Background The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. Methods Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. Results Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 ( p < .001, Cohen's d = 1.74), GAD-7 ( p < .001, d = 1.71), GDS ( p < .001, d = 1.30), K-10 ( p < .001, d = 1.93), and SDS ( p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. Conclusion ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.

Background The rampant spread of the novel coronavirus disease (COVID‐19) has assumed pandemic proportions across the world. Attempts to contain its spread have entailed varying early screening and triage strategies implemented in different countries and regions. Aim To share the experience of scientific and standardized management of fever clinics in China, which provide the first effective checkpoint for the prevention and control of COVID‐19. Introduction A fever clinic was established at our hospital in Tianjin, China, for initially identifying suspected cases of COVID‐19 and controlling the spread of the disease. Methods The management system covered the following aspects: spatial layout; partitioning of functional zones; a work management system and associated processes; management of personnel, materials and equipment; and patient education. Results Within two months of introducing these measures, there was a comprehensive reduction in the number of new COVID‐19 cases in Tianjin, and zero infections occurred among medical staff at the fever clinic. Discussion The fever clinic plays an important role in the early detection, isolation and referral of patients presenting with fevers of unknown origin. Broad screening criteria, an adequate warning mechanism, manpower reserves and staff training at the clinic are essential for the early management of epidemics. Conclusion The spread of COVID‐19 has been effectively curbed through the establishment of the fever clinic, which merits widespread promotion and application. Implications for nursing and health policies Health managers should be made aware of the important role of fever clinics in the early detection, isolation and referral of patients, and in the treatment of infectious diseases to prevent and control their spread. In the early stage of an epidemic, fever clinics should be established in key areas with concentrated clusters of cases. Simultaneously, the health and safety of health professionals require attention.

Aim This research aimed to shed light on the relationship between the sociodemographic characteristics of front‐line medical workers and their anxiety and depression, to provide the basis and reference for targeted mental health education and for relevant departments to formulate appropriate policies during the COVID‐19 outbreak. Methods This study adopted a convenient sampling method and examined the psychological status of 150 front‐line medical workers from Zhejiang Province with questionnaire surveys using the Hamilton Anxiety and Depression Scale. Results The participants had severe anxiety and depression; the top three items under the category of anxiety were genitourinary symptoms, behavior at interview, and respiratory symptoms, whereas the top three items under depression were feelings of guilt, weight loss, and retardation. Among all personal data, the following factors influenced anxiety, in decreasing order: degree of suspicion of being infected when showing associated symptoms, degree of fear of yourself and your family being infected, and the affiliated hospital ( p < .05). As for depression, the factors were the degree of suspicion of being infected when showing associated symptoms and the degree of fear of yourself and your family being infected ( p < .05). Conclusion This study revealed that front‐line medical staff presented symptoms of anxiety and depression when dealing with the COVID‐19 outbreak and the factors influencing their psychological stress. Guiding policies and psychological interventions is crucial to maintaining their psychological well‐being. Different measures may be implemented to solve this problem.

Background Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD. Methods A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT. Results ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group. Conclusions ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.

Background The home environment is an important means of support in home-based care services for older people. A home environment that facilitates healthy aging can help older adults maximize their self-care abilities and integrate and utilize care resources. However, some home environments fail to meet the needs of older adults with disabilities. Objective This paper aimed to study the needs of older adults with disabilities with respect to adaptation to aging, and to analyze the associations of individual factors and dysfunction with those needs. Methods A questionnaire survey was administered to 400 older adults with disabilities from 10 communities in Ningbo City, Zhejiang Province, China. The survey was conducted from August 2018 to February 2019. Results A total of 370 participants completed the survey. The proportion of participants with mild dysfunction was the highest (128/370, 34.59%), followed by those with extremely mild (107/370, 28.92%), moderate (72/370, 19.46%), and severe (63/370, 17.03%) dysfunction. The care needs of older adults with extremely mild and mild dysfunction pertained primarily to resting, a supportive environment, and transformation of indoor activity spaces. The care needs of older adults with moderate dysfunction pertained mainly to resting and renovation of bathing and toilet spaces. Factors influencing the needs of older adults with disabilities were dysfunction (P=.007), age (P=.006), monthly income (P=.005), and living conditions (P=.04). Conclusions The needs of older adults with disabilities varied by the degree of dysfunction, and many factors influenced these needs in the community. These findings may provide a scientific basis for developing community-specific aging-related adaptation services for older adults with disabilities in the future.