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Objectives: This systematic review and meta‐analysis aimed to examine non‐pharmacological interventions for helping people with dementia who experience feeding difficulties in order to improve their nutritional status. Methods: The articles were searched using PsycINFO, Medline, PubMed, CINAHL and Cochrane. Two independent investigators critically appraised eligible studies. The PRISMA guidelines and checklist were used. The possibility of risk of bias was assessed using a tool to assess the quality of randomised control trials (RCT) and non‐RCT studies. A narrative synthesis was conducted as a method of synthesis. The Cochrane Review Manager (RevMan 5.4) was used for meta‐analysis. Results: The systematic review and meta‐analysis included seven publications. Six interventions were identified and categorised as: eating ability training for people with dementia, staff training and feeding assistance and support. The meta‐analysis found evidence of the effect of eating ability training on feeding difficulty, quantified by the Edinburgh Feeding Evaluation in Dementia scale (EdFED) with a weighted mean difference of −1.36 (95% confidence interval: −1.84 to −0.89, p < 0.001) and on self‐feeding time. A spaced retrieval intervention showed a positive effect on EdFED. The systematic review discovered that while feeding assistance had a positive effect on feeding difficulty, staff training had no effect. According to the meta‐analysis, these interventions had no effect on improving the nutritional status of people with dementia. Conclusions: None of the included RCTs met the Cochrane risk‐of‐bias criteria for randomised trials. This review found that direct training for people with dementia and indirect feeding support from care staff resulted in fewer mealtime difficulties. More RCT studies are needed to determine the efficacy of such interventions. [ABSTRACT FROM AUTHOR]

Objective: With longer life expectancies, cardiovascular diseases are increasingly common among older adults, which also leads to functional changes that severely impact their quality of life. This study aimed to identify the predictors of health‐related quality of life (HRQOL) among older New Zealanders with cardiovascular health problems. Methods: A cross‐sectional data analysis of the 2015/16 New Zealand Health Survey was performed. In total, 2203 older New Zealanders with cardiovascular health problems were identified and included in the final analyses. The association between demographics, physical activity, health measurements, and HRQOL was examined using a multiple linear regression model. Results: Significant differences in HRQOL were identified between the demographics and cardiovascular risk factors. Predictors of higher HRQOL among older New Zealanders with cardiovascular conditions were increased physical activity (β = 0.218), age (β = −0.067), employed (β = 0.137), lower waist circumference (β = −0.261), male (β = 0.127), and being without a history of diabetes (β = −0.071). Conclusions: Physical activity is the strongest predictor of HRQOL in older adults with cardiovascular problems. Older female New Zealanders with cardiovascular health problems have lower perceptions of their health status. These predictors should be considered while designing and developing intervention and health education that aims to improve the HRQOL of older adults. [ABSTRACT FROM AUTHOR]

Aims: To examine the psychometrics and measurement invariance of the Short‐Form Health Literacy 12‐item questionnaire (HL‐SF12) among Vietnamese and Indonesian married immigrants. Design: A cross‐sectional survey design. Methods: In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple‐group CFA (MGCFA) used a series of hierarchical nested‐in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage. Results/Findings The Kaiser–Meyer–Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ2[66] = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi‐squared/degrees of freedom (X2/df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness‐of‐fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL‐SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t‐test showed that the HL‐SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05). Conclusions: The HL‐SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL‐SF12 could be integrated into future immigrant health policies. Impact As the first study of the measurement invariance of the HL‐SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

High-tech companies encounter intense competition in today's global economy. With rapid changes in working environments, high-tech employees must learn quickly and effectively to solve difficult problems and increase their productivity. Many large high-tech companies have recently implemented electronic learning (e-learning) for employee training. However, e-learning systems are expensive and often underutilised. Therefore, understanding the factors associated with acceptance to e-learning are of priority concern. By integrating locus of control, computer self-efficacy and technology acceptance model (TAM) into one model, this study examines the feasibility of the extended TAM to explain employee acceptance of e-learning systems. Data were collected from 223 employees at five high-tech companies located in the Hsinchu Science Park, Taiwan. Analytical results indicate that locus of control had significant direct effects on perceived usefulness and perceived ease of use. Computer self-efficacy had significant direct effects on perceived ease of use and behavioural intention to use. Overall, analytical results provide strong support for using the extended TAM to explain user acceptance of e-learning systems. The research and practical implications of findings are discussed. [ABSTRACT FROM AUTHOR]