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Development and psychometric testing of the Perception of Childbirth Environment Scale in Taiwan
No full text[[abstract]]Background: Previous research has shown that women's perceptions of their childbirth environment are critical in ensuring that they feel supported and in facilitating physiological childbirth.
Aim: To develop and validate the Perception of Childbirth Environment Scale (PCES) for expectant mothers.
Methods: The PCES was developed based on findings from a scoping review and a qualitative study on childbirth environments conducted by the authors. The scale underwent expert review to ensure relevance, clarity, and content validity, followed by face validity testing with five women. A total of 193 participants, recruited from two medical institutions, completed the PCES within 48 h after childbirth. Reliability was assessed using Cronbach's ? for internal consistency. Construct validity was evaluated through exploratory and confirmatory factor analyses.
Results: The PCES comprised 10 items divided into two dimensions: comfort and control. "Comfort" factors included privacy, homeliness, familiarity, relaxation facilitation, and a sense of continuity in the room, while "Control" factors were reflected in elements like a birth companion, empowerment, and safety. The model demonstrated a good fit following exploratory and confirmatory factor analyses, as well as adjustments based on modification indices.
Conclusions: The PCES displayed strong reliability and validity, making it a suitable tool for assessing women's perceptions of their labor and childbirth environment
Effects of Auricular Acupressure on Postoperative Nausea and Vomiting in Patients With Gynecological Laparoscopic Surgery: A Randomized Controlled Trial
No full text[[abstract]]Purpose: Postoperative nausea and vomiting (PONV) is common among females undergoing gynecological surgeries. PONV not only causes patients discomfort but also leads to serious complications, affecting their health outcomes. This study aimed to evaluate the effectiveness of applying auricular acupressure to alleviate PONV and postoperative anxiety and to improve satisfaction with anesthesia care in patients undergoing gynecological laparoscopic surgery (GLS).
Design: A randomized control trial was conducted for this study.
Methods: Eighty patients who received general anesthesia for GLS were recruited at a medical center in northern Taiwan and randomly assigned to the control and experimental groups. Both groups had pellets taped onto different auricular points after the surgery: the stomach (CO4), cardia (CO3), liver (CO12), occiput (AT3), shenmen (TF4), and subcortex (AT4) for the experimental group and the knee (AH4) and thoracic vertebrae (AH11) for the control group. The pellets were removed 24 hours after surgery. The severity of PONV was assessed as the primary outcome. Secondary outcomes included levels of anxiety and satisfaction with postanesthesia care.
Findings: After 24 hours of follow-up, patients in the experimental group reported significantly less PONV and a higher level of satisfaction with anesthesia care compared to patients in the control group. However, the levels of postoperative anxiety between the control and experimental groups were statistically insignificant.
Conclusions: The study demonstrates that the six auricular points, including CO4, CO3, CO12, AT3, TF4, and AT4, can effectively alleviate PONV and improve the quality of anesthesia care after GLS. Auricular acupressure is a nonpharmacologic treatment for PONV that takes cost and patient satisfaction into consideration
School adjustment experiences of ventilator-dependent children: A phenomenological study of mothers' perspectives
No full text[[abstract]]Purpose: This study aimed to describe the experiences of ventilator-dependent children (VDC) in adjusting to school life from the perspectives of their mothers.
Design and method: This study employed a descriptive phenomenological approach. From July 2021 to September 2022, ten mothers of VDC were recruited via purposive sampling and underwent in-depth individual interviews. Data were analyzed using Colaizzi's phenomenological method. This study adheres to the COREQ guidelines for qualitative study.
Findings: Four themes emerged: (1) the transition and burden of the mother's role; (2) positive adjustment and assessment of resources; (3) develop strategies to meet health and learning needs; (4) expectations for accessible school environments.
Conclusions: The mothers extensively assessed and adjusted their coping strategies on a rolling basis to ensure that their children received the resources that met their individual needs, promoted peer interactions, and helped adjustment to school life. The children's improvement and progress surpassed their mothers' expectations and demonstrated the benefits of a school education. Future educational settings should focus on building accessible school environments for special needs children.
