Determinants of the intention to work in aged care: a cross-sectional study to assess gerontological nursing competencies among undergraduate nursing students.

BACKGROUND: There are huge demands for aged-care workers, and undergraduate gerontological nursing education plays a critical role in providing academic and professional training. PURPOSE: To examine relationships of characteristics, aged-care education, and gerontological nursing competencies with the intention to work in aged care. METHODS: An online survey was distributed to undergraduate nursing students between April and June 2022 to gather characteristics, relevant aged-care education, gerontological nursing competencies, and intentions to work in aged care data. Multivariate regression analyses were conducted to identify determinants of the intention to work in aged care. RESULTS: Students (n = 358) who were older (p < 0.001) and who were married (p < 0.001) had higher intentions to work in aged care. "Promoting mental health and psychological well-being", "Providing evidence-based dementia care", and "Enabling access to technology", were also associated with positive intentions. CONCLUSIONS: This study provides evidence on determinants of the intention to work in aged care, particularly gerontological nursing competencies.

Antenatal care experiences of uninfected pregnant women during the COVID-19 pandemic: A qualitative systematic review.

BACKGROUND: There is a limited understanding of pregnant women's antenatal care experiences during the COVID-19 pandemic. PURPOSE: To review and synthesize qualitative studies on uninfected pregnant women's antenatal care experiences during the COVID-19 pandemic. METHODS: Five databases were searched for qualitative studies published between January 2020 and January 2023. This study used a thematic synthesis of qualitative evidence and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Furthermore, this review was registered with PROSPERO and a quality appraisal was assessed. RESULTS: Nine published qualitative studies were included in this review. The studies were conducted in eight countries and included 3,709 participants. Five themes were identified: (a) disruptions of normal antenatal care services, (b) feelings of uncertainty, (c) desire for sufficient spousal support, (d) coping strategies, and (e) trust in health care providers. DISCUSSION AND CONCLUSION: The themes can be utilized to reform current interventions for pregnant women by nurse-midwife managers and by health care policymakers to improve current practice and direct new research to prepare for future pandemics.

Transitional care interventions for supporting frail older adults discharged from hospitals: An umbrella review.

Transitional care interventions have been shown to assist frail older adults; however, their true efficacy remains inconclusive. This umbrella review aimed (1) to summarize the components of transitional care interventions in support of frail older adults discharged from hospitals to community-based facilities that may have impacted healthcare outcomes and (2) to synthesize the impacts of these interventions. Systematic reviews published between January 2018 and September 2022 were screened using seven electronic databases. The review protocol followed the Joanna Briggs Institute Reviewers' Manual and was registered in the PROSPERO. Nine relevant systematic reviews were assessed for their methodological quality. Four of the measured primary healthcare outcomes improved as a result of transitional care interventions. In particular, evidence indicates that high-intensity transitional care or transitional care lasting at least one month can improve healthcare outcomes in frail older adults. Additional funding research and practical guidelines are warranted.

[Establishing Age-Friendly Community Guidelines in Taiwan].

As Taiwan heads steadily toward becoming a super-aged society, the impact of aging on society at large will become increasingly extensive and intense. Therefore, establishing an age-friendly environment in Taiwan is an important issue for the government. Feasible guidelines for age-friendly communities are necessary to ensure that appropriate social welfare measures are enacted to achieve the national goal of aging in place. The first draft of the guideline questionnaire was developed based on the World Health Organization Guidelines for Age-Friendly Cities, a literature review, and input from seven experts on aging. Three rounds of questionnaire surveys were then conducted to assess the correctness, appropriateness, and importance of the guidelines, with amendments, additions, and deletions made based on the experts' responses until they all expressed a high degree of satisfaction with all of the guidelines. The Taiwan Age-friendly Community Guidelines document discussed in this article includes 38 guidelines that address the eight facets of "outdoor spaces and buildings", "transportation", "housing", "social participation", "respect and social inclusion", "civil participation and employment", "communication and information", and "community support and health services". The guidelines document describes in detail the goals of age-friendly communities in specific and easy-to-understand terms. Moreover, it provides a reference for frontline personnel in the community to promote age-friendly environs.

