Homes In Taiwan Research Articles

Information quality, work-family conflict, loneliness, and well-being in remote work settings

Teleworking has rapidly grown and become the prevailing work mode. Married teleworkers may experience increased work-family conflict, while single teleworkers may experience loneliness. This study aims to investigate how teleworkers' information reception quality (Time 1) influences their work-family conflict (Time 2), loneliness (Time 2), and well-being (Time 3) from the perspective of the job demands-resources model. The data were collected through a three-point survey involving 462 participants working from home in Taiwan. The results indicate a negative association between information accuracy and work-family conflict. Work-family conflict, in turn, mediates the relationship between information accuracy and well-being. Information timeliness, as the moderator, weakens the connection between information accuracy and work-family conflict. Additionally, information timeliness is negatively related to loneliness. Loneliness mediates the relationship between information timeliness and well-being. Information accuracy, as the moderator, strengthens the association between information timeliness and loneliness. No impact of information on family-work conflict was observed. Our findings suggest that organizations that convey precise and punctual messages to employees have distinct routes for reducing work-family interference and loneliness and ultimately improving employees’ well-being in remote work contexts. This study contributes to the wider telework literature through information experience.

Emergency department visits and associated factors among people with dementia residing in nursing homes in Taiwan: a one-year cohort study

BackgroundResiding in a nursing home (NH) may increase emergency department (ED) utilization in patients with dementia; however, evidence regarding the status of and predictors for ED utilization of NH residents with dementia remains unclear, especially in Asia. This study aimed to assess the incidence density of ED visits and associated factors for the risk of ED utilization among NH residents with dementia.MethodsThis one-year cohort study followed 6595 NH residents with dementia aged ≧ 40 years from Taiwan’s National Health Insurance Research Database between 2012 and 2014. The Andersen-Gill extension of Cox regression analysis with death as a competing risk was applied to investigate the association of the risk of all causes and the most common causes of ED utilization with the predisposing, enabling, and need factors as defined by the Andersen model.ResultsAll participants encountered 9254 emergency visits in the 5371.49 person-years observed, representing incidence densities of ED visits of 1722.80 per 1000 person-years. Among them, respiratory disease was the most common cause of ED visits. The significant predictors for the risk of all-cause and respiratory-cause ED visits included: (1) predisposing factors (i.e., age and gender); (2) enabling factors (i.e., regional variables); and (3) need factors (i.e., prolonged ventilator dependence and comorbidity status).ConclusionsPredisposing, enabling, and need factors could influence ED visits among studies patients. NH providers should consider these factors to develop strategies for reducing ED utilization.

Deriving Multiple-Layer Information from a Motion-Sensing Mattress for Precision Care.

Bed is often the personal care unit in hospitals, nursing homes, and individuals' homes. Rich care-related information can be derived from the sensing data from bed. Patient fall is a significant issue in hospitals, many of which are related to getting in and/or out of bed. To prevent bed falls, a motion-sensing mattress was developed for bed-exit detection. A machine learning algorithm deployed on the chip in the control box of the mattress identified the in-bed postures based on the on/off pressure pattern of 30 sensing areas to capture the users' bed-exit intention. This study aimed to explore how sleep-related data derived from the on/off status of 30 sensing areas of this motion-sensing mattress can be used for multiple layers of precision care information, including wellbeing status on the dashboard and big data analysis for living pattern clustering. This study describes how multiple layers of personalized care-related information are further derived from the motion-sensing mattress, including real-time in-bed/off-bed status, daily records, sleep quality, prolonged pressure areas, and long-term living patterns. Twenty-four mattresses and the smart mattress care system (SMCS) were installed in a dementia nursing home in Taiwan for a field trial. Residents' on-bed/off-bed data were collected for 12 weeks from August to October 2021. The SMCS was developed to display care-related information via an integrated dashboard as well as sending reminders to caregivers when detecting events such as bed exits and changes in patients' sleep and living patterns. The ultimate goal is to support caregivers with precision care, reduce their care burden, and increase the quality of care. At the end of the field trial, we interviewed four caregivers for their subjective opinions about whether and how the SMCS helped their work. The caregivers' main responses included that the SMCS helped caregivers notice the abnormal situation for people with dementia, communicate with family members of the residents, confirm medication adjustments, and whether the standard care procedure was appropriately conducted. Future studies are suggested to focus on integrated care strategy recommendations based on users' personalized sleep-related data.

