title: Improving activities of daily living for nursing home elder persons in Taiwan.
abstract: BACKGROUND
  Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability.
  
  
  OBJECTIVE
  The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior.
  
  
  METHODS
  This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index.
  
  
  RESULTS
  Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance.
  
  
  CONCLUSIONS
  The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is needed to determine the long-term maintenance and effectiveness of this theory-driven SCSEEP in specific culture groups.
authors.affiliation: Department of Nursing, Chung Hwa University of Medical Technology, Tainan Hsien, Taiwan, ROC. suhsian@yahoo.com
authors.forename: Su-Hsien
authors.initials: SH
authors.lastname: Chang
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Wung
authors.forename: Neva L
authors.initials: NL
authors.lastname: Crogan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009042:Motivation; D009735:Nursing Homes; D010549:Personal Satisfaction; D012648:Self Care; D012649:Self Concept; D013624:Taiwan