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"Lin, Li-Chan"
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Cross-Cultural Responses to Digital Guides in Authoritarian Heritage: A Case Study of the Chiang Kai-Shek Memorial Hall
Over the past two decades, transitional justice has become a central concern in Taiwan’s cultural and political landscape. This study investigates how 1029 visitors from Taiwan, Sinophone regions (China, Hong Kong, Macau, Malaysia), and international backgrounds engage with digital interpretation systems at the Chiang Kai-shek Memorial Hall (CKSMH)—a politically sensitive site associated with Taiwan’s authoritarian past. Using a mixed-methods approach combining surveys and qualitative responses, the study analyzes cross-cultural differences in visitor motivation, use of digital tools, perceived experiential value, satisfaction, and behavioral intention. Results show that international visitors reported higher levels of engagement and satisfaction, particularly in educational, esthetic, entertainment, and escapist dimensions. In contrast, Sinophone visitors expressed lower satisfaction and more frequent discomfort with the site’s historical narrative. Key factors such as language accessibility, cultural proximity, and usability influenced how visitors perceived the digital content. The findings suggest that interactive digital tools can support both cultural engagement and critical reflection while also revealing tensions in memory politics at sites of transitional justice.
Journal Article
Little Curators, Big Voices: Empowering Young Children’s Cultural Participation Through Exhibition-Based Learning in Preschool
This study explores how museum experiences can be integrated into preschool curricula to enhance young children’s participation, expression, and aesthetic learning. Conducted in a public kindergarten in Taoyuan, Taiwan, the research adopted a practice-based methodology over an eight-week thematic project titled Little Curators Program. Children aged 5 to 6 participated in co-curating exhibitions, including naming, spatial layout, and guided storytelling. Qualitative data were collected through observation, interviews, children’s works, and video documentation. The findings reveal that young children demonstrated agency, narrative ability, and emotional-symbolic expression when granted curatorial roles. Their collaborative dialogue and spatial reasoning suggest that exhibition-making supports social-emotional development and multimodal literacy. Additionally, teachers shifted from product-oriented to process-oriented pedagogy, engaging in reflective practice and inquiry-based teaching. The study highlights exhibitions as inclusive learning environments that align with children’s rights to cultural participation and voice, as emphasized in the UN Convention on the Rights of the Child. Recommendations are offered for fostering sustainable school–museum partnerships, teacher professional development, and equitable access to cultural learning. This research affirms the potential of exhibition-based curricula as a powerful pedagogical tool in early childhood education.
Journal Article
Effects of Mindfulness-Based Elder Care (MBEC) on symptoms of depression and anxiety and spiritual well-being of institutionalized seniors with disabilities: a randomized controlled trial
Background
Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings.
Methods
This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T
0
), mid-intervention (T
1
), post-intervention (T
2
) and follow-up (T
3
) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively.
Results
Linear mixed model (LMM) showed that MBEC participants’ mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T
2
; trait-anxiety at T
2
and T
3
) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group.
Conclusions
MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines.
Trial registration
This study was registered with Clinical Trial Registry (ClinicalTrials.gov – U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.
Journal Article
Reliability and Validity of a Chinese Version of the Cohen–Mansfield Agitation Inventory-Short Form in Assessing Agitated Behavior
Background: Patients with dementia often present agitated behaviors. The Cohen–Mansfield Agitation Inventory-short form (CMAI-SF) is one of the most widely used instruments to evaluate agitated behaviors that affect patients’ quality of life and impose burden on caregivers. However, there is no simplified Chinese version of the CMAI-SF (C-CMAI-SF) in clinical settings. Purpose: This study aimed to develop a Chinese version of the C-CMAI-SF and examine its validity and reliability. Methods: This cross-sectional study included three phases. In Phase I, the original CMAI-SF was translated to Chinese. In Phase II, experts were invited to examine the content validity index (CVI). Phase III was conducted to test the validity and reliability of the C-CMAI-SF. Results: The scale showed good validity and reliability with a scale-level CVI of 0.89, Cronbach’s alpha (measure of internal consistency) of 0.874, and test–retest correlation coefficient of 0.902 (for 257 individuals). Using factor analysis, three factors were identified. Regarding concurrent validity, the C-CMAI-SF score was correlated with the Neuropsychiatric Inventory (agitation aggression subscale) and the Cornell Scale for Depression in Dementia (agitation subscale). Conclusions: The study demonstrated that the C-CMAI-SF is a valid and reliable instrument for evaluating agitated behaviors in people with dementia. Relevance to clinical practice: The C-CMAI-SF is an easy and quick tool used to identify and evaluate agitated behaviors in busy clinical settings.
