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Factors impeding physical activity in older hospitalised patients: A qualitative meta‐synthesis

Abstract

Background

Older hospitalised patients have low levels of physical activity and multiple impairing factors.

Aims

To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs.

Design

Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations.

Methods

An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results.

Results

In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level.

Conclusion

Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older.

No Patient or Public Contribution

This study is a meta-synthesis and does not require relevant contributions from patients or the public.

What is already known

Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity.

What this paper adds

Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.

Clinical study on the role of LncRNA STX17‐AS1 in wound healing and hypertrophic scar formation

Abstract

Wound healing is a complex process that can lead to hypertrophic scarring (HS) when dysregulated. The role of lncRNAs in this process is increasingly recognized, yet the specific contributions of lncRNA STX17-AS1 require elucidation. This study investigated the expression of STX17-AS1, its regulatory effects on miR-145-5p, and downstream targets, highlighting its impact on wound repair and HS development. In a cohort of 20 HS patients and 20 matched controls, we assessed the expression of STX17-AS1, miR-145-5p and PDK1 via real-time PCR and immunohistochemistry. We correlated these expressions with wound characteristics and analysed their regulatory impact on the PI3K/AKT pathway, crucial for cellular proliferation and migration in wound healing. Elevated levels of STX17-AS1 and miR-145-5p in patient samples were correlated with larger wound areas and slower healing rates, suggesting the regulatory imbalance in scar formation. The negative correlation of PDK1 expression with age and its positive association with wound size underscored its relevance in wound repair mechanisms. Functional analysis confirmed the interaction between STX17-AS1 and miR-145-5p and modulation of PDK1, indicating the potential disruption of the PI3K/AKT pathway in the wound healing process. The study identified lncRNA STX17-AS1 as the significant mediator in wound healing, with aberrations in its pathway correlating with impaired healing and HS. The findings proposed lncRNA STX17-AS1 and miR-145-5p as molecular targets to enhance wound healing and prevent pathological scarring, offering a new avenue for therapeutic advances in wound management and regenerative medicine.

Fall status and risk factors in older Chinese adults: A cross‐sectional study

Abstract

Aim

To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China.

Methods

From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio-demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi-squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study.

Results

Of the 1712 geriatric outpatients recruited, 1626 participants (60–79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60–79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p = .007), use of a walking assistance device (p < .001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089–11.806, p < .001), living arrangement (p = .004), timed up and go test (TUGT) (p = .007) and three diseases or above (OR = 2.496, 95% CI = 1.358–11.4.586, p = .003) reached statistical significance.

Conclusions

Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life.

Relevance to Clinical Practice

The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall-related injuries, which has practical significance for promoting healthy aging.

Patient or Public Contribution

The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall-related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript.

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