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Yueh FR, Pan JH, Lee HF, Yen M, Hu FW. A Qualitative Exploration of Older Patients' Experiences With Frailty and Related Management Strategies. J Nurs Res 2023:00134372-990000000-00069. [PMID: 37351562 DOI: 10.1097/jnr.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Frailty is highly prevalent in hospitalized older patients and may increase the risk of adverse health outcomes. Understanding the experiences of older patients and the management strategies they use to recover from frailty is crucial to developing appropriate interventions. PURPOSE This study was designed to explore the frailty experiences of older adults and the management strategies they use to recover from frailty. METHODS Using purposive sampling, semistructured, face-to-face interviews were conducted with 16 older patients with frailty. Data were analyzed using content analysis. RESULTS The experiences of participants were classified into three phases, including the (a) individual sensing phase, (b) daily-living-threatening phase, and (c) acclimatization and acceptance phase. When experiencing frailty, the participants developed management strategies to facilitate recovery, which manifested in three phases: (a) making flexible adjustments to the daily routine, (b) using adequate support systems, and (c) adopting positive thinking. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The results indicate that familial support and positive thinking are important management strategies for successful recovery in frail individuals. Older patients require adequate support systems. Positive thinking was also found to be an effective management strategy for recovery. Healthcare professionals should not only focus on providing supportive resources but also provide support to older patients to facilitate their adoption of positive thinking to face life changes brought on by frailty.
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Affiliation(s)
- Fang-Ru Yueh
- MS, RN, Doctoral Student, International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University; and Assistant Head Nurse, Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC
| | - Jin-Hua Pan
- MS, RN, Doctoral Student, International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University; and Assistant Head Nurse, Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC
| | - Huan-Fang Lee
- MS, RN, Clinical Nursing Teacher, Department of Nursing, College of Pharmacy & Health Care, Tajen University, Taiwan, ROC
| | - Miaofen Yen
- PhD, RN, Professor, International Studies Department of Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
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Huang CH, Yen M. [Applying an Exercise Snack-Based Health Promotion Strategy]. Hu Li Za Zhi 2023; 70:78-83. [PMID: 36942545 DOI: 10.6224/jn.202304_70(2).10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Lack of time, lack of access to equipment, and environmental constraints are generally perceived as barriers to regular physical activity. Moreover, insufficient activity is known to promote sedentary behavior, which is a factor in many chronic diseases, negatively affects mental health, and reduces quality of life. Exercise snacks, defined as short and efficient bursts of exercise, are convenient and easy to implement, reduce sedentary time, increase physical activity, and promote the development of good exercise habits. Previous studies have found exercise snacks to be safe and feasible for the elderly, promoting physical function and reducing the incidence of falls and metabolic diseases. Exercise snacks have also been found to be effective in healthy adults as well as in patients with obesity and diabetes, helping decrease blood sugar and promoting cardiorespiratory fitness. Depending on the participant's age and tolerance, exercise snack patterns may be extended and distinguished into two forms: 10-minute bouts of gentle intermittent exercise twice a day and 60-second bouts of vigorous exercise 3 to 8 times a day. The main considerations for exercise snacks include: multi-joint exercise is better than single-joint exercise, lower body exercise is better than upper body exercise, and dynamic and rapid movement that pushes away from the ground promotes osteogenesis and helps prevent osteoporosis and fractures. Exercise snacks may be applied in healthcare practice and related research to promote health and improve quality of life for all.
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Affiliation(s)
- Chen-Hui Huang
- PhD, RN, Graduated, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
| | - Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
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Huang CH, Cheng CS, Yen M. Factors associated with poor sleep quality in patients with pre-dialysis chronic kidney disease: A systematic review. J Adv Nurs 2023; 79:2043-2057. [PMID: 36806088 DOI: 10.1111/jan.15590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/14/2022] [Accepted: 01/20/2023] [Indexed: 02/23/2023]
Abstract
AIMS To determine factors associated with poor sleep quality among patients with pre-dialysis chronic kidney disease. DESIGN This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and checklist. DATA SOURCES Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. REVIEW METHODS Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle-Ottawa Scale by two doctorial prepared nursing scientists. RESULTS A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal-related and cognitive arousal behaviours were associated with poor sleep quality. CONCLUSION Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre-dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. IMPACT Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self-management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease.
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Affiliation(s)
- Chen-Hui Huang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chieh Sunny Cheng
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA
| | - Miaofen Yen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Lam LT, Chang HY, Natashia D, Lai WS, Yen M. Self-report instruments for measuring patient dignity: A psychometric systematic review. J Adv Nurs 2022; 78:3952-3973. [PMID: 36070196 DOI: 10.1111/jan.15436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/15/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022]
Abstract
AIMS To synthesize and evaluate the psychometric properties of self-report instruments that measure patient dignity. DESIGN A psychometric systematic review. DATA SOURCES A comprehensive search of studies published from inception until February 17, 2022, was performed using PubMed, Embase, CINAHL, Web of Science, and Scopus. REVIEW METHODS The methodological quality of the psychometric studies was evaluated following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. RESULTS Eleven self-report instruments that evaluate dignity were identified. For most instruments, psychometric properties, including reliability, cross-cultural validity, responsiveness, and measurement error, had not been adequately examined. The Patient Dignity Inventory (PDI), the Jacelon's Attributed Dignity Scale (JADS), and the Inpatient Dignity Scale (IPDS) had acceptable content validity, structure validity, and internal consistency to measure dignity among adult patients under palliative care, community-dwelling older adults, and inpatients receiving daily care. CONCLUSION The PDI, the JADS, and the IPDS are recommended for future clinical practice and research to measure dignity among adult patients under palliative care, community-dwelling older adults, and inpatients receiving daily care. Early identification of patients' dignity-related problems in nursing care can prevent negative health outcomes and help develop a timely intervention to promote patients' health and recovery. IMPACT Given that the psychometric properties of the existing self-report dignity instruments have not been systematically assessed, the present review utilized comprehensive methods according to COSMIN to evaluate and determine the most appropriate measure for research and practice. The PDI, the JADS, and the IPDS demonstrated satisfactory psychometric properties and are, thus, recommended for clinical and research applications. Nursing professionals can employ these instruments to assess and promptly identify dignity issues among both young and older adults in hospitals and communities.
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Affiliation(s)
- Le Trinh Lam
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hsin-Yi Chang
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Dhea Natashia
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department Medical Surgical Nursing, Faculty of Nursing, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
| | - Wei-Shu Lai
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Miaofen Yen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Chao SM, Yen M, Teng HL, Natashia D, Yueh FR. Helping Relationships From Significant Others Scale: Chinese Version. Clin Nurs Res 2022; 31:1529-1538. [PMID: 34861775 DOI: 10.1177/10547738211060951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Using the helping relationships from significant others (HRSO) scale assists patients, such as those with chronic kidney disease (CKD), in adopting a healthy lifestyle to decelerate disease progression, complications, and mortality. To study the efficacy of the scale, we recruited a convenience sample (n = 250) of patients with CKD from a nephrology clinic in southern Taiwan. Principal axis factor analysis and a promax rotation revealed a 15-item, three-factor explanation of 68.44 % of the total variance. The confirmatory factor analysis showed a good fit. The Composite reliability was .91, .89, and .92 in the same factors. Cronbach's alpha was .90 for the 15-item scale, with the 3 subscales ranging from .86 to .91. The split reliability was .73. The HRSO is a valid and reliable scale to measure significant others' support of patients with CKD in maintaining a healthy lifestyle.
