Examining the relationship between personality traits, work experience, burnout, and intention to stay among home care aides in Taiwan.

BACKGROUND: Home care aides play an important role in providing long-term care services, but there is currently an insufficient supply of workers to meet the growing demand in Taiwan due to the increasing number of older adults and people with disabilities requiring care. There are numerous factors that influence the retention of home care aides. Previous research has indicated that taking employees' individual personalities into account can enhance task delegation and organizational efficiency within an organization. Severe occupational burnout is likely to diminish vitality and disrupt sleep, which, in turn, can result in higher employee turnover rates. To date, no research has explored the correlation between personality traits, burnout, work experience, and the retention of home care aides. Given these gaps in knowledge, the present study aims to investigate how personality traits and occupational burnout are associated with the intention to stay among home care aides in Taiwan. METHODS: The study was a cross-sectional survey that utilized purposive sampling to interview 285 home care aides in Hualien County from December 2020 to January 2021. A self-report questionnaire, administered with informed consent, was used to collect data on demographics, work experience, occupational burnout, personality, and intention to stay. The researchers utilized hierarchical regression analysis to analyze the data. All measurements exhibited high reliability and consistency, with Cronbach's α values ranging from 0.8 to 0.9. RESULTS: The subscales for personal burnout, work-related burnout, and client-related burnout, along with all personality scales, were highly correlated with intention to stay, except for the openness trait (p < .05). Moreover, married, full-time employment, satisfied with the promotion system and current job as home care aides on the whole, lower levels of work-related burnout, and agreeable personality type were found to be significant predictors for intention to stay (p < .05) , and the adjusted R2 of the model was 29.4%. CONCLUSIONS: This study has concluded that using personality traits as a criterion to select home care aides with a high level of agreeableness prior to recruitment, enhancing the professionalism and comprehensive of promotion system, and reducing work burnout are measures that may help home care service providers increase the intention to stay among home care aides.

Factor Structure of an ICF-Based Measure of Activity and Participations for Adults in Taiwan's Disability Eligibility Determination System.

To assess activity and participation for adults in Taiwan's Disability Eligibility Determination System (DEDS), we developed a measure, the Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult), based on the 36-item interviewer-administered version of the WHO Disability Assessment Schedule 2.0. The purpose of this study was to examine the factor structures of performance and capability dimensions of the FUNDES-Adult. This study followed a methodology research design to investigate the construct validity of the two dimensions of the FUNDES-Adult. Two samples were randomly stratified from the databank of adults with disabilities to examine structural validity by the exploratory factor analysis (EFA) (n = 8,730, mean age of 52.9 ± 16.81) and the confirmatory factor analysis (CFA) (n = 500, mean age of 54.3 ± 16.81). The results demonstrated that the EFA yielded 5-factor structures for both performance dimension (73.5% variance explained) and capability dimension (75.9% variance explained). The CFA indicated that the second-order factor structures of both dimensions were more parsimonious with adequate fit indices (GFI, NFI, CFI, and TLI ≥ 0.95, RMSEA < 0.09). The results of this study provide evidence that the FUNDES-Adult has acceptable structural validity for use in Taiwan's DEDS. Utility of the FUNDES-Adult in rehabilitation, employment, welfare, and long-term care services needs further study.

Associations of multicomponent exercise and aspects of physical performance with frailty trajectory in older adults.

BACKGROUND: Previous research has shown that frailty leads to falls, institutionalization, hospitalization, and the loss of functional capacity. While numerous intervention methods aim to reverse frailty, the most effective in older adults is multicomponent exercise. Physical performance has been highlighted as a key factor in mobility, independence, and the burden of chronic disease. Several studies have demonstrated an association between physical performance and frailty; however, the relation between the two over the long term has not yet been fully investigated. Therefore, the current study aims to examine how aspects of physical performance are associated with frailty in the long run for older adults in Taiwan. METHODS: This nine-month longitudinal study employed the generalized estimating equation (GEE) modeling to identify measures associated with frailty trajectory. A sample of 159 community-dwelling older adults was recruited through purposive sampling in 12 community care centers in Taiwan. A quasi-experimental approach was adopted in which participants were assigned to the control group or to receive a multicomponent exercise intervention and examined sociodemographic, physical performance, and other factors at the baseline, post intervention (3 months), and follow up (6 months) levels. The multicomponent exercise program was designed based on the principles of the American College of Sports Medicine and comprised aerobic exercise, muscle-strengthening activities, balance training, and stretching exercises once per week for 2 h per session for 12 weeks. RESULTS: After intervention, we found that the multicomponent exercise group exhibited better performance in the 2-minute step test than the control group (p < 0.05). Regarding long-term effects on frailty trajectories, the study finds that age progression, being female, and longer completion time in the timed up and go test increase the probability of frailty (p < 0.05). Conversely, more steps in the 2-minute step test and undertaking the multicomponent exercise program reduced the long-term probability of frailty (p < 0.05). CONCLUSIONS: This study is the first to explore the relation between indicators of physical performance and frailty trajectory among older adults in Taiwan. Furthermore, we provided support for the efficacy of the multicomponent exercise program in improving frailty status.