Nurse visit utilization and blood pressure control: A multi-cohort study in New Zealand.

OBJECTIVE: This study aimed to retrospectively examine the contribution of nurses to population health outcomes with reference to nurse visits and blood pressure measurement in primary health settings. DESIGN: A retrospective study was conducted using New Zealand Health Survey (NZHS) from 2012 to 2017. SAMPLE: Adult population who are 18 years old and over living in New Zealand. MEASUREMENTS: Age, gender, and ethnicity, the service utilization of primary health care nurse visit and blood pressure measurement were extracted from the NZHS (2012-2017) to compare with the service utilization of primary health care nurses by different demographic groups. RESULTS: Females who have treated hypertension shows higher utilization of nurse visit than males. From 2015 to 2017, the participants in this cohort have visited a primary health care nurse at least more than once within a year. With blood pressure control, the overall pooled results show the impact of visiting primary health nurses on systolic and diastolic blood pressure control. CONCLUSION: Our study at a national scale, demonstrated the impact of nurse's contribution to population health outcomes among people living with hypertension in New Zealand. Nurses are key to improving population health outcomes and to achieve universal health coverage.

Critical care nurses' knowledge and attitudes and their perspectives toward promoting advance directives and end-of-life care.

BACKGROUND: End-of-life care can be a difficult and challenging process for critical care nurses in intensive care units (ICUs) due to the care plan shifts from providing life-sustaining measures to end-of-life care. The aims of this study were to assess critical care nurses' perceived knowledge and attitudes toward end-of-life care, as well as their perspectives on promoting advance directives and the associated factors. METHODS: A cross-sectional study was undertaken in an acute major metropolitan medical center in northern Taiwan between February and March 2020, and 250 critical care nurses were invited to participate in the study. Data on demographics, self-perceived knowledge of end-of-life care, attitudes toward end-of-life care, and perspectives of promoting advance directives were collected. A multiple linear regression model with stepwise selection was used to identify factors associated with their perspectives of promoting advance directives. RESULTS: The law related to end-of-life care was rated as the least familiar part of the self-perceived end-of-life care knowledge, while 'I have sufficient knowledge to care for patients who have accepted end-of-life care' was the lowest level of agreement in attitude scores among critical care nurses. Increased levels of perceived knowledge (ß = 0.134; p = 0.045) and attitudes (ß = 0.423; p < 0.001) toward end-of-life care were associated with the perspectives of promoting advance directives. Nurses who worked in cardiac (ß = -0.234; p < 0.001) and respiratory ICUs (ß = -0.135; p = 0.024) had less motivation to promote advance directives (F = 16.943; p < 0.001). CONCLUSION: Given their important contributions to ICU care services, appropriate and meaningful support is required to optimize critical care nurses' involvement in end-of-life care. This study demonstrated a significant impact on perspectives of promoting advance directives of critical care nurse participants. Findings from this study can inform the design of effective nurse support programs to enhance the promotion of advance directives in intensive care settings.

Gender differences in the association between oral health literacy and oral health-related quality of life in older adults.