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Affiliation(s)
- Shu-Mei Chao
- Tzu Chi University of Science and Technology, Hualien
| | | | | | - Dhea Natashia
- National Cheng Kung University, Tainan City.,Universitas Muhammadiyah Jakarta, Indonesia
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Chang YC, Hsieh LW, Chen TC, Yen M. [Developing and Evaluating the Effectiveness of a Leadership Integrated Educational Program for Master's Nursing Students in Taiwan]. Hu Li Za Zhi 2022; 69:56-67. [PMID: 36127759 DOI: 10.6224/jn.202210_69(5).08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nursing students with master degrees have the strong potential to serve as future leaders in medical teams. Implementing a well-developed and integrated educational program for nursing leadership at the master's level can strengthen the leadership of advanced practice nurses and promote a positive nursing practice environment. PURPOSE To develop a leadership integrated educational program for master's nursing students and conduct a preliminary evaluation of the effectiveness of this program in cultivating leadership competencies in these students. METHODS Phase 1: A modified Delphi survey conducted on 14 experts with clinical or academic backgrounds was used to identify the teaching objectives and strategies of the leadership integrated educational program. Phase 2: These teaching objectives and strategies were embedded into nine compulsory courses within a current training program for master's nursing students at a national university. The core elements of the leadership integrated educational program were incorporated into each compulsory course. The objectives of each compulsory course directly reflected the objectives of the integrated program. The leadership integrated educational program was implemented for one academic year, and its effectiveness was evaluated using a quasi-experimental test with a single group pre- and post-test design. A self-developed, 10-item "Master Nursing Student's Leadership Competence Scale" covering four core elements was applied to measure the self-reported leadership competencies of the participants. A paired sample t-test was applied to analyze the differences in leadership competencies between pre- and post-intervention. RESULTS A consensus on the teaching objectives and strategies of the leadership integrated educational program was achieved in the first round of the Delphi survey. The overarching teaching objective of the leadership integrated educational program was to "lead the healthcare team with the leadership and competencies, and demonstrate the advanced nursing practice skills for improving quality of care." In addition, the four core elements under the overarching goal, i.e., personal characteristics, leading people, business management, and vision building, were proposed. Forty-eight master's nursing students participated in this study. The results showed the average total score of leadership competency was 42.33 ± 12.16 (potential range: 10 - 70), indicating that the participants had a middle level of leadership competency prior to program participation. After participating in the Leadership Integrated Educational Program for one academic year, the average total score for leadership competency increased to 51.27 ± 9.74, indicating that the participants still had a middle level of leadership competency. Nevertheless, the 8.94 increase in the post-intervention score was statistically significant (p < .01). Moreover, the scores for each subscale (personal characteristics, leading people, business management, and vision building) had all increased significantly increased from 13.52 to 15.71, 12.65 to 15.35, 8.15 to 10.31, and 8.02 to 9.90, respectively (p < .01). CONCLUSIONS / IMPLICATIONS FOR PRACTICE This study offers proactive recommendations for reforming master's degree programs in nursing. The proposed multidisciplinary-expert-informed leadership integrated educational program may be used to strengthen leadership competencies in this student population. Furthermore, the findings provide a benchmark for developing an effective nursing leadership integrated educational program that may be incorporated into domestic master's degree programs.
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Affiliation(s)
- Yu-Chun Chang
- MSN, RN, Doctoral Student, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC
| | - Li-Wei Hsieh
- PhD, RN, Deputy Secretary, Interdisciplinary Center, Taichung Hospital, Ministry of Health and Welfare, Taiwan, ROC
| | - Tzu-Chun Chen
- MSN, RN, Supervisor, Cancer Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan, ROC
| | - Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
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Chao SM, Yen M, Lin HS, Sung JM, Hung SY, Natashia D. Corrigendum to "Effects of helping relationships on health-promoting lifestyles among patients with chronic kidney disease: A randomized controlled trial" [International Journal of Nursing Studies, 126 (2022), 104137]. Int J Nurs Stud 2022; 133:104280. [PMID: 35718558 DOI: 10.1016/j.ijnurstu.2022.104280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Shu-Mei Chao
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Miaofen Yen
- Department of Nursing, College of Medicine, Office of International Affairs, National Cheng Kung University, Tainan, Taiwan.
| | - Huey-Shyan Lin
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Junne-Ming Sung
- Attending Staff of Renal Division, Deputy Chief, Dept. of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Dept. of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Yuan Hung
- School of Medicine, College of Medicine, I-Shou University/Division of Nephrology, Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan
| | - Dhea Natashia
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Faculty of Nursing, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
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Cheng HP, Chen CH, Lin HS, Wang JJ, Yen M. Relationship between Walking Activity and Sleep Quality among Community-Dwelling Older Adults. J Community Health Nurs 2022; 39:127-138. [PMID: 35603873 DOI: 10.1080/07370016.2022.2058199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To explore the relationship between walking activity and sleep quality among elderly. DESIGN A cross-sectional, correlation study with purposive sampling was conducted on participants with a walking habit but not regular moderate-intensity exercise. METHODS Data were collected by structured questionnaires, including the Walking Activity Questionnaire and the Pittsburgh Sleep Quality Index. FINDINGS The total walking time per week and frequency of walking per day were significant predictors of sleep quality. CONCLUSIONS Walking can help older community-dwelling adults improve their sleep quality. CLINICAL EVIDENCE Walking more than once per day and total walking time per week ≥210 minutes were associated with good sleep quality.
