National Taipei University of Nursing and Health Science
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Designing a Multi-Criteria Decision-Making Framework to Establish a Value Ranking System for the Quality Evaluation of Long-Term Care Services
No full text[[abstract]]Various levels of government across Taiwan are eager to promote the establishment of long-term care residential facilities to meet the significant caregiving needs arising from the wave of population aging. However, the successful establishment of an effective mechanism relies on proper supervision and guidance. Therefore, implementing a value assessment system for long-term care service quality management is of paramount importance. Using multi-criteria decision-making (MCDM) approach can provide effective conditions for the establishment of such system and enable a more comprehensive and objective evaluation of long-term care service quality. Using this system, decision-makers can incorporate different indicators based on various needs and weights to evaluate the quality and performance of long-term care services. This facilitates the determination of priorities and the formulation of improvement strategies, thereby enhancing the quality of long-term care services. This study develops an information-based assessment model for a platform that is win-win for both institutions and individuals. The model incorporates consumer reputation and environmental social governance (ESG) dimensions, in addition to indicators such as operational and management efficiency, professional care quality, safety and environmental facilities, and protection of individual rights and interests. Further, it integrates multiple indicator items and employs the analytic hierarchy process (AHP) to decompose and structure complex multi-dimensional issues, thereby aligning itself with current corporate evaluations. It aims to assist care service agencies in making key service quality decisions across different dimensions, and enhance the overall quality and competitiveness of those agencies, while increasing public trust and recognition in the evaluation of care service quality
Psychometric validation of the Cognitive Abilities Screening Instrument using Rasch analysis in people with dementia
No full text[[abstract]]This study aimed to examine unidimensionality of the Cognitive Abilities Screening Instrument (CASI) using Rasch analysis and estimate Rasch person reliability in people with dementia. CASI data of people with dementia was collected from medical records of one general hospital in northern Taiwan. A total of 506 people with dementia were recruited from the Department of Neurology. The confirmatory factor analysis was first conducted to verify the fitness of one-factor model of the CASI. Unidimensionality was confirmed through 2 assumptions: the infit and outfit mean square were 0.5 to 1.5, and residual variance of the first principal component in principal component analysis was ≤20%. Rasch person reliability was estimated after undimensionality was supported. The results of one-factor model had shown that the Comparative Fit Index = 0.99, Tucker Lewis Index = 0.99, Root Means Square Error of Approximation = 0.015, and Standardized Root Mean Square Residual = 0.067, representing a good fit to the model. Both the infit and outfit mean square were ranged 0.87 to 1.37 and 0.86 to 1.42, respectively, and low residual variance of the first principal component (12.3%). Rasch person reliability result of 0.58 was satisfactory. The person-item map indicated the difference between item difficulty and person ability was within the acceptable limits (0.22 logits). Differential Item Function was found between -0.48 to 0.44 logits for gender, indicating the CASI functioned similarly for both genders. The 46 items of the CASI showed a unidimensional construct. The CASI had been demonstrated as a valid and reliable screening tool for assessing overall cognitive function in people with dementia, capturing their cognitive functions effectively
Effectiveness of a home-based, family caregiver-administered manual massage intervention in managing dementia symptoms and reducing caregiver stress: A randomized, controlled clinical trial
No full text[[abstract]]Objectives: To investigate the effectiveness of family caregiver-administered home-based manual massages in managing dementia symptoms and reducing caregiver stress.
Methods: Thirty-eight pairs of participants-patients with dementia and their family caregivers-were randomly allocated to the experimental or the control group. The caregivers underwent 3-h-long massage training. Subsequently, the patients received a 30-min-long, home-based massage from their caregivers thrice a week for 8 consecutive weeks. The Cornell Scale for Depression in Dementia (CSDD), Cohen-Mansfield Agitation Inventory (CMAI), and Perceived Stress Scale (PSS) were assessed before and after the interventions.
