115-121. [PMID: 36495793 DOI: 10.1016/j.gerinurse.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
This study examined the association of unmet long-term care (LTC) needs with depression and anxiety in older adults and explored urban-rural disparities. Cross-sectional data for 1896 respondents with a mean age of 91.58 years was from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depression and anxiety were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Unmet LTC needs were self-reported by older adults with functional limitations. Research methods included regression analyses, decomposition analyses, sensitivity analyses. Results showed that unmet LTC needs, depression, anxiety were more severe in rural older adults. Unmet LTC needs were significantly and positively related to depression and anxiety, but their associations with CESD-10 scores, depressive and anxiety symptoms were stronger in urban older adults. Urban-rural disparities in unmet LTC needs explained about 20%-40% of disparities in depression and anxiety. The findings highlighted the role of meeting LTC needs in reducing depression and anxiety, and that LTC policymakers should not ignore the needs of urban older adults and focus solely on rural older adults.
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Affiliation(s)
- Huan Song
- School of Public Administration, Nanjing Normal University, Nanjing 210023, Jiangsu, China
| | - Hui Sun
- School of Mechanical Engineering, Tianjin University, Tianjin 300350, China.
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Kong D, Liu S, Hong Y, Chen K, Luo Y. Perspectives on the popularization of smart senior care to meet the demands of older adults living alone in communities of Southwest China: A qualitative study. Front Public Health 2023; 11:1094745. [PMID: 36908438 PMCID: PMC9998995 DOI: 10.3389/fpubh.2023.1094745] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/31/2023] [Indexed: 03/14/2023] Open
Abstract
Background Older adults who live alone face challenges in daily life and in maintaining their health status quo. Currently, however, their growing demands cannot be satisfied with high quality; therefore, these demands expressed by elders may be settled in the form of smart senior care. Hence, the improvement in smart senior care may produce more positive meanings in promoting the health and sense of happiness among this elderly population. This study aimed to explore the perceptions of demands and satisfaction with regard to the provision of senior care services to the community-dwelling older adults who live alone in Southwest China, thus providing a reference for the popularization of smart senior care. Methods This study adopted a qualitative descriptive approach on demands and the popularization of smart senior care. Semi-structured and in-depth individual interviews were conducted with 15 community-dwelling older adults who lived alone in Southwest China between March and May 2021. Thematic analysis was applied to analyze the data. Results Through data analysis, three major themes and subcategories were generated: "necessities" (contradiction: more meticulous daily life care and higher psychological needs vs. the current lower satisfaction status quo; conflict: higher demands for medical and emergency care against less access at present), "feasibility" (objectively feasible: the popularization of smart devices and applications; subjectively feasible: interests in obtaining health information), and "existing obstacles" (insufficient publicity; technophobia; patterned living habits; and concerns). Conclusions Smart senior care may resolve the contradiction that prevails between the shortage of medical resources and the increasing demands for eldercare. Despite several obstacles that stand in the way of the popularization of smart senior care, the necessities and feasibility lay the preliminary foundation for its development and popularization. Decision-makers, communities, developers, and providers should cooperate to make smart senior care more popular and available to seniors living alone, facilitating independence while realizing aging in place by promoting healthy aging.