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Affiliation(s)
- Hui-Ping Cheng
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Huey Chen
- Department of Nursing, Chang Jung Christian University, Tainan , Taiwan
| | - Huey-Shyan Lin
- Administration Dean, Office of Student Affairs, Fooyin UniversityDepartment of Health-Business, Kaohsiung, Taiwan
| | - Jing-Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Miaofen Yen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
BACKGROUND The factors related to fluid intake adherence among patients undergoing hemodialysis have been explored in many studies. However, most of these were conducted in Western countries and have produced inconsistent results. A study of this issue in Indonesia, a tropical country with strong herbal medicine traditions, may show different results. In addition to demographic characteristics, self-efficacy is a standard measurement used in chronic care management activities such as hemodialysis treatment. Understanding the reasons behind patient nonadherence in Indonesia may help nurses better manage the fluid intake of patients. PURPOSE This study was designed to determine the factors that predict patient adherence to fluid intake restrictions. METHODS A cross-sectional study was conducted on 153 patients undergoing hemodialysis at two hospitals. Intradialytic weight gain over a 1-month period was recorded to assess the participants' adherence to fluid intake restrictions. Intradialytic weight gains of more than 2 kg was considered to be nonadherent. A daily urine output and level of thirst were also recorded. The participants completed an adapted self-efficacy questionnaire, Swedish Fluid Intake Appraisal Inventory, and the data were analyzed together with demographic characteristic and clinical parameters using hierarchical multiple regression. RESULTS The results revealed that most of the respondents did not adequately adhere to fluid intake restrictions (59.5%). Intradialytic weight gain was shown to strongly correlate with self-efficacy (p < .05, β = -.201), gender (p < .05, β = -.179), educational background (p = .05, β = .159), and urine output (p < .05, β = -.168). Demographic characteristic explained 10.6% and self-efficacy explained 3.9% of the variance in fluid adherence. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Female participants with higher self-efficacy scores reported the lowest average level of intradialytic weight gain, indicating better adherence to fluid intake restrictions. Several demographic factors as well as self-efficacy were identified as potential predictors of fluid intake restriction adherence. Therefore, measuring self-efficacy periodically is a good initial step toward detecting those patients who are at higher risk of noncompliance with fluid intake restrictions.
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Affiliation(s)
- Melyza Perdana
- MS, Lecturer, Department of Medical Surgical Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Huang CH, Natashia D, Lin TC, Yen M. Development of the Adherence to Healthy Behaviors Scale. Clin Nurs Res 2021; 30:960-968. [PMID: 33472417 DOI: 10.1177/1054773820988629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adherence to healthy behaviors is a protective factor in the disease progression of chronic kidney disease (CKD). Measuring adherence can lead to the recognition of unhealthy behaviors and the suggestion of programs to prevent poor health outcomes. An assessment measurement for patients with CKD not requiring dialysis was developed and psychometrically tested. A convenience sample (n = 330) of patients with CKD attending a nephrology clinic in southern Taiwan completed the 13-item Adherence to Healthy Behaviors Scale (AHBS). A principal axis factor analysis and a parallel analysis demonstrated a three-factor structure accounting for 47.16% of the total variance. Confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate (r = .51; p < .000), with a Cronbach's alpha of .70; the test-retest reliability demonstrated good stability (r = .70; p < .000). The AHBS is a valid, reliable instrument to assess adherence to healthy behaviors among patients with CKD.
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Affiliation(s)
| | - Dhea Natashia
- National Cheng Kung University, Tainan City, Taiwan.,Muhammadiyah University of Jakarta, Jakarta, Indonesia
| | - Tzu-Chia Lin
- National Cheng Kung University, Tainan City, Taiwan.,Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
| | - Miaofen Yen
- National Cheng Kung University, Tainan City, Taiwan
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Teng HL, Yen M, Fetzer S, Sung JM, Hung SY. Tailoring Health-promoting Programs for Patients with Chronic Kidney Disease: Randomized Controlled Trial. West J Nurs Res 2020; 43:138-150. [PMID: 32698694 DOI: 10.1177/0193945920942487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on dietary and lifestyle modifications to decrease cardiovascular risk and slow disease progression has been limited to patients in the later stages of chronic kidney disease (CKD). Studies on the effectiveness of stage-of-change-tailored interventions on lifestyle modifications for individuals with early stage CKD are limited. Using random assignment, 60 patients with early stage CKD who received up to six tailored intervention visits over 30 months were compared to 60 usual care patients on physical indicators, lifestyle behaviors, and quality of life. Tailored interventions were consistent with the trans-theoretical Model of Change. Waist circumference, nutrition, and stress management improved over time in the intervention group. There was no difference or change in quality of life. To promote a healthier lifestyle, findings suggest that clinicians working with patients with CKD should consider patients' readiness to change their behaviors as well as implementation strategies tailored for different processes of change.
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Affiliation(s)
- Hsiu-Lan Teng
- Department of Nursing, Foo-Yin University, Kaohsiung City, Taiwan
| | - Miaofen Yen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Susan Fetzer
- Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA
| | - Junne-Ming Sung
- Research Institute of Clinical Medicine, School of Medicine, National Cheng Kung University/Renal Division, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Shih-Yuan Hung
- Division of Nephrology, Department of Internal Medicine, E-DA Hospital / Department of Health Management, I-Shou University, Kaohsiung City, Taiwan
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Abstract
The ongoing new coronavirus disease (COVID-19) pandemic, which arose at the end of 2019, poses a severe challenge to world public health systems. Frontline medical staffs bear a great burden to provide health care services. The Taiwan government has taken rapid and decisive actions to reduce the risk of community transmission and campus cluster infection. Nursing education includes both classroom teaching and clinical practicum components. In preparing for their practicum, students must learn not only fundamental nursing care knowledge but also basic knowledge on emerging infectious diseases. All schools nationwide have complied with the Ministry of Education order to postpone the opening of the fall semester in response to the rapid evolution of the COVID-19 pandemic. Campus epidemic prevention measures were implemented through student counseling networks, and flexible teaching strategies, including online teaching and distance teaching, were implemented to protect the learning rights of students. This paper explores the strategies implemented in response to emerging infectious diseases in nursing education based on the core values of professional nursing. Examining the precautions taken at campuses and teaching strategies adopted in response to the COVID 19 pandemic may provide valuable insights that may be applied to the future development of nursing education.
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Affiliation(s)
- Hsin-Yu Hsieh
- MSN, RN, Research Assistant, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Yu-Yun Hsu
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, and Adjunct Supervisor, Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC
| | - Nai-Ying Ko
- PhD, RN, Distinguished Professor, Department of Nursing, College of Medicine, National Cheng Kung University, and Adjunct Supervisor, Department of Infectious Diseases, National Cheng Kung University Hospital, Taiwan, ROC
| | - Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, and Adjunct Supervisor, Department of Nursing, National Cheng Kung University Hospital , Taiwan, ROC.
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Hsu YY, Chang YJ, Yen M, Wang JJ, Ko NY. [Social Impacts of International Nursing Education]. Hu Li Za Zhi 2020; 67:22-26. [PMID: 32281079 DOI: 10.6224/jn.202004_67(2).04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The objective of international nursing education in Taiwan is to prepare nursing elites to improve the quality of global healthcare. Nurses are on the frontlines in terms of helping the public through increasingly frequent climate-change disasters, helping care for the rising populations of older adults and patients with chronic diseases, and dealing with the emergence of new infectious diseases. Advancing the knowledge and capabilities of global nursing elites is imperative. The main purpose of nursing education is to educate future nursing leaders. This paper describes the internationalization of nursing education in the Department of Nursing at National Cheng Kung University as well as the process of establishing the Asia-Pacific Nursing Education Alliance to highlight the international characteristics of nursing education, the related global social influence, and the pursuit of sustainable development goals.
