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Effective communication between nurses and patients with dementia promotes the quality of patient care by improving the identification of patient needs and by reducing the miscommunication-related frustration of patients and nurses. This... more
Effective communication between nurses and patients with dementia promotes the quality of patient care by improving the identification of patient needs and by reducing the miscommunication-related frustration of patients and nurses. This study evaluates the effects of an advanced innovative Internet-based communication education (AIICE) program on nurses' communication knowledge, attitudes, frequency of assessing patient communication capacity, and communication performance in the context of care for patients with dementia. In addition, this study attempts to evaluate the indirect effects of this program on outcomes for patients with dementia, including memory and behavior-related problems and depressive symptoms. A quasi-experimental research design with a one-group repeated measure was conducted. Convenience sampling was used to recruit nurses from long-term care facilities in southern Taiwan. Data were analyzed using general estimating equations to compare changes over time a...
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The importance of effective communication with dementia sufferers has grown with the increasing prevalence of this degenerative condition. Regardless of the presence of aphasia, the vocal tones and behaviors of dementia patients are... more
The importance of effective communication with dementia sufferers has grown with the increasing prevalence of this degenerative condition. Regardless of the presence of aphasia, the vocal tones and behaviors of dementia patients are meaningful, and may signal unmet needs. If caregivers ignore or fail to respond to these messages, more irritable or aggressive behaviors may result. Therefore, it is critical for caregivers to learn and apply appropriate communication strategies and skills with dementia patients. Based on a review of the literature, this paper provides guidelines for assessing dementia patients' residual communication ability and suggests strategies and skills for communicating with dementia patients. Evidence based guidelines are important for caregivers when communicating with dementia patients in order to achieve positive outcomes and high care quality.
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A qualitative research approach was used to explore the life experience of cognitively intact (CI) residents cohabitating with residents with dementia in mixed placement facilities. Purposive sampling was used to recruit 21 CI residents... more
A qualitative research approach was used to explore the life experience of cognitively intact (CI) residents cohabitating with residents with dementia in mixed placement facilities. Purposive sampling was used to recruit 21 CI residents from 6 long-term care facilities in southern Taiwan. Using a semi-structured interview guide, data were analyzed by content analysis. Two themes emerged: emotional diversity and coping. Emotional diversity described the wide range of responses, both positive and negative, expressed by the participants. Coping referred to the CI residents’ ability to adapt to behaviors exhibited by the residents with dementia and the environment. Results of this study provide nurses and other health care providers with an understanding of the life experience of CI residents who live among residents with dementia. An understanding can lead to improved quality of life and positive social interactions among CI residents and those with dementia. [ Journal of Gerontologica...
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Although master's-prepared advanced practice nurses (APNs) are used intensively in the United States, they are uncommon in most other countries. Statistics about APNs across the world are difficult to interpret because the term... more
Although master's-prepared advanced practice nurses (APNs) are used intensively in the United States, they are uncommon in most other countries. Statistics about APNs across the world are difficult to interpret because the term "specialist" does not necessarily equate with graduate preparation. This article focuses on the difficulties of implementing advanced practice nursing in Taiwan. Suggestions for future actions that may decrease these problems are presented. Based on discussions with nurses from other Asian countries, these suggestions may apply to increasing the use of APNs in these countries as well as in Taiwan.
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This study examined the effects of reminiscence on self-health perception and self-esteem of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for... more
This study examined the effects of reminiscence on self-health perception and self-esteem of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post-tests at a 4-month interval. Subjects in the experimental group underwent weekly intervention. Forty-eight subjects participated in the study, with 24 in the control group and 24 in the experimental group. The findings indicated that the experimental group demonstrated better self-health perception. In summary, Reminiscence not only supports self-health perception of the elderly but also empower nurses to become proactive in their daily nursing care activities. Efforts to improve health perceptions of the elderly may also reach consequences on their quality of life.
