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[[alternative]]An Evidence-based Systematic Literature Analysis of Plyometric Exercise on Physical Performance of Rugby Players.
No full text[[abstract]]研究背景：橄欖球 (Rugby) 起源於1823年的英國，經過百年發展，形成多種玩法不同的橄欖球，其中英式橄欖球最受歡迎，於2016年第一次成為奧運正式項目。橄欖球運動是一項高強度肢體接觸的運動，球員除了要有良好的身體素質更需具備良好的體能 (心肺耐力、肌力、爆發力和敏捷能力) ，而增強式訓練被廣泛應用於提升運動員整體體能表現，尤其在力量、速度、爆發力和敏捷性方面。然而，增強式訓練對提升橄欖球員的體能的效益仍存在疑問。本研究旨在通過系統性文獻回顧，綜合分析增強式訓練對橄欖球運動員體能表現的影響，提供更全面、準確的研究結果和建議。研究方法：本研究運用文獻蒐集與系統性文獻回顧作為研究方法，探討增強式運動對橄欖球運動員體能表現效益，應用PICO之組成要素，以英文搜尋資料庫PubMed，搜尋時間涵蓋1990年至2024年，主要檢索「隨機對照試驗」和「臨床試驗」，排除非橄欖球運動員和非英文文章，採用布林邏輯方法輸入，透過OR同義字與AND連結關鍵字 「橄欖球運動員」 、 「增強式運動」 、 「體能表現」 、 「跳躍能力」 和 「敏捷性」 ，找出目標文獻。 最後通過Joanna Briggs Institute （JBI） 和PEDro的兩種文獻品質分析篩選文章，最終選出10篇文獻。研究結果：不同層次和類型的橄欖球運動員，在接受各類增強式訓練計畫，以及增強式訓練與複合訓練、高強度間歇訓練和抗阻力訓練相結合後，其體能表現均有顯著提升。綜合分析結果顯示，增強式運動在提升橄欖球運動員的力量、速度、敏捷性、柔韌性和平衡能力方面具有顯著效果。合併橄欖球專項訓練與增強式運動的訓練計劃，以及複合訓練，不僅顯著改善了運動員的肌肉架構和運動能力，還能有效維持賽季中的最佳體能狀態。此外，適當的訓練量和訓練內容順序選擇有助於最大化訓練效果，並且高強度間歇訓練在提升橄欖球七人制運動員體能和技術水平方面展現出明顯優勢。在實際應用中，教練應根據運動員的個體差異和比賽需求，靈活調整訓練計劃，以達到最佳的訓練成果。關鍵詞：增強式訓練、橄欖球員、跳躍能力、敏捷度[[abstract]]Background: Rugby originated in the United Kingdom in 1823. After a century of development, it has developed into a variety of rugby games with different playing methods. Among them, rugby is the most popular and became an official Olympic sport for the first time in 2016. Rugby is a high-intensity contact sport. In addition to good physical fitness, players also need to have good physical fitness (cardiopulmonary endurance, muscle strength, explosive power and agility). Plyometric training is widely used to improve the overall performance of athletes. Physical performance, especially in the areas of strength, speed, power and agility. However, questions remain about the effectiveness of plyometric training in improving physical fitness in rugby players. This study aims to comprehensively analyze the impact of plyometric training on the physical performance of rugby players through a systematic literature review, and provide more comprehensive and accurate research results and suggestions.Method: This study uses literature collection and systematic literature review as research methods to explore the benefits of plyometric exercise on the physical performance of rugby players. It uses the components of PICO to search the database PubMed in English, and the search time covers 1990 to 2024. Mainly search for "randomized controlled trials" and "clinical trials", exclude non-rugby players and non-English articles, use the Bollinger logic method to input, and use OR synonyms and AND to connect the keywords "rugby players" and "strengthening exercises" , "Physical Performance", "Jumping Ability" and "Agility" to find the target literature. Finally, the articles were screened through two literature quality analyzes by Joanna Briggs Institute (JBI) and PEDro, and 10 documents were finally selected.Results: The physical performance of rugby players of different levels and types has been significantly improved after receiving various plyometric training programs and combining plyometric training with compound training, high-intensity interval training and resistance training.Comprehensive analysis results show that plyometric exercise has a significant effect in improving the strength, speed, agility, flexibility and balance of rugby players. The training plan that combines rugby-specific training with plyometrics, as well as compound training, not only significantly improves the athlete's muscle structure and athletic ability, but also effectively maintains the best physical condition during the season. In addition, appropriate training volume and training content sequence selection can help maximize training effects, and high-intensity interval training has shown obvious advantages in improving the physical fitness and technical level of rugby sevens players. In practical applications, coaches should flexibly adjust training plans based on athletes' individual differences and competition needs to achieve the best training results.Keywords：plyometric exercise、rugby players、jumping ability、agilit
[[alternative]]An Investigation between Dyslexia and Attentional Problems by Behavioral and Neurophysiological Assessments