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Affiliation(s)
- Yu-Yun Hsu
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Ying-Ju Chang
- PhD, RN, Professor, Institute of Allied Health Science and Department of Nursing, College of Medicine, National Cheng Kung University, and Director, Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Jing-Jy Wang
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Nai-Ying Ko
- PhD, RN, Distinguish Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
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Sastra L, Büssing A, Chen CH, Yen M, Lin ECL. Spiritual Needs and Influencing Factors of Indonesian Muslims With Cancer During Hospitalization. J Transcult Nurs 2020; 32:212-220. [PMID: 32167014 DOI: 10.1177/1043659620908926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Although Muslims constitute nearly one fourth of the global population, many non-Muslims are not familiar with Islam. To address this unique need from such a specific cultural context, the present study aimed to examine the spiritual needs and influencing factors of Indonesian Muslims with cancer. Method: A cross-sectional research design with 122 cancer patients was conducted by using the Bahasa-version Spiritual Needs Questionnaire. Results: The degree of spiritual needs was generally high. Religious needs were the strongest aspect, and "praying five times a day" was the highest scoring item. Gender (p = .04), age (p = .01), and duration of being diagnosed with cancer (p = .01) were associated with spiritual needs. Female gender (p = .005) and older age (p < .001) were predictors of spiritual needs. Discussion: As expected to provide cultural-congruent spiritual interventions, nurses could meet Muslim patients' need to pray five times a day during hospitalization, thus help them manage and endure the illness.
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Affiliation(s)
- Lenni Sastra
- STIKes Mercubaktijaya Padang, Siteba-Padang, Sumatera Barat, Indonesia
| | | | | | - Miaofen Yen
- National Cheng Kung University (NCKU), Tainan
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Lin TC, Yen M, Liao YC. Hearing loss is a risk factor of disability in older adults: A systematic review. Arch Gerontol Geriatr 2019; 85:103907. [DOI: 10.1016/j.archger.2019.103907] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/18/2019] [Accepted: 07/05/2019] [Indexed: 01/11/2023]
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Natashia D, Yen M, Chen HM, Fetzer SJ. Self-Management Behaviors in Relation to Psychological Factors and Interdialytic Weight Gain Among Patients Undergoing Hemodialysis in Indonesia. J Nurs Scholarsh 2019; 51:417-426. [PMID: 30775842 DOI: 10.1111/jnu.12464] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to understand the influence of demographic and psychological factors on self-management behaviors and interdialytic weight gain (IDWG) as a fluid adherence marker among patients undergoing hemodialysis in Indonesia. DESIGN A quantitative correlational study. METHOD A convenience sample of 145 patients undergoing hemodialysis was recruited from the dialysis units in two hospitals in Jakarta from September to December 2015. Questionnaires were used to examine self-management behaviors, depression, anxiety, and stress. Data for IDWG were obtained by subtracting the individual's predialysis weight from his or her postdialysis weight from the previous session. Hierarchical multiple linear regression identified the predictors of IDWG. RESULTS Self-advocacy was ranked the least performed self-management behavior, while medication adherence was ranked the most likely to be performed. Among the subscales of the Self-Management Behavior Indices, positive correlations were found between the communication dimension with all psychological factors (depression, anxiety, and stress), while self-advocacy had positive correlation with anxiety. Subjects gained a mean of 4.5% of their postdialysis weight, with over 50% exceeding the recommended 4% IDWG. Overall, 53.6% of the IDWG was explained by the weekly duration of hemodialysis, level of depression, communication, partnership in care, and self-advocacy. CONCLUSIONS Self-management behaviors are potential predictors that can be modified by nephrology nurses in order to enhance clinical outcomes, with the specific outcome being IDWG. Self-management behaviors contribute to the promotion of appropriate IDWG. Depressed patients are less likely to adhere to weight gain restrictions. CLINICAL RELEVANCE Education combined with training in self-management behaviors-particularly communication, becoming a partner in care, and advocating for care-may improve adherence to IDWG guidelines among Indonesian hemodialysis patients. Interventions targeting depressed patients are needed.
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Affiliation(s)
- Dhea Natashia
- Doctoral Student Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan, and Lecturer, Department Medical Surgical Nursing, Faculty of Nursing, Muhammadiyah University of Jakarta, Jakarta, Indonesia
| | - Miaofen Yen
- Lambda Beta-At-Large, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Hsing-Mei Chen
- Lambda Beta-At-Large, Assistant Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Susan J Fetzer
- Eta Iota, Professor, University of New Hampshire, Department of Nursing College of Health and Human Services, Durham, NH, USA
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Lin LC, Lee HF, Yen M. Establishing a Measurement Tool for a Nursing Work Environment in Taiwan. Res Theory Nurs Pract 2018; 31:75-88. [PMID: 28196578 DOI: 10.1891/1541-6577.31.1.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM The nursing work environment is a critical global health care problem. Many health care providers are concerned about the associations between the nursing work environment and the outcomes of organizations, nurses, and patients. Nursing work environment instruments have been assessed in the West but have not been considered in Asia. However, different cultures will affect the factorial structure of the tool. Using a stratified nationwide random sample, we created a measurement tool for the nursing work environment in Taiwan. METHODS The Nursing Work Environment Index-Revised Scale and the Essentials of Magnetism scale were used to examine the factorial structure. Item analysis, exploratory factor analysis, and confirmatory factor analysis were used to examine the hypothesis model and generate a new factorial structure. RESULTS The Taiwan Nursing Work Environment Index (TNWEI) was established to evaluate the nursing work environment in Taiwan. The four factors were labeled "Organizational Support" (7 items), "Nurse Staffing and Resources" (4 items), "Nurse-Physician Collaboration" (4 items), and "Support for Continuing Education" (4 items). The 19 items explained 58.5% of the variance. Confirmatory factor analysis showed a good fit to the model (x2/df = 5.99; p < .05, goodness of fit index [GFI] = .90; RMSEA = .07). CONCLUSION The TNWEI provides a comprehensive and efficient method for measuring the nurses' work environment in Taiwan.
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Abstract
This cross-sectional study was conducted to examine 256 Muslim nurses' perception of spirituality and spiritual care in Indonesia. The Spirituality and Spiritual Care Rating Scale (SSCRS) was translated and culturally adapted. Moderately high degrees in five domains and total SSCRS were found. Specialty, education level, clinical seniority, having spiritual training, and previous spiritual caring experience could impact on the SSCRS. Most nurses have cared for patients with spiritual needs, but denied having any formal training in providing spiritual care. Providing adequate curriculum and on-job training to equip nurses' knowledge and competence of spiritual care is urgent in Muslim healthcare environment.
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Affiliation(s)
| | - Miaofen Yen
- Department of Nursing, National Cheng Kung University (NCKU) and Hospital, Tainan City, Taiwan, ROC
| | - Ching-Huey Chen
- Department of Nursing, Chang Jung Christian University, Tainan City, Taiwan, ROC
| | - Susan J Fetzer
- Department of Nursing, University of New Hampshire, Durham, NH, USA
| | - Esther Ching-Lan Lin
- Department of Nursing, National Cheng Kung University (NCKU) and Hospital, No. 1, University Rd., Tainan City, 70101, Taiwan, ROC.
