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The traditional biomedical care approach has been unsatisfactory to meet the complex needs of seniors with long‐term multimorbidity and irreversible disability, particularly for those living in residential LTC facilities. This study aimed to develop and evaluate the effectiveness of an 8‐week biopsychosocial‐spiritual (BPS‐S) group intervention with the attempt to enhance quality of life (QoL) and meaning in life among senior residents with disability. This single‐blind randomized controlled trail was conducted in eight residential LTC facilities. The primary outcome, 'participants' overall and subdomain QoL', and the secondary outcome, 'meaning in life', were repeatedly assessed, including four time points: before, mid‐ and post‐intervention, and at a 1‐month follow‐up. A generalized linear mixed model (GLMM) was used to assess between‐group differences over time. The post‐intervention differences indicated significant higher improvement on senior residents' overall and all 4 domains of QoL, as well as their meaning in life, between the baseline and both times of post‐intervention and 1‐month follow‐up. On the other hand, participants' family QoL have improved immediately in the midst of intervention. This study provides preliminary evidence to support the feasibility and effectiveness of an 8‐week BPS‐S group therapy. We recommend the BPS‐S be integrated into routine institutional care activities to help maximize senior residents' own capacity for self‐healing, achieve a state of harmonious balance between body, mind, social and spiritual relationships; and in turn, enhance holistic health of this group. [ABSTRACT FROM AUTHOR]

Aims: To identify key factors influencing institutional nurses' self‐perceived competencies in spiritual care. Background: In the past decade, interest in spiritual care has been increasing; however, in long‐term care facilities, limited knowledge is available about nurses' competencies in spiritual care. Methods: The cross‐sectional study was conducted with 202 nurses in 11 long‐term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. Results: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self‐satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. Conclusions: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. Implications for Nursing Management: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care. [ABSTRACT FROM AUTHOR]

Objectives: To examine adherence to relaxation guided imagery in women experiencing preterm labor as well as predictors influencing adherence. Methods: This study used a longitudinal follow-up approach. Each of the 57 participating women received a mini-MP3 player containing a 13-minute relaxation guided imagery audio program that they were instructed to follow daily until giving birth. Follow-up interviews were conducted weekly. A generalized estimating equation was used to predict adherence. Results: The total adherence rate was 58%. Higher adherence was predicted by the presence of at least a college degree ( p=0.006), greater perceived stress ( p=0.006), a higher risk of preterm delivery ( p<0.001), and greater relaxation effects ( p=0.028). Older maternal age was associated with lower adherence ( p=0.001). In addition, adherence decreased significantly over time ( p<0.001). Adherence was not related to marital status, employment, parity, the baseline level of anxiety, or hospitalization. Conclusions: Pregnant women with a high risk for preterm birth and greater perceived stress showed higher adherence to relaxation guided imagery. For women with a lower adherence to relaxation guided imagery, health care professionals may consider individual preferences regarding relaxation techniques. [ABSTRACT FROM AUTHOR]

The aim of this study was to test a causal model of the predictors of agitation among 405 nursing home residents in Taiwan with varying degrees of cognitive impairment. Chart review and behavioral observations were used to assess residents' physical and psychosocial condition. The final version of the model had a good fit. Cognitive function and depression had direct effects on agitation, and pain and functional ability had indirect effects on agitation via depression. Additionally, cognitive function and pain influenced functional ability directly, which in turn influenced depression and ultimately influenced agitation. The results suggest that effective management of agitation in demented residents requires identifying the needs underlying the behavior rather than directly treating the behavior itself. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]