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Affiliation(s)
- Dehui Kong
- School of Nursing, Army Medical University (Third Military Medical University), Shapingba, Chongqing, China
| | - Siqi Liu
- School of Nursing, Army Medical University (Third Military Medical University), Shapingba, Chongqing, China
| | - Yan Hong
- School of Nursing, Army Medical University (Third Military Medical University), Shapingba, Chongqing, China
| | - Kun Chen
- School of Nursing, Army Medical University (Third Military Medical University), Shapingba, Chongqing, China
| | - Yu Luo
- School of Nursing, Army Medical University (Third Military Medical University), Shapingba, Chongqing, China
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Huang D, Zeng T, Mao J, Zhao M, Wu M. The unmet needs of older adults living in nursing homes in Mainland China: a nation-wide observational study. BMC Geriatr 2022; 22:989. [PMID: 36544110 PMCID: PMC9773463 DOI: 10.1186/s12877-022-03699-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The unmet needs of older adults in nursing homes could result in their poor health status physically and psychologically. The aim of this study was to understand the characteristics of unmet needs of older adults residing in nursing homes in China, and to probe into the contributing factors. METHODS In this cross-sectional design, the demographic and health status questionnaire, Modified Barthel Index, the Numerical Rating Scale for pain assessment, Geriatric Depression Scale, Camberwell Assessment of Need for the elderly were employed to survey older adults living in 38 nursing homes in 13 cities in China from July 2017 to June 2018 through a multi-stage, stratified sampling scheme. The Short Portable Mental Status Questionnaire was adopted to exclude participants with severe cognitive impairment. Aside from descriptive analysis, a raft of hierarchical logistic regression models were run by sequentially controlling for the independent variables at 5 levels (demographic characteristics, health status, pain, ADL, and depression), aiming to identify the influencing factors of the unmet needs of the residents. RESULTS The effective sample size involved 2063 older adults (63.4% female versus 36.6% male), with a response rate of 98.5%. The median and inter-quartile range of the total needs and unmet needs of the sample was 3(1, 4) and 0(0, 1) respectively, with 122 older participants having more than 3 unmet needs (high unmet need category) versus 1922 older ones having ≤ 3 unmet needs (low unmet need category). The unmet needs of older adults in nursing homes mainly fell into social domains. Gender, religion, educational background, marital status, living condition before admission, room type, incomes, staffing, number of diseases, pain, Barthel Index, and depression were contributive to unmet needs of older adults in long-term care facilities in the final model that was adjusted for all levels of variables (all p < 0.05). CONCLUSION Understanding the influencing factors of the unmet needs of older adults in long term care provides clues for healthcare professionals to offer better care for this population. System-level support to nursing homes and training of staff are highlighted. Plus, taking measures to beef up social connections for the older adults to meet their social needs was suggested.
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Affiliation(s)
- Deqin Huang
- grid.33199.310000 0004 0368 7223Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, Hubei Province China ,grid.33199.310000 0004 0368 7223School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, 430030 Wuhan, Hubei Province China
| | - Tieying Zeng
- grid.33199.310000 0004 0368 7223Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, Hubei Province China
| | - Jing Mao
- grid.33199.310000 0004 0368 7223School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, 430030 Wuhan, Hubei Province China
| | - Meizhen Zhao
- grid.33199.310000 0004 0368 7223Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, Hubei Province China
| | - Meiliyang Wu
- grid.33199.310000 0004 0368 7223Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, Hubei Province China
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Tu J, Li H, Ye B, Liao J. The trajectory of family caregiving for older adults with dementia: difficulties and challenges. Age Ageing 2022; 51:6872692. [PMID: 36469090 DOI: 10.1093/ageing/afac254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Indexed: 12/08/2022] Open
Abstract
INTRODUCTION As the main source of informal care in China, family members bear a tremendous caregiving burden, particularly in relation to older people with dementia (PwDs). However, the continuous caregiving trajectory of family caregivers was unclear. OBJECTIVES To investigate the trajectory of PwDs' family caregivers' struggles from home care to institutional care, and identify the common tipping points leading to institutional care from their perspectives. METHODS An ethnographic study was conducted in a long-term care institution in Chengdu, China, from 2019 to 2020. Face-to-face, semi-structured interviews were carried out with 13 family members (i.e. 5 spouses and 8 adult children) of older PwDs during family caregivers' visits. The interviews were recorded and transcribed, after which the transcripts were analysed using thematic analysis. RESULTS The family caregivers' experiences before and after the PwDs' institutionalization fell into two distinctive parts, and three subthemes about their caregiving experiences in each period were identified: the mental stress, the physical care burden, and the social and emotional pressure connected to home-based care; the moral pressure and emotional torment, the financial burden, and new worries after institutionalization. The tipping points in between the two stages were major changes or incidents related to the PwDs' status. Variations in the spouse and older children's care experiences also emerged. CONCLUSION Our study provides a nuanced analysis of the trajectory of family caregiving for PwDs. The plight of family caregivers at all stages should be recognized and supported with adequate medical and social resources, with a further consideration of the caregivers' relationships with the older PwDs.