Results: After intervention, the experimental group exhibited significant improvements in CSDD and CMAI scores compared with the scores of the control group (all p < .001). Furthermore, the experimental group obtained more favorable PSS scores than did the control group (p = .013).
Conclusions: Family caregiver-administered home-based massage therapy is recommended for managing dementia symptoms and reducing caregiver stress
Acute Effects of Squats Using Elastic Bands on Postactivation Potentiation
No full text[[abstract]]Peng, H-T, Zhan, D-W, Song, C-Y, Chen, Z-R, Gu, C-Y, Wang, I-L, and Wang, L-I. Acute effects of squats using elastic bands on postactivation potentiation. J Strength Cond Res 35(12): 3334-3340, 2021-The study aimed to investigate the acute effects of squats using elastic bands at different resistance and recovery time points on postactivation potentiation (PAP). Fifteen male collegiate physical education students volunteered to participate in the study. Subjects were assigned to 6 experimental visits, which consisted of repeated factors that were 2 resistance squats (3 repetition maximum [RM] and 5RM) with elastic bands as intervention and 3 performance tests (countermovement jumps [CMJs], 20-m sprints, and change of direction [COD]). The performance test was measured before the resistance squat (pre-test) and at 15 seconds, 4 minutes, and 8 minutes after the resistance squat (post-tests) on each visit. An AMTI force plate and a set of Optojump sensors were used to obtain ground reaction force data during the CMJs and during the 20-m sprints and COD test, respectively. Repeated-measures two-way analyses of variance were performed for the resistance squats and recovery time points for each dependent variable. The 20-m sprint and COD test times at the 4-minute recovery time point after 3RM and 5RM resistance squatting were shorter than the pre-test values (p < 0.05). The rates of force development at the 4- and 8-minute recovery time points after 5RM resistance squatting were higher than the corresponding pre-test values (p < 0.05). All test performance variables significantly decreased at the 15-second recovery time point (p < 0.05). The use of elastic bands in 3RM and 5RM resistance squatting as a warm-up activity may positively affect PAP to improve sprinting, COD ability, and jump explosiveness at the 4-minute recovery time point
AI Recognizes Paintings Reflecting Emotions Improves Emotional Counseling for Teenagers
No full text[[abstract]]針對青少年情緒問題之即時性處理，需要輔導諮商人員的持續性關注與投入，傳統文字類量測工具容易造成受測者規避真實狀態，故越來越多心輔專業人士運用房樹人繪畫測驗瞭解受測者之心理狀況，但判讀畫作時間較長，且當數量多時，較容易錯失輔導黃金時刻，故本研究以房樹人繪畫測驗作為心理量測工具，輔以人工智慧協助輔導諮商人員兼具科學依據與效率進行判讀畫作，並即時幫助情緒失序的青少年，以防憾事發生。本系統之開發流程分為三階段，第一階段透過單因子變異數分析（ANOVA）與多重比較（Post Hoc）驗證文字型與繪畫型心理測驗之差異及本研究之房樹人繪畫測驗AI辨識系統與房樹人繪畫測驗專家學者之結果比對調查系統開發可行性，第二階段以YOLOv4模型、Python Flask及OpenCV DNN模塊執行系統訓練實作，第三階段以YOLOv7模型並加入OpenVINO套件執行系統優化。研究結果發現系統開發第一階段繪畫型心理測驗相較文字型較能得知受測者真實心理，第二階段採房樹人繪畫測驗專家學者提供之數據，訓練後模型全類平均準確率（mean average precision, mAP）為57.66%，而第三階段之全類平均準確率（mAP）則為64.55%。
Treating adolescent emotional issues promptly necessitates counselors' sustained attention. Conventional text-based measures risk evading true feelings. Hence, experts increasingly employ the House-Tree-Person (HTP) drawing test to grasp subjects' psychological state. However, interpreting HTP drawings is time-consuming, risking missed counseling opportunities with numerous drawings. This study employs the HTP test as a psychological measure, coupled with AI support for efficient analysis. This aids counselors in providing timely help to emotionally troubled youths, averting potential regrets. The development process of this system consists of three stages. In the first stage, the differences between text-based and drawing-based psychological tests are verified, and the results of the AI recognition system for the HTP test in this study are compared with those of expert scholars in the field. The second stage involves the implementation of system training using YOLOv4, Python Flask, and OpenCV DNN. In the third stage, YOLOv7 and OpenVINO are integrated for system optimization. The research findings indicate that in the first stage of system development, drawing-based psychological tests provide a better understanding of the true psychological state of the test subjects compared to text-based tests. In the second stage, using data provided by expert scholars in the HTP test, the trained model achieves an overall mean average precision (mAP) of 57.66%. In the third stage, the overall mAP further improves to 64.55%
