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Relationships Among Physical Activity, Daylight Exposure, and Rest-Activity Circadian Rhythm in Patients With Esophageal and Gastric Cancer: An Exploratory Study
No full text[[abstract]]Background: Although rest-activity circadian rhythm (RACR) disruption is associated with mortality in patients with cancer, few studies have examined the effect of RACR on patients with esophageal and gastric cancer.
Objective: The aim of this study was to identify the predictors of RACR.
Methods: This cross-sectional, single-site study included 276 patients with esophageal and gastric cancer recruited from chest-surgery and general-surgery outpatient departments. Actigraphy was used to assess objective physical activity (PA), daylight exposure, and RACR, and 3-day PA was used to indicate the subjective amount of PA. The parameter of objective PA was the up activity mean; the parameter of daylight exposure was >500 lx, and the parameters of RACR were the 24-hour correlation coefficient, in-bed less than out-of-bed dichotomy index, midline estimating statistic of rhythm, and amplitude. The subjective amount of PA was calculated as the sum of mild, moderate, and vigorous PA.
Results: The up activity mean predicted 24-hour correlation coefficient. The PA amount and up activity mean predicted in-bed less than out-of-bed dichotomy index. The up activity mean and >500-lx daylight exposure predicted midline estimating statistic of rhythm. Finally, the PA amount and up activity mean predicted the amplitude.
Conclusions: Increased PA and daylight exposure may improve RACR.
Implications for practice: Patients with esophageal and gastric cancer should be encouraged to engage in outdoor PA during the daytime as part of their regular lifestyle to maintain a robust circadian rhythm
Multimedia-based hormone therapy information program for patients with prostate cancer: the result of a randomized pilot study
No full text[[abstract]]Few studies have explored the feasibility and efficacy of a multimedia information intervention for patients with prostate cancer who are undergoing hormone therapy. Thus, the purpose of the study was to assess the feasibility, acceptability, and the preliminary results of a multimedia-based hormone therapy information program (HTIP) on positive thinking and quality of life (QOL; primary outcomes) as well as social support and self-efficacy (secondary outcomes) of patients with prostate cancer. Patients with prostate cancer who were receiving hormone therapy were recruited from hospitals. After completing the pre-test questionnaire, patients were randomly divided into the multimedia information group (MIG; n = 40) and the control group (CG; n = 40). Patients in the MIG received a multimedia-based HTIP once a week for 6 weeks. Data were collected at 8 and 12 weeks after the pre-test. Measurement variables included positive thinking, QOL, social support, self-efficacy, and satisfaction with the program. The recruitment rate and retention rate were calculated for assessment of feasibility. The study had a 96.3% retention rate, and patients in the MIG were satisfied with the program. Preliminary results showed that, compared with those in the CG, patients in the MIG tended to exhibit higher positive thinking, prostate cancer-specific QOL, and social support at 8 weeks and 12 weeks after pre-test; however, the effect did not reach a statistically significant level. A multimedia-based HTIP is considered feasible and acceptable in patients with prostate cancer who underwent hormone therapy. Further research with a larger sample size, patients with high homogeneity in early-stage disease and long-term follow-up is needed to assess the efficacy of the intervention program.Trial registration: ClinicalTrials.gov (NCT04693910); Registered 05/01/2021
Predictors of incident reversible and potentially reversible cognitive frailty among Taiwanese older adults
No full text[[abstract]]Background: Few studies emphasize on predictors of incident cognitive frailty (CF) and examine relationships between various gait characteristics and CF. Therefore, we conducted a 2-year prospective study to investigate potential predictors, including gait characteristics, of incident reversible CF (RCF) and potentially RCF (PRCF) among Taiwanese older adults.