Continuous Use of Home Care Services and Functional Performance: A Population-Based Approach.

BACKGROUND: Home care (HC) services are the foundational service in Taiwan, such as personal care, housekeeping, showers, meal preparation, and so on. We used population-representative data to evaluate the effects of HC services use on the long-term functional performance of older adults. METHOD: This longitudinal study used latent growth curve modeling, measured as trajectories in activities of daily living (ADL) ability. We retrieved data for 1,851 care recipients from the Long-Term Care Service Management System database. RESULTS: Continuous use of HC services had positive effects on functional performance over time of declining functional capacity (ß = .075, p < .05). While greater age was associated with slower increases in ADL scores, being female and living alone were associated with faster increases in ADL scores. DISCUSSION: Continuous use of the HC services provided has a significant impact on maintaining or improving functional performance among older adults in the early stage of declined functional capacity.

Predictors of Use of Preventative Health Services for People with Disabilities in Taiwan.

People with disabilities display less use of preventive health services, such as health examinations, flu vaccinations, Pap smears and breast screening, but evidence has shown that preventive health services can detect or even prevent serious diseases and medical problems. Therefore, identifying the factors associated with the use of preventive health services is important for people with disabilities. This study examined the use of preventive health services by people with disabilities and identified other associated factors for people with disabilities. The research used social demographics and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12 items to measure activity and participation (AP) and other factors; there were 742 people with disabilities recruited with stratified proportional sampling. The data were collected through face-to-face interviews. The findings revealed that the common types of preventive services accessed by people with disabilities were health examinations and flu vaccinations; most of them had only used one preventive health service in the past year. The factors of having caregivers of spouses (OR = 1.74), perceived good health (OR = 1.26), and less limitation of AP (OR = 0.99) were significantly associated with the use of preventive services (p < 0.01). The study found a significant association between having children as caregivers and the non-use of Pap smears and breast screening services among women, providing valuable evidence for the distribution of the use of preventive health services for people with disabilities. Furthermore, the study highlighted the present status of disparities in the use of preventive services for people with disabilities and should encourage a boost in the adjustment of the medical environment and service resource allocation by the Taiwanese government for people with disabilities.

Comparison of the cost of illness of primary liver cancer between Japan and Taiwan.

BACKGROUND: Primary liver cancer (PLC) is the fifth and second leading cause of death in Japan and Taiwan, respectively. The aim of this study was to compare the economic burden of PLC between the two countries using the cost of illness (COI) method and identify the key factors causing the different trends in the economic burdens of PLC. MATERIALS AND METHODS: We calculated the COI every 3 years using governmental statistics of both countries (1996-2014 data for Japan and 2002-2014 data for Taiwan). The COI was calculated by summing the direct costs, morbidity costs, and mortality costs. We compared the COIs of PLC in both countries at the USD-based cost. The average exchange rate during the targeted years was used to remove the impact of foreign exchange volatility. RESULTS: From 1996 to 2014, the COI exhibited downward and upward trends in Japan and Taiwan, respectively. In Japan, the COI in 2014 was 0.70 times the value in 1996, and in Taiwan, the COI in 2014 was 1.16 times greater than that in 1996. The mortality cost was the greatest contributor in both countries and had the largest contribution ratio to the COI increase in Japan. However, the direct cost in Taiwan had the largest contribution ratio to the COI decrease. CONCLUSIONS: To date, the COI of PLC in Japan has continuously decreased, whereas that in Taiwan has increased. Previous health policies and technological developments are thought to have accelerated the COI decrease in Japan and are expected to change the trend of COI of PLC, even in Taiwan.

Developing an assessment scale for long-term care reablement literacy in home care workers in Taiwan using a modified Delphi method.

