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Cited by 30Mindfulness and Compassion InterventionsGeriatric Care and Nursing HomesDiabetes Management and Education

Effect of a mindfulness programme for long-term care residents with type 2 diabetes: a cluster randomised controlled trial measuring outcomes of glycaemic control, relocation stress and depression

Open access
Chen, Shu‐Ming, Lin, Huey‐Shyan, Atherton, John J., MacIsaac, Richard J., Wu, Chiung‐Jung (Jo)·2020·International Journal of Older People Nursing
DOI 10.1111/opn.12312
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Abstract

Aims: The aim of this study was to determine physical, behavioural and psychosocial effects of a newly developed mindfulness programme for older adults with type 2 diabetes relocating to long‐term care facility. Background: Taiwan is viewed as an “aged society” with significant proportion of the population living in a long‐term care facility. Approximately one third of residents living in long‐term care facilities have been diagnosed with type 2 diabetes, and disruption to management of their glycaemic levels is at risk for up to one year after relocating to a long‐term care facility. Design: A cluster randomised controlled trial was used to examine the effects of a newly developed mindfulness programme on outcomes of glycaemic levels, relocation stress and depression. Methods: A total of 140 participants were recruited from six long‐term care facilities in Southern Taiwan. A mindfulness programme was delivered over 9 weeks and consisted of meditations, education and exercise techniques that were delivered by a Registered Nurse trained in mindfulness strategies. Participants in the control group received routine care as provided in the facilities, including routine check‐ups at diabetes clinics as necessary. Data were analysed by Johnson–Neyman technique and generalised estimating equations. Results: In total, 120 residents completed the study. The majority of patients were female (64.8%), and 83.5% of the sample were financially supported by their children. The results showed significant improvements in glycated haemoglobin (HbA1c), relocation stress (Wald χ2 = 78.91) and depression (Wald χ2 = 45.70) between groups. In the intervention group, the mean of HbA1c levels showed 16.4% reduction (Mean differences = 1.3;SD = 0.3). However, there were no significant differences in relocation stress and depression within groups. Conclusion: The results provided positive effects of the mindfulness programme for older people with diabetes moving into long‐term care facilities. The programme will assist in future planning for diabetes care in long‐term care facilities. Implications for practice: To incorporate the mindfulness program into existing diabetes education programs for older people living in LTCFs. Further investigation on the sustainability of the mindfulness program is warranted.

AI snapshot

Written from the paper’s full text.

TL;DR

A cluster randomised controlled trial in six Southern Taiwan long-term care facilities found that a nine-week mindfulness programme improved glycaemic control, relocation stress, and depression among older residents with type 2 diabetes. The authors report it as the first cluster RCT of mindfulness for this population.

Key findings

  • HbA1c in the intervention group fell from 8.0% (SD 1.8) to 6.9% (SD 1.3), a 1.1% reduction (t=5.6; p<.001), while the control group showed a non-significant 0.1% increase from 6.6% to 6.7% (t=-0.31; p=.75). The group-by-baseline HbA1c interaction was significant (F=9.47; p=.003), and Johnson-Neyman analysis showed significant improvement only among residents with baseline HbA1c greater than 6.75%.
  • Relocation stress showed a significant group-by-time interaction (Wald χ²=78.91; p<.001). Adjusted means were lower in the intervention group than control at 3 weeks (72.68 vs 78.27), 6 weeks (66.71 vs 74.54), and 9 weeks (54.39 vs 78.71), with between-group Wald χ² values of 9.45 (p<.01), 25.28 (p<.001), and 82.51 (p<.001), respectively.
  • Depression also showed a significant group-by-time interaction (Wald χ²=45.70; p<.001). Adjusted means were lower in the intervention group than control at 3 weeks (32.85 vs 40.27), 6 weeks (29.53 vs 37.82), and 9 weeks (23.01 vs 41.09), with between-group Wald χ² values of 17.86, 26.40, and 138.63 (all p<.001).
  • Within-group changes across four time points were significant in the intervention group for relocation stress (Wald χ²=209.75; p<.001) and depression (Wald χ²=116.94; p<.001), but not in the control group for relocation stress (Wald χ²=12.60; p>.05) or depression (Wald χ²=6.69; p>.05).