A rehabilitation program to improve the physical capability of seniors in a nursing home

The purpose of this study was to examine the benefits of implementing a rehabilitation program for seniors in a nursing home. A physical activity rehabilitation program study was conducted in a nursing home in Taiwan for eight weeks. Forty senior adults (20 males and 20 females) in a nursing home joined this study as human participants. All the participants were diagnosed by a licensed rehabilitation physician as having a mild physical disability. They were split into control and experimental groups. Both groups included 10 males and 10 females. The participants in the experimental group joined the rehabilitation program while the participants in the control group did not. The range of motion and handgrip strength of all the participants before and after this program was measured. The results showed that the joint range of motion (ROM) of the upper limbs, trunk, and lower limbs of the participants in the experimental group increased significantly after attending the program. The difference between all the ROM values of the participants in the control group did not change significantly during the 8-week period. Similar results were found for the grip strength.

‘No One at School Can Speak Pangcah’: Family Language Policy in an Indigenous Home in Taiwan

Abstract Olic is one of the only members of her generation to be raised speaking Pangcah (Amis) as her first language. Through an exploration of how one family is fighting to save this endangered Austronesian language, we analyse the challenges facing Indigenous language revitalisation in Taiwan. Particular attention is paid to the child’s transition from the home to formal—Mandarin-medium—schooling. In doing so, we draw on recent work that emphasises the agency of children in shaping family language policy (also referred to as ‘family language planning’). How do children’s experiences at school shape their—and other family members’—linguistic behaviour at home? After comparing Taiwan’s current family language policy to similar efforts elsewhere, we conclude by arguing that taking children’s agency seriously means that family language policy must be combined with changes in formal schooling as well—changes that are best implemented by the Indigenous communities themselves.

Factors impeding switching from clozapine to paliperidone among patients with chronic schizophrenia—A retrospective cohort study.

Clozapine is an old antipsychotic that is effective for schizophrenia, however undesirable side effects affect drug adherence. The present study aimed to investigate the predictors for failed switching from clozapine to paliperidone (FSCP) among patients with chronic schizophrenia. This 9-year (January 2010-December 2018) retrospective study included 78 individuals with schizophrenia who wished to switch from clozapine to paliperidone and resided in a nursing home in Taiwan. The univariate Cox proportional hazards regression model (Cox model) was applied to estimate the potential factors for subsequent FSCP, followed by a multivariate Cox model to determine significant predictors of FSCP after adjusting for other covariates. Thirty eight of the 78 participants (48.7%) failed to switch from clozapine to paliperidone. After forward selection in the Cox hazard regression model, a higher number of total admission days during 1 year before switching, longer duration of clozapine use before switching, and higher average daily dose of clozapine during 1 year before switching were significantly associated with FSCP. It is suggested that clinicians should discuss with their patients about the risk factors if they intend to switch from clozapine to paliperidone. Further studies are warranted to verify our findings and extend the applicability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Predictive Model for Oral Status in Elderly People in a Taiwanese Nursing Home Using a High-Protein Black Soybean Koji Food.

With increased age, the appetite, chewing, swallowing, and digestive ability gradually decrease. Previous studies have shown that poor oral health is associated with an inadequate intake of macro and micronutrients and malnutrition. Therefore, improving the diet of elderly people and promoting nutrient absorption will help to improve the quality of life for elderly people. However, few studies have predicted their oral ability based on different food textures and other factors. The purpose of this study was to explore the correlation between oral assessment and texture parameters of high-protein black soybean koji products in elderly people in a nursing home. We used cross-sectional study design for seventy-nine residents aged 65 years and older were recruited. Three different texture of cookies, including normal cookie hardness (1.4 × 105 N/m2), minced cookie hardness (4.4 × 104 N/m2), and pureed cookie hardness (1.4 × 104 N/m2) were provided to participants to test the oral status. An oral assessment scale was used by a dentist to evaluate the oral status of the elderly participants. Different cookie textures showed a significant positive correlation with pronunciation (r = 0.237, p < 0.05), face (r = 0.371, p < 0.01), tongue (r = 0.362, p < 0.01), pharynx (r = 0.256, p < 0.05), swallowing (r = 0.272, p < 0.05), breathing (r = 0.315, p < 0.01), and the total oral score (r = 0.339, p < 0.01). We also used the high-protein black soybean koji products combined with elderly people’s comprehensions in a predictive model that had a moderately high correlation to predict the oral status in the elderly group (r = 0.612). We concluded that the high-protein black soybean koji product was associated with the oral ability of elderly people in a nursing home in Taiwan. Our findings indicated that elderly people could immediately understand the correct food texture.

