This study aimed to examine the perceptions of nursing staffs on the environmental conditions in their senior care centers in Kaohsiung City. Two hundred and twenty three female nursing staffs in nursing care centers participated in this study. A Self-reported questionnaire comprised 18 items was administrated in person to the participants. Results showed that nursing staffs have high satisfaction on the quality and techniques of their services. But they rated low scores on the philosophies of the company. It showed that they did not satisfy with the management of the company. In the end, I provided several suggestions to the senior care centers based on the results in this study.

The nursing staffs play an extraordinary important role of looking after the patients in the medical service. However, short of nursing staffs in the last couple of years in Taiwan, is a very serious problem, which leads both of the medical service environment and the clinical nursing into a difficult position. The outflow of nursing personnel is an international issue. Therefore, how to keep their nursing staff is the primary job for each hospital. If we can know the factors of the fluctuation before layoff, we can improve and change them to reduce, or even prevent the layoff. The main purpose of this study is to find the decisive factors of the nursing staffs turnover intention , why they want to quit their job. This research picks the questionnaire survey. And the survey object is the non-manager nursing staffs in a medical center in Kaohsiung city. To reduce the influences of the common method variation (CMV), we collect the samples with the method of two-wave bands. We have selected 545 persons altogether to fill the questionnaire, and 358 persons have completed effectively the two questionnaires. The final effective returns-ration is 65,7%. We have analyzed the returned questionnaires by the SPSS17 edition of statistics software, and have confirmed the supposition by the mean value, the standard deviation, the t-test, the one-way ANOVA, the Pierson correlation analysis and the hierarchical regression analysis. In view of the influence factors of the turnover intention for the nursing staffs: self-efficacy, organizational commitment, job stress, job satisfaction and burnout ...ect. We have confirmed the results by the statistical analysis as follows: 1. Self-efficacy natively affects on turnover intention. 2. There is relationship between organization commitment and turnover intention (Affective commitment and continuance commitment natively affects on turnover intention¡FNormative commitment positively affects on turnover intention). 3. There is relationship between job stress and turnover intention (Job demand positively affects on turnover intention). 4. Job satisfaction natively affects on turnover intention. 5. There is relationship between burnout and turnover intention (Emotional exhaustion positively affects on turnover intention). 6. There is remarkable difference between the nursing staffs¡¦ age and turnover intention. There is remarkable difference between the nursing staffs¡¦ work change and turnover intention. 7. The organization commitment is the determinants of the nursing staffs¡¦ turnover intention. 8. Self-efficacy, organization commitment, job stress, job satisfaction and burnout are related to one another.

Bakgrund: Många äldre personer drabbas av olika former av demenssjukdomar. Om personerna inte drabbas av annan dödlig sjukdom kommer demenssjukdomen i sig slutligen leda till döden. Palliativ vård är ofta förknippat med cancer- och hjärt- och kärlsjukdomar men allt mer börjar den palliativa vården introduceras även för patienter med demenssjukdom. Då demens ofta leder till kommunikationssvårigheter uppstår det problem i att ge en god personcentrerad vård i livets slutskede. Syfte: Syftet var att belysa vårdpersonals erfarenheter i det palliativa vårdandet av patienter med demenssjukdom inom äldreomsorgen. Metod: En litteraturöversikt har genomförts utifrån sökningar på databaserna CINAHL complete, Pubmed och Ageline. De utvalda artiklarna bestod av åtta kvalitativa studier och två tvärsnittsstudier. Analysen genomfördes utifrån Fribergs analysmetod. Resultat: I resultatet beskrivs Tillämpning av palliativ vård för patienter med demenssjukdom, vårdpersonalens upplevelse av symtomlindring, vikten av god kommunikation och hinder och möjligheter för god palliativ vård. Det framkom att det kunde upplevas svårare att bedöma när en patient med demenssjukdom är i behov av palliativ vård än vid andra sjukdomstillstånd. Detta resulterade även i att vårdrelationen mellan patient och vårdpersonal var av stor betydelse för igenkänning av symtom. Vårdpersonal upplevde att det fanns brister i det emotionella stödet efter att ha vårdat en patient med demenssjukdom palliativt. Diskussion: I metoddiskussionen diskuteras metodens fördelar och nackdelar, valet av artiklar och varför vissa begränsningar har utförts. I resultatdiskussionen diskuteras det framkomna resultatet i relation till den teoretiska utgångspunkten De 6 s:n. Kopplingar till personcentrerad vård belyses i resultatdiskussionen. / Background: A great amount of elderly people suffer from different forms of dementia and unless these individuals suffer from another terminal disease the dementia will by its nature lead to death of the patient. Palliative care is often associated with cancer and cardiovascular diseases, however the palliative care is beginning to see the introduction of treatment for people with dementia. Aim: The aim was to highlight nursing staffs' experiences of patients suffering from dementia within gerontological care in end of life. Method: A literature review has been done based on search results from databases CINAHL complete, Pubmed and Ageline. The selected articles consisted of eight qualitative studies and two cross-sectional studies. The authors have based the analysis on Friberg's method of analysis.   Results: In the result describes Introduction of palliative care for the people suffering from dementia, nursing staffs´experience of symptom relief, the importance of good communication as well as hindrance and possibilities for good palliative care. It was discovered that it can be perceived as harder to judge when a patient suffering from dementia is in need of palliative care compared to patients with other medical conditions. This also resulted in the caring relationship between patient and nursing staff is of high importance for the recognition of symptoms. Nursing staff perceived there were flaws in the emotional support after having nursed a patient with dementia. Discussion: In the method discussion pros and cons regarding the chosen method is discussed, as well as the choice of articles and why some restrictions have been made. In the result discussion the result in relation to the theoretical entry points 6 S:s  is discussed. Correlations to person-centered care is discussed through the discussion of the result.