BACKGROUND: Poor oral health affects quality of life; oral health literacy studies are increasing as it plays an essential role in promoting oral health. However, little is known regarding the gender differences in oral health literacy and oral health-related quality of life (OHRQoL) among older adults. This study aimed to explore the gender differences in oral health literacy and OHRQoL among community-dwelling older adults in Taiwan. METHODS: A cross-sectional study design with convenience sampling was undertaken to recruit participants at two community service centres. Data were collected using a structured survey consisted of the demographic characteristics, instrumental activities of daily living, nutrition assessment, oral health literacy and OHRQoL. The logistic regression was used to examine the gender differences in the relationship between oral health literacy and OHRQoL. RESULTS: A total of 202 participants completed the survey. Of which 56.4% (n = 114) were female. Logistic regression analyses showed that after controlling for age, instrumental activities of daily living, nutrition, education level, and average monthly income, better oral health literacy was associated with better oral health quality of life (p = 0.006) in men. CONCLUSIONS: The relationship between oral health literacy and OHRQoL was only significant for men. No significant relationship between women's oral health literacy and their OHRQoL. However, good OHRQoL is an integral part of overall health, but it is affected by differences in oral health and the accessibility of healthcare services. We suggest that gender-specific oral health literacy education should be offered through community health-education programs.

Effectiveness of transitional care interventions for chronic illnesses: A systematic review of reviews.

AIM: This systematic review of reviews aims to critically evaluate and synthesize findings from recent systematic reviews to analyze the effectiveness of transitional care interventions in the management of adult patients with chronic illnesses. BACKGROUND: Transitional care interventions have been provided to patients with chronic illnesses for reducing fragmented care and hospital readmissions after discharge. However, the effectiveness of the interventions on outcomes other than hospital readmissions is still unclear. REVIEW METHODS: This study used the systematic review of systematic reviews methodology. From five electronic databases, systematic reviews published between January 2011 and December 2020 and those that met the inclusion and exclusion criteria were searched and screened to retrieve recent evidence. RESULTS: Eight systematic reviews that met the inclusion criteria and had high methodological quality were included. All included transitional care interventions aimed to reduce fragmented care and hospital admissions and improve health care outcomes in chronically ill patients. On summarizing and synthesizing the data, four common outcomes-hospital readmissions, quality of life, mortality, and health care cost savings-were retrieved. There was evidence regarding the effectiveness of transitional care on health care cost savings; however, other outcomes showed mixed results. CONCLUSIONS: Transitional care interventions are effective for patients with chronic illnesses. It is important to have standardized outcome measures; therefore, it is recommended to fund research and reimbursement of transitional care practices. The findings and implications of this review are important to nurse managers, health care practitioners, researchers, and policymakers.

Nurses' barriers to caring for patients with COVID-19: a qualitative systematic review.

AIM: The aim of this qualitative systematic review is to identify and synthesize qualitative studies of frontline nurses' experiences and challenges when caring for patients with COVID-19 in hospitals. BACKGROUND: This review is the first qualitative systematic review of nurses' experiences since the beginning of the COVID-19 pandemic in 2020. Understanding nurses' experiences with COVID-19 is important because nurses are among the most vital of healthcare workers. METHODS: This study used a qualitative systematic review methodology with thematic synthesis to analyse the included studies. Five databases (CINAHL, PubMed, Ovid, Web of Science, and PsycINFO) were searched from January to mid-August 2020, and 25 abstracts were screened. Based on inclusion criteria, this qualitative systematic review included nine studies. RESULTS: Five themes were identified as barriers to COVID-19 care by 133 hospital-based nurses: limited information about COVID-19, unpredictable tasks and challenging practices, insufficient support, concerns about family, and emotional and psychological stress. CONCLUSIONS: The five barriers identified in this review should be overcome to improve nurses' experiences and, in turn, the quality of care patients with COVID-19 receive. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings from this review can be used to reform current healthcare and hospital-support systems for populations with COVID-19. They can also be used to point towards areas of research interested in improving frontline nursing. Finally, nursing leaders, healthcare policymakers and governments should use these findings to better support the nursing workforce in the current or a future pandemic.

[Driving Cessation and Mental Health in Persons With Dementia: A Preliminary Study].

