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A preliminary study on the effects of the Peer-Led Self-Management (PLSM) program on self-efficacy, self-management, and physiological measures in older adults with diabetes: a block randomized controlled trial
This study explored the effects and feasibility of the peer-led self-management (PLSM) program for older adults with diabetes. Twenty-eight participants from 10 communities in southern Taiwan were randomly allocated to experimental and control groups. Those in the experimental group were enrolled in a 4-week PLSM program; those in the control group received a self-management manual and continued their usual clinical care. Improvement in outcomes (self-efficacy, self-management, physiological measures) over time in both groups were evaluated. After PLSM intervention, self-efficacy and self-management had improved; body weight and body mass index measures of the experimental group at post-test 1 and post-test 2 were significantly lower than those of the control group (p < .001); HbA1c, total cholesterol, and triglycerides at post-test 2 were also significantly better (p < .001; p = .03; p = .02). We discuss preliminary benefits and feasibility of the PLSM program
The Impact of Gender on the Effectiveness of an Auricular Acupressure Intervention Administered to Community-Dwelling Poor Sleepers: A Cluster Randomized Controlled Trial
Background: Women report a higher incidence of sleep problems than men. Few studies addressing the effect of gender on the efficacy of administering auricular acupressure (AA) at shenmen points (heart meridian 7 [HT7]) on sleep quality have been published.
Purpose: The primary aim of this study was to investigate the effects of a 4-week AA intervention applied at the HT7 points on sleep quality, perceived physical health, and perceived mental health in community-dwelling individuals with poor self-reported sleep quality. Additional analyses were used to evaluate the gender-specific effects of this intervention.
Methods: A cluster randomized controlled trial with repeated-measures design was used. One hundred seventy-nine eligible participants were randomly assigned to either the AA group (n = 88; 47 women, 41 men) or the sleep hygiene instruction (SHI) group (n = 91; 52 women, 39 men). The AA group self-administered acupressure at HT7 on both ears for a 4-week period, whereas the SHI group received an SHI information sheet. Outcome measures included the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form Health Survey-12 Version 2, with data collected at baseline and at 2, 4, and 8 weeks posttest.