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Affiliation(s)
- Jiong Tu
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, P.R. China
| | - Haiyan Li
- Law School of Chengdu University, Chengdu, P.R. China
| | - Bei Ye
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China.,Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, P.R. China
| | - Jing Liao
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China.,Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, P.R. China
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Huang L, Zhang F, Guo L, Chen Y, Feng M, You Y, Zhang L, Jiang Z, Liu Y. Experiences and expectations of receiving volunteer services among home-based elderly in Chinese urban areas: A qualitative study. Health Expect 2022; 25:3164-3174. [PMID: 36264586 DOI: 10.1111/hex.13624] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/24/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The various complex needs for assistance among home-based older adults have increased dramatically. Thus, it would be advantageous to recruit volunteers with medical knowledge and a better understanding to support and assist the elderly living in urban communities. AIM This study aimed to explore the experiences and expectations of receiving volunteer services among the home-based elderly in Chinese urban areas. DESIGN, SETTING AND PARTICIPANTS: A descriptive qualitative study was conducted following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. This study was performed in two communities in Wuhan, Hubei Province. A purposive sampling method, which includes criterion and maximum variation sampling, was used to identify and select a diverse range of participants. Semistructured face-to-face interviews with 20 older adults (aged 62-90 years old) were performed. The conventional content analysis method was used for thematic analysis. RESULTS Three categories with associated subcategories were identified: experiences of receiving volunteer services including negative and positive experiences; specific needs for volunteer services involving physiological, psychosocial, health-related behaviours and environmental domains; characteristics of expected volunteer services including availability, formats, recipients, providers and service strategies. CONCLUSIONS The volunteer services provided to the home-based elderly were found to be unsatisfactory, and lacking relevance and effectiveness. Due to a lack of family support or difficulty in meeting some high-level needs, the home-based elderly expressed a strong demand for volunteer services involving physiological, psychosocial, health-related behaviours and environmental domains. This finding can provide a basis for developing training plans beneficial to volunteers. Furthermore, the present research clarifies the criteria for selecting volunteers and the necessity of supervising and managing volunteers. Improving the effectiveness and accessibility of urban-community volunteer service may reduce the burden on care institutions and home caregivers while enhancing the quality of life and well-being of the elderly. PATIENT OR PUBLIC CONTRIBUTION Developing research questions, study design, management and conduct and interpretation of evidence.
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Affiliation(s)
- Lei Huang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengjian Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Guo
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Yuqin Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingjiao Feng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanjie You
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lihua Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziyun Jiang
- Jiukang Elderly Care Service Corporation, Wuhan, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Jiang H, Xiao S, Hu H, He H. Study on the Measurement and Influencing Factors of Care Service Demand of Disabled Elderly in Urban and Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711112. [PMID: 36078829 PMCID: PMC9518346 DOI: 10.3390/ijerph191711112] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 06/03/2023]
Abstract
Caregiving services are currently the weakest part of China's social security system for the elderly. It is well needed to investigate the fac-tors affecting the unmet care needs of the elderly with disabilities. Based on the Behavioral Model of Health Services Use (BMHSU), this paper explores the needs and influencing factors of care services for the disabled elderly in urban and rural areas using data from the 2018 Project of Social Policy Support System for Disadvantaged Families in China. The demand for care services of the disabled elderly in central and western areas is significantly higher than that in eastern, along with that in rural areas significantly higher than that in urban areas. The demands for care services of the disabled elderly in urban and rural areas are significantly affected by tendency factors, resource factors, and need factors. Urban and rural attributes, worried pension and LCI are the common influencing factors for the care service demand of the disabled elderly from economically disadvantaged families and ordinary families. The demands for care services of the disabled elderly were associated with tendencies, resources, and needs, increased chronic disease prevention and mental health services benefit caregivers.