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The purpose of this study was to determine the prevalence and level of depressive symptoms and the influence of demographic characteristics on depressive symptoms in elders residing in rural Taiwan. Also, the association was explored... more
The purpose of this study was to determine the prevalence and level of depressive symptoms and the influence of demographic characteristics on depressive symptoms in elders residing in rural Taiwan. Also, the association was explored between depressive symptoms and life stressors in the Taiwanese Elderly Stress Inventory (TESI). A cross-sectional design utilizing face-to-face administered instruments was used. A total of 195 older community residents participated in the study. Levels of depressive symptoms wese measured by the Geriatric Depression Scale - Short Form (GDS-SF) while life stressors were assessed with the Taiwanese Elderly Stress Inventory (TESI). Overall, 57% of the subjects had a GDS-SF score of 7 or above (M = 7.58, SD = 3.89), indicating that the majority were depressed. Additionally, gender, educational level, marital status, living arrangements, and socioeconomic status (SES) were significant factors to depressive symptoms. Women were more likely to experience depression than men. Elders who had received no formal education, were separated from their spouse due to death or divorce, lived alone, or had lower SES were at higher risk of more severe depression. Also, significant correlations were found between depressive symptoms and 19 stressors identified in the TESI. These stressors mostly include events related to physical functioning and family issues. The findings of this study will provide community health professionals in Taiwan with a better recognition of depressive symptoms in rural elders and stressors that are associated with depressive symptoms. This information can be used to plan health-related services and interventions for rural elders.
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This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for... more
This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post- tests at a 4 month interval, but subjects in the experimental group underwent weekly individual reminiscence therapy. Geriatric Depression Scale short form (GDS-SF) and Apparent Emotion Rating Scale (AER) were used as study instruments. Forty-eight subjects completed the study, with 25 in the experimental group and 23 in the control group. The experimental findings indicated that the experimental group demonstrated fewer depressive symptoms (p < 0.05) and better mood status (p = 0.05) on the post-test comparing to the control group. These warranted that reminiscence therapy is a recommended therapy for older people who reside in care facilities. It can provide a basis for planning geriatric care in community to promote the well being and quality of life of older people.
Research Interests: Psychology, Cognitive Science, Gerontology, Depression, Long Term Care, and 15 moreMedicine, Mood, Affect, Humans, Female, Male, Clinical Sciences, Geriatric Psychiatry, Aged, Geriatric Depression Scale, Prevalence, Longitudinal Studies, Institutionalization, Depressive Symptoms, and Age distribution
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Research Interests: Psychology, Cognitive Science, Depression, Dementia, Cognition, and 15 moreGroup Psychotherapy, Medicine, Mood, Humans, Taiwan, Female, Male, Clinical Sciences, Geriatric Psychiatry, Aged, Geriatric Depression Scale, Randomized Controlled Trial, Guidance and Counseling Intervention Programs, Reminiscence, and Cognition disorders
Background The increase in the older adult population has resulted in an epidemiological transition—namely, a shift in disease patterns from infections and nutritional disorders to degenerative diseases such as diabetes, hypertension,... more
Background The increase in the older adult population has resulted in an epidemiological transition—namely, a shift in disease patterns from infections and nutritional disorders to degenerative diseases such as diabetes, hypertension, cancer, and coronary heart disease. Disorders due to other decreased functions that often occur in older adults are also related to cognitive function. The purpose of the study was to analyse the effects of risk factors and disease history on the cognitive level of older adults in nursing homes. Methods This research involved an analytical survey with a cross-sectional approach. The research subjects were 372 older adults living in nursing homes. The data in this study were obtained through interviews using demographic data questionnaires and the Montreal Cognitive Assessment (MoCA). Data analysis was performed using a chi-square test. Results The results showed that there was a relationship between risk factors and the cognitive levels of older adults...
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Using problem solving strategies in pro fessional nursing concepts course (PS-PNC) was a newly developed core course in a two-year baccalaureate nursing pro gram in an institute of technology. The purpose of this study was to evaluate the... more
Using problem solving strategies in pro fessional nursing concepts course (PS-PNC) was a newly developed core course in a two-year baccalaureate nursing pro gram in an institute of technology. The purpose of this study was to evaluate the efficacyofprob1cm solving strategies used in this new course to improve students’ clinical problem solving abilities. Prior to the PS-PNC, 12 faculty who participated in the teaching received complete training, and then continued to receive super visionand to conduct group discussions during the whole period of the PS-PNC implementation. A one-group posttest design with repeated measures was used. In total 49 nursingstu dents from one class agreed to be recruited as the study subjects. The PS-PNC was per formed separately in three semesters. After each class learning, students would start their clinical practice, were advised by the same faculty group who participated in the PS-PNC, and were asked to submit three writ ten nursing process recordings...