Distribution of Yeast Species and Risk Factors of Oral Colonization after Oral-Care Education among the Residents of Nursing Homes.

Most yeasts causing infections in humans are part of commensal microflora and etiological agents of different infections when hosts become susceptible, usually due to becoming immunocompromised. The colonization of potentially pathogenic microbes in the oral cavity is increased by poor oral hygiene. This follow-up survey was conducted approximately two months after providing information on proper oral care at 10 nursing homes in Taiwan. Among the 117 of 165 residents colonized by yeasts, 67 were colonized by more than one yeast species. A total of 231 isolates comprising eight fungal genera and 25 species were identified. Candida albicans (44.6%) was the dominant species, followed by Candida glabrata (17.7%), Candida parapsilosis (8.7%), Candida tropicalis (7.8%), and Candida pararugosa (7.3%). Residents having a yeast colony-forming unit >10 (OR, 8.897; 95% CI 2.972–26.634; p < 0.001) or using a wheelchair (OR, 4.682; 95% CI 1.599–13.705; p = 0.005) were more likely to be colonized by multiple species. By comparing before and after oral-care education, dry mouth (OR, 3.199; 95% CI 1.448–7.068; p = 0.011) and having heart disease (OR, 2.681; 95% CI 1.068–6.732; p = 0.036) emerged as two independent risk factors for increased density of colonizing yeast.

Gratitude Strengthens the Relationship Between Leisure Social Support and Self-Rated Health Among Nursing Home Residents.

A central outcome indicator of person-oriented services in primary health care is self-rated health (SRH). Therefore, promoting SRH among nursing home residents is valuable. We examined whether demographic variables, gratitude, and leisure social support (LSS) related to SRH, and whether gratitude moderated the relationship between LSS and SRH. To collect demographic information and measure gratitude, LSS, and SRH, we conducted face-to-face interviews with 237 participants from four nursing homes in Taiwan. We used hierarchical regression analysis to examine data. Results demonstrated that duration of residence, gratitude, and LSS predicted SRH, and that gratitude interacted with LSS. We discuss implications of these results in terms of facilitating gratitude to promote SRH among nursing home residents and guiding them to seek sources of LSS. In particular, we further discuss how gratitude strengthens the relationship between LSS and SRH. [Journal of Gerontological Nursing, 48(2), 23-30.].

The effects of a pharmacist-led medication review in a nursing home: A randomized controlled trial.

Background:In this study, an intensive review of pharmaceutical care for elderly patients was conducted in a Veterans Administration nursing home in Taiwan and its effects were evaluated.Methods:One hundred participants were enrolled in this randomized controlled study with even distribution. The inclusion criteria were age 65 years or older, prescriptions for at least 5 oral medicines daily, and ≥2 chronic diseases, for the period May 2013 to October 2014. Subjects were excluded if they had previously been included in an intensive medication review conducted by a pharmacist. The primary outcomes were numbers of drugs prescribed, potential inappropriate medications, and numbers of drug-related problems. The secondary outcomes were self-reported medical usages, measurements of quality of life, results of a satisfaction survey, and health status.Results:A total of 80 cases (42 in the intervention group with medication reconciliation and 38 in the control group without medication reconciliation) completed the study. Baseline characteristics were not statistically different between the 2 groups. The overall prevalence of potential inappropriate medication was 74.3%. There were no differences between the 2 groups, with the exception of “medical problems,” which showed a significantly higher prevalence in the intervention group (P < .05). The intervention group reported greater satisfaction regarding pharmacist visits and medication compliance (P < .01). The mean number of drug-related problems was significantly lower after the intervention (P < .01).Conclusion:In this study, the intensive review of the elderly patients’ medications revealed that the only significant effect of pharmaceutical care was on “all outcomes.” A possible reason for this is the rather advanced ages of some patients who needed a considerable number of medications to treat several chronic diseases. Another reason may be the small sample size. However, participants who received the pharmacist intervention did have higher satisfaction with medication reconciliation and fewer drug-related problems.