No full text[[abstract]]學習障礙是源於神經心理功能異常造成的學習異常，在神經心理功能的異常中，發現學習障礙者在腦部結構、功能以及認知相關測驗與典型發展者有所差異。在臨床中，有學習障礙的學童常常呈現不專注的樣態，然而此樣態是否由於學習困難造成的分心，抑或是學生本身有注意力不足過動症，仍是值得討論的問題。本研究採用病歷回溯，分析台北市萬芳醫院學習障礙門診近五年學習障礙學童之語言測驗、聽覺事件相關電位資料，並以注意力問卷進行分組，比較學習障礙有注意力不足學童，以及無注意力不足學童在行為與事件相關電位之表現。研究共納入142位學習障礙學童，並依照問卷回溯進行分組，納入27位有注意力不足以及32位無注意力不足之學童進行分析。結果顯示：（ㄧ） 全體學習障礙學生中，在N200與P300異刺激音下的事件相關電位潛時有顯著差異。（二） 與無注意力不足學生相較，有注意力不足學童在P200的Cz、N2以及P300的Cz潛時顯著較短。（三） 有注意力不足學童中，P300中Fz的振幅在異刺激音後的上升情形較無注意力不足學童低。（四） 僅在有注意力不足的學童中，P200、N200位於Pz的異刺激音潛時與語言分數呈顯著正相關。本研究呈現整體學習障礙，以及有無注意力不足學童在語言和事件相關電位的表現差異，作為未來研究與臨床上之參考。[[abstract]]Learning disabilities originate from neuropsychological dysfunctions that lead to abnormal learning patterns. Clinically, children with learning disabilities often display inattentive behaviors. However, whether this inattentiveness is due to the difficulties in learning causing distraction, or if the children inherently have Attention Deficit-Hyperactivity Disorder (ADHD), remains a topic of discussion. This study adopts a retrospective analysis approach, to examine language tests and auditory event-related potentials (ERPs) from children with learning disabilities at the Wanfang Hospital in Taipei City over the past five years. This study also uses questionnaires to categorize the children with or without attentional difficulties and compare their behavioral and ERP performances. A total of 142 children with learning disabilities were included in this study. Based on the retrospective questionnaire analysis, 27 children with attention difficulties and 32 children without attention difficulties were analyzed. The results indicated: (1) There were significant differences in N200 and P300 latencies under oddball stimuli among children with learning disabilities. (2) Children with attentional problems showed significantly short latencies in Cz under P200 and P300, and all components in N200. (3) Among children with attention difficulties, the Fz amplitude in P300 increase following deviant stimuli were lower compared to children without attentional difficulties. (4) Significant positive correlations in Pz under P200 and N200 in children with attentional problems. This study presents differences in language and ERP performances between learning disability children with and without attentional difficulties, providing a reference for future research and clinical applications
[[alternative]]Montessori Material Design and Implementation for Three-to-six-year-old Children-Fruit
No full text[[abstract]]本研究名為「蒙特梭利教材設計與實施 - 水果學習」，旨在探討蒙特梭利教育工具如何提升幼兒對香港常見水果的認識與理解。研究涵蓋了一系列精心設計的教材與活動，旨在體現蒙特梭利教育的自我引導學習與探索原則。活動包括分類和配對遊戲、講故事以及唱歌，不僅旨在教授水果的名稱、外觀、口味和營養價值，還旨在提升幼兒相關的語言技巧和詞彙。在為期四週的研究期間，十五名三至六歲的香港蒙特梭利幼兒園學生參與了使用自製蒙特梭利水果教材的活動。通過前後測評估，研究發現幼兒對香港常見水果的知識和詞彙有顯著提升，從而證明了蒙特梭利教學方法和教材在增進幼兒水果知識方面的有效性。[[abstract]]The study examined the impact of Montessori educational tools on the comprehension and knowledge of fruits among 3-6-year-old students in a Hong Kong Montessori preschool. The study aimed to assess if Montessori methods and customized fruit-related materials could enhance children's understanding of various local fruits. Over a four-week intervention, children engaged with tactile Montessori materials and participated in interactive activities, including sorting games and storytelling about fruits. The study employed pre-tests and post-tests to measure the children's initial and subsequent knowledge of fruits. Results indicated significant improvements in the children’s fruit-related vocabulary and their ability to identify and describe different fruits. The Montessori approach not only increased cognitive and linguistic skills but also fostered a greater interest in and curiosity about fruits, suggesting potential for promoting healthy eating habits. The findings support incorporating Montessori methods into early childhood education to enrich learning experiences and development
[[alternative]]Montessori Design and Implementation for Preschool Aged Students in English as a Foreign Language-Dinosaurs
No full text[[abstract]]本研究以準實驗行動研究的方式，以英語為外語(EFL)運用蒙特梭利教學法向18位以中文為母語的學前兒童介紹恐龍相關字彙和知識。然後根據Stephen Krashen博士的第二語言習得(SLA)理論(1981)來檢驗英語作為第二語言(ESL)環境的預測因素，例如：第一語言主題和動機是否也適用於蒙特梭利在EFL學前幼兒園中的成效，以實現外語習得的可能性。在實施蒙特梭利教具和英語團體時間示範前後，分別以英語和中文進行口頭訪談，所有訪談問題都與恐龍字彙和恐龍相關的知識相關。在實施實驗教學五週後，對量化資料進行分析，以了解有多少學生能夠回答問題。研究結果顯示，多數學生在實驗教學後能夠以英語回答與恐龍有關的問題，而他們在這個實驗開始之前無法回答這些問題。質性資料顯示，在與實施專案實驗教學前相比，學生在實施期間對選擇恐龍相關工作更感興趣，同時，他們也能夠將課堂上獲得的訊息應用到課堂內外的適當場合中。蒙特梭利教具設計和實施的這項行動研究幫助一些學生在EFL中習得有關恐龍字彙和恐龍相關的新知，並增加了他們選擇較不喜歡的材料(如:數學)的頻率。研究數據還顯示，即使在課堂上不曾教過，學生也用中文學習了恐龍的詞彙和知識。調查第一語言主題和動機的作用，以幫助瞭解學前兒童在實施蒙特梭利教具和方法的環境中如何最有效地習得外語。[[abstract]]This study introduced dinosaur related culture vocabulary and knowledge with the Montessori Method in English as a Foreign Language (EFL) to 18 Mandarin speaking preschool students in Taiwan using quasi-experimental action research. The results were then examined according to Dr. Stephen Krashen’s Second Language Acquisition (SLA) Theory (1981) to investigate if the role of factors for an effective English as a Second Language (ESL) program, such as first language subject matter and motivation, are also applicable to a Montessori EFL preschool environment in order for foreign language acquisition to be possible. Verbal interviews were conducted with questions asked in English and Mandarin before and after implementing Montessori materials and circle time demonstrations in English, all related to dinosaurs and culture vocabulary. The quantitative data was reviewed to see how many more students were able to answer the questions after implementing the materials for five weeks. The data showed that a significant amount of students were able to answer dinosaur related questions in English after implementation that they were unable