Determinants of improved quality of life among older adults with multimorbidity receiving integrated outpatient services: A hospital-based retrospective cohort study
No full text[[abstract]]Background: Older adults with multiple complex care needs tend to receive fragmented care that may jeopardize their quality of life (QoL) and health outcomes. This study evaluated the determinants of improved QoL among integrated outpatient service recipients with multimorbidity.
Methods: We conducted a retrospective cohort study of integrated geriatric outpatient services (IGOS) at a tertiary medical center in Taiwan. Data from 2018 to 2019 were retrieved. All patients underwent comprehensive geriatric assessment, which included demographic information, serial functional assessments, and assessment for QoL. QoL was reassessed through a telephone survey 6 months after the patients' first visit to IGOS. Factors associated with the interval changes in QoL were identified using multivariate logistic regression.
Results: Data from 995 patients receiving IGOS (mean age: 82.21 ± 7.96 years, 54.5% males) were analyzed. An overall mean improvement in QoL was noted (EQ-5D index: +0.055±0.26, p <0.001) while 747 recipients reported maintained or improved QoL. The results of the multivariate logistic regression showed that poorer nutritional status (OR = 1.56, 95% CI: 1.07-2.28), depressive symptoms (OR = 1.99, 95% CI: 1.38-2.86), and frailty (OR = 1.66, 95% CI: 1.10-2.52) were independent risk factors for poorer QoL after adjustment for baseline QoL.
Conclusions: Integrated outpatient services improved the quality of life of older adults with multimorbidity. Those with poorer nutritional status, depressive symptoms and frailty were less likely to show improvement in their QoL
Different impacts of various tocolytic agents on increased risk of postoperative hemorrhage in preterm labor women undergoing Cesarean delivery: A population-based cohort study
No full text[[abstract]]Tocolytic agents, commonly used for inhibiting preterm labor, pose the risk of uterine atony, leading to postpartum hemorrhage. This study elucidated the effects of different tocolytic agents on postoperative hemorrhage among women in preterm labor undergoing Cesarean delivery (CD). Data from Taiwan National Health Insurance Research Database were analyzed. The risk (adjusted hazard ratio [aHR] and 95% confidence intervals [CI]) of postoperative hemorrhage in CD women with preterm labor diagnosis using tocolytic agents (Tocolysis group) comparing to CD women not using tocolytic agents (Control group) were determined. Impacts of different tocolytic agents in this regard were also investigated. Our data revealed that the incidence (11.7% vs 2.6%, P < .001) and risk (aHR: 1.21, 95% CI: 1.12-1.31, P < .001) of postoperative hemorrhage were significantly higher in the Tocolysis group (n = 15,317) than in the Control group (n = 244,096). Ritodrine was the most frequently used tocolytic agent (80.5%), followed by combination therapy (using more than one tocolytic agents) (8.5%), magnesium sulfate (MgSO4, 4.6%), calcium channel blockers (3.8%), betamimetics other than ritodrine (1.9%), prostaglandin synthase inhibitors (0.5%), and nitrates (0.1%). Barring those using calcium channel blockers and combination therapy, the use of MgSO4 (aHR: 1.43, P = .001), betamimetics other than ritodrine (aHR: 1.71, P < .001), prostaglandin synthase inhibitors (aHR: 2.67, P < .001) and nitrates (aHR: 3.30, P = .001) was associated with higher risks of postoperative hemorrhage compared with ritodrine. In conclusion, CD women with preterm labor diagnosis using tocolytic agents exhibit an increased risk of postoperative hemorrhage and that this risk varies with the use of different tocolytic agents