Practice implications: These findings allow healthcare professionals to assess the needs of VDC at different educational levels and create care plans that meet their healthcare and educational needs. This study also provides a reference for amending policies and regulations on individualized educational programs for VDC and developing guidelines for realizing accessible school environments to help them adjust to school life
Feasibility and effect of cognitive-based board game and multi-component exercise interventions on older adults with dementia
No full text[[abstract]]Background: Taiwan is an aging society, and the number of people with dementia is rapidly increasing. Due to a decline in cognitive and physical function, older adults with dementia not only gradually lose the ability to complete daily living tasks on their own, but are also at a higher risk of falls and injurious falls. It is important to develop interventions that combine cognitive and exercise training for older adults with dementia to promote or maintain their cognitive and physical functions and reduce their risk of falls. This study aimed to investigate the feasibility and effect of cognitive-based board games and multi-component exercise interventions on cognitive function, physical fitness, and fall risk in older adults with dementia.
Methods: This was a quasi-experimental study with a single-group pretest and post-test design. The study participants were 41 community-dwelling older adults with mild to moderate dementia. They received cognitive-based board games and multi-component exercise interventions once a week for 12 weeks. The interventions included 1 hour of exercise training and 1 hour of cognitive training. Scores for the Taiwan version of the Montreal Cognitive Assessment (MoCA-T), physical fitness, and the St. Thomas Risk Assessment Tool for Falling Elderly Inpatients (STRATIFY) were measured as outcome indicators at baseline and after the 12-week period.
Results: The overall MoCA-T score increased significantly (effect size = 0.402), with participants with mild dementia showing a greater increase (effect size = 0.522) than those with moderate dementia (effect size = 0.310). Participants' physical fitness performance improved. Female participants exhibited significant improvements in the 30-second chair stand test (effect size = 0.483) and 8-foot up-and-go test (effect size = 0.437). The fall risk score decreased by 0.05 points, the change was not significant.
Conclusion: The cognitive-based board game and multi-component exercise interventions used in this study are beneficial for improving cognitive function and physical fitness in older adults with dementia. These interventions are feasible and suitable for promotion among community-dwelling and institution-dwelling older adults with mild cognitive impairment or dementia to delay the decline in cognitive and physical function
Evaluating the impact of modified care meals on the quality of life in older adults with chewing disorders during early stages of frailty
No full text[[abstract]]Objectives: This study aims to investigate whether the intervention of modified care meals can improve oral health, nutritional status, quality of life, and meal satisfaction.
Design: A Randomized Controlled Trial (RCT) study.
Setting: This study enrolled at the outpatient clinic in a certain regional hospital in the eastern Taiwan as the research subjects.
Participants: The study collected the data using single-blind design, and enrolled 60 research subjects of older adults.
Interventions: The experimental group received the modified care meals.
Main outcome measure: This study observed the chewing functional status, oral health functional status, nutritional status, oral health quality of life, and meal satisfaction of the two groups before the intervention and at Week 6 and Week 12 after the intervention to analyze the effectiveness of the intervention scheme.
Analysis: This study used Generalized Estimating Equation (GEE) to analyze the effectiveness indicators.
Results: After the intervention of the 12-week modified care meals, 30 subjects in each of the experimental group and control group completed the study, with a zero-attrition rate.
Gee analysis results: Oral Health Assessment Tool (OHAT) (p-value <0.05(T1); p-value = 0.071(T2)); Mini Nutritional Assessment-short form (MNA-SF) (p-value <0.001(T1); p-value = 0.05(T2)); Taiwan Oral Health Impact Profile (OHIP-14) (p-value <0.001(T1); p-value <0.001(T2)); Geriatric Oral Health Assessment Index (GOHAI) (p-value <0.001(T1); p-value <0.001(T2)); meal satisfaction (p-value <0.001(T1); p-value <0.001(T2)) all reached statistically significant differences.
Conclusions and implications: This study found that poor oral health management and chewing functional abnormalities have negative effects on the meal intake of the older adults. The modified care meal manual improved the oral quality of life and meal satisfaction of the older adults
Effectiveness of Applying the Theory of Planned Behavior with Yoga Program on the Physical Activity and Mental Health of the Prefrailty Older Adults
No full text[[abstract]]Objectives: Grounded in the theory of planned behavior (TPB), this study evaluated the effectiveness of a yoga program intervention on the physical functioning and mental health in older adults.