BACKGROUND: Reablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in LTC research. This study aimed to develop a scale for the assessment of long-term care reablement literacy (LTCRL) and employ this scale to assess the performance of home care workers in Taiwan. METHODS: To develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from northern, central, and southern Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire that included items related to basic demographic characteristics and questions to assess LTCRL. RESULTS: Based on the experts' consensus on the procedure of the modified Delphi technique, the LTCRL assessment sale consists of 29 questions on four aspects of knowledge acquisition: the abilities to access/obtain, understand, process/appraise, and apply/use. The results revealed that higher education levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers. CONCLUSIONS: The LTCRL assessment scale based on a modified Delphi technique is useful and feasible for evaluating LTCRL in home care workers who provide reablement services in Taiwan.

The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan.

Developmental disability is likely to be lifelong in nature and to result in substantial activity and societal participation limitations. The performance of individuals is related to the environment, supports, and urbanization of living cities. Most of the surveys for people with disabilities have not discussed the relationship between the cognitive impairment properties and performance of participation and activities functioning, and most cognitive impairments are regarded as having similar performance. The location of residence in childhood is mainly influenced by parents and main caregivers, but the factors related to the preferences of adults with cognitive impairment in the location of residence are more complicated. OBJECTIVE(S): The aim was to explore and compare the relationships of the urbanization degree of their living cities and the functioning performance of daily living in various domains among adults with intellectual disability (ID), autism, and concomitant communicative impairment (CCI). METHOD: The cross-sectional study was applied, and the data was collected face-to-face by professionals in all authorized hospitals in Taiwan. The participants were 5374 adults with ID (n = 4455), autism (n = 670), CCI (n = 110) and combination disabilities (n = 139) which were according to the International Statistical Classification of Diseases 9th Revision (ICD-9) from a total of 167,069 adults with disabilities from the Disability Eligibility System (DES) in Taiwan between July 2012 and October 2013. The authors used the World Health Organization Disability Assessment Schedule 2.0-36 item version of WHO (WHODAS 2.0-36 items) to measure performance and capability of daily living. RESULTS AND CONCLUSIONS: There were significant differences in age, gender, disabled severity, and the urbanization between all subgroups (p < 0.05). After adjusting the age of all participators, the degree of urbanization just significantly affected the functioning score distribution in domain 1: cognition for an adult with ID, autism, and CCI; in domain 2, mobility for an adult with CCI and combination disability; in domain 3, self-care; domain 4, independent domains for ID (p < 0.05). There were no significant differences between urbanization degree and functioning scores in all domains for adults with autism. All in all, only in groups with combination disability did we find that the worse the degree of impairment was, the lower the degree of urbanization of their place of residence was, and there was no such phenomenon in adults with autism and ID in our study.

From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country.

BACKGROUND: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan's fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated community-based LTC system incorporating both health care and disability prevention. This three-tier model consists of the following: two LTC services with a day-care center as their base and case management (Tier A), a day-care center and a single LTC service (Tier B), and LTC stations that provide primary prevention services and respite services for frail community-dwelling older adults to prevent further disabilities (Tier C). A defined cluster of agencies in a local area works together as a Tier ABC team. LTC Plan 2.0 is a new policy for Taiwan, and hence it is important to understand the agencies' initial difficulties with implementation and identify future challenges to help further policy development. METHODS: This preliminary study explored the challenges to implementing LTC 2.0 through in-depth interviews based on Evashwick's integration mechanisms with representatives from three service teams. We interviewed three chief executive officers and three case managers. RESULTS: We found that the LTC Plan 2.0 mechanisms for service integration have been insufficiently implemented. Recommendations include (1) Build up the trust between agencies and government, avoid duplication of LTC services within Tier ABC team, and encourage agencies within a team to create a shared administrative system with the same mission and vision. (2) Clarify the roles and responsibilities of government care managers and agency case managers. (3) Provide an integrated information system and create an official platform for sharing client records across different agencies and caregivers. (4) Establish a tool and platform to track the budget and payment across different levels of service as soon as possible. CONCLUSION: There is an increased demand for LTC services in Taiwan because of its rapidly aging population. Our findings shed some light on the challenges to developing integrated LTC services and thus may help both policymakers and service providers find ways to overcome these challenges.

Validation of the World Health Organization Disability Assessment Schedule 2.0 in adults with spinal cord injury in Taiwan: a psychometric study.