The purpose of this paper was to introduce the significance of applying group reminiscence therapy on dementia elders in order to promote their health and quality of life. Several outcome variables associated with dementia patients,... more
The purpose of this paper was to introduce the significance of applying group reminiscence therapy on dementia elders in order to promote their health and quality of life. Several outcome variables associated with dementia patients, including depressive symptoms, cognitive impairment, behavior competence and physical functioning were suggested. The procedure of group reminiscence and cultural sensitive themes designated into each group reminiscence intervention session were introduced. The reminiscence intervention demonstrated effects for alleviating depressive symptoms and cognitive impairment, however it did not show any effectiveness on increase in behavior competence and physical functioning in elders with dementia. In conclusion, reminiscence can be a care modality of promoting healthy aging.
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The second paper ‘REAFF A framework for developing technology to address the needs of people with dementia’ describes a protocol that provides guidance on the development of technologies to support people with dementia. The set of... more
The second paper ‘REAFF A framework for developing technology to address the needs of people with dementia’ describes a protocol that provides guidance on the development of technologies to support people with dementia. The set of principles has been developed from needs-based research but it is argued that they have a broad applicability to aid those seeking to develop technology to support all people with dementia.
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Moderate-to-vigorous physical activity (PA) is recommended to mitigate the risk of diabetes. This study explored the PA of adults at risk for diabetes in rural Indonesia and determined the requirements for meeting the recommended PA... more
Moderate-to-vigorous physical activity (PA) is recommended to mitigate the risk of diabetes. This study explored the PA of adults at risk for diabetes in rural Indonesia and determined the requirements for meeting the recommended PA level. In total, 842 adults were screened using a diabetes risk test in a rural health centre; among them, 342 were at risk of diabetes. The level of PA was assessed using the International Physical Activity Questionnaire, whereas the associated factors underlying the three domains –individual, support, and environment—were determined by the Influences on Physical Activity Instrument. The data analysis included a three-step multiple linear regression (MLR) and logistic regression (LR). Overall, 40.6% of the participants met the recommended PA. According to the MLR analysis, among males, individuals who gave PA a higher priority and had enough time to perform PA were predicted to have a higher activity energy expenditure (MET-minutes per week). According ...
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Introduction: The Saint Louis University Mental Status (SLUMS) examination is a common screening instrument to detect mild cognitive impairment (MCI) in Western countries. However, further work is needed to identify optimal SLUMS cutoff... more
Introduction: The Saint Louis University Mental Status (SLUMS) examination is a common screening instrument to detect mild cognitive impairment (MCI) in Western countries. However, further work is needed to identify optimal SLUMS cutoff scores for screening MCI and dementia in Chinese populations. Objective: The aim of this study was to evaluate the utility and diagnostic accuracy of the SLUMS examination in the diagnosis of dementia and MCI in Chinese population. Methods: A cross-sectional multicenter design was conducted. Patients were recruited from the outpatient department of our neurology and psychiatric clinics. The establishment of the gold standard for the SLUMS-Chinese version (SLUMS-C) to detect MCI and dementia was based on the clinical criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and related neuropsychological testing conducted by 3 certified dementia specialists. The consistency of the diagnosis process and administering SLUMS-C were ...
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The current study examined the effects of aromatherapy massage on alleviating agitation and depressive mood in individuals with dementia. A randomized controlled trial and repeated measures design was conducted. A total of 59 participants... more
The current study examined the effects of aromatherapy massage on alleviating agitation and depressive mood in individuals with dementia. A randomized controlled trial and repeated measures design was conducted. A total of 59 participants were randomly assigned to intervention or control groups. The intervention group received aromatherapy massage once per week for 8 weeks. Results indicated no significant changes over time in overall agitation for either group, but agitation decreased from Week 1 to Week 5 for the intervention group. In addition, the overall depressive symptoms decreased significantly over time for the intervention group compared to the control group (p < 0.001). However, changes in agitation within 24 hours following aromatherapy massage showed some significant changes in Weeks 5 and 9. Aromatherapy massage can be an effective and safe intervention to alleviate specific agitated behaviors and depressive mood in individuals with dementia. [Journal of Gerontologi...