Methods: Eligible participants were individuals aged ≥ 65 years, who could ambulate independently, and did not have RCF/PRCF at the baseline. The baseline assessment collected information on physical frailty and cognitive measures, in addition to sociodemographic and lifestyle characteristics, preexisting comorbidities and medications, gait characteristics, Tinetti's balance, balance confidence as assessed by Activities-specific Balance Confidence (ABC) scale, and the depressive status as assessed by the Geriatric Depression Scale. The Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, and Digit Symbol Substitution Test were used to evaluate cognitive functions. Incident RCF and PRCF were ascertained at a 2-year follow-up assessment.
Results: Results of the multinomial logistic regression analysis showed that incident RCF was significantly associated with older age (odds ratio [OR] = 1.05) and lower ABC scores (OR = 0.97). Furthermore, incident PRCF was significantly associated with older age (OR = 1.07), lower ABC scores (OR = 0.96), the presence of depression (OR = 3.61), lower MMSE scores (OR = 0.83), slower gait velocity (OR = 0.97), and greater double-support time variability (OR = 1.09).
Conclusions: Incident RCF was independently associated with older age and lower balance confidence while incident PRCF independently associated with older age, reduced global cognition, the presence of depression, slower gait velocity, and greater double-support time variability. Balance confidence was the only modifiable factor associated with both incident RCF and PRCF
Nursing Innovation - Mobile App Development in Nursing Practice
No full text[[abstract]]護理創新實務是近年來發展的多元照護面向之一，可以使用多種技術來提高護理照護的質量和效率。護理創新實踐相關的技術如人工智慧（Artificial Intelligence; AI），可以用於護理照護中的多個方面，例如：病人監測、病歷管理、疾病預測和診斷等；資料分析（data analysis）可以用於病人數據的收集和分析，以提高病人的照護質量；智能設備（smart device）可以用於病人監測和照護，例如：智能手錶、智能衣服和智能床。本文以護理人員開發app提供個人照護紀錄實作為範例分享。
In recent years, innovative nursing practices have emerged as one of the diversified aspects of care. A multi range of technologies can be used to enhance the quality and efficiency of nursing care. Technologies associated with innovative nursing practices, such as Artificial Intelligence (AI), have multiple applications (app) in patient monitoring, medical record management, disease prediction, and diagnosis. Additionally, data analysis plays a crucial role in collecting and analyzing patient data to elevate the quality of patient care. Moreover, smart devices such as watches, attire, and beds contribute significantly to patients for monitoring and caring purposes. This article will share a case where nursing staff developed an app to provide personalized care records
Patients' Symptomatic Descriptions of the Osteoarthritis in Chinese Medicine Outpatients
No full text[[abstract]]研究背景：病人對於症狀描述與醫療人員不同，病人對自身症狀的描述較多元。研究目的：了解中醫門診骨關節炎病人對症狀的描述。研究方法：2019年12月至2020年4月，於某區域醫院中醫門診求醫者為研究對象。邀請符合第十版國際疾病分類標準之骨關節炎診斷碼，且同意訪談過程全程錄音者為研究對象。將訪談逐字稿依疼痛相關、關節表現、日常活動困難、其它身體症狀等類別，進行分類、編碼與統計次數。結果：8位受訪者最常提到的不適部位為膝關節，且不侷限於一個關節；遇冷及長時間重複關節動作，是疼痛加劇的主要因素；疼痛導致日常活動受限。病人使用日常生活經驗、身體感受、活動受限情形、肢體語言與中西醫術語等描述症狀。結論：病人用生活經驗、身體感受、肢體語言與中西醫術語等，描述其疼痛、活動困難、關節表現與其它等症狀。這樣結果與文獻及臨床用語不盡相同。醫護人員應了解病人對症狀的描述，以提高照護品質。
Research background: Patients have different ways in describing their symptoms to medical professionals. Research purpose :To understand the symptoms described by osteoarthritis patients in an outpatient Chinese medicine clinic. Research method: The research subjects are patients seeking medical treatment in a Chinese medicine clinic of a regional hospital between December 2019 and April 2020. Patients qualifying for the osteoarthritis diagnostic criteria of the International Statistical Classification of Diseases and Related Health Problems 10th Revision and who agreed to the recording of the whole interview process were invited to participate in the study. Pain-related, joint symptoms, difficulty in daily activities and other physical symptoms described during the interview were transcribed verbatim, coded and counted. Results: The most commonly mentioned discomfort location in the 8 interviewees was the knee joint, and not limited to one joint. Encounter cold temperature and repeated joint movements over a length of time are the main cause of aggravation, and the pain led to