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Affiliation(s)
- Haixia Jiang
- School of Public Administration, Hunan University, Changsha 410082, China
| | - Suhua Xiao
- School of Public Administration, Hunan University, Changsha 410082, China
| | - Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China
| | - Haotian He
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China
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13
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Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159332. [PMID: 35954687 PMCID: PMC9368037 DOI: 10.3390/ijerph19159332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022]
Abstract
Population aging has increased the demand for elderly care worldwide. The home-based elderly care system plays an important role in meeting this demand in developing countries. The quality of home-based elderly care is associated with the job satisfaction of caregivers in home-based elderly care programs, which has rarely been studied. This paper explores the factors that affect the job satisfaction of these elderly caregivers, including personal characteristics, working conditions, employment status, training, caregiver–client relationships, welfare, work experience, and burnout. It utilizes data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over the period from May to September 2021. This paper selected a sample of elderly caregivers (n = 285) to examine their job satisfaction. The results show that gender, age, marital status, how they earned the job, relation with clients, social insurance, and work experience are significantly associated with the job satisfaction of in-home elderly caregivers, and their job satisfaction is negatively associated with their burnout levels. However, training and working conditions have no significant effect on the job satisfaction of in-home elderly caregivers, which is different from previous studies on formal care workers, such as nurses, in the institutional care system.
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Park Y, Park S, Lee M. Analyzing Community Care Research Trends Using Text Mining. J Multidiscip Healthc 2022; 15:1493-1510. [PMID: 35873091 PMCID: PMC9297196 DOI: 10.2147/jmdh.s366726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study utilized text mining to analyze research trends around community care, which focuses on improving patients' quality of life by lessening the financial burden on caregivers and relieving patient discomfort. Methods To examine research trends by community care stage, Section 1 is set from 2017 to 2019, when the community care was implemented, and Section 2 from 2020 to 2021, after the end of the community care. Papers used for the analysis were extracted using the Korea Citation Index (KCI); a total of 132 articles were selected and subjected to text mining analysis. Results First, the main community care research areas included work, housing, economy, disability, and mind. Second, from 2017 to 2019, there was considerable interest in community care centered on households, and main keywords, such as nursing, family, and experience, appeared. Third, from 2020 to the present, there was high interest in community care centered on disabilities, and keywords, such as space, business, and Seoul City, appeared. Conclusion The results reveal the changing issues, with the implementation of community care. Overall, research has tended to focus on social and welfare systems, rather than health and medical systems. In the future, local, community-integrated health and medical care systems should be restructured and regional delivery systems established to make them more accessible.
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Affiliation(s)
- Yoonseo Park
- Department of Bio Medial Engineering, Ajou University, Suwon, Republic of Korea
| | - Sewon Park
- Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Munjea Lee
- Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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15
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Care poverty among older adults in East Asia: a comparison of unmet care needs between China and Taiwan. Arch Gerontol Geriatr 2022; 102:104738. [DOI: 10.1016/j.archger.2022.104738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/21/2022]
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16
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Chen R, Zhao WB, Zhang XP, Liang H, Song NN, Liu ZY, Xiao H, Peng XT, Song Y, Liao RT, Luo WH, Wei L. Relationship between frailty and long-term care needs in Chinese community-dwelling older adults: a cross-sectional study. BMJ Open 2022; 12:e051801. [PMID: 35487750 PMCID: PMC9058676 DOI: 10.1136/bmjopen-2021-051801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Our study aimed to investigate the relationship between the severity of frailty and the long-term care (LTC) needs of older adults from Chinese communities. DESIGN A cross-sectional study. SETTING Three Chinese community health centres. All data were collected by trained researchers through face-to-face collection. PARTICIPANTS We surveyed a total of 540 older residents who aged 60 or older from community in Guangzhou, China. MEASURES The Chinese version of the Tilburg frailty indicator was used to assess the frailty status of participants. LTC needs was evaluated by Integrated Home Care Services Questionnaire. Using non-adjusted and multivariate adjusted logistic regression analysis to evaluate frailty and LTC needs, then smoothed plots, threshold effect analysis and P for trend were used to further investigate the relationship between them. RESULTS The prevalence of frailty was 45.2% among the 540 older adults enrolled (aged 70.4±8.3 years; 65.7% females). 