to answer before this project began. Qualitative data also showed students to be more interested in choosing dinosaur related work during implementation compared to before the project and that they were able to generalize the information acquired in class in appropriate situations both in and out of the classroom. This action research of Montessori material design and implementation helped some students to acquire new knowledge about dinosaurs and culture related concepts and vocabulary in EFL and increased their choice of less preferred materials, such as Mathematics. Data also showed that students were learning dinosaur vocabulary and knowledge in Mandarin even though it was not being taught in class. The roles of age, first language subject matter and motivation are investigated to help understand how preschool children can most effectively acquire a foreign language in an environment that implements Montessori materials and methods
[[alternative]]Exploring First and Second Oral Language Acquisition Effectiveness in Montessori Classrooms - West Indian Cherry
No full text[[abstract]]本研究探討在蒙特梭利教育環境中，西印度櫻桃主題蒙特梭利教具對口語語言第一語言(中文)和第二語言(英文)的習得影響。本研究研究在臺灣台中一所蒙特梭利幼兒園進行，參與者為20名年齡在四至六歲的幼兒，本研究採用混合研究法，研究時間從2023年2月13日至6月9日進行，並於2023年2月7日和6月12日至13日分別進行前測和後測。量化結果顯示，參與者口語語言習得方面有顯著進步，參與者在命名和理解與西印度櫻桃相關的內容皆很精通，特別是中文組表現出稍高的理解程度，可能是長時間身處於第一語言的環境中。從觀察日誌的質性資料中發現兒童參與度和好奇心的顯著轉變，從表面互動轉為對櫻桃特性和生長過程的深入探索。研究結論是，西印度櫻桃主題的蒙特梭利教具不僅促進了語言學習，還加強了幼兒與環境之間的連結，這與蒙特梭利教育理念相符。兩個語言組別均顯示出顯著的成功，強調了蒙特梭利方法在支持雙語語言習得方面的適應性和有效性。這些發現顯示，主題性、動手操作的教具能顯著增強幼兒的認知理解和情感聯繫。這些結果顯示，蒙特梭利方法不僅有助於第一語言的習得，也有效支持了第二語言的學習，顯示了其在雙語教育中的廣泛應用潛力。[[abstract]]This study investigates the impact of integrating West Indian Cherry-themed materials on language acquisition within a Montessori educational environment, focusing on both first language (Chinese) and second language (English). Conducted at a Montessori school in Taichung, Taiwan, the research involved 20 participants aged four to six and spanned from February 13 to June 9, 2023. Using a mixed-methods approach, pre-tests were administered on February 7, 2023, and post-tests on June 12 and 13, 2023.Quantitative analysis revealed significant advancements in language acquisition, with participants demonstrating universal proficiency in recognizing and understanding West Indian Cherry-related content. Specifically, the Chinese language group exhibited slightly higher comprehension levels, likely due to greater immersion. Qualitative findings from daily observation journals highlighted a transformative shift in the children's engagement and curiosity, moving from superficial interactions to a deeper exploration of the cherry's characteristics and growth process.The study concludes that integrating West Indian Cherry-themed materials not only facilitates language learning but also fosters a holistic connection between children and their environment, aligning with foundational Montessori principles. The success observed in both language groups underscores the adaptability and effectiveness of the Montessori method in supporting bilingual language acquisition. These findings suggest that thematic, hands-on materials can significantly enhance both cognitive understanding and emotional connection in young learners
[[alternative]]A Study on the Professional Growth of Early Childhood Teachers Through Scientific Activities by POE Teaching Strategies
No full text[[abstract]]本研究旨在瞭解幼教師對於運用POE（Prediction-Observation-Explanation）教學策略進行科學活動之想法、教學歷程及對幼教師專業成長之影響。本研究採行動研究方式，內容以「風的蹤跡與抓風趣」、「小鳥風箏、童玩風車與風帆車」及「竹蜻蜓」等風的主題三階段進行研究。研究對象以新北市某國小附幼之兩位幼教師，透過週誌、省思、教案文本、訪談大綱及自編幼教師融入POE教學策略自我評量表等，搭配錄音錄影、觀察日誌及觀察記錄以探究教師在科學活動教學過程中運用POE策略對其想法、歷程及專業成長之影響。研究結果發現如下：一、兩位教師的心態由謹慎轉為開放，並期待本次研究能增進他們在專業成長上的發展，也期盼自身在教學上能有突破。二、在教學歷程上，老師在逐漸掌握POE的教學技巧後，運用不同的策略，如：提問方式的改變、輔助工具的運用、活動設計的調整及教師自省後的修正讓科學活動得以持續進行。三、運用POE策略使得教師得以透過預測了解幼兒先備經驗、藉由觀察與幼兒一同在過程中學習成長、根據解釋讓師生能在統整活動時豐富研究發現的完整度。[[abstract]]This study aims to understand preschool teachers' thoughts on and teaching processes using the POE teaching strategy in science activities, as well as its impact on their professional growth. The study employs an action research approach, focusing on themes related to wind, such as "Traces of the Wind/Fun with Wind," "Little Bird Kites/Toy Windmills/Sail Cars," and "Bamboo Dragonflies."The participants are two preschool teachers from an affiliated kindergarten of a primary school in New Taipei City. Through weekly journals, reflection, lesson plan texts, interview outlines, and a self-compiled preschool teacher's self-assessment form on integrating POE teaching strategies, along with audio and video recordings, observation logs, and observation records, the study explores the impact of teachers' use of the POE strategy on their thoughts, processes, and professional growth in science activity teaching.The research findings are as follows:1. Both teachers' attitudes shifted from cautious to open, and they hoped that this study would enhance their professional development and bring about breakthroughs in their teaching.2. In the teaching process, after gradually mastering POE teaching techniques, teachers employed different strategies, such as changing questioning methods, using auxiliary tools, adjusting activity designs, and making corrections after self-reflection, to sustain science activities.3. The use of the POE strategy enables teachers to understand preschoolers' prior experiences through prediction, learn and grow together with children through observation during the process, and enrich the completeness of research findings when integrating activities based on explanations
