The effects of a combination of 3D virtual reality and hands-on horticultural activities on mastery, achievement motives, self-esteem, isolation and depression: a quasi-experimental study.

BACKGROUND: Aging societies are a public health concern worldwide. It is critical to develop strategies that harness technology to enhance older adults' mastery, achievement motives, self-esteem, isolation and depression effectively. METHODS: This study aimed to explore the effects of a combination of three-dimensional virtual reality (VR) and hands-on horticultural activities on the psychological well-being of community-dwelling older adults. We used a quasi-experimental design. A total of 62 community-dwelling older adults were recruited and assigned to the experimental (n = 32) and comparison groups (n = 30). The members of the experimental group participated in an 8-week intervention program. Participants of both groups completed before-and-after intervention measurements for outcome variables that included perceived self-esteem, depression, isolation, and mastery and achievement motives, which were analyzed using the generalized estimating equation (GEE). A baseline score of depression was used as an adjustment for the GEE analyses to eliminate the effects of depression on outcomes. RESULTS: After controlling age and gender as confounders, GEE analyses indicated that the experimental group showed significant post-intervention improvements in scores for self-esteem (ß = 2.18, P = .005) and mastery (ß = 1.23, P = .039), compared to the control group. CONCLUSIONS: This study supported a combination of three-dimensional VR and hands-on horticultural activities on community-dwelling older adults to improve self-esteem and mastery. The findings suggest that the future implementation of a similar program would be feasible and beneficial to community-dwelling older adults. TRIAL REGISTRATION: The study was posted on www. CLINICALTRIALS: gov (NCT05087654) on 21/10/2021. It was approved by the Institutional Review Board of En Chu Kong Hospital and performed in accordance with the Declaration of Helsinki.

Effect of involvement and motivation on self-learning: Evaluating a mobile e-learning program for nurses caring for women with gynecologic cancer.

AIM: To evaluate a mobile e-learning program for nurses caring for women with gynecologic cancer and explore the effect of personal involvement and motivation on self-learning. BACKGROUND: Cancer care has gradually come to be regarded as chronic disease management. In this context, nurses require health education skills to impart cancer-related knowledge and teach patients the relevant practices to enhance their adaptation to the illness. Thus, nurses would benefit from a mobile program to facilitate learning educational skills efficiently as it allows learners to learn at their own pace and convenience. METHODS: A cross-sectional study design was used. A mobile e-learning program with interactive tasks was designed to function as supplementary education for nurses. The program comprised four topics including exercise, illness representations based on the Common Sense Model, caring principles associated with chemotherapy and radiation therapy in caring for women with gynecologic cancer. In total, 84 purposively sampled nurses completed the program successfully. Data were collected via structured questionnaire from March to August 2021. Partial least squares structural equation modeling was used to examine the proposed hypotheses regarding the effects of involvement and motivation on learning outcomes. RESULTS: The results showed that cognitive involvement had significant effects on learning motivation. However, no significant effects were found for affective involvement. Furthermore, cognitive involvement was indirectly associated with learning effects via motivational components. The strongest associations between motivational factors and learning effects were found for perceived attention, followed by perceived relevance. CONCLUSIONS: The results suggest that motivation is a proximal influencing factor for learning effects. However, the effects of perceived attention and relevance were stronger than those of perceived confidence and satisfaction. Furthermore, the authors identified the different aspects of involvement and found that cognitive involvement had significant effects on learning motivation, while no effects were observed for affective involvement.

User experience evaluation of a 3D virtual reality educational program for illegal drug use prevention among high school students: Applying the decomposed theory of planned behavior.

Objective: To evaluate user acceptability of an immersive three-dimensional virtual reality program for preventing illegal drug use and identify factors associated with continuous usage intention of three-dimensional virtual reality learning among high school students based on the decomposed theory of planned behavior. Methods: In this cross-sectional observational study, we developed five educational modules and serious games based on three-dimensional virtual reality technology. Ninety student-participants' experiences were assessed by a structured questionnaire based on the decomposed theory of planned behavior variables. We applied partial least squares structural equation modeling to examine the correlates of continuous usage intention. Results: The proposed model demonstrated an acceptable fit to the observed data. Eight of the 11 hypotheses based on the decomposed theory of planned behavior were supported. Continuous usage intention was significantly associated with attitudes, subjective norms, and perceived behavioral control; these variables explained 55.4% of the variance in continuous usage intention. Perceived usefulness and compatibility were significant antecedents of attitude. The significant antecedent of subjective norms was support from school staff. Self-efficacy and resource-facilitating conditions were significant antecedents of perceived behavioral control. Conclusions: Our findings support the applicability of the decomposed theory of planned behavior as a framework for evaluating a three-dimensional virtual reality program for illegal drug use. We recommend that the program be included as teaching material for illegal drug prevention education in senior high schools.