27% had higher LTC needs, which increased to 65.1% for individuals with frailty. Logistic regression analysis showed that frailty was strongly associated with LTC needs (OR 3.06, 95% CI 2.06 to 4.55, p<0.01). In the multivariate model, after adjusting for demographic characteristics, economic situation, activities of daily living and comorbidities, frailty remained significantly associated with LTC needs (OR 2.32, 95% CI 1.39 to 3.88, p<0.01). The smoothed plots showed a nearly linear relationship between frailty and LTC needs. Threshold effect analysis showed that every point increase in frailty, the score of LTC needs increased 1.3 points. The IQR to regroup individuals with frailty. Compared with the first quartile (scores ≤2), the incidence of LTC needs increased with the frailty status (p value for trend <0.01). CONCLUSION There is a linear relationship between frailty and LTC needs. With the increasing degree of frailty, the LTC needs of older adults dramatically increases.
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Affiliation(s)
- Rui Chen
- Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Wen Bo Zhao
- Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiao Pei Zhang
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Hao Liang
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Na Na Song
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhu Yun Liu
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Hui Xiao
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Nursing, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Xue Ting Peng
- Neurology, Foshan Hospital of TCM, Foshan, Guangdong, China
| | - Yang Song
- Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ruo Tong Liao
- Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Neurology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Wang Hui Luo
- Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Lin Wei
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
- Nursing, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
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Shu R, Liu C, Liang H, Liang Y. Potential mediators of the relationship between vision impairment and self-rated health in older adults: A comparison between long-term care insurance claimants in residential care institutions versus those living in the community. Geriatr Nurs 2022; 44:259-265. [DOI: 10.1016/j.gerinurse.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/24/2023]
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Wu Y, Liu Y, Su Z, Sun S, Liu C, Ding W, Gao Y. Demands for Telenursing-Based Long-Term Care Among Disabled Older Adults in Qingdao, China: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:1981-1990. [PMID: 34522091 PMCID: PMC8434935 DOI: 10.2147/ppa.s326413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the current status of and factors influencing the demands for telenursing-based long-term care in disabled older adults. METHODS In this cross-sectional study, data from 213 participants from five districts of Qingdao, China, were investigated using multistage stratified sampling. The assessment scale of the long-term care demands level and the questionnaire of the demands of telenursing-based long-term care for disabled older adults were used to estimate the demands for telenursing-based long-term care for older adults with disabilities in Qingdao. RESULTS Of the participants, 60.51% were willing to receive telenursing-based long-term care. The item with the highest score was "Internet +" information management and first aid (3.77 ± 0.71); the item with the lowest score was "Internet +" daily care (2.97 ± 0.72). Average family income (P < 0.001), age (P = 0.004) and educational level (P = 0.003) were significant factors influencing the demands for telenursing-based long-term care. CONCLUSION Disabled older adults had a high demand for telenursing-based long-term care. Urgent actions are needed to integrate telenursing with long-term care as soon as possible. In the development of telenursing-based long-term care, it is necessary to fully consider the average family income, age and educational level of disabled older adults.
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Affiliation(s)
- Yu Wu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yuxiu Liu
- School of Nursing, Weifang Medical University, Weifang, People’s Republic of China
| | - Zhe Su
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Songwei Sun
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Wei Ding
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yufang Gao
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
- Correspondence: Yufang Gao The Affiliated Hospital of Qingdao University, Qingdao, 266000, People’s Republic of ChinaTel +86-19863737553 Email
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