BACKGROUND: The driving safety of persons with dementia (PwD) is an important public-health issue worldwide. Driving is closely related to personal autonomy, self-esteem, and independence. When PwD lose their driving privileges, this may lead to negative effects on mental health. PURPOSE: The purpose of this study was to evaluate the relationship between driving cessation and mental health in PwD. METHODS: A cross-sectional design with convenient sampling was used, Data were collected using structured questionnaires. Participants were all PwDs who were recruited from a medical center in northern Taiwan. RESULTS: A total of 78 PwD were recruited. Two-fifths (41%) of the participants were still driving, with motorcycle the most common vehicle used. The participants who had retired from driving were older, and most did not have a spouse, were less socially active, had a lower mean level of functional ability, and perceived a lower association between driving and quality of life. Driving cessation was found to be positively correlated with age and the instrumental activities of daily living. Depression and anxiety levels in former drivers were higher than in current drivers, although the differences were not significant. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Among PwD, depression and anxiety is higher in former drivers. It is suggested that a prospective study should be conducted, that driving safety issues for PwD should be addressed in public health education, and that standards of driving safety for PwD should be developed and enacted.

Validation and evaluation of the Mandarin version of the oral health literacy adult questionnaire in Taiwan.

OBJECTIVES: This study aimed to translate the Oral Health Literacy Adult Questionnaire into a Mandarin version (MOHL-AQ) and to examine its psychometric properties. METHODS: A methodological research using psychometric testing and evaluation of a translated instrument. A convenience sample of 402 participants from northern Taiwan were recruited for the validation of the MOHL-AQ. Internal consistency reliability, split-half reliability, inter-rater reliability, face validity, content validity, and construct validity were evaluated. RESULTS: The value of internal consistency and split-half reliability of the MOHL-AQ were 0.77 and 0.78, respectively. Content validity reported a high content validity index (CVI = 95%). Exploratory factor analysis (EFA) and parallel analysis (PA) were used to determine a unidimensional model and confirmatory factor analysis (CFA) was employed to confirm the model. The indices of good fit model were achieved at GFI = 0.93, AGFI = 0.92, RMSEA = 0.04, CFI = 0.90, PGFI = 0.73, χ2 /df = 1.86 (p < .001). Most of the item-total correlations indicated adequate and acceptable convergent validity (r > .30). CONCLUSION: MOHL-AQ demonstrates adequate psychometric properties for measuring the oral health literacy in Mandarin-speaking population. Public health nurses can use MOHL-AQ to assess oral health literacy in the community settings and further screen potential population with inadequate oral health literacy.

Investigating missed care by nursing aides in Taiwanese long-term care facilities.

AIMS: (a) To identify the frequencies and reasons for missed care by nursing aides in long-term care facilities and (b) to clarify the correlation between missed care and the characteristics of nursing aides and facilities. BACKGROUND: Missed care by nursing aides in long-term care facilities affects the resident's quality of care and, therefore, requires attention. METHODS: A cross-sectional study was conducted, wherein 184 nursing aides and 80 registered nurses were recruited from 10 long-term care facilities. RESULTS: (a) The most frequently missed item of care by nursing aides was assistance with body cleaning (30.4%). (b) Among all participants, 90.2%, 89.8% and 64% indicated poor communication, labour shortages and material resource insufficiencies, respectively, as the reason for missed care. (c) Participants who perceived staff to be insufficient missed care tasks more frequently than those who perceived staff to be sufficient (p < .05). CONCLUSIONS: Missed handover and insufficient nursing aides on duty were identified as the primary reasons for missed care. IMPLICATIONS FOR NURSING MANAGEMENT: Handover as a nursing process should be improved to promote accuracy and continuity. Flexibility in human resources should be maintained to respond adequately to resident's emergencies, thereby ensuring effective completion of the job.

Virtual reality among the elderly: a usefulness and acceptance study from Taiwan.