STUDY DESIGN: Psychometric study including exploratory factor analysis and Rasch analysis. OBJECTIVE: The aim of the present study was to examine the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in terms of its dimensionality and metric properties in a sample of people with spinal cord injury (SCI). SETTING: Two hundred and thirty-nine hospitals in Taiwan METHODS: Secondary analysis of cross-sectional data from the National Disability Determination System in Taiwan, including data of individuals with more than 1-year chronic spinal cord injury and over 18 years of age. We would ask the all 6 domains of WHODAS 2.0, except those participants who were not working in present, based on the WHODAS 2.0 manual. RESULTS: Data from 521 persons were included. The internal consistency of WHODAS 2.0 was high for all six domains (Cronbach's α between 0.87-0.99). The exploratory factor analysis supported the original six domain structure of WHODAS 2.0 to a large extent. Rasch analysis provided domain scores usable for measurement at the individual level and an overall WHODAS 2.0 score that takes into account the multidimensionality of the instrument. CONCLUSIONS: WHODAS 2.0 provides a reliable and valid instrument to measure relevant aspects of "activity and participation" in the context of functioning in people with SCI in Taiwan and may guide their rehabilitation.

Leisure time activities as mediating variables in functional disability progression: An application of parallel latent growth curve modeling.

OBJECTIVES: The aims of this study were to investigate (1) whether and (2) the extent to which Taiwanese older adults' leisure time activity (LTA) trajectories mediated the potential association between their sociodemographic factors and their functional disability trajectories. METHODS: Longitudinal data from four waves of the Taiwan Longitudinal Study on Aging (TLSA), collected between 1996 and 2007, were used for analysis (N = 3,429). Parallel-process latent growth curve modeling was adopted to evaluate the process by which LTA mediated between sociodemographic factors (age, gender, education, self-rated health, comorbidities, and depression) and the outcome process of functional disabilities. RESULTS: When mediated by baseline level of LTA, five sociodemographic factors-age, gender, education level, self-rated health, and number of comorbidities-had significant and negative mediating effects on baseline or change in functional disability, thus improving disability outcomes. However, four of the sociodemographic factors (age, education level, and number of comorbidities), when mediated through the rate of change in LTA, were found to have significant and positive mediating effects, which increased disability levels. The proportion of effects mediated by the LTA trajectory ranged from 0% to 194%. DISCUSSION: The large proportion of effects mediated through the LTA process underlines the importance of LTA to public health policy and health programs for older adults. The study's findings shed light on how to better target populations of older adults to promote an active lifestyle and achieve more successful aging in late life in Asian countries.

What is the gap in activity and participation between people with disability and the general population in Taiwan?

BACKGROUND: In 2010, the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed, based on the concept of the International Classification of Functioning, Disability and Health (ICF). The ICF provides a common language and framework for health and health-related status and attempts to integrate the biopsychosocial model as a multidimensional perspective in understanding functioning. Activities and participation (AP) is one salient component of the ICF refers to the execution of a task by an individual, and how such tasks are involved in their daily life. It is essential to examine the gap between the general adult population and adults with disabilities. This gap may be attributed to health status, personal factors, and natural and social environments, which include social and health services and policies. The purposes: (1) To develop a normative activity and participation (AP) value for the adult population and people with disabilities; and (2) to compare the gap in AP normative values between the two groups in Taiwan. METHODS: We use the WHODAS 2.0 to survey and develop a normative AP value for the general adult population, and used secondary data from National Disability Eligibility Determination System (NDEDS) of Taiwan to describe the AP functioning distribution of adult with disability. There were 1100 participants, selected by stratified proportional sampling from two cities. There were also 144,850 participants who were adults with disability, selected from the secondary database in Taiwan. RESULTS AND CONCLUSIONS: The AP curve for the disabled population increased rapidly at the beginning. The summary score was 13.21 in the performance at 90 percentile for the general population and 82.61 score for disabled adults that the similar gap in every domain, its means that there are significant functioning difference and health equality in general adults population and adults with disabilities. This presents a substantial challenge for both the government and the whole population of Taiwan, to begin considering how to reduce the gap in AP functioning and promote equality for people with disabilities, using social welfare policy. It is important to make sure disabled people have the same rights to be included in society as anybody else and better access to things in all areas of life that are according to Convention on the Rights of Persons with Disabilities (CRPD).

Development of Activity and Participation Norms among General Adult Populations in Taiwan.

Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual's activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. METHOD: A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan's general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. RESULTS: Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of other countries and subgroups.

New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers: a cross-sectional study.

BACKGROUND: Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4% of people aged 15 or above live with a disability, and 15.3% of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". METHODS: This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. RESULTS: There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3% of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9% in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. CONCLUSIONS: Our new "profit willing distance" and the "tolerance limited distance" are considered to be clearer and more equitable than other evaluation indices. They have practical application in considering resource distribution issues around the world, and in particular the rural-urban disparities for public resource.

Validity and reliability of the Functioning Disability Evaluation Scale-Adult Version based on the WHODAS 2.0--36 items.

BACKGROUND/PURPOSE: The disability eligibility determination system is based on the International Classification of Functioning, Disability and Health (ICF) framework in Taiwan. The Functioning Disability Evaluation Scale (FUNDES) has been developed since 2007 for assessing the status of an individual's activities and participation in the disability eligibility system. The purpose of this study was to examine the reliability and validity of the FUNDES-Adult Version (FUNDES-Adult). METHODS: During 2011-2012, a total of 5736 adults with disabilities (aged 58.4 ± 18.2 years) were randomly recruited for a national population-based study. These adults were assessed in person by certified professionals in the authorized hospitals. Domains 1-6 of the FUNDES-Adult addressing the performance and capability dimensions are modified from the World Health Organization Disability Assessment Schedule 2.0-36-item version, and Domain 7 (Environmental attribute) and capability and capacity dimensions of Domain 8 (Motor action) are designed based on the ICF coding system. RESULTS: The internal consistency was excellent (Cronbach's α ≥ 0.9). An exploratory factor analysis yielded a five-factor FUNDES structure with a variance of 76.1% and 76.9% and factor loadings of 0.56-0.94 and 0.55-0.94 for the performance and capability dimensions, respectively. The factor loadings for the second-order confirmatory factor analysis for the performance and capability dimensions were from 0.81 to 0.89. In Domains 1-6 and 8, the ceiling effects were from 9% to 36%, and the floor effects were from 5% to 45%. CONCLUSION: FUNDES-Adult has acceptable reliability and validity and can be used to measure activities and participation for people with disabilities.

Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses.

BACKGROUND: World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. AIMS: To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument. METHODS: The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. RESULTS: The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r=0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. CONCLUSION: For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.

Does the planned long-term care policy in Taiwan meet the needs of people with disabilities?

The long-term care (LTC) insurance policy will be enacted in Taiwan. Under the proposed policy, people with disabilities will have priority in receiving insurance. The aim of this study was to compare the functional statuses of 3 disability groups and to investigate the coverage provided by the planned LTC insurance in Taiwan. A cross-sectional study was conducted in this study to fulfill this research goal. There were 3239 subjects with physical, sensory, or intellectual disabilities from the Disability Eligibility System during September 2011 and July 2012. The World Health Organization Disability Assessment Schedule 2.0 - 36-item version (WHODAS 2.0)--traditional Chinese version was used to assess their functional statuses. Significant differences in all of the domain scores and summary scores of the WHODAS 2.0 were determined after adjusting for age among the 3 groups. People with physical or sensory disabilities exhibited the most drastic differences in the domain of daily living, and people with intellectual disabilities exhibited major differences in the cognition domain. After matching the planned coverage services, we determined that the planned LTC insurance does not meet the diverse needs of people with disabilities. In particular, social participation and a sense of security and satisfaction regarding the psychological aspects of having a disability must be considered in LTC insurance policies.

Comparison of population pyramid and demographic characteristics between people with an intellectual disability and the general population.

The purposes of this study were to measure disparities of age structure between people with an intellectual disability and general population, and to explore the difference of demographic characteristics between these two populations by using data from a population based register in Taiwan. Data were analyzed by SPSS 20.0 statistical software. Results found that the gender and mean age were significantly different between people with an intellectual disability and general population (mean age: 28.86 years vs. 35.26 years; p<0.001). The shape of the pyramid in general population tended to be fatty in the middle age, and intellectual disability population was more populous in the younger age. Furthermore, there were very few people with an intellectual disability can live more than 65 years old (3%) while there were nearly 10% of the general population were the elderly. The results also showed that two groups were different in marital status, educational levels, family status of veteran and aborigine (p<0.001). As the premature aging and short life span of people with an intellectual disability, this study suggested that the government authority should initiate necessary assistance for this group of people in the future.