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AIM: This study aims to discuss how narrative pedagogy of improving the positive attitude toward older people among nursing students and increasing students' willingness to practice older people's care. BACKGROUND: Considering the progress of population aging, the requirement for nursing manpower in older people care is on the rise. However, related studies have demonstrated that nursing students generally have a negative attitude toward older people, which affects students' willingness to engage in older people's care in the future. DESIGN: This study applied mixed method research design. For the quantitative study design, we have adopted a quasi-experimental study, pretest-posttest design. METHODS: The study adopted purposive sampling. A total of 87 nursing students in two classes of five-year junior college program in northern Taiwan were selected as the study subjects. The students were randomly allocated into an experimental group of 43 subjects and a control group of 44 subjects. The experimental group received narrative pedagogy of geriatric care course for 18 weeks with 2 h per week, the control group received general lectures. This study was conducted between October 2019 and February 2020. The quantitative data were collected using the structured questionnaire. The qualitative data were collected by individual interviews and students' reflective writing. RESULTS: The average scores of the older people's attitude (F=4.60, p < 0.05) and the willingness to care for the older people (F=4.19, p < 0.05) in the experimental group increased significantly, reaching a statistically significant level. According to the adjusted post-test score averages of the two groups, under the control of the pre-test, the Older Adults Attitude Scale (64.02 >60.22) and the post-test of the Older Adults Care Willingness Scale (11.63 >9.93) in the experimental group were significantly higher than those in the control group. In the qualitative analysis, four themes were emerged, which were negative stereotypes about the older people, myth-breaking for prejudice against the older people, new older people impression for replacement and rethinking for older people care. CONCLUSION: Narrative pedagogy is an effective teaching method, which can improve nursing students' older people's positive attitudes and increase students' willingness to practice older people's care.

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BACKGROUND: With the rapid increase in the aging population, a greater number of older individuals will require nursing care in the future. Therefore, it is important for nurses to be willing to engage in gerontological nursing. Nursing students must increase their experience in providing care to older people during their education and must receive education that improves their attitudes toward aging; this will help provide care to the older people, develop positive attitudes toward aging, and increase their empathy and willingness to provide care to older people after graduation. Hence, studies focused on improving the attitude of nursing students toward aging are urgently required. METHODS: In this mixed-method experimental study, participants were interviewed individually and observed to better understand the connection between quantitative and qualitative data. Service learning and learning portfolio constructions were integrated in the gerontological nursing curriculum of an experimental group, whereas traditional gerontological nursing curriculum was provided to a control group. Quantitative data on the nursing students were collected using the attitudes toward aging scale (ATAS) and older people behavioral intention scale (OBIS) and analyzed using descriptive and inferential statistics. RESULT: From the pre- to the post-test, the average ATAS and OBIS scores of the experimental group increased significantly, reaching a statistically significant level. However, the results of the control group indicated that the educational intervention does affect the attitudes toward aging and older people behaviors. A qualitative analysis revealed that educational intervention can improve the students' attitudes toward aging and older people behavioral intention. CONCLUSION: Our study results showed that integrating community older people service and learning portfolio construction into the curriculum can effectively improve the attitudes of nursing students toward aging and older people's behaviors, thus providing substantial assistance to students intending to care for the older people in the future.