[[alternative]]The follow up effectiveness of collaborative health management model on heart failure patient functional status, self care behavior, depression, quality of life, and rehospitalization: Randomized controlled trial
No full text[[abstract]]背景：心臟衰竭是一種嚴重且常見的疾病，在全球公共衛生領域備受關注，常伴隨功能受損、影響心臟功能，而有自我照顧困難、心理問題及生活品質不佳等諸多挑戰。為有效應對這些複雜問題，協同健康照顧模式介入後，能有效減少再入院率、降低醫療照護成本並改善生活品質。目的：第一階段研究計劃（導入期）：以進行系統性文獻回顧和統合分析，嚴謹的文獻搜尋和評析，萃取相關證據，探討協同健康照護模式(Collaborative Health Management Model, CHMM)在心臟衰竭病人管理中的實證照護依據並深入瞭解其效益，做為建構介入措施的基礎。第二階段研究計劃（建置期）：建構與發展協同健康照護方案之介入措施並進行前驅性研究，評估可行性、接受度和有效性，以調整和優化方案，以確保能有效實施和產生預期效果。第三階段研究計劃（運作期）：探討及評值協同健康照護模式對心臟衰竭病人功能狀態、自我照顧、焦慮憂鬱、生活品質、再住院及再住院醫療成本之追踨成效。方法：本研究為三階段研究計劃，第一階段進行系統性文獻回顧搜尋Cochrane Library、PubMed、CINAHL、Medline之資料庫，年份為2002-2022年，依納入及排除條件篩選後共計13篇文獻納入嚴謹評讀並萃取證據。文獻評讀由2位獨立評審員進行，方法學品質由外部研究人員利用Jadad 量表(Jadad Quality Scale)以盲法進行評估。研究中將採用Review Manager (RevMan Version 5.4)進行統合分析，以評估異質性及統計量。第二階段依據系統性文獻回顧與統合分析結果，以協同健康照顧模式(CHMM)，發展介入措施元素建構的協同健康照顧模式的預設新方案架構，經由前驅試驗來修正協同健康照顧模式，並發展協同健康照顧方案的照護影片和照護手冊，由五位臨床專家進行內容專家效度測試，以確保其符合研究目的，並根據專家意見進行修正。再進行前驅性研究（pilot study），採用隨機對照試驗設計，招募20位符合收案條件的病人，分為實驗組和對照組各10人，對協同健康照顧模式進行效度和使用操作模式的測試，確定研究之安全性及可行性，檢討未來研究改善之處，發展更完善的介入措施。第三階段研究採隨機對照控制試驗，以隨機取樣設計，在南部某區域教學醫院之心臟內科病房，選取符合收案標準之100位心臟衰竭患者，50位為對照組接受醫院常規照護，50位為實驗組接受協同健康照護方案介入措施。資料收集包括功能狀態、自我照顧、焦慮憂鬱、生活品質、再住院等變項，測量工具包含歐洲心臟衰竭自我照顧行為量表、醫院焦慮與憂鬱量表、明尼蘇達心臟衰竭生活品質量表等收集介入後1個月、2個月、3個月的成效指標。介入成效將以廣義估計方程式(Gerneralized estimating equation,GEE)進行檢定分析。結果：第一階段研究：心臟衰竭(Congestive Heart Failure)協同健康照護模式(collaborative health management model)的13項研究進行系統文獻回顧和統合分析，研究結果為協同健康照護模式可顯著降低心臟衰竭住院率（RR=0.50,95%CI=0.42-0.60；p<.001）、全因死亡率（RR=0.65, 95%CI=0.50-0.83；p<.001）、全因住院率（RR=0.75, 95%CI=0.56-1.00；p =<.05）、改善心臟衰竭生活品質（RR=-9.70, 95%CI=-10.85--8.55；p<.001）。(研究結果已投稿SSCI期刊Journal of Advance Nursing, Accepted for publication Date 11.28.2023)。第二階段研究：根據協同健康照護模式之系統性文獻及統合分析之實證結果，本階段將發展及建構一套以專科護理師為主導的協同健康照護方案，包含多專業團隊照護與會議、門診追踨、電話追踨、協同健康照護影片和手冊等一系列介入措施，以提升病人的照護成效及照護品質。第三階段研究：本研究以中高齡、無職業、道教信仰、已婚、與家人同住、教育程度以國小含識字及男性居多的心臟衰竭病人為對象，透過協同健康照護方案介入，在追踨的第三個月，實驗組的B型利鈉利尿胜肽（BNP）、心肌旋轉蛋白（Troponin I）、肌酸磷化酶-MB型（CK-MB）、舒張壓（DBP）、飯前血糖（Glucose）等生理檢測指標顯著下降，但其他生理檢測指標未顯著改善。此外，協同健康照護方案對功能狀態、自我照顧行為、焦慮憂鬱和生活品質等方面也有顯著影響，且達三個月（β=-0.482, SE=0.093, p<.001）、（β=-17.300, SE=1.006, p<.001）、（β=-2.320, SE=0.344, p<.001）、（β=-19.360, SE=1.871, p<.001）。在再住院方面，實驗組的平均再住院時間明顯延長，相較於對照組的平均再住院時間1.45個月；實驗組的平均再住院時間則為3.00個月。另外，實驗組亦顯示出降低再住院醫療成本的效果，尤其在介入初期效果最為顯著。結論：本研究結果證實運用協同健康照護模式於心臟衰竭病人的重要性。透過此模式，能有效提升心臟功能，促進病人自我照顧行為，減輕焦慮與憂鬱情緒。這顯示協同健康照護模式的全面性和多專業特性對於心臟衰竭病人照護的必要性。經由專業團隊的溝通與協同合作，提供更有效、更全面的照護方案，能有效管理疾病並提高生活品質。同時，有助於減少再住院及相關醫療成本，帶來正面的影響。這些發現不僅對臨床實務具重要意義，也為未來發展更具實證支持的心臟衰竭照護方案提供重要的參考。因此，這項研究為臨床照護提供一個有效的整合式管理架構，值得在臨床實務上推廣實施。臨床與實務應用：在心臟衰竭病人的臨床實務照護中，實施協同健康照護模式已具顯著效益，透過多專業團隊的協同合作，可得到更全面和個別性的照護，不僅強化病人對疾病及症狀的自我管理能力，減輕症狀困擾，提升整體的生活品質。此照護模式有助於降低再住院並減少醫療成本。研究成果強化協同健康照護模式作為提升心臟衰竭照護成效和效率的策略，提供一種以證據為基礎、實用並具有成本效益的照護選擇。[[abstract]]Background: Heart failure (HF) is a prevalent and severe condition that presents significant challenges in global public health. It is often associated with functional impairment, affecting cardiac function and leading to difficulties in self-care, psychological distress, and reduced quality of life. Collaborative health management model (CHMM) interventions have been proposed to address these complex challenges in HF care, aiming to reduce readmission rates, lower healthcare costs, and enhance quality of life.Puropose: First phase of our research project (introductory phase) involves a systematic review and meta-analysis to extract relevant evidence and explore the empirical basis for the collaborative health care model in the management of heart failure patients, forming a foundation for the construction of intervention measures.Second phase of our research project (development phase), focuses on constructing and developing intervention measures for the CHMM program and conducting pilot studies to assess their feasibility, acceptability, and effectiveness. This phase aims to refine and optimize the intervention measures to ensure effective implementation and desired outcomes.Third phase of the research project (operational phase) investigates and evaluates the effectiveness of the collaborative health care models on functional status, self-care, anxiety and depression, quality of life, readmission rates, medical costs in patients with heart failure.Methodology: This research comprises three stages. First stage a systematic review was conducted