Results: Linear mixed-model analysis revealed that the participants in the AA group experienced significantly greater reductions in mean PSQI global score and the three indices of sleep latency, subjective sleep quality, and daytime dysfunction than the SHI group at 2 and 4 weeks posttest. The improvements in subjective sleep quality and daytime dysfunction remained at 4 weeks posttest in the AA group, but not in the SHI group. The PSQI global score decreased significantly more in men than women in the AA group between baseline and 4 weeks posttest.
Conclusions/implications for practice: Four weeks of self-administered acupressure at HT7 on both ears is an effective intervention for community-dwelling poor sleepers who are over 45 years old. Moreover, the improvements in subjective sleep quality and daytime dysfunction persist for up to 4 weeks after the end of the intervention. This self-administered acupressure intervention is more effective in men than in women in terms of improving sleep quality. Gender bias is known to influence research results and may lead to inappropriate generalizations. Thus, future studies that are performed to build basic scientific evidence should include considerations of the effects of gender in the study design
The Learning Effects of Health Promotion on the Meaning of Life, Positive Beliefs, and Well-being among Nursing Students in Taiwan
Smartphone usage and associated mental health and academic achievement in nursing students
指導教授:蔡佳純背景:越南護理系學生過度使用智慧型手機的情況有所增加。但是,沒有足夠的證據表明越南護生中使用智能手機對心理健康和學業表現有潛在的風險。
目的:研究目的為確定和探討越南護理系學生使用智慧型手機的頻率、心理健康和學業成就之間的關係。
方法:這項橫斷面研究於2019年11月至2020學年5月在峴港Duy Tan大學護理系進行,納入了280名男女學生。該問卷是針對青少年問題性智慧型手機使用自我評估問卷(SQAPMPU)收集的個人資料、使用方式、使用手機的目的和強度。使用憂鬱性焦慮憂鬱症(DASS 21)評估憂鬱,焦慮和壓力症狀。學業成就是基於學生在Mydtu系統上的得分以及班上學習行為的總結。
數據的統計分析包括描述性統計的應用,t檢定,卡方檢定,變異數分析,二元羅吉斯迴歸和相關檢定。
結果:學生使用智能手機問題的比例為24.6%。 多變量線性回歸分析結果顯示,每天的通話次數 (β = 0.602, 95% CI = 0.098-1.107 p = 0.02) 、 每天的短訊 (β = -0.277, 95% CI = (-0.54) – (-0.015), p = 0.038)、 用於學習目的的時間 (β = -0.459, CI 95% = (-0.838)- (-0.08), p = 0.018) 與憂鬱症狀有關。 在手機上花費在社交網絡上的時間(β = 0.884,95% CI = 0.231 - 1.538,p = 0.008)與壓力症狀相關密切。 學生的 PMPU與憂鬱指數(β = 1.668,95% CI = 0.804 - 2.531,p < 0.0001)、焦慮(β = 1.619,95% CI = 0.743 - 2.495,p < 0.0001)和壓力密切相關(β = 1.395,95% CI = 0.505 - 2.286,p = 0.002)。 學生的 PMPU 分數越高,憂鬱、焦慮和壓力的症狀就越多。 尚未發現智能手機使用與學業成績之間的關係。
結論:智能手機使用和有問題的智能手機使用 (PMPU) 與學生的憂鬱、焦慮和壓力有關。 然而,研究中沒有足夠的證據證明智能手機的使用和有問題的智能手機使用會影響學生的學習成就