Associations between phthalic acid esters in house dust and home characteristics/living habits in a rural region of Taiwan.

Phthalic acid esters (PAEs) commonly used as plasticizers are distributed ubiquitously in the living environment. We conducted a field study to examine the associations between PAE residue in dust and home characteristics/living habits in 47 rural homes in Taiwan. A questionnaire regarding home characteristics/living habits and composite sampling of house dust were conducted in each participating home. Five PAEs were selected for analysis on gas chromatography-mass spectrometry with the limits of quantification being 0.5 ng/g or lower. Uni- and multivariate linear regression analyses were performed for examining the associations. The five PAEs were prevalently detected from the samples, and the concentrations were below 1000 ng/g; di(2-ethylhexyl) phthalate (DEHP) was the most frequently detected PAE (85%), whereas di-isobutyl phthalate (DiBP) appeared to the most abundant congener with the maximum concentration of 807.65 ng/g. Floor cleaning frequency and use of detergents for floor cleaning were significantly associated with DEHP in dust (P < 0.05), suggesting additives of plasticizers in detergent products. The factors of plastic wraps in storage and use of disposable cups were both significantly related to DiBP (P < 0.01), which could be extensively used in food packaging products. We confirmed that several home characteristics/living habits were related to certain PAE residue in dust.

The experience of executing preventive measures to protect a nursing home in Taiwan from a COVID-19 outbreak.

We share our strategies for preventing the COVID-19 outbreak in a nursing home in Taiwan. We compared the number of outpatient department visits, the days of prescription from the outpatient department, the number of emergency department visits of the nursing home residents and staff, the number of admissions, and the days of admission of the residents for respiratory tract infection treatment between 2019 and 2020 to examine the effect of our preventive measures in the nursing home. Residents and staff who continuously lived and worked in the nursing home from 2019 to 2020 were included. The differences in outcomes between 2019 and 2020 were examined using pairedsamplet tests. The multivariate analyses were presented through generalized estimating equation analysis. A cohort of 183 residents and 127 staff was included and their electronic medical documentation was analyzed in two periods: January-September 2019 and January-September 2020. These residents had lower numbers of outpatient department visits (P < 0.001), days of prescription from the outpatient department (P < 0.001), number of emergency department visits (P < 0.001), number of admissions (P < 0.001), and days of admission (P < 0.001) to treat respiratory tract infections from January-September 2020 than January-September 2019. These staff members had lower numbers of outpatient department visits (P = 0.015) and days of prescription from the outpatient department (P = 0.009) to treat respiratory tract infections from January-September 2020 than January-September 2019. The association between our preventive measures and decreasing the risk of respiratory tract infection in nursing home residents and staff could be found. Sharing these experiences is valuable, as they provide important insights related to clinical practice during the COVID-19 pandemic.

Determinants of Successful Nursing Home Accreditation.

Objectives: This study examined the factors associated with better accreditation outcomes among nursing homes. Method: A total of 538 nursing homes in Taiwan were included in this study. Measures included accreditation scores, external factors (household income, Herfindahl–Hirschman Index, old-age dependency ratio, population density, and number of older adult households), organizational factors (hospital-based status, chain-affiliated status, occupancy rate, the number of registered nurses or nurse aides per bed, and bed size), and internal factors (accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care). Results: Bed size, hospital-based status, accountability, deficiencies, person-centered care, nursing skills, quality control, and integrated care were found to predict accreditation. Conclusion: Among all variables in this study, the quality indicators contributed to the most variation, followed by organizational factors. External environmental factors played a minor role in predicting accreditation. A focus on quality of care would benefit not only the residents of a nursing home but also facilitate its accreditation.