Methods

  • Cluster randomised controlled, single-blinded trial across six hospital-affiliated long-term care facilities in Southern Taiwan; three facilities were allocated to intervention (n=66) and three to control (n=74). A total of 140 participants were recruited, and 120 completed the study (60 per group).
  • Inclusion criteria: age over 65 years, diagnosed type 2 diabetes, moved into the facility within 12 months, no obvious delirium/confusion or current psychiatric illness, and able to communicate in Chinese; terminally ill residents were excluded.
  • Intervention: nine weekly 1.5-hour mindfulness sessions in groups of 8–10, including 30 minutes of mindful deep breathing relaxation and 60 minutes of mindfulness activities. Primary outcome was HbA1c at baseline and 3 months; secondary outcomes were depression (Chinese DASS-21) and relocation stress (Chinese Relocation Stress Scale) at baseline, 3, 6, and 9 weeks. Analysis used SPSS v22, GEE for depression and relocation stress, and Johnson-Neyman technique for HbA1c where interaction effects were found.

Limitations

  • The paper states the study focused on a specific cultural Taiwanese population, restricting generalisability, and that time constraints mean results may not support longitudinal effects after 9 weeks.
  • Evident from the text: only six facilities/clusters were randomised, the intervention and secondary follow-up were short (9 weeks), and HbA1c was measured only at baseline and 3 months.
  • Evident from the text: after an intention-to-treat check found no significant differences between completers and withdrawals, further analyses were performed only on participants who completed the study.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/opn.12312

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 46 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The control group reported a non-significant HbA1c level increase of 0.1% from baseline to 12-week, from 6.6 (SD=1.9) to 6.7 (SD=1.9) (t=-0.31, p=.75).

    “In comparison, the control group reported a non-significant HbA1c level increase of by 0.1% from baseline to 12-week respectively (M = 6.6;SD = 1.9) to (M = 6.7;SD = 1.9) (t= -0.31, p=.75).”
    Quote in the paperNot a substantial claim
  • Findingown data

    There was a significant interaction effect between the four time points and two different groups in the depression scores (Wald chi-square=45.70; p<.001).

    “Results identified a significant interaction effect between the four-time points and two different groups in the depression scores (controlling for baseline test) (Waldχ 2 = 45.70;p <.001) (Figure 3B).”
    Quote in the paperSubstantial claim
  • Findingown data

    The mindfulness program did significantly improve HbA1c among residents with baseline values greater than 6.75%.

    “The result showed mindfulness program did significantly improve HbA1c among residents with baseline values greater than 6.75%.”
    Quote in the paperSubstantial claim
  • Findingown data

    No significant differences were identified between participants who completed the study and those who withdrew.

    “No significant differences were identified therefore further data analyses were performed only on participants who completed the study.”
    Quote in the paperSubstantial claim
  • Findingown data

    The interaction of group and baseline HbA1c was significant (F=9.47; p=.003).

    “However, because the interaction of group and baseline HbA1c was significant (F= 9.47; p=.003), Johnson-Neyman-Technique rather than independent samples one-way ANCOVA was used to explore the intervention effect on HbA1c.”
    Quote in the paperSubstantial claim
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 17
  • The quote only partly states this claim. 2

  • May combine two claims.

    Findingown data

    In the intervention group, depression post-test scores were all smaller than pre-test scores, indicating that after the intervention, participants' depression scores decreased significantly by the 9th week.

    “The scores in the post-tests were all smaller than the pre-test scores (Table 2), indicating that after the intervention, participants' depression scores decreased significantly by the 9th week of intervention.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The adjusted depression scores of participants in the intervention group were significantly lower than those in the control group at T1 (Wald chi-square=17.86; p<.001), T2 (Wald chi-square=26.40; p<.001) and T3 (Wald chi-square=138.63; p<.001).

    “The adjusted depression scores of participants in the intervention group were significantly lower than those in the control group at T1 (Waldχ 2 = 17.86; p <.001), T2 (Waldχ 2 = 26.40;p <.001) and T3 (Waldχ 2 = 138.63;p<.001) respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The adjusted relocation stress scores of participants in the intervention group were significantly lower than those in the control group at T1 (Wald chi-square=9.45; p<.01), T2 (Wald chi-square=25.28; p<.001) and T3 (Wald chi-square=82.51; p<.001).

    “The adjusted relocation stress scores of participants in the intervention group were significantly lowered than those in the control group at T1 (Waldχ 2 = 9.45; p <.01), T2(Waldχ 2 = 25.28;p <.001) and T3 tests, respectively (Waldχ 2 = 82.51;p<.001).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the intervention group, relocation stress post-test scores were all smaller than pretest scores, indicating that after the mindfulness intervention, participants' relocation stress decreased significantly and had improved at the 9th week.

    “The scores in the post-tests were all smaller than the pretest scores (Table 2), indicating that after the mindfulness intervention, participants' relocation stress decreased significantly and had improved at the 9th week (T3).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no significant differences in control and intervention groups, indicating similar demographic profiles of the participants.