Journal Article
From Emotions to Actions: Developing Social and Emotional Learning (SEL) Competencies Through Board Game Design in a Fifth-Grade Curriculum
This study explores the design and implementation of a fifth-grade emotional education curriculum that integrates design thinking and board game creation within a social and emotional learning (SEL) framework. Using an action research approach, students collaboratively designed and fabricated an original board game titled “Emotion Toolbox.” In this context, the emotion toolbox refers to a set of student-generated emotional strategies and expressions, embedded as game mechanics (e.g., emotion cards, response tokens), to help externalize, share, and regulate emotions through gameplay. Through a sequence of experiential and reflective activities, including emotional role-play, peer feedback, and creative decision-making, students engaged deeply with emotional content. These activities were supported by tools such as laser cutting and character development workshops. Findings revealed significant gains in students’ SEL competencies, particularly in self-awareness, relationship skills, and responsible decision-making. Quantitative data showed statistically significant improvement across all five CASEL (Collaborative for Academic, Social, and Emotional Learning) domains, while qualitative evidence demonstrated enhanced emotional vocabulary, interpersonal communication, and collaborative behaviors. In addition, the curriculum design process fostered the teacher’s professional growth, emphasizing the value of responsive pedagogy and interdisciplinary innovation. This model offers actionable strategies for post-pandemic emotional recovery and provides transferable insights for future SEL curriculum development across diverse educational contexts.
Journal Article
Understanding the Burden: Exploring Key Factors in Dementia Caregiving in Residential Care Homes
Background: The factors of influence on caregiver burden with regard to dementia care provided in residential care homes are multifaceted. Few studies in the literature have simultaneously investigated the variables related to residential care recipients with dementia and their formal caregivers. Purpose: This study was designed to assess caregiving burden in formal caregivers of residential care recipients with dementia and to identify significant predictors of this burden associated with these care recipients and their caregivers. Methods: This prospective cross-sectional study enrolled 206 registered nurses and nursing assistants working as formal caregivers, as well as 256 residents with dementia across 6 residential care homes. Structured questionnaires were used to collect data on the sociodemographic characteristics, attitudes, dementia care knowledge, and caregiver burden of nursing staff, as well as data on the sociodemographic characteristics, daily functional ability, cognitive functioning, and neuropsychiatric symptoms of residential care recipients with dementia. Results: The formal caregivers in this study reported experiencing mild to moderate care burden. Stepwise linear regression analysis identified prior dementia care training, confidence in care provision, and attitude in the formal caregivers and number of medications and agitation/aggression levels in the residents as significant predictors of caregiving burden, explaining 32% of the variance. Unexpectedly, the basic dementia care knowledge of the caregivers and the physical dependence and other neuropsychiatric symptoms of the residents were not identified as significant predictors of caregiver burden. Conclusions/Implications for Practice: The findings of this study underscore the critical importance of caregiver attitude, confidence, and coping skills in determining caregiving burden, noting that not all behavioral and psychological symptoms impact this burden equally. These insights emphasize the need to enhance confidence and positive attitudes in formal caregivers and to effectively manage residents' aggressive behaviors through both pharmacological and nonpharmacological approaches to ameliorate the high caregiver burden associated with dementia care.