by searching the Cochrane Library, PubMed, CINAHL, and Medline databases for articles published between 2002 and 2022. After applying inclusion and exclusion criteria, a total of 13 articles were selected for rigorous review and evidence extraction. The literature review was carried out by 2 independent reviewers, and methodological quality was assessed by external researchers using the Jadad Quality Scale in a blinded manner. Statistical heterogeneity was evaluated, and meta-analysis was performed using Review Manager (RevMan Version 5.4). Second stage utilizes the findings from the systematic review and integrated analysis to develop and construct a CHMM program led by nurse practitioner, incorporating a range of intervention measures such as interdisciplinary care conferences, outpatient and telephone follow-ups, collaborative health management videos, and handbooks, aiming to enhance patient health outcome and quality of care.Third stage, a randomized controlled trial design is employed to evaluate the effects of the CHMM program on HF patient outcomes. Data collection includes physiological and psychological indicators measured at multiple time points post-intervention. The effectiveness of the intervention will be analyzed using appropriate statistical methods.Results: First phase of our research project: A systematic literature review and integrated analysis of 13 studies on the Collaborative Health Management Model (CHMM) for Heart Failure (HF) patients were conducted. The results indicated that the CHMM model significantly reduced the rate of heart failure hospitalizations (RR = 0.50, 95%CI=0.42-0.60; p<.001), all-cause mortality (RR=0.65, 95%CI=0.50-0.83; p<.001),and all-cause hospitalizations (RR=0.75, 95%CI=0.56-1.00; p<.05).It also improved the quality of life for patients with heart failure (RR=-9.70, 95%CI =-10.85--8.55; p<.001).(The research findings have been submitted to the SSCI journal-Journal of Advanced Nursing and accepted for publication on November 28, 2023.). Second phase of our research project: In this phase, based on the empirical results of the systematic review and integrated analysis of the CHMM, a collaborative health management plan was developed and constructed. A series of intervention measures were designed, including interdisciplinary care conferences, outpatient follow-up, telephone tracking, collaborative health management videos, and handbooks. Third phase of the research project: This study targeted middle-aged and older, unemployed, married, cohabitating with family, predominantly male patients with Heart Failure, with a Taoist faith background, and an educational level ranging from illiteracy to elementary education. Through the intervention of the collaborative health management plan, significant reductions in physiological indicators such as B-type natriuretic peptide (BNP), Troponin I, creatine kinase-MB (CK-MB), diastolic blood pressure (DBP), and preprandial blood glucose (Glucose) were observed in the experimental group during the third month of follow-up. However, other physiological indicators did not show significant improvement. Additionally, the collaborative health management plan significantly impacted functional status, self-care behaviors, anxiety, depression, and quality of life with effects lasting up to three months.(β=-0.482, SE=0.093, p<.001), (β=-17.300, SE=1.006, p<.001), (β=-2.320, SE=0.344, p<.001), (β=-19.360, SE=1.871, p<.001).Regarding rehospitalization, the average rehospitalization duration for the experimental group significantly increased compared to 1.45 months for the control group, with the experimental group averaging 3.00 months. Moreover, the experimental group also demonstrated a reduction in rehospitalization medical costs, particularly with significant effects observed in the early stages of intervention.Conclusion: The results confirm the importance of using the collaborative health care model for heart failure patients. Through this model, cardiac function can be effectively enhanced, promoting self-care behaviors and alleviating anxiety and depression. This highlights the necessity of the comprehensive and multidisciplinary nature of the collaborative health care model in caring for heart failure patients.Through professional team communication and collaboration, a more effective and comprehensive care plan can be provided, effectively managing the disease and improving quality of life. Additionally, it helps reduce rehospitalization and associated medical costs, bringing positive impacts. These findings are not only of significant clinical relevance but also provide important references for future development of more evidence-supported heart failure care programs. Therefore, this study provides an effective integrated management framework for clinical care, worthy of promotion and implementation in clinical practice.Clinical and Practical Application: In the clinical practice of caring for heart failure patients, the implementation of the collaborative health care model has shown significant benefits. Through the cooperative efforts of a multidisciplinary team, more comprehensive and individualized care is achieved, not only enhancing patients' self-management capabilities regarding condition and symptoms but also alleviating symptom distress and improving overall quality of life. This care model helps to reduce rehospitalizations and decrease medical costs. The research findings reinforce the collaborative health care model as a strategy to enhance the effectiveness and efficiency of heart failure care, offering an evidence-based, practical, and cost-effective care option