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Research Interests: Psychology, Gerontology, Cognition, Quality of life, Medicine, and 15 moreIndependent Living, Humans, Female, Male, Clinical Sciences, Community Mental Health, Aged, Middle Aged, Sex Factors, Recall, Age Factors, Educational Status, Neuropsychological Tests, Surveys and Questionnaires, and Cognitive dysfunction
The purpose of this study was to investigate the prevalence of do-not-resuscitate (DNR) orders and to identify relevant factors influencing the DNR decision-making process by patients' surrogates in the emergency department (ED). A... more
The purpose of this study was to investigate the prevalence of do-not-resuscitate (DNR) orders and to identify relevant factors influencing the DNR decision-making process by patients' surrogates in the emergency department (ED). A prospective, descriptive, and correlational research design was adopted. A total of 200 surrogates of cancer or non-cancer terminal patients, regardless of whether they signed a DNR order, were recruited as subjects after physicians of the emergency department explained the patient's conditions, advised on withholding medical treatment, and provided information on palliative care to all surrogates. Of the 200 surrogates, 23 % signed a DNR order for the patients. The demographic characteristics of patients and surrogates, the level of understanding of DNR orders, and factors of the DNR decision had no significant influence on the DNR decision. However, greater severity of disease (odds ratio (OR) = 1.38; 95 % confidence interval (CI) = 0.95-1.74), ...
Research Interests: Decision Making, Palliative Care, Quality of life, Medicine, Nursing Research, and 14 moreProspective studies, Humans, Taiwan, Female, Male, Aged, Middle Aged, Odds ratio, Neoplasms, Do Not Resuscitate, Emergency Department, Psychology and Cognitive Sciences, Medical and Health Sciences, and withholding treatment
Appropriate communication skills are essential for understanding patient needs, particularly those of patients with dementia. Assessing health care providers' competence in communicating with patients with dementia is critical for... more
Appropriate communication skills are essential for understanding patient needs, particularly those of patients with dementia. Assessing health care providers' competence in communicating with patients with dementia is critical for planning a communication education program. However, no formally established scale can be used. The purpose of the current study was to develop a valid and reliable instrument for determining the communication competence of health care providers with patients with dementia. Through use of a literature review and previous clinical experience, an initial 28-item scale was developed to assess the frequency of use of each item by health care providers. Fourteen items were extracted and three factors were distinguished. Results indicated that the internal consistency reliability of the 14-item scale was 0.84. Favorable convergent and discriminant validities were reached. The communication competence scale provides administrators or educators with a useful t...
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Research Interests: Psychology, Nursing, Primary Care, Psychotherapy, Depression, and 15 moreComparative Study, Medicine, Memory, Humans, Depressive Disorder, Aged, Randomized Controlled Trial, Nursing Studies, Geriatric Assessment, Older Adult, Elsevier, Personal Satisfaction, Life Change Events, Psychiatric Status Rating Scales, and Outcome measure
This study examined the effects of reminiscence on self-health perception and self-esteem of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for... more
This study examined the effects of reminiscence on self-health perception and self-esteem of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post-tests at a 4-month interval. Subjects in the experimental group underwent weekly intervention. Forty-eight subjects participated in the study, with 24 in the control group and 24 in the experimental group. The findings indicated that the experimental group demonstrated better self-health perception. In summary, Reminiscence not only supports self-health perception of the elderly but also empower nurses to become proactive in their daily nursing care activities. Efforts to improve health perceptions of the elderly may also reach consequences on their quality of life.
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A satisfaction instrument specifically designed for use with nursing home residents, the Satisfaction with the Nursing Home Instrument (SNHI), was developed and tested with a sample of 110 nursing home residents from three proprietary... more
A satisfaction instrument specifically designed for use with nursing home residents, the Satisfaction with the Nursing Home Instrument (SNHI), was developed and tested with a sample of 110 nursing home residents from three proprietary facilities in Minnesota. As hypothesized, significant relationships were found between SNHI scores and measures of affect (negatively associated with depression and positively associated with morale), providing support for the construct validity of the scale. The lack of a significant relationship between SNHI scores and both age and mental status confirmed the predicted divergent validity of the instrument. The alpha coefficient for the 29-item scale was 0.81.