    “There were no significant differences in control and intervention groups, indicating similar demographic profiles of the participants (Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The DASS-21 (Chinese version) has good internal consistency of .92 for depression, .94 for anxiety, and .91 for stress subscales.

    “The DASS-21 (Chinese version) consists of 21 items with a 4-point Likert scale with good internal consistency of .92 for depression, .94for anxiety, and .91 for stress subscales (Moussa, Lovibond, & Laube, 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moussa, Lovibond, & Laube, 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Approximately one third of residents living in long-term care facilities in Taiwan are diagnosed with type 2 diabetes.

    “Additionally, approximately one third of residents living in LTCFs in Taiwan are diagnosed with type 2 diabetes, and this figure continues to grow (Liu et al, 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Liu et al, 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The Relocation Stress Scale (Chinese version) has good internal consistency of .72.

    “The Relocation Stress Scale (Chinese version) consists of a 29-item functional assessment of health status with a 5-point Likert scale (5 is the highest, 1 is the lowest), and has good internal consistency of .72 (Yang, Chen, Kuo, & Lee, 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Yang, Chen, Kuo, & Lee, 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Less stringent HbA1c levels of 7.0% (53 mmol/mol) for older adults are recommended.

    “Thus, less stringent HbA1c levels of 7.0% (53 mmol/mol) for older adults are recommended (American Diabetes Association, 2019;Inzucchi et al., 2015).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites American Diabetes Association, 2019

      Not checked in the free run.

    • cites Inzucchi et al., 2015

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Residents with depressive symptoms and decreased function are less likely to adhere to treatment regimens and physical activity recommendations, which can result in poor management of blood sugar levels.

    “Consequently residents are less likely to adhere to treatment regimens and physical activity recommendations, which can result in poor management of blood sugar levels (Khullar et al., 2016;Asuzu, Walker, Williams, & Egede, 2017;Indelicato et al., 2017;Gonzalez et al., 2018;Retornaz, Grino, Mari,& Oliver, 2017;Brownley, Boettiger, Young, & Cefalu, 2015).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Khullar et al., 2016

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    • cites Asuzu, Walker, Williams, & Egede, 2017

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    • cites Indelicato et al., 2017

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  • May combine two claims.

    Interpretationown data

    Residents in the intervention group achieved a 1.1% reduction in HbA1c levels, which proposes significant health benefits.

    “Residents in the intervention group achieved a 1.1% reduction in HbA1c levels, which proposes significant health benefits.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    Sample size calculation determined that 60 participants per group were required, calculated on a total sample of 140, allowing for attrition rate of 20% on primary outcome of HbA1c, with 90% power and an alpha of .05.

    “To identify significant differences between groups, it was determined that 60 participants per group were required.This was calculated on a total sample of 140, allowing for attrition rate of 20% on primary outcome of HbA1c, with 90% power and an α of .05(Cohen, 1988;Tovote et al., 2014).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Cohen, 1988

      Not checked in the free run.

    • cites Tovote et al., 2014

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  • May combine two claims.

    Premisecitation

    Relocation to a long-term care facility is a significant stressful life event for older adults and has potentially caused negative psychological outcomes.

    “Relocation to a LTCF is a significant stressful life event for older adults and has potentially caused negative psychological outcomes (Fitzpatrick &Tzouvara, 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Fitzpatrick &Tzouvara, 2017

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Previous research has demonstrated reduced psychological distress, anxiety, depression, and improved quality of life, well-being and glycemic control for patients with chronic conditions such as type 2 diabetes, cancer, chronic pain, and eating disorders, following implementation of a mindfulness program.

    “Previous research has demonstrated reduced psychological distress, anxiety, depression, and improved quality of life, well-being and glycemic control for patients with chronic conditions such as type 2 diabetes, cancer, chronic pain, and eating disorders, following implementation of a mindfulness program (Hartmann et al., 2012;Alsubaie et al., 2017;Dinardo et al., 2017;Pascoe, Thompson & Chantal,”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hartmann et al., 2012

      Not checked in the free run.

    • cites Alsubaie et al., 2017

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    • cites Dinardo et al., 2017

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Clinical symptoms of relocation stress may continue throughout the first year after moving into a long-term care facility.

    “Although residents, family members and caregivers may expect the stress of relocation to diminish soon after the resident has become oriented to their new home, clinical symptoms may continue throughout the first year (Fitzpatrick & Tzouvara, 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fitzpatrick & Tzouvara, 2019

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    More than 30% of long-term care facility residents present with depressive symptoms and decreased physical, cognitive and social function.