limited daily activities. In addition,other physical symptoms. The patients described their symptoms in terms of daily life experience, physical sensations, restricted activity, body language, and Chinese and Western medical terms, etc. describe symptoms. Conclusion: Patients use to daily life experience, physical sensations, body language, and Chinese and Western medical terms, etc, description of pain, difficult activities, articular manifestation and other physical symptoms described. This is different from the literature and clinical terms. The medical staff should understand the patient's description of the symptoms to improve the quality of care
Implementation of the Mini-CEX Training Workshop in the Faculty of Nursing Development-A Comparison between Nurses and Doctors in Terms of Workshop Rating
No full text[[abstract]]鑒於「迷你臨床演練評量(mini-clinical evaluation exercise, mini-CEX)」師資訓練工作坊的效度已在文獻肯定，此次在護理部之臨床教師訓練中引進mini-CEX師資訓練工作坊，共有43位護理師參訓。將43位護理師的評量分數與過去參訓完成的230位醫師的評分相互比較，試圖探討不同的醫療訓練背景下的醫護人員對參加mini-CEX師資訓練工作坊的成效差異。本文針對學員在工作坊後實際評量3段美國內科醫學會(American Board of Internal Medicine, ABIM)官方影帶之結果加以分析。結果發現，護理師整體在諮商衛教影帶部份的評分都略高於醫師，但在醫療面談及身體檢查兩份影帶部分則醫護之間評分沒有差異。在與ABIM吻合度方面，雖然醫護兩組沒有統計上顯著意義，但是在醫療面談及身體檢查兩份影帶部分，醫師都有少部分出現與建議答案差異達2個等級的異常評分，護理師部分則沒有此差異現象。本研究醫師出現「疑月暈效應」及「不良回饋」的比例都顯著高於護理師。護理師在病房者評分較非病房工作者來得低，尤其在醫療面談方面。工作5年以上或職級第三級以上較資深護理師的評分較寬鬆。總結，此次針對護理師參與mini-CEX師資訓練工作坊的課後評分與之前醫師參予的評分相近，因此，再次肯定此訓練工作坊的成效。護理師的整體學習認真度稍優於醫師，因此護理師在工作坊的評分共識較醫師容易整合。
The validity of the rater training workshop of the mini-clinical evaluation exercise (mini-CEX)＜||＞ has been confirmed in the literature; therefore the Department of Nursing adopted this workshop in the Preceptor Program for the training of members of nursing faculties. A total of 43 nurses participated in this training. By comparing the rating details of these nurses with the existing rating records of the 230 doctors who had previously attended the same kind of workshops, we have tried to evaluate the efficacy of this workshop when applied to these two medical specialties with different training backgrounds. We analyzed the rating records for the three official videotapes produced by the American Board of Internal Medicine (ABIM) after the completion of this workshop. The rating scores for the tapes involving medical interviewing and physical examination were similar when the nurses and doctors were compared. This contrasted with the results for counseling, where the nurses rated with significantly higher scores than the doctors. Based on the answers provided by the ABIM-authorized videotapes, there was no difference in the concordance rate between the nurses and doctors. However, the unacceptable rating, characterized by a two-level difference between the raters and the ABIM-answers, was found in a few raters among the doctor group, but none occurred within the nurse group. This was especially true for the medical interviewing and physical examination tapes. Phenomena such as suspected halo effects and poor feedback were prevalent to a significant degree in the doctor group. The nurses working in wards gave a higher level of performance rating than their non-ward counterparts and this was especially true for medical interviewing. Senior nurses with working experience above 5 years or that were the third nursing grade or above were rated less critically than junior nurses. In summary, discrepancies in rating between the nurses and doctors were not very obvious for the mini-CEX training workshop although they were present. Thus, this confirms the validity of this concise and structured workshop yet again. The nurses seem to have worked more earnestly throughout this workshop and a consensus on clinical rating ought to be effectively achieved for nurses
Stress, anxiety, and depression: The role of mediating and moderating mechanisms of dispositional mindfulness and its impact on maternal outcomes
No full textAssociated factors of sexual dysfunction among postpartum women in Taiwan- a cross-sectional study