Assessment of Nursing students' knowledge and attitudes toward people living with HIV/AIDS
指導教授:莊麗玉背景:愛滋病已成為全球最重要的公共衛生問題之一。愛滋病不僅破壞身體免疫造成易感染,還影響受愛滋病患者(PLWHA)的心理健康和社會關係。多年來,雖然對愛滋病取得了相當大治療和照護成效的成功,然而社會仍然害怕並歧視罹患愛滋病的患者,愛滋病的污名化況仍然是最大挑戰之一,這導致愛滋病患者(PLWHA)面臨許多障礙。而污名化也在醫療機構中發生,醫護人員歧視,在照顧愛滋病患者(PLWHA)時持消極態度,這將影響對愛滋病人的照護品質。
目的:本研究的目的是評估護理學生對愛滋病的知識和愛滋病患者(PLWHA)的態度,以及了解護理學生的人口學變項和照顧經驗對HIV知識和態度的影響。
方法:採用橫斷面描述性設計在越南大學某護理系三年級和四年級共 206 名護生進行研究。分別以人口學變項、愛滋病知識問卷(18 HIV-Q)與愛滋病態度量表(AAS) 調查。利用百分比和平均數分析人口學變項、愛滋病知識和態度得分。以T檢定、單因子獨立變異數分析(ANOVA)了解人口學變項和照顧經驗對愛滋病知識和態度的影響;皮爾森相關係數 (Pearson correlation) 來檢定知識和態度之間的關係。
結果:結果表明,在206名護理學生中,平均HIV知識得分(SD)為11.33±2.66,76.22%學生(n = 157)知識得分高於平均數,有23.78%的學生(n = 49)低於平均數。態度得分為4.19(SD = 0.51)。護生的年齡、年級、生活水平和對愛滋病的知識了解程度之間存在顯著的關係。態度方面在人口學變項,沒有關係,但與居住地有關(t = 2.11,p = 0.04)。知識和態度之間存在顯著相關性(P <0.05)。
結論:本研究顯示,儘管幾乎所有的大學生都具有愛滋病的知識和態度很好,但是大約有23.8%的護理學生沒有足夠的知識,這顯示須加強有關愛滋病正確知識的課程,在其學習過程中
Knowledge and Attitudes toward cancer pain management among Vietnamese Nurses
指導教授:許瓊尹背景:疼痛管理是臨床護理中十分重要的任務,因為疼痛若沒有處置會讓病患產生負面的影響,也阻礙了治療的效果更降低了生活品質。 因此,在臨床照護的護理人員,應該對疼痛管理具備正確的知識、態度和評估技巧。 如此,才不會造成疼痛評估的失誤。
目的:本研究的目的聚焦於了解在治療腫瘤專責醫院工作的越南護士對癌痛管理的知識和態度。
方法:本研究採用橫斷面研究方式。使用的研究工具是一份定名為“Knowledge and Attitudes Survey Regarding Pain (KASRP)” —「對於疼痛的知識與態度」的問卷,另外,就是護理人員基本資料的收集。KASRP問卷共有三種類型的題目:(1) 是非題,從第一題到第21題;(2) 選擇題(單選),從第22題到第35題;(3)案例問題,從第36題到第37題。 本研究在一家治療腫瘤的專責醫院施作,並邀請全院的護理人員參與。問卷資料的分析則採用SPSS 22資料分析程式分析。
結果:本研究共有178位護理人員回覆問卷,他們都在越南胡志明市一家治療腫瘤的專責醫院服務。問卷問題類型分為:是非題、單選題及案例問題三大類。護理人員在答題的正確率如下:是非題、選擇題答對的題目的比率超過70%,案例問題的答對率則接近50%;而且工作經驗少於七年的護理人員比工作經驗超過七年的護理人員有更多的正確答案(p < 0.05)。此外,會自行閱讀疼痛管理相關書籍或期刊的護理人員也比沒有閱讀的護理人員答對更多的題目(p < 0.05)。
結論:從研究結果顯示:參與本研究的護理人員有較多的癌痛管理的知識。此外,工作經驗在七年以下的護理人員比起工作經驗七年以上的護理人員會更主動閱讀有關癌痛的書籍或期刊
Exploring the Influences on Applying Shared Decision Makingon with Nursing Staff Workplace Fatigue Factors
指導教授:羅家倫近年來,衛生福利部推動醫病共享決策模式是目前臨床醫療照護的趨勢,護理人員在照護團隊中扮演著重要的角色,對於醫病共享決策的執行過程應具備完整的教育訓練。護理人員長期面對臨床工作上的壓力,易導致職場疲勞進而影響工作滿意度。本研究採橫斷式調查法,以高雄某區域教學醫院有參與醫病共享決策360位護理人員為研究樣本,共有效問卷306份,回收率85%。研究工具使用林(2000)發展之情緒勞務量表及葉(2008)編製之中文版職業疲勞量表,以SPSS軟體進行統計分析。
研究結果發現整體情緒勞務平均總分125.23 ±17.51,屬於偏高層度;職業疲勞平均總分187.78±58.37,屬於中至高程度。在已婚、有子女、每週工作時數,年齡、工作年資顯示有較高程度的職業疲勞。分析在接受過醫病共享決策訓練之課程時數顯示在工作疲勞(F=2.43,p< 0.05)、服務對象疲勞(F=2.76,p< 0.05)及工作過度投入(F=3.51,p< 0.01),在接受訓練課程時數有顯著的差異性。進一步分析在護理人員接受過醫病共享決策課程時數與工作疲勞(r=-.140, p<0.05)、服務對象疲勞(r=-.152,p<0.01)呈現負相關,工作過度投入(r=.126, p<0.05) ,呈現正相關。預測因子有年齡、工作年資、工作單位、職級、工作時數、基本情緒表達、情緒多樣性程度、深層的情緒偽裝及接受醫病共享決策課程時數。
研究結果有助於瞭解護理人員參與醫病病共享決策教育訓練方面的需求,作為建置改善之依據。在醫療院所方面可以制定有效訓練課程的策略,如此才能引導護理人員在醫病共享決策中積極應對,以減輕職場疲勞的程度