    “More than 30% of residents present with depressive symptoms and decreased physical, cognitive and social function (Fiocco & Mallya, 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fiocco & Mallya, 2015

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Negative psychosocial impacts of relocation for people with type 2 diabetes include increased stress, anxiety, depression, confusion, feelings of loneliness and hopelessness.

    “Such impacts include increased stress, anxiety, depression, confusion, feelings of loneliness and hopelessness (Yang, Chen, Kuo, & Lee, 2014;Fitzpatrick & Tzouvara, 2018).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Yang, Chen, Kuo, & Lee, 2014

      Not checked in the free run.

    • cites Fitzpatrick & Tzouvara, 2018

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All sessions in the mindfulness program were delivered by a Registered Nurse who had received additional training qualifications teaching mindfulness.

    “All sessions in the mindfulness program were delivered by a Registered Nurse who had received additional training qualifications teaching mindfulness.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    HbA1c levels greater than 8.0% increase risk of all-cause mortality in older adults with diabetes and are associated with poor cardiovascular outcomes.

    “HbA1c levels >8.0% increase risk of all-cause mortality in older adults with diabetes and are associated with poor cardiovascular outcomes (Palta, Huang, Kalyani, Golden, Yeh, 2017;Schmitt et al., 2015;Asuzu, Walker, Williams, & Egede, 2017;Indelicato et al., 2017).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Palta, Huang, Kalyani, Golden, Yeh, 2017

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    • cites Schmitt et al., 2015

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    • cites Asuzu, Walker, Williams, & Egede, 2017

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mindfulness programs can provide training in body scan meditations, yoga stretches and postures, mindful meditation, awareness and use of a nonjudgmental perspective.

    “Mindfulness programs can also provide training in body scan meditations, yoga stretches and postures, mindful meditation, awareness and use of a nonjudgmental perspective (Whitebird, Kreitzer, Vazquez, & Enstad, 2018;Gallegos, Hoerger, Talbot, Moynihan, & Duberstein, 2013).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Whitebird, Kreitzer, Vazquez, & Enstad, 2018

      Not checked in the free run.

    • cites Gallegos, Hoerger, Talbot, Moynihan, & Duberstein, 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A research assistant blinded to the study protocol undertook data collection at baseline, three, six and nine weeks.

    “A research assistant, blinded to the study protocol, was employed to undertake data collection at baseline (T0), three (T1), six (T2) and nine (T3) weeks.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Six centers were randomly allocated into the intervention group (3 facilities, n=66) or control group (3 facilities, n=74).

    “After obtaining agreements from facility authorities to participate to the study, six centers were randomly allocated into the intervention group (3 facilities, n=66) or control group (3 facilities, n=74) (Figure 1).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A cluster randomized controlled, single blinded trial was used to examine the effect of the mindfulness program.

    “A cluster randomized controlled, single blinded trial was used to examine the effect of the mindfulness program.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Following Intention-to-Treat principles, analysis was undertaken at TI to compare differences between participants who completed the study and those who withdrew.

    “Following Intention-to-Treat (ITT) principles, analysis was undertaken at TI to compare differences between participants who completed the study and those who withdrew.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Within one year of moving into a long-term care facility, residents with type 2 diabetes develop persistently higher blood sugar levels and are more likely to be hospitalized than people who have been living in the facility over one year.

    “It is reported that within one year of moving into a LTCF residents with type 2 diabetes develop persistently higher blood sugar levels and are more likely to be hospitalized than people who have been living in the LTC over one year (Lin, Tsai, Chiang, & Koo, 2010;Newton et al., 2013;Yang, Chen, Kuo, &Lee, 2014).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Lin, Tsai, Chiang, & Koo, 2010

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    • cites Newton et al., 2013

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    • cites Yang, Chen, Kuo, &Lee, 2014

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  • The quote only partly states this claim.

    Interpretationown data

    The findings of this study support the mindfulness intervention as a way of minimizing relocation stress and depression in this specific cohort of older adults with diabetes in long-term care facilities.

    “The findings of this study support the mindfulness intervention as a way of minimizing the relocation stress and depression in this specific cohort.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Due to time constraints, the results may not support longitudinal effects of the programme on the same outcomes after 9 weeks.

    “Also due to time constraints results may not support longitudinal effects, after 9 weeks, of the program on the same outcomes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Randomization was applied at facility level only, and 140 individuals stayed within their allocated facility.

    “*140 individuals stayed within their allocated facility, randomization applied at facility level only”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A major strength of the study was the context of the sessions used to implement friendly, customized-training elements of the mindfulness programme for the participating residents.

    “The major strengths of this study were the contexts of sessions used to implement friendly customized-training elements of the mindfulness program for participated residents.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evidence shows benefits of mindfulness programmes for a range of clinical populations on depression, anxiety and stress in older adults.