[[alternative]]The Predictions of Peripheral Neuropathy, Symptom Management Self-Efficacy and Social Support on Quality of Life Among Women with Gynecological Cancer Undergoing Chemotherapy
No full text[[abstract]]隨著醫療科技的進步，婦癌婦女在接受手術和化學藥物治療後，平均存活率提高，而化療次數的增加，副作用也造成生、心理及社會等各層面生活品質的衝擊，尤以神經系統影響甚劇。本研究之目的旨在預測婦癌婦女化療引發之周邊神經病變、社會支持及症狀處理自我效能對生活品質之影響。採用橫斷面研究設計，方便取樣於北市某醫學中心婦癌病房，於接受化學治療前收集資料。對象以年滿20歲、被診斷為婦科癌症且接受≧3次化學治療者，共招募128人參與研究。研究工具包含個人資料調查表、神經毒性次量表(FACT/GOG-NTX Subscale)、化療症狀處理自我效能量表(SMSE)、醫療社會支持量表(MOS-SSS)、癌症治療相關生活品質量表(FACT-G)。使用SPSS 20.0軟體及百分比、平均值、標準差、皮爾森相關係數與階層迴歸等統計方法進行分析。結果顯示年齡、教育、婚姻、工作、婦癌診斷、手術、化學治療合併放射治療、化療週期、化療次數在生活品質皆有顯著差異(p < .05)；與生活品質相關分析中，周邊神經病變呈顯著負相關(r = -.54, p < .001)、症狀處理自我效能、社會支持呈顯著正相關(r = .628, p < .001)、(r = .464, p < .001)；階層迴歸分析結果顯示婦癌婦女生活品質預測模型具統計顯著意義(F = 9.013, p < .001)，其中周邊神經病變14.3% (R2 change = .143)、社會支持8.7% (R2 change = .087)、症狀處理自我效能7% (R2 change = .07)，皆可顯著預測婦癌婦女生活品質(p < .001)，代表當周邊神經病變症狀越嚴重、社會支持越少、症狀處理自我效能越低，則婦癌婦女的生活品質越差。本研究結果顯示改善周邊神經病變症狀、增強社會支持和提高症狀處理自我效能對改善婦癌婦女生活品質的重要性，期待能提供臨床醫護人員擬定照護措施的參考，提高患者治療後的生活品質。[[abstract]]With advancements in medical technology, survival rates for women with gynecological cancer have increased following surgery and chemotherapy. Despite these gains, the rising number of chemotherapy sessions exacerbates side effects that significantly impact the overall quality of life, including physical, psychological, and social dimensions, particularly affecting the nervous system. This study explores the predictions of chemotherapy-induced peripheral neuropathy, social support, and self-efficacy in symptom management on the quality of life among women with gynecological cancer.A cross-sectional research design was implemented at a specialized medical center for gynecological cancer in Taipei, Taiwan. Data were collected prior to chemotherapy treatment from participants who were over 20 years old, diagnosed with gynecological cancer, and had received at least three chemotherapy sessions. A total of 128 individuals participated in the study. Research tools included a personal background survey, the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-NTX), the Symptom-Management Self-Efficacy (SMSE), the Medical Outcome Study Social Support Survey (MOS-SSS), and the Functional Assessment of Cancer Therapy-General (FACT-G). Data analysis was conducted using SPSS 20.0, employing methods such as percentages, means, standard deviations, Pearson’s correlations, and hierarchical regression analysis.The analysis highlighted significant disparities in quality of life related to demographic and clinical variables including age, education, marital status, employment, type of cancer diagnosis, surgical history, combined chemotherapy and radiotherapy, chemotherapy cycles, and chemotherapy treatments (p < .05). Notably, there was a significant negative correlation between peripheral neuropathy and quality of life (r = -0.54, p < .001), and considerable positive correlations between symptom management self-efficacy and quality of life (r = 0.628, p < .001), and between social support and quality of life (r = 0.464, p < .001). The findings of this study corroborate the Hierarchical multiple regression model of the quality of life was statistically significant (F = 9.013, p < .001). Including peripheral neuropathy increased the explained variance by 14.3% (R2 change = 0.143), and adding social support further enhanced the predictive power by 8.7% (R2 change = 0.087). Incorporating symptom management self-efficacy increased the predictive power by an additional 7% (R2 change = 0.07). The findings indicate that severe peripheral neuropathy symptoms, reduced social support, and lower self-efficacy in symptom management correlate with poorer quality of life.This research underscores the importance of addressing peripheral neuropathy symptoms, enhancing social support, and boosting symptom management self-efficacy to improve quality of life for women with gynecological cancer. The insights gained from this study are expected to inform clinical care strategies for patients undergoing chemotherapy and contribute to enhancing their post-treatment quality of life
[[alternative]]Exploring the effect of immersive interactive nursing guidance on anxiety,cognition and self-efficacy in patients with coronary heart disease undergoing cardiac catheterization.
