Study on the Effects of Individualized Learning Therapy on Cognitive Function and Behavioral and Psychological Symptoms of Dementia in the Institutionalized Older Adults.

BACKGROUND: The increasing number of elderly people affected by dementia in Taiwan has made dementia care a crucial issue of concern. This issue is particularly important in terms of the proper management of behavioral symptoms and improvement of the cognitive functions of those affected by this disease. PURPOSE: This study examined the effects of individualized learning therapy on cognition and neuropsychiatric symptoms among elderly people with dementia. METHODS: A quasi-experimental, pretest-posttest research design was adopted. We recruited elderly people with dementia at the only two institutions for elderly patients with dementia in Central Taiwan. These institutions were assigned randomly as the experimental or control group, with totals of 23 and 21 participants, respectively. The participants in the experimental group received individualized learning therapy for 30 minutes twice weekly for 3 months. The comparison group received usual care only. The cognitive function and neuropsychiatric symptoms of all participants were measured using the Mini-Mental Status Examination (MMSE) before the start of and immediately after the 12-week intervention and the Chinese version of the Neuropsychiatric Inventory (CNPI), which was administered once per week during the intervention. Independent t tests (or Mann-Whitney U tests), chi-square tests (or Fisher's exact tests), paired t test, and generalized estimating equations were used for data analysis. RESULTS: Participants in the experimental group had significantly higher MMSE scores (p < .01) and lower CNPI scores (p < .01) than their comparison group peers after the intervention. Furthermore, the neuropsychiatric symptoms in the experimental group such as hallucinations, bizarre behavior, depression, apathetic expression, irritability, and sleep disorder had significantly improved by the seventh week. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Individualized learning therapy may be an effective approach to improve cognitive function and reduce neuropsychiatric symptoms among older people with dementia. Therefore, future clinical application is warranted.

Work-family conflict and job performance in nurses: the moderating effects of social support.

BACKGROUND: A large number of women are employed in the labor market. This phenomenon has widely supplanted the traditional family model of full-time working fathers and full-time housewives with the dual-income family model. Most nurses have both family and work responsibilities and hope to balance these two aspects of their lives. Work-family conflict (WFC) is thus a significant issue faced by professional nurses. PURPOSES: This study examines the relationship between WFC and job performance in the nursing context and explores the moderating effects of different sources of social support. METHODS: This study questionnaire used a self-reporting scale. To avoid common method variance, research data were collected at two time points. Five hundred twenty questionnaires were sent to nurses working at five hospitals in Taiwan, and 501 were returned, of which 495 were valid and used in analysis. Hierarchical regression analysis was used to test study hypotheses. RESULTS: Study findings were (a) degree of family-to-work conflict influenced job performance negatively, (b) level of WFC did not significantly affect job performance, (c) support from friends strengthened the negative effect of family-to-work conflict on job performance, and (d) support from coworkers weakened the relationship between WFC and job performance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: It is hoped that the findings of this study will be useful for nursing managers, organizations, and future research. Hospital organizations and nursing departments have a positive role to play in fostering an organizational culture that helps its staffs balance work and family responsibilities. A strategy of human resource management that is consistent with the demands of nurses may help reduce WFC.