Search

AIM: This paper reports a study to investigate the prevalence of and risk factors for depressive symptoms in elders in long-term care facilities in Taiwan. BACKGROUND: Depression has been identified as a major health concern and is very common among frail elders in Western nursing homes. It is under-diagnosed, and may be associated with eating difficulties and subsequent malnutrition, functional ability and sociodemographic factors. There have been no previous studies of these issues in Taiwan. METHODS: Residents of 18 long-term care facilities were recruited. Those able to communicate in the Mandarin or Taiwanese dialect, resided in long-term care facilities including skilled nursing facilities and intermediate care facilities, and who scored three or above on the Short Portable Mental Status Questionnaire were selected. Data were collected using the Geriatric Depression Scale, Barthel Index and Masticatory Index, and age, duration of institutionalization, and level of impaired swallowing were also measured. RESULTS: The number of participants identified as depressed was 267 (52.05%). There was no significant difference noted relating to age, gender, duration of institutionalization, type of institution, mental status and masticatory ability between the depressed and non-depressed groups, but significant differences of functional status and impaired swallowing between the two groups were found. However, functional status, impaired swallowing, and type of institution were three independent factors associated with depressive symptoms after controlling for all other factors. CONCLUSIONS: Future studies on the detection of symptoms of depression should use a validated observational measure to overcome under-reporting of symptoms by the frailest residents. [ABSTRACT FROM AUTHOR]

Psychometrics of a Chinese translation of the swallowing questionnaire Aims of the study. The purpose of this study was to determine the psychometric properties of a Chinese version of a swallowing questionnaire. Background/Rationale. Impaired swallowing may lead to serious complications if health care professionals do not accurately assess the problem and promptly intervene. The recognition of symptoms indicative of a swallowing problem is essential for nurses. The swallowing questionnaire could provide nurses with a valid instrument to assess patients’ impaired swallowing. Designs/Methods. Phase I consisted of experts doing the initial translation into Chinese and back-translations of the questionnaire. Five experts then determined content validity of the Chinese version, and 35 bilingual subjects determined equivalence of the Chinese translation and English version. Phase II determined concurrent validity and internal consistency using 113 screened medical patients as subjects. Phase III used 105 screened long-term care subjects to determine construct validity. Results/Findings. In Phase I, rating on the appropriateness of items on the Chinese version yielding a content validity index of 0·988. The coefficient of equivalence between the Chinese and English versions of the instrument was 0·81, while per cent agreement for all items on the two versions ranged from 0·80–1·00. Phase II established internal consistency with a K-R20 of 0·74, and concurrent validity yielded a correlation between the swallowing questionnaire and the neurological swallowing exam of 0·675 (P < 0·01). Phase III determined construct validity with significant positive correlations found between the swallowing questionnaire and stroke history and masticatory ability. Significant negative correlations were found between swallowing and cognitive status, functional status and albumin. Conclusions. Although useful as a tool for nursing assessment and intervention, further work on the swallowing questionnaire such as conducting video fluoroscopy and a swallowing speed test, are recommended to further validate its accuracy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate opinions on the RN/LPN licensure exams held by nursing faculty teaching at vocational nursing schools, community nursing colleges and full universities. The research process consisted of questionnaire construction and major study phases. In phase I, faculty members were chosen from one community college and given tape recorded interviews which were then transcribed. Interview data were analyzed and yielded the inventories of the opinion and attitude towards the RN/LPN licensure exams. Kendall's Coefficient of Concordance was used to test the content validity and yielded w = .18 (p < .01) for opinion and w = .42 (p < .01) for attitude. Cronbach's Alpha was used to test internal consistency and yielded 0.84 and 0.69 respectively. In phase II, nursing faculty members were chosen from all levels of institutions offering nursing degrees in Taiwan. The responses for item opinion towards the RN/LPN licensure exams ranged from 22-65 with a mean score of 47.61; while responses for attitude towards item constructors of the licensure exams ranged from 11-29 with a mean score of 19.16. The attitude towards the RN/LPN exam constructors had significant negative correlations with age, clinical experience, and teaching experience, but had significant positive correlation with opinion towards the items on the RN/LPN licensure exams. There was significant negative correlation between the opinion towards the items on RN/LPN exams and clinical experience (p < .05). The faculty members with experience in item construction for the RN/LPN licensure exams showed a significantly greater negative opinion in the attitude towards the RN/LPN licensure exam constructors compared to faculty without experience in item construction (p < .01). A significant difference in scores of attitude toward the RN/LPN licensure exams was found with different faculty educational levels and different teaching positions within the various types of institutions (p < .01). Further studies to engage in item analysis for the RN/LPN exam are recommended.