Juo-Hsiang Sun

Background: By 2025, Taiwan is projected to enter a super-aging society. Although significant advancements in medical technology have been made, the challenges associated with chronic diseases persist, particularly the issue of "multiple comorbidities" that often accompanies aging. Maintaining good spiritual health is not only crucial for psychological well-being but also plays a significant role in disease recovery, fostering positive health behaviors, and improving overall well-being. This study therefore aimed to investigate the effect of self-efficacy on spiritual health and explore other influencing factors. Methods: Stratified sampling was employed to survey individuals aged 45 years or older, who had been diagnosed with chronic diseases for a duration exceeding 3 month. A total of 120 valid samples were obtained with an effective response rate of 93%. The research instruments used in this study consisted of a demographic information questionnaire, the Herth Hope Index, an Acceptance of Illness Scale, and a Spiritual Health Scale. The collected questionnaire data underwent analysis using a structural equation model. Results: Among middle-aged and older adults living with chronic diseases, hope in life was found to be positively associated with self-efficacy (β = 0.48, P < 0.000). Their acceptance of illness was also found to be positively correlated with self-efficacy (β = 0.20, P < 0.019). Furthermore, self-efficacy exerts a significant positive impact on various dimensions of spiritual health, encompassing religious sustenance (β = 0.23, P < 0.017), connection with oneself (β = 0.38, P < 0.000), the meaning of life (β = 0.56, P < 0.000), transcendence of adversity (β = 0.61, P < 0.000), and connection with nature (β = 0.43, P < 0.000). Conclusions: Self-efficacy has a positive impact on the spiritual health of older adults with chronic diseases. Higher levels of self-efficacy are associated with better spiritual health outcomes. Additionally, hope in life and acceptance of the disease influence self-efficacy, subsequently affecting spiritual health indirectly. Greater levels of hope in life and acceptance of the disease can lead to increased self-efficacy, which in turn contributes to improved spiritual health. In the future, enhancing spiritual health can be achieved by promoting factors that influence spiritual well-being. Individuals can make adjustments to their lifestyle and adopt healthy behaviors, thereby improving self-worth and fostering positive emotions that contribute to overall health improvement.

Objective: This study aimed to investigate the correlation between self-care knowledge, psychological well-being, and disease self-management in patients with hypertensive nephropathy, and to assess the effect of psychological well-being as a mediator of self-care knowledge and disease self-management. Methods: This is a cross-sectional study. The 220 patients with hypertensive nephropathy were recruited from a teaching hospital in Taiwan using purposive sampling. The average age was 70.14 (SD = 11.96) years old. Among them, 128 (58.2%) were male and 92 (41.8%) were female. Instruments included a hypertensive nephropathy self-care knowledge scale, the World Health Organization-5 Well-Being Index, and the chronic kidney disease self-management instrument. The mediating effect was determined with linear regression models and the Sobel test. Results: The total explanatory variation of age, systolic blood pressure, psychological well-being, and self-care knowledge on the disease self-management was 27.7%. Psychological well-being was the most important explanatory factor and alone explains 16%. Psychological well-being was a partial mediator of self-care knowledge and quality of life in patients with hypertensive nephropathy, with a total effect of 23.2%. Conclusions: This study showed that older patients with hypertensive nephropathy and those with a higher systolic blood pressure had lower levels of disease self-management. The higher the patients’ self-care knowledge and psychological well-being, the better their disease self-management.

This study aimed to understand the behaviors of older adults in rural areas at all stages of active aging after participating in senior self-directed learning groups. This study adopted a qualitative research method and conducted one-on-one semi-structured interviews with six members of a senior learning center in a rural area. The themes identified from the thematic analysis were categorized into three levels: health, safety, and participation. The health level included (1) understanding the importance of exercise and taking the initiative in leading simple group exercises to develop regular exercise habits and (2) paying greater attention to disease and diet control through knowledge sharing with group members.The safety level included (1) paying more attention to safe driving when volunteering with other members; and (2) resonating with fall prevention techniques and cultivating a safe home to prevent falls. The participation level included (1) having more common topics to share with family members to enhance relationships (2) changing conceptualizations of interpersonal relationships and actively expanding and managing a circle of friends; and (3) increasing willingness to actively participate in social activities compared to before participating in the group. The results of this study showed that after joining the senior self-directed learning groups, the older adults had a positive change in their cognition of active aging, recognized the importance of active aging, and then faced their aging process with a positive attitude.