No full text[[abstract]]Sexual function among postpartum women is often overlooked by health-care professionals. This study aimed to investigate associated factors of sexual dysfunction among postpartum women. This study used a cross-sectional study design. A total of 135 postpartum women from a teaching hospital in northern Taiwan who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. A multiple linear regression was using to identify the predictors of sexual dysfunction among Taiwanese postpartum women. Results indicated that the categories of sexual dysfunction that most commonly experienced in postpartum women were lack of sexual desire, delay or absence of orgasm, pain during intercourse, and inability to become physically aroused. Parity, types of delivery, perineal laceration, breastfeeding, postpartum fatigue, and postpartum depression were significantly associated with sexual dysfunction (p< .05). Sexual counseling and mental support should be necessary for women at risk of postpartum sexual problems such as nulliparous with perineal laceration, breastfeeding mothers, experiencing postpartum fatigue and depressive symptoms to improve their sexual health and quality of life
Factors associated with the utilization of antenatal care services among pregnant women in Eswatini - A cross-sectional study
No full text[[abstract]]The study aimed to assess the utilization of antenatal care services and its associated factors among pregnant women in Eswatini. A cross-sectional study was adopted. Convenience sampling was conducted in a public referral hospital in central Eswatini from 1st of August to the 30 of September 2021. A total of 400 newly delivered women who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. Results indicated that only 13% of pregnant women booked their first ANC in the first trimester and 24.8% of them attended less than four ANC visits. Maternal education, gestational age, gravity, pregnant-related complications, medical history, and maternal health literacy were significantly associated with the utilization of ANC services (p < .05). To increase the utilization of ANC service, healthcare professionals should pay special attention to pregnant women with tertiary education, gave birth below 38 weeks, multi-gravities, medical history, and poor maternal health literacy
Effects of three-dimensional holograms on the academic performance of nursing students in a health assessment and practice course: A pretest-intervention-posttest study
No full text[[abstract]]Background: Traditional teaching approaches are generally teacher-directed, and students are taught in a manner that is conducive to sitting and listening. Using three-dimensional (3D) holograms has many benefits in a higher education environment. However, relevant studies on this topic are very limited.
Objectives: To confirm the efficacy of 3D holograms for educational purposes to support the academic and practical performance of nursing students.
Design: A randomly allocated pretest and posttest quasi-experimental design.
Settings: Mackay Medical College in Taiwan.
Participants: Ninety third-year nursing students at a medical school in Taiwan.
Methods: The data were collected between January and May 2020. The participants were randomly allocated to an intervention group and a control group. The learning method used in the intervention group was a combination of a 3D hologram learning module and classroom lectures. The control group was exposed to classroom lectures without 3D holograms. The tool included hardware (Windows Mixed Reality Helmet and VR Remote Control) and software (Health Assessment® and Patient First Patient Condition VR System®). The Health Assessment and Practice Knowledge Assessment tool and the Health Assessment and Practice Techniques Performance tool were used to evaluate the effects of the study intervention on the knowledge and techniques of the students.
Results: A total of 79 participants (40 in the intervention group and 39 in the control group) were included in the final statistical analysis. The response rate was 88%. Statistically significant differences in knowledge and practical learning in the health assessment and practice course were observed between the intervention group and the control group (p < .05). The η2 effect level was 0.134.
Conclusions: After attending classroom lectures, the students who also attended the 3D hologram-based laboratory courses had significantly higher knowledge and practical learning scores. This approach may be used as a complementary learning tool in higher education