Journal Article
Development of the Nurses’ Occupational Stressor Scale
Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses’ Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses’ stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses’ work environments. Nine subscales were included: (1) work demands, (2) work–family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach’s α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.
Journal Article
Primary diagnoses and outcomes of emergency department visits in older people with dementia: a hospital-based retrospective study in Taiwan
ABSTRACTObjectivesThe objectives of this study were to investigate the primary diagnoses and outcomes of emergency department visits in older people with dementia and to compare these parameters with those in older adults without dementia. Design and SettingThis hospital-based retrospective study retrieved patient records from a hospital research database, which included the outpatient and inpatient claims of two hospitals. ParticipantsThe patient records were retrieved from the two hospitals in an urban setting. The inclusion criteria were all patients aged 65 and older who had attended the two hospitals as an outpatient or inpatient between January 1, 2009, and December 31, 2016. Patients with dementia were identified to have at least three reports of diagnostic codes, either during outpatient visits, during emergency department visits, or in hospitalized database records. The other patients were categorized as patients without dementia. MeasurementsThe primary diagnosis during the emergency department visit, cost of emergency department treatment, cost of hospital admission, length of hospital stay, and diagnosis of death were collected. ResultsA total of 149,203 outpatients and inpatients aged 65 and older who were admitted to the two hospitals were retrieved. The rate of emergency department visits in patients with dementia (23.2%) was lower than that in those without dementia (48.6%). The most frequent primary reason for emergency department visits and the main cause of patient death was pneumonia. Patients with dementia in the emergency department had higher hospital admission rates and longer hospital stays; however, the cost of treatment did not show a significant difference between the two groups. ConclusionsFuture large and prospective studies should explore the severity of disease in older people with dementia and compare results with older adults without dementia in the emergency department.
Journal Article
Comparison of long-term effects of exergaming (Xbox one kinet) and companionship programs on attitude towards dementia and the older adults among adolescents: a quasi-experimental longitudinal study
Background
Many studies have been performed on the use of intergenerational programs to improve the negative attitudes and misunderstandings of adolescents toward older people with dementia. However, the findings of these studies are inconclusive. The aim of this study was to compare the long-term effects of exergaming (Kinect) and companionship programs on attitudes toward dementia and the elderly among adolescents.
Methods
A quasi-experimental longitudinal design was used. A total of 200 adolescents aged 12–18 years old were recruited from nine schools in northern Taiwan. The adolescents were assigned to five different groups, namely, a 5-week exergaming group, a 5-week companion group, an 8-week exergaming group, an 8-week companion group, and a control group, using a single blinding procedure. Data collection was performed pretest, post-test and at 1, 3 and 6 months after the post-test. The long-term effects of the two programs (i.e., exergaming and companionship) were analyzed using a generalized estimating equation.
Results
Regarding attitudes toward dementia, the 8-week exergaming group had a significantly better attitude than the control group at the 6-month follow-up (
p
< 0.001). Similarly, the results of the 8-week companion group also showed a significantly improved attitude compared with the control group at the 6-month follow-up (
p
= 0.041). Regarding attitudes toward the elderly, the 8-week exergaming group had a significantly better attitude than the control group at the 6-month follow-up (
p
< 0.001). The 8-week companion group had a similar effect on better attitude compared with the control group at the 6-month follow-up (
p
= 0.016). Furthermore, the 5-week companion group showed a significant improvement compared with the control group at the 6-month follow-up (
p
= 0.004).
Conclusions
Spending companionship time with older adults is beneficial for improving the attitudes of adolescents toward the elderly. Furthermore, exergaming improves the attitudes of adolescents toward both dementia and older adults.
Trial registration
Chinese Clinical Trial Registry:
ChiCTR2100053003
. Retrospectively registered on 07/11/2021.
Journal Article