Relationship between physical activity and perceptions of ageing from the perspective of healthy ageing among older people with frailty with chronic disease: a cross-sectional study.

BACKGROUND: In Taiwan, the 2019 Elderly Frailty Assessment found that 11.2% of older people have frailty problems. Some researchers have found that older persons' negative perspectives on ageing aggravate the progression of frailty, thereby increasing their risk of disability. This study aimed to investigate associations of physical activity and perceptions of ageing on perspectives of healthy ageing in older people with frailty and chronic diseases and to compare the differences in their frailty status. METHODS: This study used a descriptive cross-sectional design. Participants were recruited from community long-term care stations. The inclusion criteria were (1) no severe cognitive impairment and ability to communicate in Mandarin and Taiwanese; (2) over 65 years old; (3) at least one chronic disease; and (4) at least one debilitating item in the Study of Osteoporotic Fracture index. A total of 312 participants were recruited. The Brief Ageing Perceptions Questionnaire Chinese version, Healthy Ageing Perspectives Questionnaire, and Physical Activity Scale for the Elderly Chinese Version were used for measurement. RESULTS: The study results found that demographic variables, perceptions of ageing, and physical activity were significantly correlated with perspectives on healthy ageing, including age, Activities of Daily Living, education, all domains of perceptions of ageing, and household- and work-related physical activity. With regard to the frailty status level, prefrailty was better than frailty from the perspective of healthy ageing in older people with chronic disease (t = 5.35, p < 0.05). Hierarchical regression analysis was used to predict the healthy ageing perspectives of older persons with chronic disease involving a chronic time-line, positive control, health-related changes, and work-related activities. Those domains could predict 21% of the variance in healthy ageing perspectives. CONCLUSION: It is suggested that in community long-term care stations, health care providers can arrange activities to improve the perception of ageing that are acceptable for older people with frailty and chronic diseases and encourage older people to participate in service activities to achieve a sense of social participation.

Exploring Key Factors Influencing Nursing Students' Cognitive Load and Willingness to Serve Older Adults: Cross-sectional Descriptive Correlational Study.

BACKGROUND: Virtual learning environments (VLEs) use a virtual environment to support learning activities. VLEs are commonly used to overcome the temporal and spatial restrictions of learning activities held in conventional face-to-face classrooms. In VLEs, students can participate in learning activities using the internet, and teachers can provide assistive learning tools during the process. OBJECTIVE: The purpose of this study was to investigate the relationships among nursing students' mental load, cognitive load, and affective learning outcomes in terms of their willingness to serve older adults in an interaction-based educational virtual reality (VR) learning environment. METHODS: This study used a cross-sectional method. A total of 130 students participated in interaction-based VR learning and completed related questionnaires. Descriptive and inferential statistics and stepwise regression for data analysis were used. RESULTS: The research results revealed that in the dimension of willingness to use VR learning materials, perceived usefulness received the highest score (mean 4.42, SD 0.45). In the dimension of nursing ability, students scored the highest in information management and application ability to care for case patients (mean 4.35, SD 0.54). Correlation analysis revealed that cognitive load during learning and willingness to serve older adults were negatively correlated, whereas willingness to use VR learning materials was positively correlated with nursing ability and willingness to serve older adults. Analyzing the regression coefficients of predictor variables revealed that willingness to use VR learning materials (ß=.23; t2=2.89, P=.005) and cognitive load during learning (ß=-.35; t2=-.4.30, P<.001) were predictive factors of nursing students' willingness to serve older adults. CONCLUSIONS: This study demonstrated that students' willingness to use VR learning materials and their cognitive load during learning affected their willingness to care for older adults. Therefore, the components of mental or cognitive load generate inconsistent predictive effects on affective variables and willingness to serve older adults.

Factors Related to Care Competence, Workplace Stress, and Intention to Stay among Novice Nurses during the Coronavirus Disease (COVID-19) Pandemic.

The outbreak of coronavirus (COVID-19), a public health emergency of international concern, has made healthcare staff preparation and the nurturing of high-quality and adequate nursing professionals critical issues. This study aimed to explore registered nurses' competence in nursing care and their intention to stay in their current workplace. In this study, participants who had graduated from different nursing education systems were recruited. The results indicated that nurses' level of commitment to the workplace and clinical stress were positively correlated with the experience of working with patients. Stepwise regression analysis revealed the following significant predictors for intention to stay: clinical stress, frequency of caring for people with infections, and taking a course on infectious nursing. The novice nurses' competencies in the areas of pandemic disease care and care for infectious adults depended on the experience of nursing care and nursing competence in their professional careers, which may have impact on the nurses' intention to stay. Therefore, clinical stress, frequency of caring for patients, and taking nursing courses were correlated with novice nurses' intention to stay in their professional careers.

Validating a brief aging perception questionnaire (B-APQ) for older persons with chronic disease in Taiwan.

OBJECTIVES: The purpose of this study was to validate the Chinese version of the Brief Aging Perception Questionnaire (B-APQ) for older persons with chronic disease living in Taiwan. METHODS: This study recruited older patients with chronic diseases from outpatient departments of a medical center in southern Taiwan. Five steps were used to develop the Chinese version of the B-APQ, including assessment of item quality, testing of the original model by confirmatory factor analysis (CFA), establishing the new model by exploratory factor analysis (EFA) and CFA, testing the correlation between the new model and criterion instrument, and evaluating the reliability. RESULTS: A total of 415 participants completed the survey. The structure of the original version was not suitable for the Taiwanese elderly. We developed a Chinese version of the B-APQ from outpatient dimensions and one additional item that accounted for cultural differences (for a total of 18 items). The indicators of construct validity were Chi-square (387.79), GFI (0.91), AGFI (0.88), RMSEA (0.07), and SRMR (0.054). For the convergent validity, the correlation coefficient was -0.07-0.39 for the Physical Activity Scale and -0.07-0.71 for the scale of the World Health Organization Quality of Life. The Cronbach's alpha was 0.86-0.91. CONCLUSIONS: The Chinese version of the B-APQ has good validity and reliability and is suitable for the measurement of the aging perceptions of older persons with chronic diseases in Taiwan.

A Meta-Analysis of the Effects of Coping Strategies on Reducing Nurse Burnout.

OBJECTIVE: Nurse burnout is a global issue; however, it remains unclear how coping strategies over a maintained period of time may influence nursing burnout. This meta-analysis aimed to evaluate the literature on the effects of coping strategies in reducing nurse burnout. METHODS: Systematic reviews of English and Chinese articles were conducted for relevant articles published between 1979 and 2014 in six electronic databases (PubMed, CINAHL, The Cochrane, PsycARTICLES, Airiti Library, and the Index of the Taiwan Periodical Literature System). The search terms included 'nurse,' 'burnout' and 'coping.' Studies were included in the review if they were randomized controlled trials or controlled clinical trials, and they used the measurement tool, Maslach Burnout Inventory-Human Service Survey. Three hundred fifty-one studies were identified, and seven studies were ultimately included in the meta-analysis. RESULTS: A total of 1,521 participants were included in the meta-analysis for each burnout subgroup. Participants were measured immediately after the intervention and 6months, 1year, 2years, 2.5years, and 4years thereafter. Coping strategies were hypothesized to decrease burnout. The maintained period for coping strategies was 1year for emotional exhaustion and depersonalization and 6months for personal accomplishment. CONCLUSIONS: Coping strategies can reduce nurse burnout and maintain effectiveness between 6months and 1year.