Setting and Participants
This study was conducted in 10 nursing homes in
Kaohsiung, Southern Taiwan. These nursing homes
were privately funded, government accredited, and
equipped with 49 beds, which resembled the majority
of nursing homes in Taiwan. Based on the nursing
home registry in Kaohsiung, the principal investigator
called the directors of the nursing homes to determine
their willingness to participate in the study; 10 nursing
home directors volunteered to participate. Inclusion
criteria were as follows: (a) aged 65 and over, (b) using
wheelchairs for mobility, (c) living in the facility for at
least 3 months, (d) cognitively intact (Short Portable
Mental Status Questionnaire score 8; Pfeiffer, 1975),
and (e) heavily or moderately dependent on others to
perform activities of daily living (ADLs; Barthel Index
Setting and ParticipantsThis study was conducted in 10 nursing homes inKaohsiung, Southern Taiwan. These nursing homeswere privately funded, government accredited, andequipped with 49 beds, which resembled the majorityof nursing homes in Taiwan. Based on the nursinghome registry in Kaohsiung, the principal investigatorcalled the directors of the nursing homes to determinetheir willingness to participate in the study; 10 nursinghome directors volunteered to participate. Inclusioncriteria were as follows: (a) aged 65 and over, (b) usingwheelchairs for mobility, (c) living in the facility for atleast 3 months, (d) cognitively intact (Short PortableMental Status Questionnaire score 8; Pfeiffer, 1975),and (e) heavily or moderately dependent on others toperform activities of daily living (ADLs; Barthel Index
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