Factors Related to Meaning in Life Among Residents of Long-Term Care Institutions.

BACKGROUND: Meaning in life plays an important role in, and is associated with all dimensions of, well-being. Finding meaning in life has been shown to increase life satisfaction in residents of long-term care (LTC) institutions, whereas social support has been found to relate positively with meaning of life. Interactions with LTC staff are the main source of social support for LTC residents. PURPOSE: The purpose of this study was to explore the factors related to meaning in life in LTC residents, especially those associated with interactions between nursing assistants and residents. METHODS: A cross-sectional study design was applied to interview participants from October 2015 through July 2016. One hundred fifty-four residents from six LTC institutions participated in this study. The Staff-Patient Interaction Scale and Meaning-in-Life Scale were used to collect data. The statistical methods of t test, Pearson's correlation, and stepwise regression of forward selection analysis were used to explore the factors related to meaning in life in the study population. RESULTS: The participants were found to perceive a moderate level of meaning in their lives, with a Meaning-in-Life Scale average total score of 42.75 (range: 17-63, SD = 10.19). Staff-patient interaction (ß = .50), financial support from government subsidies and social assistance (ß = -.41), and number of medical diagnoses (ß = -.18) were the three most important factors related to meaning in life, explaining 44.2% of the variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Improving the quality of interactions between nurse assistants and residents and health promotion may increase meaning in life in LTC residents.

Discrimination of the Cognitive Function of Community Subjects Using the Arterial Pulse Spectrum and Machine-Learning Analysis.

Early identification of cognitive impairment would allow affected patients to receive care at earlier stage. Changes in the arterial stiffness have been identified as a prominent pathological feature of dementia. This study aimed to verify if applying machine-learning analysis to spectral indices of the arterial pulse waveform can be used to discriminate different cognitive conditions of community subjects. 3-min Radial arterial blood pressure waveform (BPW) signals were measured noninvasively in 123 subjects. Eight machine-learning algorithms were used to evaluate the following 4 pulse indices for 10 harmonics (total 40 BPW spectral indices): amplitude proportion and its coefficient of variation; phase angle and its standard deviation. Significant differences were noted in the spectral pulse indices between Alzheimer's-disease patients and control subjects. Using them as training data (AUC = 70.32% by threefold cross-validation), a significant correlation (R2 = 0.36) was found between the prediction probability of the test data (comprising community subjects at two sites) and the Mini-Mental-State-Examination score. This finding illustrates possible physiological connection between arterial pulse transmission and cognitive function. The present findings from pulse-wave and machine-learning analyses may be useful for discriminating cognitive condition, and hence in the development of a user-friendly, noninvasive, and rapid method for the early screening of dementia.

Development of a performance scale for nurses in community-based long-term care facilities in Taiwan.

BACKGROUND: There is a lack of reliable and valid performance assessments for nurses in long-term care facilities in Taiwan. PURPOSE: This study develops a performance assessment instrument for nurses working in long-term care facilities. METHODS: A participatory action research approach was used to validate the performance assessment instrument. After 19 experts evaluated the results from the focus groups, field testing of the instrument was carried out among 190 nurses working in long-term care facilities. Factor analysis was employed to establish the construct validity of the scale. RESULTS: The final scale consisted of 11 categories with 69 items. The overall scale reliability had a Cronbach's alpha of .98, and the values of the Cronbach's alphas for the various categories ranged from .84 to .97. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The performance scale evaluated in this article has acceptable reliability, content validity, and construct validity. This scale can be used as an objective tool for measuring the performance of nurses working in long-term care settings.