Materials and methods: This was a quasi-experimental two-group, pre- and posttest, single-blind study. The participants were older adults above 65 years of age and in the early stage of frailty. The intervention for the experimental group was a twice weekly 60-min yoga session for 12 weeks; the control group received physical activity lectures in the 1st and 8th weeks. Pretest is conducted before the intervention, posttest one is conducted in the 8th week, and posttest two is conducted in the 12th week. Outcome indicators include physical activity level, body balance, flexibility, lower limb muscle strength, mental health (Brief Symptom Rating Scale [BSRS]), exercise behavior questionnaire, etc.
Results: After 12-week silver yoga intervention, there were 31 participants in the experimental group with a loss of 9% (29% loss rate), whereas there were 29 participants in the control group with a loss of 6% (20% loss rate). Results from generalized estimating equations that grip strength index (P = 0.000), right lower limb muscle strength (P = 0.000), left lower limb muscle strength (P = 0.000) were significant between groups for both experimental and control groups, whereas other outcome indicators such as physical activity level, balance, flexibility, and mental health were not significant between groups. However, experimental within-group mean differences at week 12 for grip strength (P = 0.000), BSRS (P = 0.016), physical activity level (P = 0.000), right lower limb muscle strength (P = 0.000), left lower limb muscle strength (P = 0.000), simple physical function assessment (P = 0.000), single-leg standing (P = 0.000), upper limb flexibility (P = 0.000), lower limb flexibility (P = 0.000), exercise behavior evaluation attitude (P = 0.000), and exercise behavior evaluation perceived behavioral control (P = 0.000) were all significant.
Conclusions: This study uses Ajzen's TPB as a basis to explore the behavioral intention after silver yoga intervention. This theory believes that an individual's specific behavior is affected by his or her behavioral intention, and the behavioral intention depends on the actor's attitude and subjective attitude toward the behavior. Norms perceived behavioral control. The research results show that yoga intervention attitude has the highest impact on behavioral intention, followed by perceived behavioral control and finally subjective norms. The experimental group has changed their attitudes and cognitions to increase their behavioral intentions. They have a deeper understanding of yoga asanas. They have broken through the difficult limb bending and kneeling postures seen in the past, which has increased their participation in yoga activities and confidence in their perceived behaviors. It also enhances behavioral intention, which means that the attitude and personal behavior of the research subjects after the intervention increase the elder's exercise intention, making the elder more clearly aware that yoga asanas are competent, thereby increasing the regularity of activity participation
Association between Thyroid Profile Levels and Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study
No full text[[abstract]]Background: Thyroid cancer is the most common endocrine carcinoma, accounting for 3.26% of all cancers. The most histologically, well-differentiated thyroid cancer is papillary thyroid carcinoma (PTC). Although PTC is regarded as an indolent tumor, a portion of the cancer cells metastasize to lymph nodes around the thyroid gland. Lymph node metastasis (LNM) is a critical risk factor for tumor recurrence in PTC, which strongly affects disease prognosis and the quality of life. Methods: This study aims to examine how differences in the level of the thyroid profile and other risk factors may influence LNM incidence in patients with PTC in Taiwan. We carried out a single-center retrospective study. These PTC patients were retrospectively reviewed by the Department of Endocrinology from 2016 to 2019. A total of 165 patients were included in our research. Results: The findings revealed a close relationship with the level of free thyroxine (FT4), the level of the thyroid-stimulating hormone (TSH), and lymph node metastases. The correlation in terms of FT4 (p = 0.005) and TSH (p = 0.417) with LNM was found as a result of the univariate regression analysis. In the multiple regression analysis, the findings revealed a close relationship between LNM, FT4 (p < 0.001), and TSH (p = 0.008). Conclusions: Although the predictability of the TSH should be examined further, the association between LNM and FT4 or TSH should not be ignored. The results could help guide decision-making and patient counseling, using the level of serum FT4 or the TSH as a possible predictive factor of the LNM in PTC
Using a Mobile Health App (ColonClean) to Enhance the Effectiveness of Bowel Preparation: Development and Usability Study
No full text[[abstract]]Background: Colonoscopy is the standard diagnostic method for colorectal cancer. Patients usually receive written and verbal instructions for bowel preparation (BP) before the procedure. Failure to understand the importance of BP can lead to inadequate BP in 25%-30% of patients. The quality of BP impacts the success of colonoscopy in diagnostic yield and adenoma detection. We developed the "ColonClean" mobile health (mHealth) app for Android devices. It incorporates visual representations of dietary guidelines, steps for using bowel cleansing agents, and observations of the last bowel movement. We used the Technology Acceptance Model to investigate whether the use of the ColonClean mHealth app can improve users' attitudes and behaviors toward BP.