BACKGROUND: Virtual reality (VR) has several applications in the medical domain and also generates a secure environment to carry out activities. Evaluation of the effectiveness of VR among older populations revealed positive effects of VR as a tool to reduce risks of falls and also improve the social and emotional well-being of older adults. The decline in physical and mental health, the loss of functional capabilities, and a weakening of social ties represent obstacles towards active aging among older adults and indicate a need for support. Existing research focused on the effects of VR among older populations, and its uses and benefits. Our study investigated the acceptance and use of VR by the elderly. METHODS: This pilot study was conducted on 30 older adults who voluntarily participated during March to May 2018. Nine VR applications that promote physical activities, motivate users, and provide entertainment were chosen for this study. Participants were asked to use any one of the applications of their choice for 15 min twice a week for 6 weeks. At the end of 6 weeks, participants were asked to fill out a questionnaire based on the Technology Acceptance Model and a literature review, to evaluate their acceptance of VR technology. Cronbach's alpha reliability analysis was used to test the internal consistency of the questionnaire items. Pearson's product moment correlation was used to examine the validity of the questionnaire. A linear regression and mediation analysis were utilized to identify relationships among the variables of the questionnaire. RESULTS: In total, six male and 24 female participants aged 60~95 years volunteered to participate in the study. Perceived usefulness, perceived ease of use, social norms, and perceived enjoyment were seen to have had significant effects on the intention to use VR. Participants agreed to a large extent regarding the perceived usefulness, perceived enjoyment, and their experience of using VR. Thus, VR was seen to have high acceptance among this elderly population. CONCLUSIONS: Older people have positive perceptions towards accepting and using VR to support active aging. They perceived VR to be useful, easy to use, and an enjoyable experience, implying positive attitudes toward adopting this new technology.

Application of the Integrated Behavioral Model to oral self-care behavior of community-dwelling middle-aged and older people in Taiwan.

OBJECTIVES: This study evaluated the Integrated Behavioral Model and examined oral self-care behavior of community-dwelling middle-aged and older people. DESIGN: A cross-sectional design was used. SAMPLE: Purposive sampling was employed to recruit middle and older age community-dwelling individuals, with research locations in public health centers in northern Taiwan. MEASUREMENTS: Structured questionnaires comprised: participant demographics, oral health literacy, oral self-care attitude, self-efficacy, intention, and behavior, and significant others' perceptions and beliefs as well as environmental constraints. The Model verification was evaluated by path analysis. RESULTS: Two hundred and sixty-three participants (N = 263) completed the questionnaire survey. Results identified significant direct effects of the independent variables of oral health care literacy, intention of oral self-care, and perception of environmental constraints on the dependent variable of oral self-care behavior; and significant indirect effects on attitude of oral self-care, perception of significant other beliefs, self-efficacy of oral self-care. CONCLUSION: Public health nurses work with the whole community and can potentially improve the oral self-care behavior of middle-aged and older adults by enhancing their oral health knowledge, maintaining their positive attitudes, assisting acceptance of recognition and support from others, increasing their ability to perform oral self-care, reducing environmental constraints, and thereby enhancing their oral self-care awareness.

Predictors of Emergency Department Use Among Community-Dwelling Older Adults.

A cross-sectional research study was conducted to explore factors associated with and predictors of emergency department (ED) use among community-dwelling older adults. Data were collected using questionnaires regarding demographic characteristics, health literacy, comprehensive assessment instruments, and ED use. Age, fall frequency, number of diseases, number of medications, health literacy, nutritional status, cognitive function, and activities of daily living were associated with ED use. Age (adjusted odds ratio [aOR] = 1.04, 95% confidence interval [CI] [1.00, 1.07]), health literacy (aOR = 0.89, 95% CI [0.79, 0.99]), number of diseases (aOR = 1.34, 95% CI [1.01, 1.78]), and cognitive function (aOR = 0.73, 95% CI [0.55, 0.96]) were significant predictors of ED use. Health care professionals, researchers, and education providers need to assess patients' health literacy, number of diseases, and cognitive function and take approaches to improve health literacy in older adults to maintain their health as well as reduce ED use. [Journal of Gerontological Nursing, 45(5), 31-38.].

