Analyzing the factors influencing adoption intention of internet banking: Applying DEMATEL-ANP-SEM approach.

The main purpose of this study is to propose a research model to explore the key factors affecting consumers' willingness to use online banking. There are two stages in this research. Firstly, the decision making trial and evaluation laboratory (DEMATEL) and analytic network process (ANP) were used to explore the key factors of companies in operation of online banking. Secondly, the structural equation modeling (SEM) was used to explore the key factors of consumers' actual use of online banking. The results showed differences in the factors that companies and consumers adopted. Based on the findings, companies can adjust their business strategies and improve the consumers' willingness of online banking usage. The primary factor valued by both companies and consumers is trust. Hence, in the business of internet banking, the companies must strengthen areas such as liquidity monitoring, information security, and compliance with financial regulations, in order to reduce risks and gain customers' trust.

Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus.

OBJECTIVE: To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). METHODS: Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. RESULTS: Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. CONCLUSIONS: The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. PRACTICE IMPLICATIONS: Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM.

Mediating Effect of Family Caregivers' Hesitancy to Use Analgesics on Homecare Cancer Patients' Analgesic Adherence.

CONTEXT: Family caregivers play an increasingly critical role in cancer patients' symptom management as the number of cancer patients receiving home care grows. However, there is a lack of research measuring the impact of the family caregivers' hesitancy to use analgesics on analgesic adherence and the resulting influence on patient pain intensity. OBJECTIVES: To examine whether family caregivers' hesitancy to use analgesics is a mediator that influences patient adherence and investigate how analgesic regimen adherence affects pain intensity. METHODS: This study used a cross-sectional and descriptive design. One hundred seventy-six patient-family caregiver dyads (N = 352) were recruited from one local hospital in southern Taiwan. Instruments included the Short Version of the Barriers Questionnaire-Taiwan, the Morisky Medication Adherence Measure-Taiwan, the Brief Pain Inventory-Chinese, and demographic and illness questionnaires. A one-way analysis of variance and post hoc comparisons were performed to assess the influence of analgesic regimen adherence on pain intensity. Sobel tests were used to examine mediating effects. RESULTS: Family caregivers' hesitancy to use analgesics was a significant mediator between patient barriers to use analgesics and patient analgesic regimen adherence (P < 0.0001). Patients with low and moderate adherence levels reported significantly higher levels of pain severity (F = 3.83, P < 0.05). CONCLUSION: This study showed that family caregivers' hesitancy to use analgesics was a significant mediator associated with their hesitancy to use analgesics and the patients' analgesic adherence. It is important for health care providers to consider family caregivers' hesitancy to use analgesics when attempting to improve adherence to pain management regimens in clinical practice.

Hydration status of nursing home residents in Taiwan: a cross-sectional study.

AIM: To investigate fluid intake, dehydration and the key factors affecting nursing home residents' fluid intake and dehydration. BACKGROUND: Inadequate fluid intake is a common problem in nursing homes, but related studies on risk factors of inadequate fluid intake and dehydration in nursing homes have seldom been explored in detail in nursing research. METHODS: A cross-sectional design was developed and implemented. The sample was composed of 111 residents from nursing homes in Kaohsiung, Taiwan. Data of demographic characteristics, activities of daily living, and modes of feeding were collected and tested for association with hydration status. Laboratory data on hydration status were also collected. Data was collected from October to December 2005. RESULTS: Average daily fluid intake of the residents was 2083 mL. Forty-five per cent of the residents had a daily fluid intake that was less than their estimated requirements. Seventeen per cent of the residents had a blood urea nitrogen/creatinine ratio that was higher than 20. Mode of feeding and a diagnosis of dementia were the significant predictors of daily fluid intake and contributed to 28.8% of the total variance in daily fluid intake. Age, gender and a diagnosis of heart disease were the significant predictors of blood urea nitrogen/creatinine ratio, contributing to 17.0% of the total variance in the ratio. CONCLUSION: The nursing home residents in our study, especially females or those fed orally, had a comparatively higher prevalence of inadequate fluid intake. It is important to assess periodically the hydration status of nursing home residents and adjust their fluid intake accordingly.