Keeping at-risk youth at the center: lessons learned from a community-based participatory research Photovoice project in Taiwan

Youth in the foster care and juvenile justice systems have numerous unmet health needs and long-term negative health outcomes. Photovoice is a qualitative research method in which participants produce photographs and narratives to communicate their perspectives. While Photovoice has been used in various contexts relating to at-risk youth, no known study has been conducted among youth in the foster care or juvenile justice systems. However, numerous challenges exist for the inclusion of at-risk youth in research. Thirteen youth from a group home in Taiwan for teenage boys in the foster care and juvenile justice systems participated in this yearlong study which utilized a strengths-based approach to examine resiliency, their needs, and sources of support. After receiving in-depth training, participants spent three months taking photos and writing accompanying narratives relating to the research questions. Then, via facilitated individual and group discussions, participants selected photo-narrative pairings relating to five key themes, which were then used in exhibitions for local stakeholders. This article describes nine key lessons learned to keep at-risk youth at the center of future similar research studies through protecting, representing, and empowering them: 1) consider ethical challenges, 2) identify community partners, 3) develop mutual trust with participants, 4) use symbolism, 5) have a strengths-based approach, 6) allow participants to direct the process, 7) maximize time to develop participants’ introspective skills, 8) disseminate study results widely, and 9) include participant empowerment as a key objective. Conducting research with at-risk youth is challenging but vital to identifying ways society can best support them. Photovoice remains a meaningful way for marginalized communities to articulate their needs and share their experiences and perspectives. Recognizing and addressing logistical and ethical challenges early can ultimately lead to more impactful studies for at-risk youth both individually and systemically.

Motivations for Family Members' Visits to Nursing Home Residents With Dementia in Taiwan: A Qualitative Study.

The purpose of this study was to explore what motivates family members to visit a relative with dementia who has been transferred to a nursing home in Taiwan. Data were collected for this qualitative descriptive study using audiotaped, semi-structured, in-depth, face-to-face interviews. A total of 20 family members of elderly nursing home residents participated in the study. Nursing home residents were from four nursing homes in Taiwan and had been diagnosed with probable or possible dementia by a psychiatrist or neurologist. Transcribed audiotaped interviews were analyzed using thematic analysis. Most family members were the children of the residents (n =17, 85%). The theme describing the core motivation for family members' visits to nursing home residents was "to maintain the unforgotten family affection." This motivation comprised four relevant categories: hoping to slow degeneration, providing a congruous environment, honoring filial and karmic duty, and ensuring the quality of care. Motivations for Taiwanese family members' visits to nursing home residents with dementia were similar to those in Western cultures. However, "hoping to slow degeneration" and "providing a congruous environment" were unique categories. Nurses and policymakers could use these findings to design interventions that might increase holistic care for both family members and nursing home residents with dementia. Providing programming focused on family members' unique priorities could address swallowing difficulties, management of dementia symptoms, nutritional needs, and selection of residents' roommates. These programs could improve the quality of family members' visits as well as the quality of staff-family relationships.

Nasal Methicillin-Resistant Staphylococcus aureus Carriage Among Foreign Workers Recruited to Taiwan From Southeastern Asian Countries.

BackgroundIn 2012, we identified the dissemination of methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)45 strain in 14 nursing homes in Taiwan and foreign nurse workers, a significant risk factor for MRSA carriage. We conducted this study to understand MRSA carriage and molecular characteristics among foreign workers recruited from Southeastern Asian countries.MethodsA cross-sectional study involving a total of 1935 foreign workers—929 (arrival group) and 1006 (staying group)—from Vietnam (n = 843), Indonesia (n = 780), the Philippines (n = 239), and Thailand (n = 70) were conveniently recruited during upon-arrival and regular health examination in a regional hospital. A nasal swab was obtained from each participant for detection of MRSA.ResultsOverall, MRSA carriage rate was 2.72%, with 2.26% for arrival group and 3.18% for staying group, and 4.74% for Vietnamese, 1.28% for Indonesians, 1.26% for Filipino, and none for Thai workers. Pulsotype AK/ST45 (57%) and pulsotype AX/ST188 (14%) were the top 2 dominant clones for the arrival group, whereas pulsotype D/ST59 (41%) (an endemic community clone in Taiwan) and pulsotype AK/ST45 (19%) were predominant for the staying group. A significant decrease of pulsotype AK/ST45 from 57% to 19% (P = .007) and increase of pulsotype D/ST59 from 4.8% to 41% (P = .004) were found between the arrival and the staying groups.ConclusionsApproximately 3% of foreign workers recruited from Southeastern Asian countries to Taiwan were colonized with MRSA, including the ST45 strain. However, the MRSA isolates from workers staying in Taiwan were mostly a locally endemic clone and genetically different from those identified from workers on arrival.

Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer\u2019s disease in a residential aged care facility: a cross-sectional study

BackgroundChronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer’s disease (AD).MethodsA cross-sectional study of patients aged 80 years and older was conducted at a veterans’ home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR).ResultsA total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m2. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders.ConclusionsWe found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.

Effectiveness of acupoint pressure on older people with constipation in nursing homes: a double-blind quasi-experimental study

Aims: To compare the differences between acupoint pressure, abdominal massage and laxatives in treatment of constipation for residents in two nursing homes. Background: There is lack of evidence on the utility of complementary therapies in the management of constipation among older adults. Design: Quasi-experimental. Methods: A total of 90 participants from two nursing homes in Taiwan were assigned to three groups: the control group (with laxatives only), group I (with laxatives and abdominal massage) and group II (with laxatives, acupoint pressure therapy [APT] and abdominal massage). The intervention was performed over 10 days. A double-blind technique was applied in both participants and the outcome assessors. Constipation as main outcome was evaluated and recorded for 10 days. Observation of the frequency of defecation and the consistency, particularly firmness of faeces over each 24 h’ period was recorded. The Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist was utilised in reporting methods and findings. Results: Three variations were revealed as interface factors and showed significant differences in each group. The results showed a statistically significant decrease in constipation in the experimental groups I and II. The scores of defecation frequency, difficulty degree and time of defecation, stool quality and awareness of defecation were obviously improved after treatment. Conclusions: We concluded APT could be used in conjunction with laxatives and must be considered as a long-term intervention. The combination of APT, abdominal massage and laxatives is superior to both abdominal massage with laxatives and laxatives alone. Relevance to clinical practice: Acupoint pressure as an effective complementary therapy of constipation among older adults living in nursing home provides a non-pharmacological, independent nursing intervention that nurses could use. This is relevant to nursing home settings where nurses make autonomous decision on important clinical assessments and interventions.

“Tailoring homely meals”: Family members’ motivations underlying nursing home visits during residents’ meals

Elderly nursing home residents are often malnourished or at risk of malnutrition. Family members often visit residents during mealtimes, which might be an ideal opportunity for interventions targeted at improving the nutritional status of older residents. Therefore, this study aimed to explore motivations behind family member visits with nursing home residents during mealtime in Taiwan. This phenomenological study was conducted with family members of residents from four nursing homes in Taiwan. Participants were purposively sampled. Data were collected with individual face-to-face interviews from 18 family members. Data from transcribed audio-recorded interviews were analyzed using the approach of van Manen. Analysis of the interview data identified the essence of motivations underlying family members' visits to nursing home residents during mealtimes, which we termed "tailoring homely meals." This referred to providing food tailored to residents' needs, providing a comforting family atmosphere, assisting residents during mealtime, and monitoring food consumption. The motivations of family members to visit during mealtime could guide healthcare professionals working with East Asian populations in developing interventions to reduce the possibility of malnutrition, while also improving their quality of life. We recommend providing the following for nursing home residents: a nutritious and balanced diet, supporting their independence and ability to feed themselves, and encouraging involvement of family members during mealtimes.

Apply the SERVQUAL Instrument to Measure Service Quality for the Adaptation of ICT Technologies: A Case Study of Nursing Homes in Taiwan.

The adoption of information and communication technology by elderly care organizations is an inevitable trend. Most empirical studies on e-Health service quality have focused predominantly on the general population rather than on the elderly. Thus, the generalizations are rather problematic. In addition, in the planning stage, pre-implementation analysis is considered critical but seldom performed. In this research, an instrument to evaluate the e-Health service quality in nursing homes was developed based on the SERVQUAL model. Furthermore, a pre-implementation analysis combining the SERVQUAL questionnaire and importance performance analysis was performed. Dissatisfactory factors were identified as follows. Regarding the physical environment quality, the residents expressed that the nursing homes did not provide well-maintained rooms and that the temperature in the rooms was unsuitable. Regarding the outcome quality, the elderly residents replied that the medical treatments and doctor visits were not well scheduled. Regarding the interaction quality, the residents indicated that the staff did not solve their problems sincerely or clearly understand their needs. Health care informatics (HCI) such as an electronic shift system (ESS) and electronic health records (EHR) are proposed to eliminate these problems. Given current resource limitations, our instrument and methodology proposed in this research could be extremely meaningful in practical application.