    “Although evidence shows the benefits of mindfulness program for a range of clinical populations on depression, anxiety and stress in older adults (Li & Bressington, 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Li & Bressington, 2019

      Not checked in the free run.

  • The quote only partly states this claim.

    Interpretationcitation

    The present study's findings on relocation stress and depression were consistent with previous studies of mindfulness programmes.

    “These findings were consistent with previous studies reporting on a mindfulness program”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The learnt skills of a mindfulness programme effectively reduce negative mood states, with improvements reported in patients with type 2 diabetes in emotional distress, quality of life, and ability to change stress perceptions.

    “The learnt skills of a mindfulness program are reported to effectively reduce negative mood states (Van Son et al., 2013), with improvements noted in patients with type 2 diabetes and their levels of emotional distress, quality of life, and individual ability to change”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Van Son et al., 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stress and depression in older adults with chronic diseases might differ in presentation from stress and depression in younger adults.

    “Research suggests that stress and depression in older adults with chronic diseases might differ to presentation of stress and depression in younger adults (Fitzpatrick &Tzouvara, 2018;Li & Bressington, 2019;Geiger et al., 2016;Karlin, et al., 2013;Mallya & Fiocco, 2016;Dinardo et al., 2017).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Fitzpatrick &Tzouvara, 2018

      Not checked in the free run.

    • cites Li & Bressington, 2019

      Not checked in the free run.

    • cites Geiger et al., 2016

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33 of 33

  • The paper relies on this without support.

    Limited evidence is found for mindfulness programs designed specifically for older adults with type 2 diabetes and living in a long-term care facility.

    “Despite the apparent benefits of mindfulness programs, limited evidence is found for such programs designed specifically for older adults with type 2 diabetes and living in a LTCF.”

  • The paper relies on this without support.

    The six long-term care facilities provided similar diabetes care programs and had capacity for 200 to 250 residents of similar ethnicities, age groups, and nurse-resident ratios.

    “Each LTCF provided similar diabetes care programs and had capacity for 200 to 250 residents of similar ethnicities, age groups, and nurse-resident ratios.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • SPSS version differs between methods and reference

    Minor

    The methods identify SPSS Version 22.0, whereas the cited IBM reference identifies Version 24.

  • Intervention-group financial-support percentage does not match count

    Minor

    The table reports 7 of 62 intervention participants as receiving financial support from themselves, or 11.1%. That fraction is 11.29%, which rounds to 11.3% at the printed precision.

    Reported 11.1 · recomputed 11.290323

  • Reported 46.2% within 12 months conflicts with eligibility criterion

    Minor

    The results say only 46.2% of participants moved into the facility within 12 months, but moving in within 12 months was an inclusion criterion for every participant.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Gadsby R., 2018, Diabetes care for older people: A practical view on management, Diabetes & Primary Care, 20, 27
  2. IBM Corp., 2016, IBM SPSS statistics for Windows, Version 24.0
  3. Ministry of the Interior Taiwan, 2017, Interior national indicators‐land and population (online)
  4. Moussa M. T., 2003, Psychometric properties of a Chinese version of the 21‐item depression anxiety stress scales (DASS21)
  5. Social and Family Affairs Administration, Ministry of Health and Welfare, 2016, Economic safety for older adults

Cited by

Sorted by citations

Related

Authors
Chen, S., Lin, H., Atherton, J. J., MacIsaac, R. J., & Wu, C. (.
Affiliations
  • Fooyin University (TW)
  • Queensland University of Technology (AU)
  • The University of Melbourne (AU)
  • The University of Queensland (AU)
Corresponding author
Wu, Chiung‐Jung (Jo)
ORCID
Venue
International Journal of Older People Nursing
Publisher
Wiley
Published
2020-02-26
Volume
15
Issue
3
Pages
e12312-e12312
ISSN
  • 1748-3735 (ISSN-L)
  • 1748-3743
DOI
10.1111/opn.12312
OpenAlex
W3006887419
Semantic Scholar
28f0d4ad61e281e330b5ec898e5f25dad11fce5d
Cited by
30
References
49
Citations by year
2026: 3 · 2025: 6 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 2
FWCI
1.50
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • International Journal of Older People Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
Ministry of Science and Technology (MOST 105‐2410‐H‐242‐002)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
type 2 diabetes, long-term care residents, older adults, glycemic control, HbA1c, relocation stress, depression, diabetes education, nursing interventions, Taiwan
MeSH terms
Glycemic Control, Aged, Depression, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Long-Term Care, Male, Patient Transfer, Taiwan, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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