No full text[[abstract]]背景與目的：根據衛生福利部統計2022年心臟疾病在台灣地區年十大死因中列排第二且長達十年，然而當罹患冠狀動脈心臟病時心導管處置是診斷及治療最準確的方法，使用率約佔70%是不可或缺的治療工具，亦屬高風險侵入性治療。護理人員功能角色除了提供身心靈的照護外，護理人員運用教學及諮詢技巧，提供病人有計劃的學習歷程，改變病人的健康知識與行為，最終促進健康，亦是為護理師重要的任務。現數位科技的來臨如何優化護理指導更貼近病患需求、護理指導由被動式學習轉化成互動式學習，提升護理照護品質，因此本研究探討沉浸式互動護理指導對冠狀動脈心臟病病人接受心導管處置的焦慮、認知及自我效能之成效。研究方法：本研究採前後測實驗試驗設計，於台灣北部某區域教學醫院的心臟內外科病房進行召募，納入符合收案條件研究對象，收案時間2023年02月15日至2024年03月30日，共計108位。以隨機分派將個案分配至實驗組54人，對照組54人。實驗組採用沉浸式互動護理指導，對照組使用一般傳統紙張衛教單進行護理指導。以結構式問卷調查收集資料，量表內容包含「情性-特質焦慮量表」、「認知量表」、「自我效能量表」及「滿意度調查表」。兩組在住院時進行完成前測問卷，在護理指導後執行心導管檢查前進行填答後測問卷。研究資料以SPSS 22版套裝軟體進行資料分析，統計方式包括描述性統計以個案數、百分比、平均數、標準差進行；推論性統計以獨立樣本t檢定、成對樣本t檢定、卡方檢定、廣義估計方程進行分析。結果：共計收案108位，實驗組54名、對照組54名，基本資料屬性同質性，年齡平均為59.22歲、以「男性」較多，計68人（63.0%）。介入沉浸式互動護理指導後，其「組別 × 時間」交互作用達統計上顯著差異者分別為情境焦慮（β= -18.87，95 % CI -24.14至-13.60 ）、特質焦慮(β= -13.20，95 % CI -17.83至-8.58)、疾病認知（β= 3.81，95 % CI 2.49至5.14)、自我效能（β= 6.89，95 % CI 4.43至.43)；在滿意度問卷結果實驗組整體平均滿意度3.69分(SD=0.36)高於對照組3.26分 (SD = 0.63)達統計上有顯著差異。結論：沉浸式互動護理指導提升學習的可近性與易用性放大學習效能，可以改善心導管病人焦慮情形、增強疾病認知、自我效能，亦能鞏固臨床照護品質的發展，這不僅減輕護理師的工作負荷，也促進病人參與自我健康照護。[[abstract]]Background and purpose: According to statistics from the Ministry of Health and Welfare in 2022, heart disease ranlced second among the top ten causes of death in Taiwan for ten years. However, when suffering from coronary heart disease and cardiac coronary catheterization intervention are is the most accurate method of diagnosis and treatment. , with a usage rate of about 70%, is an indispensable treatment tool and is also a high-risk invasive treatment. In addition to providing physical and mental care, nursing staff also use teaching and consulting skills to provide patients with a planned learning process, change patients' health knowledge and behavior, and ultimately promote health. This is also an important task for nurses. With the advent of digital technology, how can we optimize nursing guidance to be closer to the needs of patients, transform nursing guidance from passive learning to interactive learning, and improve the quality of nursing care? Therefore, this study explores the effect of immersive interactive nursing guidance on patients with coronary heart disease undergoing cardiac catheterization Anxiety, cognition and self-efficacy outcomes.Research methods: This study adopted a pre- and post-test experimental design, and recruited subjects from the cardiac surgery ward of a teaching hospital in northern Taiwan, and included research subjects who met the admission conditions. The admission period was from February 15, 2023 to March 2024. On the 30th, there were 108 people in total. The cases were randomly assigned to the experimental group with 54 people and the control group with 54 people. The experimental group used immersive interactive nursing guidance, while the control group used ordinary traditional paper health education sheets for nursing guidance. Data were collected through a structured questionnaire, and the scale content included the "Emotion-Trait Anxiety Scale", "Cognitive Scale", "Self-Efficacy Scale" and "Satisfaction Questionnaire". Both groups completed the pre-test questionnaire when they were hospitalized, and filled in the post-test questionnaire after nursing guidance and before performing cardiac catheterization. The research data was analyzed using the SPSS version 22 software suite. Statistical methods include descriptive statistics using the number of cases, percentages, averages, and standard deviations; inferential statistics using the independent sample t test, paired sample t test, and chi-square test. Generalized estimating equations are used for analysis.Results: A total of 108 cases were received, 54 in the experimental group and 54 in the control group. The basic information attributes were homogeneous. The average age was 59.22 years old, and there were more "males", accounting for 68 people (63.0%). After intervention in immersive interactive nursing guidance, those whose "group × time" interaction effects reached statistically significant differences were situational anxiety (β= -18.87, 95% CI -24.14 to -13.60) and trait anxiety (β= -13.20 , 95% CI -17.83 to -8.58), disease awareness (β= 3.81, 95% CI 2.49 to 5.14), self-efficacy (β= 6.89, 95% CI 4.43 to .43); in the satisfaction questionnaire results experimental group The overall average satisfaction score of 3.69 points (SD = 0.36) was higher than that of the control group, 3.26 points (SD = 0.63), which was a statistically significant difference.Conclusion: Immersive interactive nursing guidance improves the accessibility and ease of use of learning and amplifies learning effectiveness. It can improve the anxiety of cardiac catheterization patients, enhance disease cognition and self-efficacy, and also consolidate the development of clinical care quality. This not only reduces the burden of nursing care It reduces the workload of teachers and also promotes patients’ participation in self-health care
[[alternative]]Resourcefulness, Depression Levels, and Spiritual Health in Older Adults in the Community.