User Evaluation of a Chat-Based Instant Messaging Support Health Education Program for Patients With Chronic Kidney Disease: Preliminary Findings of a Formative Study.

BACKGROUND: Artificial intelligence-driven chatbots are increasingly being used in health care, but few chat-based instant messaging support health education programs are designed for patients with chronic kidney disease (CKD) to evaluate their effectiveness. In addition, limited research exists on the usage of chat-based programs among patients with CKD, particularly those that integrate a chatbot aimed at enhancing the communication ability and disease-specific knowledge of patients. OBJECTIVE: The objective of this formative study is to gather the data necessary to develop an intervention program of chat-based instant messaging support health education for patients with CKD. Participants' user experiences will form the basis for program design improvements. METHODS: Data were collected from April to November 2020 using a structured questionnaire. A pre-post design was used, and a total of 60 patients consented to join the 3-month program. Among them, 55 successfully completed the study measurements. The System Usability Scale was used for participant evaluations of the usability of the chat-based program. RESULTS: Paired t tests revealed significant differences before and after intervention for communicative literacy (t54=3.99; P<.001) and CKD-specific disease knowledge (t54=7.54; P<.001). Within disease knowledge, significant differences were observed in the aspects of CKD basic knowledge (t54=3.46; P=.001), lifestyle (t54=3.83; P=.001), dietary intake (t54=5.51; P<.001), and medication (t54=4.17; P=.001). However, no significant difference was found in the aspect of disease prevention. Subgroup analysis revealed that while the findings among male participants were similar to those of the main sample, this was not the case among female participants. CONCLUSIONS: The findings reveal that a chat-based instant messaging support health education program may be effective for middle-aged and older patients with CKD. The use of a chat-based program with multiple promoting approaches is promising, and users' evaluation is satisfactory. TRIAL REGISTRATION: ClinicalTrials.gov NCT05665517; https://clinicaltrials.gov/study/NCT05665517.

Medical care-seeking patterns among women with menstrual syndromes-related diagnoses: a longitudinal population-based study.

BACKGROUND: Many women experience menstruation-related health issues during their child-bearing years. This study aimed to evaluate women's tendency to seek Traditional Chinese Medicine (TCM) and/or Western Medicine (WM) when newly diagnosed with menstrual syndromes and to identify factors associated with their medical care-seeking behaviors. METHODS: The data of a total of 47,097 women aged between 15 and 50 years with newly diagnosed menstrual syndromes in 2005 were extracted from the Taiwan National Health Insurance Database. The follow-up period was divided equally into 6 month segments over 5 years starting with patients' first visit for obstetric/gynecologic care. Outcomes were outpatient visits and number of TCM or WM visits during each period. Patients' tendency for medical care utilization was estimated using Poisson regression analysis. RESULTS: Number of outpatient visits using TCM was 0.62 (29187/47097), and using WM was 1.67 (78697/47097) within 6 months after the first menstrual syndrome diagnosis. The tendency for TCM utilization increased as follow-up time increased after controlling for potential confounders, while WM utilization decreased as follow-up time increased. Age, economic status, infertility, value of prevention, baby delivery, and obstetric/gynecologic inpatient histories were significantly associated with patients' medical care-seeking behaviors. CONCLUSIONS: TCM and WM medical care-seeking patterns are significantly different among women with diagnoses associated with menstrual syndromes. Related factors affecting medical care-seeking behavior include age, economic status, infertility, value of prevention, childbirth and Ob/Gyn inpatient histories.

Impact of Two Types of Board Games on Drug-Use Prevention in Adolescents at Senior High Schools.

Objective: A technology-assisted teaching tool with interactive features may improve the outcomes of illegal drug-use prevention strategies. This study explores augmented reality (AR) and paper board games incorporating a brief antidrug educational program for students without drug-use problems to increase their antidrug knowledge, attitude, life skills, subjective norms, perceived behavioral control, and intention to avoid using drugs. Materials and Methods: A total of 600 students were recruited, and 578 completed the intervention program and pre-and post-tests. The participants were randomly assigned to one of the following three groups: AR board game, paper board games, and comparison groups. The brief educational program consisted of two sessions. Generalized estimation equations were used to assess group differences in outcome variables. The paired t-tests were used to assess improvements in outcome variables of the two experimental groups. Results: The study found that the students who received the brief educational program featuring the AR board game was significantly different from the comparison group in outcome variables, including antidrug knowledge (P = 0.001), life skills (P = 0.004), subjective norms (P < 0.001), perceived behavioral control (P < 0.001), and intention (P = 0.02). The group with the paper board games also revealed similar findings as to the AR board game group in outcome variables, except for antidrug knowledge. There were no group differences in antidrug attitude between experimental and comparison groups. Conclusion: The results of this study support the efficacy of the two types of board games incorporated with a brief educational program. Results suggest that schools can adopt AR or paper board games as learning tools to assist in drug-use prevention programs and reduce the likelihood of students using illegal drugs.