Health professionals need continuing education to maintain their qualifications and competency. Online learning increases the accessibility and flexibility of continuing education. Assessment of nurses’ attitudes toward, and needs for, online learning can provide suggestions regarding learning program design and delivery. This study aimed to evaluate Chinese nurses’ attitudes toward, and needs for, online learning, and to explore the differences in attitudes and needs between nurses working in rural and urban hospitals. This work is a secondary analysis of a multicenter cross-sectional study conducted in Shanghai in 2015 (n = 550). Multiple regression techniques were used to determine the factors associated with nurses’ attitudes toward, and needs for, online learning. Results showed that nurses in rural hospitals had more positive attitudes toward online learning (102.7 ± 14.2) than those in urban hospitals (98.3 ± 12.9) (p < 0.001). For rural hospitals, nurses who could use computers and access the internet in their workplace reported more positive attitudes than those who could not. For urban hospitals, nurse educators showed significantly more positive attitudes than others. Communication skills (86.5%) and patient education (86.3%) were the most commonly-reported learning needs for nurses regardless of their working settings. Chinese nurses were willing to adopt online learning as a continuing education method. Nurses working in rural hospitals displayed more positive attitudes toward, and needs for, online learning than those working in urban hospitals. Nursing educators and managers should develop online learning programs and provide appropriate support to fulfill nurses’ learning needs, especially for those working in rural healthcare settings.

Background: Older adults with physical disability need long-term services and support, which incur enormous costs. However, supportive environments may reduce disability and promote aging in place. It is unclear how the physical and social environment affect different types of functional impairments and influence the performance of activities of daily living (ADL) in physically disabled older adults. Objective: The purpose of this study was to examine the relationship between person, environmental factors, and ADL performance among physically disabled older adults living at home. Methods: This was a cross-sectional study. Using long-term care insurance claims data from a pilot city in China, we used a structural equation model to assess the potential paths among person, environmental factors, and ADL performance. Results: Education and income had different influences on the social environment and physical environment. The functional impairments had significant effects on ADL performance, either directly or through physical environment (with handrails) and social environment (family support). Conclusions: The present findings offer crucial evidence for understanding the interactions between a person and the environment, as well as their influence on physical ADLs, suggesting the importance of a supportive environment and a subpopulation-targeting strategy for disabled older adults.

Psychological well-being is becoming an increasingly important part of the public health mission, and is multifaceted and has various interrelated dimensions. A thorough understanding of its presentation patterns (i.e., subtypes) and change process is essential for effective interventions. However, longitudinal research examining the subtypes of psychological well-being among Chinese older adults remains scarce, and little is known about the factors influencing the belonging and transition of these subtypes. We used two waves of national longitudinal data (2011 and 2014) from the Chinese Longitudinal Healthy Longevity Survey, with 5778 respondents aged 65 and above. Psychological well-being was assessed by eight indicators from three dimensions: quality of life, positive feelings, and negative feelings. Latent profile transition analysis was used to identify subtypes of psychological well-being and explore the transition of older adults among different subtypes over time. Four distinct subtypes of psychological well-being were identified, with the Mainly Unhappy Subtype being prevalent among Chinese older adults. Unhappiness and uselessness were indicative; eliminating unhappiness was vital to complete psychological recovery; feeling of uselessness was found as a crossroads in the process of psychological health. The psychological well-being of older adults was unstable; emotion blunting was found in the transition from the Mainly Unhappy Subtype to the Satisfied and Positive Subtype, and emotion augmentation was found in the transition from the Resilient yet Useless Subtype to the Discontented and Negative Subtype. A paradox in aging was observed in the membership of the Mainly Unhappy Subtype and the Discontented and Negative Subtype. Marital status, residence, education, household income, exercise, and leisure activity were significantly positively related to both initial membership and transition of the psychological well-being subtypes. Smoking status, drinking status, and social support were significantly associated with the transition between subtypes. Physical health was significantly correlated with the initial subtype membership. Our findings suggest some indicators and critical steps in improving psychological well-being among older adults. These provide insight for healthcare professionals and policymakers to develop tailored interventions considering subtypes and individual characteristics.

This study aimed to identify multimorbidity patterns and explore the disablement process by utilizing the model raised by Verbrugge and Jette as a theoretical framework. This cross-sectional study used public Long-term Care Insurance (LTCI) claimants’ assessment data of Yiwu city in Zhejiang Province, China, for 2604 individuals aged 60 years and older, from September through December 2018. Latent Class Analysis (LCA) was conducted using 10 common chronic conditions. Structural Equation Modeling was used to examine the disablement process. The latent classes of multimorbidity patterns were the “coronary atherosclerotic heart disease” class (19.0%), the “lower limb fractures” class (26.4%), and the “other diseases” class (54.6%). The structural model results show that coronary atherosclerotic heart disease had a significant influence on incontinence, but it was not statistically significant in predicting vision impairment and mobility impairment. Lower limb fractures had significant effects on vision impairment, incontinence, and mobility impairment. Vision impairment, incontinence, and mobility impairment had significant effects on physical activities of daily living (ADLs). Our findings suggest that different impairments exist from specific patterns of multimorbidity to physical ADL disability, which may provide insights for researchers and policy makers to develop tailored care and provide support for physically disabled older people.

This policy brief aims to help policymakers develop inter-sectoral interventions in megacities to prevent and control COVID-19. Based on the case of Changning District in Shanghai, China, several policy options are identified. The guiding principles include ensuring a coordinated national response (i.e., moderation is required in epidemic prevention and control); making science-based, precise, and differentiated epidemic control strategies; and establishing a joint prevention and control mechanism. Policy tools include localized management, closed-loop management, community grid management, digital management, and sub-population management. There is no “one size fits all” policy; however, it will be helpful to learn by trial and error through on-the-ground experience with minimal information in real time.