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Keirns J, Desai A, Kowalski D, Lademacher C, Mujais S, Parker B, Schneidkraut MJ, Townsend R, Wojtkowski T, Yamazaki T, Yen M, Kowey PR. QT Interval Shortening With Isavuconazole: In Vitro and In Vivo Effects on Cardiac Repolarization. Clin Pharmacol Ther 2017; 101:782-790. [PMID: 28074556 PMCID: PMC5485736 DOI: 10.1002/cpt.620] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 01/17/2023]
Abstract
The effects of isavuconazole (active moiety of isavuconazonium sulfate) on cardiac ion channels in vitro and cardiac repolarization clinically were assessed in a phase I, randomized, double‐blind study in healthy individuals who received isavuconazole (after 2‐day loading dose), at therapeutic or supratherapeutic doses daily for 11 days, moxifloxacin (400 mg q.d.), or placebo. A post‐hoc analysis of the phase III SECURE trial assessed effects on cardiac safety. L‐type Ca2+ channels were most sensitive to inhibition by isavuconazole. The 50% inhibitory concentrations for ion channels were higher than maximum serum concentrations of nonprotein‐bound isavuconazole in vivo. In the phase I study (n = 161), isavuconazole shortened the QT interval in a dose‐ and plasma concentration‐related manner. There were no serious treatment‐emergent adverse events; palpitations and tachycardia were observed in placebo and supratherapeutic isavuconazole groups; no cardiac safety signals were detected in the SECURE study (n = 257). Isavuconazole was associated with a shortened cardiac QT interval.
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Affiliation(s)
- J Keirns
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - A Desai
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - D Kowalski
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - C Lademacher
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - S Mujais
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - B Parker
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - M J Schneidkraut
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - R Townsend
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - T Wojtkowski
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - T Yamazaki
- Astellas Pharma Global Development, Inc, Northbrook, Illinois, USA
| | - M Yen
- PAREXEL, Glendale, California, USA
| | - P R Kowey
- Lankenau Medical Center and Institute for Medical Research, Main Line Health System, Wynnewood, Pennsylvania, USA.,Jefferson Medical College, Philadelphia, Pennsylvania, USA
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20
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Chang YC, Yen M, Chang SM, Liu YM. Exploring the relationship between nursing hours per patient day and mortality rate of hospitalised patients in Taiwan. J Nurs Manag 2016; 25:85-92. [PMID: 27885747 DOI: 10.1111/jonm.12443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 11/28/2022]
Abstract
AIM To investigate the relationship between nursing hours per patient day and the inpatient mortality rate in Taiwan. BACKGROUND Nursing hours per patient day has been associated with better patient outcomes. The literature is inconclusive on the relationship between nursing hours per patient day and the inpatient mortality rate, and no studies have yet examined this issue in Taiwan. METHODS A retrospective longitudinal study analysed data from the 'Nursing Utilization of Resources, Staffing and Environment on Outcome Study: NURSE-outcome study'. Hierarchical regression estimated the relationship between nursing hours per patient day and in-hospital mortality rate after controlling for confounding variables. RESULTS The mean nursing hours per patient day in Taiwan was 2.3, while the mean inpatient mortality rate was 0.73% higher nursing hours per patient day was associated with a lower inpatient mortality rate after controlling for confounding variables. The total explained variance of this study in inpatient mortality rate was 19.9%. Significant relationships to inpatient mortality were found in levels of hospitals, seasonal variation and nurses' work experience. CONCLUSION Nursing hours per patient day affects the mortality rate among hospitalised patients in Taiwan. IMPLICATIONS FOR NURSING MANAGEMENT According to the results, we suggested the government and managers in Taiwan double the nursing hours per patient day so that the inpatient mortality rate will decline by 1.1%. This might be the optimal nurse configuration that could provide a balance between cost-effectiveness and patient safety.
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Affiliation(s)
- Yu-Chun Chang
- Department of Nursing, National Cheng Kung University Hospital, Taiwan
| | - Miaofen Yen
- Department of Nursing, College of Medicine, Taiwan
| | | | - Ya-Ming Liu
- Department of Economics & Graduate Institute of Political Economy, College of Social Sciences, National Cheng Kung University, Taiwan
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21
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Yen M, Lee PY, Tsai HC. [Applying the Strategies of Helping Relationship From Significant Others in Patients With Chronic Kidney Disease]. Hu Li Za Zhi 2016; 63:19-25. [PMID: 27026553 DOI: 10.6224/jn.63.2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The absence of easily perceived symptoms in the early stages of chronic kidney disease (CKD) causes low levels of awareness and treatment of this disease. Therefore, adherence to measures that may prevent disease progression, i.e., lifestyle changes, regular clinic visits, and timely medication administration, is often low among early-stage CKD patients. However, continuous assistance from significant others through trusting, understanding, sharing, and coaching assistance may promote a healthy lifestyle and prevent progression of the disease. The necessary characteristics of significant others include dependability, credibility, and positivity. Significant others may use their understanding, caring, faith, and honesty to help patients face CKD and improve self-care efficacy. This article discusses the assistance that significant others may provide to CKD patients, including warning mechanisms, target setting, encouragement, and feedback. By developing the functions of supervision, companionship, and support, significant others may help patients live a healthier life and improve their medical compliance and thus postpone disease progression.
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Affiliation(s)
- Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan, ROC.
| | - Pei-Yu Lee
- BSN, RN, Graduate Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Hui-Chen Tsai
- BSN, RN, Graduate Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
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Chao S, Yen M, Lin TC, Sung JM, Wang MC, Hung SY. Psychometric Properties of the Kidney Disease Quality of Life–36 Questionnaire (KDQOL-36™). West J Nurs Res 2016; 38:1067-82. [DOI: 10.1177/0193945916640765] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Kidney Disease Quality of Life–36 Questionnaire (KDQOL-36™), modified by RAND, has been widely used for measurement of quality of life among hemodialysis or peritoneal dialysis patients. The purpose of this study was to refine and evaluate, by using confirmatory factor analysis, the structure of the KDQOL-36™ when the questionnaire was used to evaluate chronic kidney disease patients in Stages 1 to 5 in Taiwan. The psychometric properties of the translated version were determined among Mandarin-speaking adults ( N = 428). Because the sample data did not fit the hypothetical model, one item was deleted and nine error terms were estimated. After improving the model fit, the modified model was presented as follows: χ2 = 1390.903, χ2/ df = 2.711, p < .001, goodness-of-fit index = .833, adjusted goodness-of-fit index = .806, root mean square error of approximation = .063. According to the study results, the researchers suggest that because of content overlap, some items may be deducted from the KDQOL-36™.