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Background: Obesity is the main risk factor of cardiovascular diseases (CVD) and metabolic diseases. The middle-aged population is the age group with the highest prevalence of obesity. Thus, improving cardiometabolic health is important to prevent CVD and metabolic diseases in middle-aged obese adults. The aim of this study was to examine the effects of exercise alone or in combination with a high-protein diet on markers of cardiometabolic health in middle-aged adults with obesity. Methods: Sixty-nine middle-aged adults with obesity were assigned randomly to the control group (C; n = 23), exercise group (E; n = 23), or exercise combined with high-protein diet group (EP; n = 23). Individuals in the E and EP groups received supervised exercise training and individuals in the EP group received high-protein diet intervention. Body composition (assessed by dual-energy X-ray absorptiometry), oral glucose tolerance test (OGTT), lipid profiles, and inflammatory markers were determined before and after 12 weeks of intervention. Insulin sensitivity index (ISI0,120) was calculated from values of fasting and 2-h insulin and glucose concentration of OGTT. Insulin-peak-time during the OGTT was recorded to reflect ß-cell function. Analysis of covariance with baseline values as covariates was used to examine the effects of the intervention. The significant level was set at 0.05. Results: After 12 weeks of intervention, the E group had a greater percentage of individuals with early insulin-peak-time during the OGTT than that in the C and EP groups (p = 0.031). EP group had lower total cholesterol and triglycerides than that in the C group (p = 0.046 and 0.014, respectively). Within-group comparisons showed that the 2-h glucose of OGTT and C-reactive protein decreased in the EP group (p = 0.013 and 0.008, respectively) but not in the E and C groups; insulin sensitivity improved in the EP group (p = 0.016) and had a trend to improve in the E group (p = 0.052); and abdominal fat mass and total body fat mass decreased in both intervention groups (p < 0.05). Conclusion: Combined high-protein diet and exercise intervention significantly decreased fat mass and improved lipid profiles, insulin sensitivity, glucose tolerance, and inflammation in middle-aged adults with obesity. Clinical Trial Registration: Thai Clinical Trials Registry, TCTR20180913003, 13-09-2018.

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BACKGROUND: Advancements in medical care have increased the average life span in many countries, resulting in a generally longer postretirement life span. However, retirees may find it difficult to adapt to retirement. Therefore, encouraging retirees to engage with society is important. PURPOSE: In this study, a senior social participation mobile software application (SSP-App) was developed to stimulate social participation among seniors with the goal of improving their social participation intentions and behaviors. METHODS: After developing the SSP-App based on user experiences, a quasi-experimental study was conducted. Participants were recruited from the Keelung Ren'ai Community Center. Next, Random Allocation Software Version 1.0.0 software was used to randomly allocate the participants into experimental and control groups. The 54 participants in the experimental group took part in an SSP-App program, whereas the 53 participants in the control group did not participate in any experimental treatment program. Measurements were conducted at Week 4 (T1) and Week 12 (T2) to evaluate the effects. Data were collected using a demographic datasheet, Geriatric Depression Scale-Short Form, Emotional and Social Support Scale, Social Participation Intention Scale, and Social Participation Behavior Scale. The generalized estimating equations method was used to determine intervention effectiveness. RESULTS: The SSP-App has six main functions, including an activity partner message board, an activity search function that provides information about different activities, a "Seniors Learning Kiosk" that provides useful information, transportation information, an activity planning and reminder system, and a "First-Aid Station." Most participants in the SSP-App precursor test expressed approval. At T1, effects were observed in social participation intention only. However, at T2, effects were observed in both social participation intention and social participation behavior. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The SSP-App developed in this study uses information and communication technology and multiple strategies covering information provision, social support, education, and reminders. Social participation obstacles must be overcome to effectively provide seniors with social participation opportunities and improve their social participation.

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A scarcity in the intake of dairy products in older women begets a wide range of musculoskeletal problems, especially osteoporosis. However, dairy products are often not consumed in sufficient quantities in Eastern societies. This study used empowerment education to improve daily dairy intake in 68 older Asian women in the community through a quasi-experimental study design. The 34 participants in the experimental group took part in empowerment education programs that included lectures, sharing sessions, situation dramas, and cooking activities, for two hours per week for 6 weeks. The 34 participants in the control group had no interventions. The generalized estimating equation was used to evaluate the intervention's effectiveness. The test was conducted for the two groups at 1 and 12 weeks after the completion of the lessons. We used daily dairy intake self-efficacy, intention, and behavior scale to measure the outcome. The change in the experimental group's daily dairy intake self-efficacy and intention score at post-1 week and post-12 weeks was higher compared to the control group, but the dairy intake behavior was only changed at post-12 weeks. The empowerment education was effective in encouraging older women to change their dairy intake behavior and improved their dairy intake self-efficacy and intentions.

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