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This study examined the comparative effects of reminiscence on self-esteem, self-health perception, depressive symptoms, and mood status of elderly people residing in long-term care facilities and at home. A quasi-experimental design was... more
This study examined the comparative effects of reminiscence on self-esteem, self-health perception, depressive symptoms, and mood status of elderly people residing in long-term care facilities and at home. A quasi-experimental design was conducted, using pre-intervention and post-intervention tests and purposive sampling. Rosenberg &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; s Self-Esteem Scale (RSE), Health Perception Scale (HPS), Geriatric Depression Scale Short Form (GDS-SF), and Apparent Emotion Rating Scale (AER) were used as study instruments. Each subject was administered pre- and post-experimental tests at a four month interval and all subjects underwent weekly individual reminiscence intervention. Forty-eight subjects completed the study, with 25 institutionalized elderly people and 23 non-institutionalized home-based elderly people. Independent t-tests and paired t-tests were conducted to measure the differences in variable means between and within groups. A significant difference was found between groups in mood status post-test (t = 5.96, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001) and significant differences were noted in self-health perception, depressive symptoms, and mood status (t = -2.56, 2.83, -3.02; p =.018,.009,.007) between the pre- and post-intervention tests in the institutionalized group. These results suggest that reminiscence therapy is especially appropriate for older people who reside in care facilities. Implementing strategies that enrich the lives of elderly people residing in long-term cares is crucial, and reminiscence offers a method for promoting healthy aging.
Research Interests: Program Evaluation, Psychology, Nursing, Depression, Medicine, and 15 moreMemory, Affect, Humans, Nursing Homes, Female, Male, Psychiatric Nursing, Geriatric Psychiatry, Aged, Institutionalization, Internet privacy, Geriatric Assessment, Login, Psychiatric Status Rating Scales, and attitude to health
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BackgroundElderly people with cognitive impairments are often associated with depressed mood and are heavy consumers in both medical services and need in caregivers. Reminiscence is believed to be effective in improving the cognition and... more
BackgroundElderly people with cognitive impairments are often associated with depressed mood and are heavy consumers in both medical services and need in caregivers. Reminiscence is believed to be effective in improving the cognition and mood of demented people.ObjectivesThis study tested the hypothesis that structured group reminiscence therapy can prevent the progression of cognitive impairment and enhance affective function in the cognitively impaired elderly.MethodsA randomized controlled trial (RCT) based on a two group pre‐ and post‐test design was used. The experimental subjects underwent eight group sessions, one session per week. The measurements were performed using Mini‐Mental State Examination (MMSE), Geriatric Depression Scale short form (GDS‐SF), and Cornell Scale for Depression in Dementia (CSDD).ResultsThe sample consisted of 102 subjects, with 51 in the experimental group and 51 in the control group. Results demonstrated that the intervention significantly affected ...
Research Interests: Psychology, Cognitive Science, Depression, Dementia, Cognition, and 15 moreGroup Psychotherapy, Medicine, Mood, Humans, Taiwan, Female, Male, Clinical Sciences, Geriatric Psychiatry, Aged, Geriatric Depression Scale, Randomized Controlled Trial, Guidance and Counseling Intervention Programs, Reminiscence, and Cognition disorders
This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for... more
This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post- tests at a 4 month interval, but subjects in the experimental group underwent weekly individual reminiscence therapy. Geriatric Depression Scale short form (GDS-SF) and Apparent Emotion Rating Scale (AER) were used as study instruments. Forty-eight subjects completed the study, with 25 in the experimental group and 23 in the control group. The experimental findings indicated that the experimental group demonstrated fewer depressive symptoms (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) and better mood status (p = 0.05) on the post-test comparing to the control group. These warranted that reminiscence therapy is a recommended therapy for older people who reside in care facilities. It can provide a basis for planning geriatric care in community to promote the well being and quality of life of older people.