[A Preliminary Study on the Oral Health Literacy and Related Factors of Community Mid-Aged and Older Adults].

BACKGROUND: Oral health literacy is one of the factors known to affect oral health. The results of prior studies indicate that Taiwanese lack accurate oral health knowledge and skills. Assessing the understanding of Taiwanese of the various aspects of oral health literacy is necessary to explore their ability to access, process, and understand basic oral health information and to make informed health decisions. PURPOSE: To understand the oral health literacy of mid-aged and older adults living in the community and to identify the related factors that significantly affect their oral health literacy. METHODS: This cross-sectional study was conducted on a convenience sample of 263 mid-aged and older adults living in the community. Each participant completed a demographics datasheet and the Oral Health Literacy-Adult Questionnaire. The survey data were analyzed using descriptive statistics, independent t test, one-way analysis of variance test, and Pearson's correlation. RESULTS: The reading comprehension domain earned the lowest average score, indicating that reading comprehension of oral-health-related information should be strengthened in the mid-age/older population. Age was negatively associated with oral health literacy, while educational level and financial status was positively associated with oral health literacy. Furthermore, the participants who scored higher in oral health literacy were better able to accurately choose the oral hygiene tools that best suited their needs. CONCLUSIONS: The results of this study suggest that strategies aiming to promote oral health literacy among community-dwelling mid-aged and older adults should focus particularly on strengthening reading comprehension abilities and on those of older age, lower education level, and lower financial status.

[Effects of TimeSlips on Depressive Symptoms and Quality of Life in People With Dementia in Day Care Centers].

BACKGROUND: Day care centers provide supportive services to older individuals with disability and dementia. Those who suffer from cognitive impairment typically also suffer from depression. PURPOSE: To explore whether TimeSlips, a reminiscence creative storytelling approach, improves depressive symptoms and quality of life (QoL) in older individuals of day care centers who have mild to moderate cognitive impairment. METHODS: A randomized non-blind controlled trial design was conducted. A total of 20 older individuals who met the inclusion criteria were recruited and randomly assigned to the experimental group and control group using the Internet randomization system, with 10 subjects in each group. The experimental group participated in the one-hour TimeSlips intervention once a week for six consecutive weeks, while the control group maintained their normal daily activities. We used the Cornell Scale for Depression in Dementia (CSDD) to measure depressive symptoms and used EQ-5D (EuroQol-5 dimensions) VAS (visual analogue scale) and utility values to measure QoL. RESULTS: (1) With the exception of age, there were no significant differences in the demographic data between two groups. (2) Under ANCOVA, when age was used as the covariate and the change in CSDD before and after the intervention was used as the dependent variable, the score of the experimental group was significant lower than that of the control group (p < .05). The interaction between group and age was also a significant difference in the change of CSDD before and after the intervention (p < .05). In terms of QoL, the EQ-5D VAS and EQ-5D utility value both decreased after the intervention in the experimental group. ANCOVA was performed separately using the change of EQ-5D VAS and the ranked change of EQ-5D utility values as dependent variables, with no significant differences found between the groups (p = .37 and p = .20, respectively). CONCLUSIONS: The results indicate that using TimeSlips may significantly improve depressive symptoms in mild to moderate cognitively impaired older individuals of day care centers. However, no evidence was found to support an effect of TimeSlips on QoL. Our findings provide information to help day care centers staffs design related activities.

Palliative care for advanced dementia: Knowledge and attitudes of long-term care staff.

