Yu-Rung Wang

Aim: Both Taiwan and China, the two most predominant Chinese‐speaking regions in the world, are experiencing rapid population aging. The relationships between age and perspectives of healthy aging for older adults with chronic diseases across different settings have been underexplored. This study aimed to compare aging perceptions, physical activity, and perspectives of healthy aging among older adults with chronic diseases in Taiwan and China. It investigated whether aging perceptions and physical activity accounted for the association between age and healthy aging perspectives. Methods: We conducted a cross‐sectional study using face‐to‐face surveys. Participants ( N = 812; 412 from Taiwan and 400 from China) aged > 60 years with one or more chronic diseases were recruited from outpatient departments and community health service centers in two coastal cities. Parallel mediation analyses were performed using PROCESS for SPSS with 5000 bootstrap samples. Results: Significant differences were found between the two samples in body mass index, religious affiliation, smoking, drinking, living status, aging perceptions, and overall physical activity. In Taiwan, aging perceptions and leisure activity statistically accounted for the association between age and healthy aging perspectives, explaining 47.6% of the variance. In China, aging perceptions and health‐related changes accounted for this association, explaining 21.9% of the variance. Conclusions: The pathways linking age to healthy aging perspectives among older adults with chronic diseases differed between Taiwan and China. Region‐specific healthcare policies and interventions targeting aging perceptions and promoting leisure activity in Taiwan, and health‐related change management in China are needed to enhance healthy aging perspectives.

Background: Taiwan’s status as a super-aged society underscores the need for efficient strategies to promote healthy aging. While the benefits of mindfulness-based interventions for sleep and mental health are evident, there is a shortage of cultural adaptations for Taiwan’s older adults. Current courses mainly focus on mindfulness-based stress reduction, while neglecting mindfulness-based elder care, and mindful sustainable aging principles. However, the abstract nature of some mindfulness concepts, combined with limited digital support and localized resources, makes it challenging for older adults to engage effectively. Objective: To enhance healthy aging outcomes in older community-dwelling adults in Taiwan, this study developed an 8-week theory-based mindfulness curriculum that combined the mindfulness-based stress reduction, mindfulness-based elder care, and mindful sustainable aging frameworks with digital health support. Methods: This research employed a mixed methods feasibility study design. We used the modified Delphi method in phase 1 to reach agreement on curriculum content and digital material selection. Ten older adults participated in the pilot study, which comprised phase 2. We used quantitative measurements to assess mindfulness, sleep quality, cognition, heart rate variability, perceptions of aging, healthy aging perspectives, and physical function and activity at baseline, at weeks 4 and 8, and at a 1-month follow-up. Qualitative interviews were conducted to gather insights into participants’ experiences. Results: Participants achieved significant improvements in mindfulness, sleep quality, aging perception, healthy aging outlook, and physical function during the study (all P <.05). Cognition, heart rate variability, and physical activity levels showed no significant changes throughout the study. The qualitative data supported these findings, as participants selected simple practices, such as mindful breathing, which they practiced daily to enhance their emotional well-being and social connections. Participants valued the digital learning materials for aiding their practice; however, some older adults with reading difficulties faced challenges accessing the content. Conclusions: Using the Delphi method resulted in an acceptable and feasible theory-based digitally supported mindfulness program that improved several indicators of healthy aging in older adults in Taiwan. Our findings need to be validated using longer trials to assess cognitive and physiological effects. Furthermore, digital accessibility requires further development.

The purpose of this study was to develop a questionnaire which investigates perspectives regarding healthy aging among old patients with chronic illness. This study used qualitative and quantitative methods, including in-depth interviews, focus groups, and surveys between 2014 and 2016. Participants were recruited from the outpatient department of a medical center and a community healthcare center, 23 for interviews and 332 for surveys. The exploratory factor analysis was applied to identify the domains of the questionnaire and reduce the number of scale items. Criterion validity and reliability were evaluated. The final instrument (19 items) comprised the following four domains affected by disease: physical and psychological changes; living environment changes; social relationship changes; and changes in family life. The instrument explained 62.71 of the total variance in healthy aging perspectives. Criterion validity was supported by a significant correlation of the questionnaire with the World Health Organization Quality of Life scale (r, range: 0.140.65). The internal consistency of the questionnaire was 0.8 (Cronbachs α, range: 0.710.89). The questionnaire is a valid and reliable instrument useful for examining healthy aging perspectives in older adults with chronic diseases. To enhance healthy aging for older persons with chronic disease, policy makers should acknowledge that elderly with chronic diseases not only have healthcare needs but also need attention regarding their psychological health and social and environmental relationships. The healthy aging perspectives questionnaire (HAPQ) can help clinicians to determine how to approach their older patients with chronic diseases to promote healthy aging.