Can transcranial direct current stimulation combined with interactive computerized cognitive training boost cognition and gait performance in older adults with mild cognitive impairment? a randomized controlled trial
No full text[[abstract]]Background: Older adults with Mild Cognitive Impairment (MCI) are often subject to cognitive and gait deficits. Interactive Computerized Cognitive Training (ICCT) may improve cognitive function; however, the effect of such training on gait performance is limited. Transcranial Direct Current Stimulation (tDCS) improves cognition and gait performance. It remains unclear whether combining tDCS with ICCT produces an enhanced synergistic effect on cognition and complex gait performance relative to ICCT alone. This study aimed to compare the effects of tDCS combined with ICCT on cognition and gait performance in older adults with MCI.
Method: Twenty-one older adults with MCI were randomly assigned to groups receiving either anodal tDCS and ICCT ( tDCS + ICCT ) or sham tDCS and ICCT ( sham + ICCT ). Participants played Nintendo Switch cognitive games for 40 min per session, simultaneously receiving either anodal or sham tDCS over the left dorsolateral prefrontal cortex for the first 20 min. Cognitive and gait assessments were performed before and after 15 training sessions.
Results: The global cognition, executive function, and working-memory scores improved in both groups, but there were no significant interaction effects on cognitive outcomes. Additionally, the group × time interactions indicated that tDCS + ICCT significantly enhanced dual-task gait performance in terms of gait speed (p = 0.045), variability (p = 0.016), and dual-task cost (p = 0.039) compared to sham + ICCT.
Conclusion: The combined effect of tDCS and ICCT on cognition was not superior to that of ICCT alone; however, it had a significant impact on dual-task gait performance. Administering tDCS as an adjunct to ICCT may thus provide additional benefits for older adults with MCI
Baby-friendly hospital initiative accreditation in Taiwan: Challenges and assistance needs
No full textEffectiveness of Tailored Care Program on Diabetes Self-Care Activity, Risk of Cardiovascular Disease and HbA1C among Patients with Diabetes in Indonesia: A Randomized Controlled Trial
No full text[[abstract]]Background: A tailored care intervention program implemented related to diabetes self-care activity, HbA1c, and the risk of cardiovascular disease (CVD) complications was not undertaken in Indonesia. Thus, the purpose of this study was to evaluate the effectiveness of a tailored care intervention program for patients with diabetes in Indonesia. Methods: A randomized controlled trial (RCT) with pre- and post-testing was conducted from January to April 2021 with a total of 163 participants: 80 in the intervention group and 83 in the control group (undertaken at three months following baseline collection). The intervention group received a tailored care intervention program that included: (1) brief deducting teaching; (2) assessment for self-care activity and CVD risk; (3) brainstorming and support group; and (4) follow-up. The control group received standard education in the primary health care facilities (Moyo Hilir and Moyo Hulu Primary Health Care). Results: Improvements in diabetes self-care activity, HbA1c, and a lower risk of CVD among patients in the intervention group were the advantages of the tailored care intervention program after the three-month evaluation. Blood pressure, body weight, body mass index (BMI), triglycerides, blood glucose, cholesterol, and a triglyceride glucose index showed no differences in change over time between the intervention and control groups. Conclusion: The tailored care intervention program improved diabetes self-care activity, HbA1c, and decreased the percentage of CVD risk. Moreover, it is culturally acceptable to the Indonesian community with diabetes