No full text[[abstract]]現今全球正面臨人口高齡化問題，我國老年人口逐漸攀升。對老人而言，靈性健康更是生命最終的體悟和整合結果。國內對於社區老人智謀、憂鬱與靈性健康的研究相對缺乏，因此希望透過本研究能找到促進老人靈性健康的一塊重要拼圖。本研究旨在探討社區老人智謀、憂鬱程度與靈性健康之現況，並探討變項與變項間之相關性。本研究採用橫斷式、相關性研究設計，以方便取樣方式，選取北台灣社區老人共100人，使用結構式問卷進行相關資料收集。研究工具包括：「人口基本屬性」、「中文版智謀量表」、「中文版靈性智謀量表」、「老年憂鬱量表」及「老人靈性健康量表」共五個部分。以描述性統計及推論性統計等方法進行統計分析。研究結果顯示，北台灣社區老人智謀程度平均為94.19分(SD= 16.29, IS= 67.28)，顯示社區老人智謀能力屬中等程度；其靈性智謀程度平均為36.59分(SD= 9.88, IS= 60.98)，即社區老人具中等程度的靈性智謀；本研究的社區老人憂鬱程度平均為3.71分(SD= 3.64, IS= 21.13)，顯示社區老人憂鬱程度為低度；社區老人的靈性健康程度平均為63.79分(SD= 12.27, IS= 75.94)，顯示社區老人具中高等程度的靈性健康。此外，社區老人智謀能力與憂鬱程度呈顯著負相關(r= -.52, p< .01)；社區老人智謀能力(r= .59, p< .01)及靈性智謀(r= .52, p< .01)與靈性健康呈顯著正相關；社區老人憂鬱程度與靈性健康呈顯著負相關(r= -.54, p< .01)。本研究更發現，智謀、靈性智謀與憂鬱程度均為靈性健康之重要預測因子，三者對靈性健康之預測力分別為28.4%、24.0%及39.9%，且智謀對憂鬱程度和靈性健康之間的關係有顯著而部分的中介效應(ꞵ= .588, p< .001)。本研究結果可以協助護理人員了解社區老人智謀與憂鬱程度對靈性健康之影響，並提供臨床照護人員在照護老人時之實證學理依據，護理人員可以發展智謀能力之支持性團體及介入方案，提升社區老人的智謀能力，使其學習適時應用個人內外在的資源，減少憂鬱程度，從而改善憂鬱情緒對靈性健康之負面影響，以維持身心健康的平衡並達到良好的靈性健康。 關鍵字：老人、智謀、靈性智謀、憂鬱、靈性健康[[abstract]]The world is facing the challenge of an aging population, with the elderly population gradually increasing in Taiwan. For older people, spiritual health is the ultimate realization and integration of life. Very few studies reported the resourcefulness, depression, and spiritual health among community older adults in our country. Therefore, this study aimed to identify an essential piece of the puzzle in promoting the spiritual health of older adults in Taiwan. The purposes of this study were to survey the levels of resourcefulness, depression, and spiritual health among older adults in the community and to investigate the relationships among these variables. A cross-sectional, correlational research design with convenience sampling was used in this study. In total, 100 older adults were successfully recruited from communities in Northern Taiwan. Other than Demographic characteristics, four structured questionnaires such as the Resourcefulness Scale, the Spiritual Resourcefulness Scale, the Geriatric Depression Scale (GDS-15), and the Spiritual Health Scale for the Elderly were used to collect older adults’ resourcefulness, spiritual resourcefulness, depression levels, and spiritual health. Descriptive and inferential statistics were conducted to analyze research data.The study results show that the Mean resourcefulness level in older adults was 94.19 (SD= 16.29, IS= 67.28), indicating a moderate level of resourcefulness. The Mean for spiritual resourcefulness was 36.59 (SD= 9.88, IS= 60.98), indicating a moderate level of spiritual resourcefulness in older adults. For the depression level, the older adults in the community had a Mean score of 3.71 (SD= 3.64, IS= 21.13), referring to a low level of depression. Finally, the Mean score of spiritual health in community older adults was 63.79 (SD= 12.27, IS= 75.94), meaning a moderate to high level of spiritual health. Furthermore, a significant and negative relationship between resourcefulness and depression levels was found among the older adults in the community (r= -.52, p< .01). Resourcefulness (r= .59, p< .01) and spiritual resourcefulness (r= .52, p< .01) both showed significant and positive correlations with spiritual health. Additionally, depression levels and spiritual health were significantly and negatively correlated with each other (r= -.54, p< .01). The findings of this study also showed resourcefulness, spiritual resourcefulness, and depression levels were essential predictors of spiritual health with significant prediction of 28.4%, 24.0%, and 39.9% respectively. Moreover, resourcefulness is an influential but partial mediating factor between depression levels and spiritual health (β= .588, p< .001). The results of this study can assist nursing professionals in understanding the impact of resourcefulness and depression levels on the spiritual health of older people, providing an evidence-based rationale for the clinical care of older adults in the community. Nursing professionals can develop supportive groups and intervention programs to enhance the resourcefulness of older adults, enabling them to apply personal and social resourcefulness effectively, reduce depression levels, and thereby mitigate the negative impact of depression on spiritual health, maintaining a balance of physical and mental health and achieving good spiritual health.Keywords: Older adults, Resourcefulness, Spiritual Resourcefulness, Depression, Spiritual Healt