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Affiliation(s)
- Shumei Chao
- Fooyin University, Kaohsiung, Taiwan
- National Cheng Kung University, Tainan, Taiwan
| | - Miaofen Yen
- National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Chia Lin
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan
| | | | | | - Shih-Yuan Hung
- E-Da Hospital, Kaohsiung, Taiwan
- I-Shou University, Kaohsiung, Taiwan
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Shen SH, Yen M, Yang SL, Lee CY. Insomnia, anxiety, and heart rate variability among nurses working different shift systems in Taiwan. Nurs Health Sci 2016; 18:223-9. [DOI: 10.1111/nhs.12257] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/22/2015] [Accepted: 09/28/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Shu-Hua Shen
- National Cheng Kung University; Department of Allied Health Sciences; Tainan City Taiwan
- Jianan Psychiatric center, Ministry of health welfare; Tainan City Taiwan
| | - Miaofen Yen
- National Cheng Kung University; Department of Nursing, College of Medicine; Tainan City Taiwan
- National Cheng Kung University; Department of Allied Health Sciences; Tainan City Taiwan
| | - Shou-Lin Yang
- Department of Business Administration; Da-Yeh University; Changhua Taiwan
| | - Chiung-Ying Lee
- Chang Jung Christian University; Department of Finance; Tainan City Taiwan
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24
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Kuo YW, Yen M, Fetzer S, Lee JD, Chiang LC. Effect of family caregiver oral care training on stroke survivor oral and respiratory health in Taiwan: a randomised controlled trial. Community Dent Health 2015; 32:137-142. [PMID: 26513847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of home-based oral care training programs on tongue coating (TC), dental plaque (DP), and symptoms of respiratory infection (SRI) in stroke survivors. METHODS A single-blind, randomised, controlled trial conducted in a home-based setting over 2 months. Stroke survivors (n=48, experimental group) and their family caregivers received home-based oral care training programme while a control group of 46 stroke survivors and family caregivers received routine oral care education with swabs. TC, DP, and SRI were assessed at baseline and after one and two months, with results analysed using Mixed Model ANOVA. RESULTS Poor oral hygiene and overall neglect of home oral care practices were observed at baseline. TC and DP scores were significantly reduced in the experimental group receiving the home-base oral care training program compared to the control group, who received only routine oral care education (P<0.001). The groupxtime interaction was significant, with decreased TC and DP scores for both groups at one month and at two months of additional care (when compared to baseline). The SRI scores were not significantly different between groups (P>0.05). The groupxtime interaction did not correlate with SRI for either group when compared to the baseline and to one month and two months of additional care. No adverse events were encountered and there was no external funding. CONCLUSIONS Home-based oral care training programme had a beneficial effect on oral health as measured by TC and DP scores. The effect on SRI requires further longitudinal study.
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Abstract
Nurse burnout is a crucial issue for health care professionals and impacts nurse turnover and nursing shortages. Individual and situational factors are related to nurse burnout with predictors of burnout differing among cultures and health care systems. The predictors of nurse burnout in Asia, particularly Taiwan, are unknown. The purpose of this study was to investigate the predictors of burnout among a national sample of nurses in Taiwan. A secondary data analysis of a nationwide database investigated the predictors of burnout among 1,846 nurses in Taiwan. Hierarchical regression analysis determined the relationship between predictors and burnout. Predictors of Taiwanese nurse burnout were age, physical/psychological symptoms, job satisfaction, work engagement, and work environment. The most significant predictors were physical/psychological symptoms and work engagement. The variables explained 35, 39, and 18 % of the emotional exhaustion, personal accomplishment, and depersonalization variance for 54 % of the total variance of burnout. Individual characteristics and nurse self-awareness, especially work, engagement can impact Taiwanese nurses' burnout. Nurse burnout predictors provide administrators with information to develop strategies including education programs and support services to reduce nurse burnout.
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Affiliation(s)
- Huan-Fang Lee
- Department of Nursing, Institute of Allied Health Sciences, National Cheng Kung University, Tainan City, Taiwan
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Kuo YW, Yen M, Fetzer S, Chiang LC, Shyu YIL, Lee TH, Ma HI. A home-based training programme improves family caregivers’ oral care practices with stroke survivors: a randomized controlled trial. Int J Dent Hyg 2015; 14:82-91. [DOI: 10.1111/idh.12138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 01/30/2023]
Affiliation(s)
- Y-W Kuo
- Department of Nursing; Asia University; Taichung Taiwan
| | - M Yen
- Department of Nursing and Institute of Allied Health Sciences; College of Medicine; National Cheng Kung University; Tainan Taiwan
| | - S Fetzer
- Department of Nursing, College of Health and Human Services; University of New Hampshire; Durham NH USA
| | - L-C Chiang
- School of Nursing; National Defense; Medical Center; Taipei Taiwan
| | - Y-IL Shyu
- School of Nursing and Healthy Aging Research Center; Chang Gung University; Taoyuan Taiwan
| | - T-H Lee
- College of Medicine; Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Neurology; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - H-I Ma
- Department of Occupational and Institute of Allied Health Sciences; College of Medicine; National Cheng Kung University; Tainan Taiwan
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Lin ECL, Shao WC, Yang HJ, Yen M, Lee SY, Wu PC, Lu RB. Is abnormal non-high-density lipoprotein cholesterol a gender-specific predictor for metabolic syndrome in patients with schizophrenia taking second-generation antipsychotics? Metab Brain Dis 2015; 30:107-13. [PMID: 25034455 DOI: 10.1007/s11011-014-9587-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/30/2014] [Indexed: 01/31/2023]
Abstract
Evidence supports an association between metabolic syndrome (MetS) and schizophrenia. However, specific risk factors for MetS and gender differences in patients with schizophrenia taking second-generation antipsychotics (SGAs) have not been well explored. A cross-sectional cohort of 329 Han Chinese patients was recruited in a psychiatric hospital in central Taiwan. Using the definitions of the International Diabetes Federation for Chinese, the prevalence of MetS was 23.7% (men: 25.7%; women: 21.2%). Logistic regression analyses showed that patients with a BMI ≥ 24 and an abnormal non-high-density lipoprotein cholesterol (non-HDL-C) were significantly (p < 0.001) more likely to develop MetS. A BMI ≥ 24 was a significant risk factor in men (OR: 6.092, p < 0.001) and women (OR: 5.886, p < 0.001). An abnormal non-HDL-C was a significant specific risk factor for men with MetS (OR: 4.127, p < 0.001), but not for women. This study supports a greater prevalence of MetS in patients with schizophrenia taking SGAs than in the general population. Abnormal BMI and non-HDL-C were significantly associated with developing MetS, and an abnormal non-HDL-C was a specific risk factor for men. Future development of specific interventions and regular monitoring for MetS is imperative for early identification and prevention.
