Age-related macular degeneration (AMD) causes vision impairment which is not recoverable under existing treatment options. It has been a major leading cause of blindness in the aged population. To ameliorate the self-care ability for AMD patients, educational interventions to mediate negative impacts of the disease on quality of life have become a research interest. Current practice in the proposed Hong Kong setting, Elderly Health Centre A and Elderly Health Centre B, depends on nurses giving general advice which is lack of scientific support and non-specific to AMD. Purpose of this dissertation is to translate the best evidence to practice for improving the care of older adults with AMD in the proposed setting. Evidences showed that self-management education programmes were effective in improving emotional distress and self-efficacy. Electronic searches located 9 relevant RCTs of high level and methodologically strong evidences. Data was extracted into tables of evidence. Data summary and synthesis was presented. Assessment on the implementation potential indicated that the SEP was worth to try in the local setting. Twelve recommendations for the practice guidelines of SEP were presented and a communication process to facilitate the change in a top-down approach was introduced. A pilot study plan in Centre A followed by a main study in Centre A and Centre B was presented. A total of 98 elderly patients with AMD will be recruited as 10 SEP groups. Approximately 1.8 years will be used to finish the main study. Outcomes will be measured at the 6th week follow-up. ‘Emotional distress’ will be measured as primary outcome and ‘self-efficacy’ will be measured as secondary outcome. ‘Client satisfaction’, ‘staff satisfaction’ and the ‘utilization rate of the innovation’ will also be assessed in evaluation. A two-tailed paired (one-sample) t-test will be adopted for analysis, with a 95% confidence interval. The basis for effectiveness for the outcome measurements and basis for adoption of the clinical guidelines were stated. Adoption of the developed guidelines in the local setting will optimistically improve the substantial clinical outcomes for AMD patients, mediating the negative impacts of vision impairment or vision loss on their quality of life. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Decline of memory is often a complaint registered by members of an older adult population. There has been a limited amount of previous research evaluating subjective and objective memory in elderly Asian cultures. The purpose of this study was to explore factors related to memory function among Taiwanese older adults which included the following: the individual’s characteristics, perception of metamemory, degree of memory self-efficacy, and level of memory performance. This was a cross-sectional, descriptive, and correlational study. A proposed conceptual framework, based on the previous literature, was developed as the guideline for the study. Well established instruments were employed in measuring participants’ memory knowledge and attitudes, namely metamemory, (Metamemory in Adulthood), memory self-efficacy (Memory Efficacy), and memory performance (Rivermead Behavioural Memory Test). A non-probability sample of 130 Taiwanese older adults completed the interview. The research findings indicated that the participants reported above average knowledge of memory processes, achievement motivation regarding memory, a good memory capacity, personal control over their memory, and an ability to use memory strategies. In contrast, they perceived their memory as declining over time and were slightly anxious when considering memory tasks. In addition, they displayed a moderate level of confidence about their own memory, with elderly males expressing more confidence than females about their memory abilities. The memory performance of older Taiwanese adults was in the range of poor memory on the Rivermead. Factors contributing to memory function were correlated with each other. As stated above, these were individual characteristics, metamemory and memory self-efficacy. Significant predictors for memory performance were age, education, health status and memory selfefficacy. The results of this study suggested that culture-specific factors regarding memory are vital for older Taiwanese adults to evaluate their own memory. Potential topics for future research include: exploring the meaning of memory with an in-depth interview to distinguish memory self-efficacy from positive adaptation to memory deficit; understanding how memory operates while participants work in pairs rather than individually; and implementing an interventional program for health and cognitive promotion. / text

This experiment investigated memory changes across the adult lifespan and some factors that might be associated with these changes. Adult participants of all ages (16 to 83 years old) were asked to orally describe scenic color photographs, and then following a delay, to re-describe these pictures from memory. Given information is objective, physical objects and their attributes that are depicted in a target picture, whereas beyond information is subjective, personal experiences and inferences that are not depicted in a target picture per se but are associated with a target picture. Chapter 3 examined the content of these picture descriptions for the amount of given and beyond information that was encoded and retrieved about target pictures. The results indicated an age-related decline in memory for given information and preserved memory for beyond information. Chapter 4 examined the relationship between perceptual and verbal ability and memory for given and beyond information. Perceptual ability was assessed by self-report measures of auditory and visual ability and verbal ability was measured by a standardized test. The results indicated that an age-related improvement in verbal ability, but not an age-related decline in perceptual ability, was related to memory for given and beyond information. Chapter 5 explored age-related changes in memory for feminine and masculine information across the adult female lifespan. Feminine and masculine information is information that would be considered exclusively relevant to young women and men, respectively. The results indicated an age-related increase in memory for feminine information and no age-related change in memory for masculine information. The divergent age-related changes in memory for given and beyond information and for feminine and masculine information were interpreted in terms of a developmental approach to schema theory and the lifespan psychology notions of selective optimization with compensation and loss in the service of growth. The present study suggests an integration between the domains of personality and cognitive psychology as one avenue for future research that could lead to a more complete understanding of memory and aging.

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Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 13-17). / vii, 17 leaves, bound ill. 29 cm