AIMS AND OBJECTIVES: To investigate the knowledge of and attitudes towards palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long-term care settings. BACKGROUND: Nursing facilities are places where persons with dementia die; therefore, providing quality end-of-life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia. DESIGN: A descriptive, cross-sectional, survey design was used. METHODS: In total, a sample of 300 nurses (n = 125) and nursing assistants (n = 175) working in long-term care settings in Taiwan participated in this study. Two instruments were administered: demographic characteristics and responses to the Questionnaire of Palliative Care for Advanced Dementia. Descriptive statistics and multiple regression were used for data analysis. RESULTS: Overall, the nurses and nursing assistants had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Additionally, nursing staff who were nurses with greater work experience and those who had received palliative care and hospice training had greater knowledge of palliative care. In addition, nursing staff who had received dementia care training and who had worked in nursing homes had higher levels of positive attitudes towards palliative care. CONCLUSIONS: This study indicates the need to provide nurses and nursing assistants with more information about palliative care practice for people with advanced dementia. Particularly, providing education to those who are nursing assistants, who have less working experience, who have not received palliative and dementia care training, and who have not worked in nursing homes can improve overall nursing staff knowledge of and attitudes towards palliative care. RELEVANCE TO CLINICAL PRACTICE: Continuing education in principles of palliative care for advanced dementia is necessary for currently practicing nursing staff and should be developed according to their educational background and needs.

The efficacy of music therapy for people with dementia: A meta-analysis of randomised controlled trials.

AIMS AND OBJECTIVES: To (1) perform a meta-analysis of randomised controlled trials pertaining to the efficacy of music therapy on disruptive behaviours, anxiety levels, depressive moods and cognitive functioning in people with dementia; and (2) clarify which interventions, therapists and participant characteristics exerted higher and more prominent effects. BACKGROUND: Present study was the first to perform a meta-analysis that included all the randomised controlled trials found in literature relating to music therapy for people with dementia over the past 15 years. DESIGN: A meta-analysis study design. METHODS: Quantitative studies were retrieved from PubMed, Medline, Cochrane Library Database, CINAHL, SCOPUS and PsycINFO. A meta-analysis was used to calculate the overall effect sizes of music therapy on outcome indicators. RESULTS: Music therapy significantly improved disruptive behaviours [Hedges' g = -0·66; 95% confidence interval (CI) = -0·44 to -0·88] and anxiety levels (Hedges' g = -0·51; 95% CI = -0·02 to -1·00) in people with dementia. Music therapy might affect depressive moods (Hedges' g = -0·39; 95% CI = 0·01 to -0·78), and cognitive functioning (Hedges' g = 0·19; 95% CI = 0·45 to -0·08). CONCLUSION: Music therapy exerted a moderately large effect on disruptive behaviours of people with dementia, a moderate effect on anxiety levels and depressive moods, and a small effect on cognitive functioning. RELEVANCE TO CLINICAL PRACTICE: Individual music therapy provided once a week to patients with cognitive functioning and manual guided in music intervention construction is suggested. Group music therapy is provided several times a week to reduce their disruptive behaviours, anxiety levels and depressive moods. Music therapy is a cost-effective, enjoyable, noninvasive therapy and could be useful for clinical nurses in creating an environment that is conducive to the well-being of patients with dementia.

As they see it: A qualitative study of how older residents in nursing homes perceive their care needs.

OBJECTIVES: Meeting care needs of nursing home residents is a significant element in providing the best quality care. A literature review revealed that there is poor understanding of the care needs of older residents from their own viewpoints within a nursing home context. Therefore, this study aimed to explore the older nursing home residents' care needs from their own perspectives. METHODS: This was a qualitative study. In-depth interviews were conducted by a purposive sample of 18 nursing home residents with a mean age of 80.7 years in Taiwan. All data was transcribed and coded for emerging themes. RESULTS: A qualitative data analysis generated six themes including the body, economics, environment, mind, preparation for death, and social support, referred to subsequently as BEEMPS. CONCLUSIONS: These findings can provide nursing home managers with information on how to improve nursing home care protocols to accommodate residents' expressed needs and also inform healthcare professionals about the care needs of older residents, thus fostering better care.