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Affiliation(s)
- Esther Ching-Lan Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, and National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China,
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Yueh FR, Ko NY, Yen M. [The effectiveness of far-infrared therapy in hemodialysis patients with arteriovenous fistula: a systematic review]. Hu Li Za Zhi 2014; 61:78-86. [PMID: 25464959 DOI: 10.6224/jn.61.6.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Over 85% of end-stage renal disease (ESRD) patients receive hemodialysis and 80% of hemodialysis patients in Taiwan contract arteriovenous fistula (AVF). Studies have shown that using far infrared therapy (FIR) improves AVF by improving blood flow. However, the systematic literature reviews have been insufficient to make definite conclusions regarding the effectiveness of this intervention. PURPOSE This paper uses a systematic review of the literature to evaluate the FIR intervention and to explore its effectiveness. METHODS Researchers searched the following five Chinese and English electronic databases for relevant articles: National Dissertations and Theses, Airiti Library, CINAHL, Cochrane Library, ProQuest, and PubMed/MEDLINE. Keywords including "far infrared therapy", "arteriovenous fistula", and "hemodialysis" were entered. The search was limited to articles published before February 2014. A total of 98 articles that matched the search criteria were extracted. Article topics were screened and repetitions of topics were removed. Three articles met the study inclusion criteria and were selected for further analysis. An assessment of the quality of these 3 studies using the Modified Jadad Scale earned a score of 3. RESULTS Findings of this systematic review show that FIR interventions improve blood flow to and from the AVF and that the intervention decreases AVF malfunctioning. Currently, literature on this topic is limited in Taiwan. Therefore, more evidence is needed to validate the findings of the current study. CONCLUSIONS / IMPLICATIONS FOR PRACTICE The results of the current study support the ability of patients with FIR to improve their AVF functions as well as the immediate clinical applicability of the suggested intervention. Although current empirical evidence supports the effectiveness of gripping a ball in maintaining AVF functions, many hemodialysis patients, due to age or illness, are not physically capable of doing this exercise. Therefore, FIR is a very good alternative measure.
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Affiliation(s)
- Fang-Ru Yueh
- Department of Nursing, National Cheng Kung University, Taiwan, ROC
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Miaofen Yen
- Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan, ROC.
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Chen CH, Yen M, Fetzer S, Lo LH, Lam P. The effects of tai chi exercise on elders with osteoarthritis: a longitudinal study. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 2:235-41. [PMID: 25029961 DOI: 10.1016/s1976-1317(09)60005-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 09/12/2008] [Accepted: 11/24/2008] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Tai Chi exercise has been proven to be beneficial among elders with osteoarthritis (OA). The long-term effects of this exercise remain unclear. The purpose of this study was to evaluate the effects of the Tai Chi exercise for Arthritis (TCEA) program on the physical status and quality of life of OA elders. METHODS This was a time series study with one group design. Subjects diagnosed with OA of the lower extremities, aged 60 years or over, were recruited from an outpatient clinic at a community teaching hospital. Thirteen participants joined a TCEA exercise class three times per week for 2 years. Physical status including body mass index (BMI), lean body mass, hand grasp strength, flexibility, and equilibrium were measured four times-at baseline, 3 months, 1 year, and 2 years of the TCEA exercise class. Quality of life was also measured at these time points. RESULTS Lean body mass was significantly decreased within the study period (p < .05). Participants experienced significant improvements in physical functioning, role limitations, and social functioning on the dimensions of quality of life (SF-36) (p < .05). CONCLUSION Elderly people with OA should be encouraged to exercise using Tai Chi for maintaining physical function and improving quality of life.
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Affiliation(s)
- Ching-Huey Chen
- Associate Professor, Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Miaofen Yen
- Associate Professor, Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Susan Fetzer
- Associate Professor, Department of Nursing, College of Health and Human Services, University of New Hampshire, New Hampshire, USA
| | - Li-Hua Lo
- Associate Professor, Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan
| | - Paul Lam
- Lecturer of University of New South Wales and Family Physician, Sydney, Australia
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Hsu SY, Yen M, Wang MC, Chen LK. [Exploring the lived experiences of middle-aged males diagnosed with chronic kidney disease]. Hu Li Za Zhi 2013; 60:64-72. [PMID: 24096466 DOI: 10.6224/jn.60.5.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The majority of studies addressing chronic kidney disease (CKD) have been quantitative. The lived experiences of patients with early stage CKD have not been explored in the literature. Due to the lack of symptoms during the early stages of CKD, the progress of this disease is often ignored. PURPOSE This study explores the lived experiences of middle-aged males diagnosed with CKD. Research focuses on the work experiences, interpersonal relationships, and dietary habits of this group. METHODS This qualitative study used a narrative research method with purposive sampling. Ten middle-aged male patients were interviewed. We employed the 3 strategies of member checks, peer review, and debriefing in order to enhance the trustworthiness of the data analysis. RESULTS Four major themes were identified: (1) keeping the same life pace as usual with concerns of deterioration; (2) continuing to support their family and play the role of father; (3) hoping to participate in family and friend relationships despite the illness; and (4) being challenged to maintain a healthy diet. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Although the physical status of participants was similar to the general middle-aged adult population, participants were concerned regarding disease deterioration. The results of this study suggest that health professionals: (1) provide appropriate information based on patients' personality, particularly at the first onset or apparent deterioration of the disease; (2) offer specialized healthcare information to patients relevant to their career choices; and (3) understand CKD-patient difficulties in daily life such as eating out habits and challenges faced in maintaining a healthy diet. Results may provide important information to healthcare providers in education planning and implementation and support programs for patients and families.
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Affiliation(s)
- Shih-Yin Hsu
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
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Huang JJ, Lin HS, Yen M, Kan WM, Lee BO, Chen CH. Effects of a Workplace Multiple Cardiovascular Disease Risks Reduction Program. Asian Nurs Res (Korean Soc Nurs Sci) 2013; 7:74-82. [DOI: 10.1016/j.anr.2013.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Revised: 02/17/2013] [Accepted: 03/20/2013] [Indexed: 11/25/2022] Open
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Levine M, Froberg B, Ruha AM, Burns-Ewald M, Yen M, Claudius IA, Arthur AO, Tormoehlen L, Thomas SH. Assessing the toxicity and associated costs among pediatric patients admitted with unintentional poisonings of attention-deficit/hyperactivity disorder drugs in the United States. Clin Toxicol (Phila) 2013; 51:147-50. [PMID: 23473458 DOI: 10.3109/15563650.2013.772623] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is widespread, with a national (United States) prevalence of nearly 10%. The 2011 changes in the diagnostic criteria will likely further increase the prevalence of this disorder. Little is known about the incidence of toxicity from unintentional poisonings of ADHD medications. This study attempted to determine the incidence of these ingestions and the corresponding financial impact in the United States. METHODS Four geographically different centers were chosen. Subjects with unintentional poisonings due to ADHD medications were included if the admission dates were between 2000 and 2002 (cohort A) or between 2009 and 2010 (cohort B). Using data from the participating hospitals and the number of monitored beds in each corresponding county, data were extrapolated on a national (United States) level. RESULTS Sixty-three subjects were admitted at four hospitals (18, cohort A and 45, cohort B). The crude incidence rate ratio increased in the later time frame as compared to that in the earlier time frame (incidence rate ratio, 3.13; 95% CI, 1.80-5.68; p < 0.0001). The median (IQR) charges per patient, adjusted for inflation, were $4780 ($3,895-$8,287) and $5912 ($3,432-$9,433) for cohorts A and B, respectively (p = 0.57). If the subjects in the participating counties were only admitted to the participating hospitals, the annual charges, extrapolated throughout the United States for the two periods, would be $2,419,016 and $8,129,538, respectively. If the subjects were evenly distributed across all pediatric monitored beds in a given county, the annual charges extrapolated throughout the United States for the two periods would be $5,694,232 and $24,126,640, respectively. CONCLUSION The incidence of unintentional poisonings from ADHD drugs is increasing and is associated with a significant cost.