Background: Virtual learning environments (VLEs) use a virtual environment to support learning activities. VLEs are commonly used to overcome the temporal and spatial restrictions of learning activities held in conventional face-to-face classrooms. In VLEs, students can participate in learning activities using the internet, and teachers can provide assistive learning tools during the process. Objective: The purpose of this study was to investigate the relationships among nursing students’ mental load, cognitive load, and affective learning outcomes in terms of their willingness to serve older adults in an interaction-based educational virtual reality (VR) learning environment. Methods: This study used a cross-sectional method. A total of 130 students participated in interaction-based VR learning and completed related questionnaires. Descriptive and inferential statistics and stepwise regression for data analysis were used. Results: The research results revealed that in the dimension of willingness to use VR learning materials, perceived usefulness received the highest score (mean 4.42, SD 0.45). In the dimension of nursing ability, students scored the highest in information management and application ability to care for case patients (mean 4.35, SD 0.54). Correlation analysis revealed that cognitive load during learning and willingness to serve older adults were negatively correlated, whereas willingness to use VR learning materials was positively correlated with nursing ability and willingness to serve older adults. Analyzing the regression coefficients of predictor variables revealed that willingness to use VR learning materials (β=.23; t2=2.89, P=.005) and cognitive load during learning (β=–.35; t2=–.4.30, P<.001) were predictive factors of nursing students’ willingness to serve older adults. Conclusions: This study demonstrated that students’ willingness to use VR learning materials and their cognitive load during learning affected their willingness to care for older adults. Therefore, the components of mental or cognitive load generate inconsistent predictive effects on affective variables and willingness to serve older adults.

The outbreak of coronavirus (COVID-19), a public health emergency of international concern, has made healthcare staff preparation and the nurturing of high-quality and adequate nursing professionals critical issues. This study aimed to explore registered nurses’ competence in nursing care and their intention to stay in their current workplace. In this study, participants who had graduated from different nursing education systems were recruited. The results indicated that nurses’ level of commitment to the workplace and clinical stress were positively correlated with the experience of working with patients. Stepwise regression analysis revealed the following significant predictors for intention to stay: clinical stress, frequency of caring for people with infections, and taking a course on infectious nursing. The novice nurses’ competencies in the areas of pandemic disease care and care for infectious adults depended on the experience of nursing care and nursing competence in their professional careers, which may have impact on the nurses’ intention to stay. Therefore, clinical stress, frequency of caring for patients, and taking nursing courses were correlated with novice nurses’ intention to stay in their professional careers.

Objectives: The purpose of this study was to validate the Chinese version of the Brief Aging Perception Questionnaire (B-APQ) for older persons with chronic disease living in Taiwan. Methods: This study recruited older patients with chronic diseases from outpatient departments of a medical center in southern Taiwan. Five steps were used to develop the Chinese version of the B-APQ, including assessment of item quality, testing of the original model by confirmatory factor analysis (CFA), establishing the new model by exploratory factor analysis (EFA) and CFA, testing the correlation between the new model and criterion instrument, and evaluating the reliability. Results: A total of 415 participants completed the survey. The structure of the original version was not suitable for the Taiwanese elderly. We developed a Chinese version of the B-APQ from outpatient dimensions and one additional item that accounted for cultural differences (for a total of 18 items). The indicators of construct validity were Chi-square (387.79), GFI (0.91), AGFI (0.88), RMSEA (0.07), and SRMR (0.054). For the convergent validity, the correlation coefficient was −0.07–0.39 for the Physical Activity Scale and -0.07–0.71 for the scale of the World Health Organization Quality of Life. The Cronbach’s alpha was 0.86–0.91. Conclusions: The Chinese version of the B-APQ has good validity and reliability and is suitable for the measurement of the aging perceptions of older persons with chronic diseases in Taiwan.