Huichao Zhang

Background: Although intensive care unit‐acquired weakness (ICU‐AW) is well recognized, its conventional focus on limb and trunk weakness overlooks the critical domain of oropharyngeal function. Although oral frailty has been described in geriatric and community settings, there remains no ICU‐specific, experience‐informed conceptualisation of ICU‐acquired oral frailty. Aim: This study aimed to explore and conceptually define ICU‐acquired oral frailty from the perspectives of patients, family members and clinicians. Study Design: A qualitative exploratory study was conducted in two Chinese intensive care units. Semi‐structured interviews were performed with a purposive sample of former ICU patients, family members, ICU physicians and ICU nurses. Data were analysed using inductive thematic analysis, with data sufficiency considered at the level of the overall multi‐perspective dataset rather than within each participant subgroup. Findings: Twenty‐four participants were interviewed (2 former ICU patients, 8 family members, 6 ICU physicians and 8 ICU nurses). Analysis revealed four central themes: Disruption of Bodily Integrity, The Barrier to Communication, Yearning for Professional Guidance and Challenges in Clinical Management. These themes were generated from analysis of an integrated multi‐perspective dataset. Conclusions: ICU‐acquired oral frailty is a distinct, multifaceted syndrome affecting physical, psychological and social well‐being. It remains under‐recognized because of the lack of an ICU‐specific conceptual definition and context‐appropriate assessment tools. Relevance to Clinical Practice: Recognizing this syndrome is a necessary first step towards developing targeted interventions and future assessment frameworks to support recovery of essential oral functions and improve long‐term quality of life after critical illness.

Background: Patients with advanced hepatocellular carcinoma (HCC) and decompensated cirrhosis face a poor prognosis and complex decision-making. Advance care planning (ACP) can improve end-of-life care but is underutilised in China, where family-centred decision-making is predominant. The needs and experiences regarding ACP for this specific population and their families remain largely unexplored. Aim: To explore the needs, preferences, and barriers to ACP implementation among families of Chinese patients with advanced HCC and decompensated cirrhosis within a family-centred decision-making model. Design: A qualitative study informed by a phenomenological perspective, following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: Purposive sampling was used to recruit primary family decision-makers of patients with advanced HCC (BCLC Stage C/D) and decompensated cirrhosis (Child-Pugh B/C) from a major tertiary hospital in China. Semi-structured interviews were conducted between May and October 2024. Data were analysed using inductive reflexive thematic analysis. Results: In-depth interviews with 20 family members revealed four main themes: 1) The Dual Dilemma of Cognitive Fog and Emotional Preparedness, 2) The Cultural Negotiation of Value Prioritization and Decision-Making Authority, 3) The Dynamic Network of Communication Bridges and Role Coordination, 4) The Dual Call for Institutional Safeguards and Plan Flexibility. Conclusion: Implementing ACP for advanced HCC patients in China requires addressing significant knowledge gaps, emotional ambivalence, and complex cultural dynamics. Effective strategies must be family-centred, involve healthcare professionals as skilled guides and moderators, ensure institutional recognition of ACP plans, and accommodate their dynamic nature. This study provides a foundation for developing culturally sensitive ACP models in China and similar contexts.

Aim: To explore the perceptions of elderly patients with chronic diseases and their healthcare providers on the use of wearable devices for home health monitoring, identifying barriers and facilitators to their effective adoption in China’s rapidly aging population. Background: As China’s population ages, managing chronic diseases among elderly patients has become increasingly complex. Wearable health monitoring devices offer a promising solution, enabling remote and continuous health tracking. However, the adoption of these devices remains limited, particularly among elderly patients. Understanding the perspectives of both patients and healthcare providers is crucial for optimizing wearable device use in chronic disease management. Design: A qualitative descriptive study. Method: From May 2023 to March 2024, semistructured interviews were conducted with 16 elderly patients and 11 healthcare providers in Nanjing, China. Participants were selected through purposive sampling. Data were analyzed using Colaizzi’s 7‐step method, generating key themes that address both the challenges and opportunities in adopting wearable health technologies. Findings: Seven major themes emerged: (1) Technology Acceptance and Motivation, (2) Changes in Social Support and Interaction, (3) Adjustments in Healthcare Work Modes, (4) Barriers and Risks in Technology Application, (5) Device Compliance and Knowledge Gaps, (6) Identifying Key Features for Quality Assessment of Wearable Devices, and (7) The Role of Customization and Adaptability. While the potential benefits of wearable devices for chronic disease management were widely recognized, concerns about complexity, cost, and data security were key obstacles. Conclusion: Wearable devices hold significant potential for improving the management of chronic diseases among elderly patients, yet multiple barriers hinder their widespread adoption. Addressing issues related to usability, privacy, and affordability, alongside providing education and policy support, will be critical to enhancing their integration into healthcare settings. Implications for the Profession and Patient Care: This study underscores the importance of creating targeted strategies to overcome the challenges in using wearable health devices among elderly patients. Healthcare providers and policymakers should focus on simplifying technology, enhancing patient education, and addressing privacy concerns to foster broader acceptance and use of these devices in chronic disease care. Impact: By promoting the adoption of wearable health technologies, healthcare systems can improve chronic disease management outcomes for elderly patients, reduce the burden on healthcare services, and support a more patient‐centered approach to care. Patient or Public Contribution: Elderly patients with chronic diseases and their healthcare providers contributed valuable insights by sharing their experiences with wearable health monitoring devices, shaping the study’s findings.

Aims The goal of this study was to explore caregivers' experiences, perspectives, emotions, knowledge and needs in caring for older people during the COVID-19 pandemic. These included, but were not limited to, experiences in hospital care, home care and nursing home care. Background Because of the high mortality rate associated with the COVID-19 pandemic, senior care is critical. During the COVID-19 pandemic, caregivers caring for older people have had unique experiences potentially affecting the quality of care provided. This topic has received substantial attention since the start of the pandemic and has been studied by numerous researchers. However, experiences may differ among countries and time periods. In addition, no qualitative systematic reviews on this topic appear to have been published. Evaluation In this systematic review of qualitative studies, data were collected from the following electronic databases: PubMed, Web of Science, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Science Direct and PsycINFO. Titles and abstracts were screened according to the inclusion and exclusion criteria, full texts were screened and the methodological quality of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research by two independent reviewers. Key issue(s) A total of 141 findings were extracted and aggregated into 20 categories; 6 synthesized findings were identified. Conclusion This review indicates caregivers' experiences and perceptions regarding caring for older people during the COVID-19 pandemic. The results of a qualitative systematic review show that caregivers' emotions, cognitions and knowledge have affected the quality of caregivers' senior care services during the pandemic. Caregivers caring for older adults should practise self-awareness, understanding their knowledge and attitudes to improve the quality of senior care. Moreover, health care administrators and policymakers should make concerted efforts to cultivate a better working environment. Implications for Nursing Management Managers should formulate timely and effective management strategies. During the COVID-19 pandemic, the workload of caregivers has increased, thus requiring better scheduling by managers. Furthermore, managers should consider the negative emotions of caregivers and prevent negative emotions from affecting their work. Besides, virtual technology should be applied to senior care and psychological support be provided for caregivers in this special care setting.