In response to the emergence of the aging society, the vocational high school education system in Taiwan has established a care service department since 2018. The purpose of this study was to develop core competencies and a professional curriculum for the care service department in vocational high schools. First, this study invited 20 experts and scholars to take part in a focus group to collect suggestions as the basis for the development of core competencies and a curriculum. Second, this study invited 10 experts and scholars to participate in three rounds of a Delphi survey to evaluate the planning for the development of core competencies and a curriculum that meet educational needs. In this study, we identified eight core competency constructs and 15 indicators across two dimensions relating to the care services taught in vocational high schools. We then designed 26 professional subjects according to the core competencies. We identified the core competencies for long-term care service education and devised a professional curriculum to foster the skills and knowledge among students that are required for successfully meeting the care needs of a rapidly aging society through work in the long-term care industry after graduation.

Background In response to the emergence of the aging society, the vocational high school education system in Taiwan has established the care service department since 2018. The purpose of this study was to develop core competencies and a professional curriculum for the care service department in vocational high schools. Methods This qualitative study enrolled experts and scholars in the field of long-term care as subjects. First, this study invited 20 experts and scholars to take part in a focus group to collect suggestions as the basis for the development of core competencies and a curriculum. Second, this study invited 10 experts and scholars to participate in three rounds of a Delphi survey to evaluate the planning for the development of core competencies and a curriculum that meet educational needs. Results In this study, we identified eight core competency constructs (interpersonal communication, care, creativity and execution, professional care, patient safety and care, resource connection and application, problem-solving and improvisation, and adherence to a professional code of conduct and ethics) and 15 indicators across two dimensions (general competencies and professional competencies) relating to the care services taught in vocational high schools. We then designed 26 professional subjects according to the core competencies. Conclusions In the past, the core competencies required for providing long-term care could only be cultivated in universities. In response, the Taiwanese government has promoted the cultivation of caregivers in high school, encouraging vocational high schools to establish care service departments and learning pathways to meet long-term care demands in Taiwan, overturn the stereotype that long-term care is an unspecialized profession, and enhance the willingness of young adults to work in the long-term care industry. To foster students’ professional competencies, we identified the core competencies for long-term care service education and devised a professional curriculum to foster the skills and knowledge among students that are required for successfully meeting the care needs of a rapidly aging society through work in the long-term care industry after graduation.

The study investigated the relationships between job satisfaction and career transition competency among middle-aged and older employees. The study adopted a survey method and used purposive sampling to recruit middle-aged and older employees in Taiwan as study participants. A total of 512 questionnaires were distributed, with a response rate of 96.68%. Two survey instruments were used in the questionnaire, namely a job satisfaction scale and a career conversion ability Scale. The results of the study were that: 1. Subjects held a relatively positive and active attitude towards their career transition competency. Among the facets of career transition competency, career networks had the highest mean score, whereas individual career management had the lowest mean score. 2. Significant positive correlation was found between job satisfaction and career transition competency. 3. Significant explanatory power (R-2 = 0.45) was found in the factors of age, educational level, work place, reason for job change, and job satisfaction. The principal conclusion was that the government should collaborate with social education institutions to facilitate the education of middle-aged and older workers to help them better adapt to the changing employment environment, thereby improving their employment stability.

Long-term stress experienced by caregivers is often overlooked, as is their pre-planning for senior life, but helping middle-aged and older caregivers to prepare for senior life is the foundation for active aging. The purpose of this study is to elucidate middle-aged and older caregivers’ attitudes toward aging, proactive coping, and the need to learn life safety and to identify the factors influencing their need for life safety instruction. In this study, a questionnaire survey was administered to middle-aged and older caregivers with 1 year of experience or more in caring for older adults. In total, 500 questionnaires were distributed using a snowball sampling method, of which 415 valid questionnaires were recovered. The research tools included a personal information questionnaire, attitude toward aging scale, proactive coping scale, and need for life safety instruction scale. The results of this study were that: 1. Middle-aged and older caregivers had a low psychological evaluation of aging and a weak response to aging. 2. Respondents demonstrated a strong need to learn life safety. 3. Average monthly salary, aging awareness, aging behavior, attitude toward proactive coping, and proactive coping ability were strong predictors of the need to learn life safety. The principal conclusion was that the need for life safety instruction increased concurrently with unemployment, a decrease in aging awareness and behavior, an improvement in attitude toward proactive coping, and a decrease in proactive coping ability. Therefore, life safety education can be provided to the aforementioned group to satisfy their learning needs adequately.