This study was undertaken to document the knowledge, attitude and behavior among family caregivers, and to identify the related factors influencing their behavior in promoting their and children's oral health. A cross-sectional study was conducted to collect self-administered questionnaires from 503 family caregivers, who cared for 6-12 year-old children with disabilities in 10 special schools. Multiple regression models were used to analyze the association between caregiver's oral health behaviors and related factors. Most caregivers were female (74.8%). The top three sources of oral health knowledge among caregivers were dentists (66.60%), books (34.59%) and television (31.21%). Comparison of oral health knowledge and attitude scores among different education levels of caregivers yielded statistically significant differences (p < 0.05). Eighty-four percent of caregivers cleaned their teeth twice a day and 46.12% used dental floss. More than half of caregivers (60.44%) assisted their children to brush teeth. Only 12.65% took their children to receive fluoride varnish services. Caregivers' favorable oral health behavior was found to be significantly associated with a higher education level, better knowledge and positive attitude. The determining factor of caregivers' preventive behavior was attitude. Education level influenced the caregiver's knowledge. Knowledge is positively associated with attitude. Inadequate knowledge is the major factor preventing caregivers from favorable oral health behavior. Oral health related educational programs aimed at promoting caregivers' behavior must take into consideration the caregivers' knowledge level first. Education programs should be recommended to caregivers with a lower education level.

Aspiration pneumonia (AsP) was reported to be closely related to poor oral hygiene. This study aimed to investigate the association between caregivers' oral hygiene behavior with AsP in the community dysphagia persons with nasogastric tube feeding (DPNgTF). A cross-sectional study was conducted on 128 DPNgTF and their corresponding caregivers. A self-reported structuralized questionnaire was used to measure the oral care behavior of caregivers. All data analyses were performed using the SPSS. The Chi-square was used for comparison of nonparametric data. Fisher's exact test was used when the expected frequency of any cell in the table was less than five. A p value <0.05 was considered statistically significant. Fifty-five DPNgTF had developed AsP (43.0%) and they had statistically significantly halitosis (adjusted OR = 4.46; 95%CI = 2.01-9.93), deposition of oropharyngeal secretion (OR = 4.39; 95%CI = 1.99-9.66), dry mouth (OR = 4.23; 95%CI = 1.81-9.85) and closing mouth and not allow to brush (adjusted OR = 2.83; 95%CI = 1.28-6.27). The poor oral hygiene status of DPNgTF was significantly correlated with the occurrence of AsP. The caregivers' oral care to DPNgTF after getting up (OR = 14.09; 95%CI = 2.92-68.08) and using sponge stick to care (OR = 3.29; 95%CI = 1.26-8.55) were the risk factors of AsP. The implemented oral care after getting up only, using sponge stick has a higher risk compared to the implemented oral care prior to sleeping, using toothbrush. The importance of implementing oral care prior to sleeping by using toothbrush should be reinforced in DPNgTF. Guidelines of oral care and education courses for caregivers during the process in their career training are needed.

Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and/or swallowing difficulties (NCSD) and with chewing and/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p < 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults.

Most senior veterans who live in veteran homes in Taiwan have few interpersonal relationships. Aging is often accompanied by solitude and illness, which causes senior veterans to doubt the meaning of life and to lose confidence in the value of life. This study tested the effectiveness of a group reminiscence therapy protocol on the depression and meaning of life among elderly institutionalized veterans. A quasi-experimental design was applied. A convenience sample of older adults was drawn from two veteran homes in southern Taiwan. Participants were assigned to intervention or control groups based on the veterans' homes they attended. The participants in the intervention group carried out group reminiscence therapy for 8 weeks in addition to their daily activities. The participants in the comparison group maintained their daily activities. Both groups were evaluated using the GDS-SF and MLS scale including two aspects of depression mood and meaning of life in weeks 1 and 8. The overall life satisfaction increased significantly over time for the intervention group compared to the comparison group from week 1 to week 8. The group reminiscence therapy programs showed promising effects in improving the depression and meaning of life of older veterans living in veteran homes.