Objective: This study aims to validate the effectiveness of the ColonClean app in enhancing user behavior and improving BP, providing safe and cost-effective outpatient colonoscopy guidance.
Methods: This study uses a structured questionnaire to assess perceived usefulness, perceived ease of use, and users' attitudes and behaviors toward BP regarding the ColonClean mHealth app. A total of 40 outpatients who were physically and mentally healthy and proficient in Chinese were randomly chosen for this study. The data were analyzed using SPSS 25.0, and we used Pearson product-moment correlation and simple regression analysis to predict the perception of ColonClean.
Results: The results showed that 75% (30/40) of participants achieved an "excellent" or "good" level of BP according to the Aronchick Bowel Preparation Scale. Perceived usefulness and perceived ease of use of the ColonClean mHealth app were positively correlated with users' attitudes and behaviors (P<.05).
Conclusions: The ColonClean mHealth app serves as an educational reference and enhances the effectiveness of BP. Users expressed their willingness to use the app again in the future and recommend it to family and friends, highlighting its effectiveness as an educational guide for BP
Maternal Health Literacy in Pregnant Women: A Concept Analysis
No full text[[abstract]]Objectives: Maternal health literacy (MHL) plays a vital role in pregnancy outcomes, healthcare researchers should further analyze, refine, and develop this concept. This study aims to clarify the definition of MHL in pregnant women through a analysis of the concept.
Methods: Walker and Avant's concept analysis approach was used to analyze the concept of MHL. A search of the literature was completed using the databases PubMed, CINAHL, Web of Science (WOS), and the Science and Technology Index (SINTA) for years 2001-2021; literature search included grey literature, publications from the government and academic institutions, and available both in English and Indonesia. A total of 12 articles were reviewed.
Results: MHL is a multifaceted and comprehensive concept. This study presents a working definition of MHL during pregnancy as the skills enabling women to access, comprehend, evaluate, and apply health information related to pregnancy, which are necessary for making decisions for improving and maintaining both maternal and fetal health. Guided by Walker and Avant's method, the major attributes and outcomes are determined in this study.
Conclusion: Healthcare professionals can utilize this analysis to familiarize their institutions with the MHL concept, emphasize its importance, and apply it to practice. This contributes to enhancing the body of knowledge on MHL and potentially improving maternal health outcomes
Development and Evaluation of a Care Needs Scale for Parents of Children With Tourette Syndrome
No full text[[abstract]]BACKGROUND: Tourette syndrome (TS) is a chronic neurodevelopmental disorder that begins in school-age children. Although TS is not life-threatening, the tics and comorbidities can impact a child's physical and mental health, as well as interpersonal interactions. Understanding the care needs of parents of children with TS is essential for providing healthcare services that effectively support these children. The aim of the study was to develop and evaluate the psychometric properties of the care needs scale for parents of children with TS (CNS-PCTS) in Taiwan. METHODS: This study used a methodological design. The scale was developed by preliminarily identifying relevant items and dimensions through a systematic review of the literature. A pilot test with 30 participants and exploratory factor analysis (EFA) confirmed the subscales and items pertaining to the care needs of the parents. Data analysis included content validity, item analysis, internal consistency, test-retest reliability, and EFA. The Chinese version of the Pittsburgh Sleep Quality Index was adopted to assess the discriminant validity of the CNS-PCTS. RESULTS: Two hundred fifty-six parents of children with TS completed the scale. The scale-level content validity index was 0.92. The EFA revealed that the CNS-PCTS consisted of 13 items, with the factor loadings ranging from 0.656 to 0.83, and covered 3 factors: getting information about TS, assisting children in social engagement, and obtaining parenting support. The discriminant validity showed a positive correlation between the Chinese version of the Pittsburgh Sleep Quality Index and the CNS-PCTS. Cronbach's ? coefficients of the subscales ranged from 0.89 to 0.94, and the intraclass correlation coefficient was 0.94. CONCLUSION: The CNS-PCTS demonstrated satisfactory psychometric properties. It helps health professionals understand parents' care needs and assess the effectiveness of interventions. Confirmatory factor analysis can be performed in future studies to provide more rigorous validity