Feasibility and effect of cognitive-based board game and multi-component exercise interventions on older adults with dementia.

BACKGROUND: Taiwan is an aging society, and the number of people with dementia is rapidly increasing. Due to a decline in cognitive and physical function, older adults with dementia not only gradually lose the ability to complete daily living tasks on their own, but are also at a higher risk of falls and injurious falls. It is important to develop interventions that combine cognitive and exercise training for older adults with dementia to promote or maintain their cognitive and physical functions and reduce their risk of falls. This study aimed to investigate the feasibility and effect of cognitive-based board games and multi-component exercise interventions on cognitive function, physical fitness, and fall risk in older adults with dementia. METHODS: This was a quasi-experimental study with a single-group pretest and post-test design. The study participants were 41 community-dwelling older adults with mild to moderate dementia. They received cognitive-based board games and multi-component exercise interventions once a week for 12 weeks. The interventions included 1 hour of exercise training and 1 hour of cognitive training. Scores for the Taiwan version of the Montreal Cognitive Assessment (MoCA-T), physical fitness, and the St. Thomas Risk Assessment Tool for Falling Elderly Inpatients (STRATIFY) were measured as outcome indicators at baseline and after the 12-week period. RESULTS: The overall MoCA-T score increased significantly (effect size = 0.402), with participants with mild dementia showing a greater increase (effect size = 0.522) than those with moderate dementia (effect size = 0.310). Participants' physical fitness performance improved. Female participants exhibited significant improvements in the 30-second chair stand test (effect size = 0.483) and 8-foot up-and-go test (effect size = 0.437). The fall risk score decreased by 0.05 points, the change was not significant. CONCLUSION: The cognitive-based board game and multi-component exercise interventions used in this study are beneficial for improving cognitive function and physical fitness in older adults with dementia. These interventions are feasible and suitable for promotion among community-dwelling and institution-dwelling older adults with mild cognitive impairment or dementia to delay the decline in cognitive and physical function.

Perspectives of Indonesian Muslim patients with advanced lung cancer on good death: A qualitative study.

PURPOSE: Lung cancer is the leading cause of cancer-related death. Patients with advanced lung cancer may experience burdensome distress at the end of life. The concept of good death has been shown to be complex, and continues to be expanded by gaining a better understanding of the cultural views of different populations. This study aimed to explore the perspective of Indonesian Muslims patients with advanced cancer on the concept of good death. METHOD: A qualitative design comprising in-depth interviews was employed. Seven male and 3 female Muslim patients between ages 36 and 68 and diagnosed with advanced lung cancer were recruited from a teaching hospital in Central Java, Indonesia. RESULTS: Content analysis of the interviews revealed five themes: dying without physical discomfort, dying in religious ways and in a desirable place, dying without emotional discomfort, receiving help and support, and having a good relationship with medical staff. CONCLUSIONS: Indonesian Muslim patient with advanced lung cancer have unique perspectives on good death, especially based on the themes of religious ways of dying and support from family. Health care providers should be aware that good death is not an individual concern and should thus adopt highly sensitive observation skills to assess the physical and emotional state of patients. These providers must also understand their patients' preferences and respect their needs, regardless of their own beliefs.

Struggle between survival and death: the life experience of Taiwanese older adults with suicidal ideation.

The purpose of this study was to use grounded theory to explore the subjective experiences of suicidal ideation among Taiwanese older adults in the community. Fifteen participants ages 66 to 88 were interviewed, and data were analyzed using a constant comparative analysis method. The Struggle Between Survival and Death was defined as the core category. Loss of loved ones, possession, and health was defined as the antecedent condition. The older adults struggled between survival and death during a suicidal ideation process categorized as negative emotions without an outlet, reminiscence about past achievements,lingering or persistent suicidal ideation, and hesitation to commit suicide. Lastly, the participants reported experiencing a meaningless existence in their daily lives. It is crucial to provide sensitive support to older adults who have had loss of life experiences, including providing an outlet to express negative emotions, religious support, reminiscence therapy, or a life review.

[The application and evaluation of the system theory for community health assessment in a rural village].

In assessing the health of a community is important to select tools appropriate to the community's characteristics. The framework for this paper is the system framework for community assessment developed by Trotter, Smith and Maurer (2000); the data were collected by windshield survey, literature review, interview, and observation. Through data analysis and the identification of the community's problem, the authors prioritize those problems in accordance with Goeppinger and Schuste's (1992) criteria. They illustrate the practicality and local applicability of this method by means of a local case. Finally, the authors evaluate the framework in terms of concept clearance, variable classification, and indicator measurement. In addition, they propose concrete suggestions for community workers to consider in the selection of assessment tools, and to enrich nursing knowledge.