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Affiliation(s)
- M Levine
- Department of Emergency Medicine, Section of Medical Toxicology, University of Southern California, Los Angeles, CA, USA.
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Teng HL, Yen M, Fetzer S, Sung JM, Hung SY. Effects of targeted interventions on lifestyle modifications of chronic kidney disease patients: randomized controlled trial. West J Nurs Res 2013; 35:1107-27. [PMID: 23618821 DOI: 10.1177/0193945913486202] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Targeting interventions to an individual's readiness to modify lifestyle factors, specifically diet and exercise behaviors, may delay chronic kidney disease (CKD) progression. This study examined the effects of a targeted Lifestyle Modification Program based on the readiness to change health-promotion lifestyle behaviors, renal protection knowledge, and physical indicators of patients with early CKD. A repeated-measures design randomized 160 CKD patients from four southern Taiwan outpatient nephrology clinics into control and intervention groups. Data were collected five times over a year with a participant retention rate of 64.4%. The intervention group demonstrated significant improvement with regard to diet behavior modifications. Compared with the control group, the intervention group showed a significant improving trend of renal function protection knowledge, stress management, and interpersonal relations. Targeted interventions for patients in the early phases of CKD promotes adherence to proper diet, exercise behavior, and positive lifestyle modifications.
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Malik M, van Gelderen EM, Lee JH, Kowalski DL, Yen M, Goldwater R, Mujais SK, Schaddelee MP, de Koning P, Kaibara A, Moy SS, Keirns JJ. Proarrhythmic safety of repeat doses of mirabegron in healthy subjects: a randomized, double-blind, placebo-, and active-controlled thorough QT study. Clin Pharmacol Ther 2012; 92:696-706. [PMID: 23149929 DOI: 10.1038/clpt.2012.181] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Potential effects of the selective β(3)-adrenoceptor agonist mirabegron on cardiac repolarization were studied in healthy subjects. The four-arm, parallel, two-way crossover study was double-blind and placebo- and active (moxifloxacin)-controlled. After 2 baseline ECG days, subjects were randomized to one of eight treatment sequences (22 females and 22 males per sequence) of placebo crossed over with once-daily (10 days) 50, 100, or 200 mg mirabegron or a single 400-mg moxifloxacin dose on day 10. In each period, continuous ECGs were recorded at two baselines and on the last drug administration day. The lower one-sided 95% confidence interval for moxifloxacin effect on QTcI was >5 ms, demonstrating assay sensitivity. According to ICH E14 criteria, mirabegron did not cause QTcI prolongation at the 50-mg therapeutic and 100-mg supratherapeutic doses in either sex. Mirabegron prolonged QTcI interval at the 200-mg supratherapeutic dose (upper one-sided 95% CI >10 ms) in females, but not in males.
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Affiliation(s)
- M Malik
- St Paul's Cardiac Electrophysiology, London, UK
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Levine M, Ruha A, Froberg B, Burns M, Yen M, Arthur A, Thomas S. 347 Increasing Prevalence of ADHD Drug Toxicity. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.06.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yen M, Lin TC, Yang WC. [Measuring quality of life in chronic kidney disease patients: reflections and prospects]. Hu Li Za Zhi 2011; 58:5-9. [PMID: 21455886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Quality of life is a complex and multidimensional concept. Understanding a patient'squality of life can assist healthcare providers to assess risk factors associated with hospitalization and mortality, and, potentially, delay disease progression. As chronic kidney disease (CKD) symptoms vary during different stages of the disease, instruments must be properly adjusted to measure quality of life accurately. This article explores comprehensively the development and appropriateness of relevant instruments, and recommends specific instruments for use at specific CKD stages.
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Affiliation(s)
- Miaofen Yen
- Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, ROC.
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Kuo YW, Yen M, Fetzer S, Lee JD. Reducing the pain of nasogastric tube intubation with nebulized and atomized lidocaine: a systematic review and meta-analysis. J Pain Symptom Manage 2010; 40:613-20. [PMID: 20678892 DOI: 10.1016/j.jpainsymman.2010.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 01/18/2010] [Accepted: 01/28/2010] [Indexed: 10/19/2022]
Abstract
Nasogastric tube (NGT) intubations occur frequently in clinical practice and can be a painful procedure for patients. A systematic review of current knowledge concerning the use of nebulized lidocaine to reduce the pain of NGT insertion was conducted in order to develop evidence-based guidelines. In addition, a meta-analysis of appropriate randomized controlled trials (RCTs) was performed. The databases included PubMed (1996-2009), ProQuest (1982-2009), CINAHL (1982-2009), and the Cochrane Central Register of Controlled Trials (2009), and reference lists of articles. Experts in this field also were contacted. Two investigators selected the research based on inclusion criteria and reviewed each study's quality according to the Jadad scale. Five RCTs with 212 subjects were identified. A total of 113 (58%) subjects were women. The mean age of treatment and control groups was 59.6 and 55 years, respectively. The countries of studies were the United States, United Kingdom, Australia, Canada, and Thailand. In the treatment groups, the use of lidocaine concentration was 4% and 10%. The pooled effect size was 0.423 (95% confidence interval: 0.204-0.880; Z=-2.301; P=0.021), indicating that the use of nebulized lidocaine before NGT insertion can decrease pain by 57.7%. There is insufficient evidence to recommend the dosage, concentration, or delivery method. Further research is needed to articulate a comprehensive clinical guideline.
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Affiliation(s)
- Ya-Wen Kuo
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Abstract
AIMS AND OBJECTIVES The aim of this study was to test the Chinese version of the Critical Thinking Disposition Inventory (CTDI-CV) among nurses in Taiwan. BACKGROUND Critical thinking is the use of purposeful self-regulatory judgments to identify patient's problems and provide patient care. Critical thinking influences nurses' decision making. To date, no inventory to understand nurse's critical thinking disposition has been developed. DESIGN This was a survey design with a stratified random sampling to test the reliability and validity of the CTDI-CV. METHODS The participants comprised 864 registered nurses who were chosen by stratified random sampling from seven hospitals in Taiwan. Data were collected through self-administered structured questionnaires. RESULTS A new scale, short form (SF) CTDI-CV, contains 18 items with three subscales: 'systematic analysis', 'thinking within the box' and 'thinking out of the box', was generated from the analysis with 44% explained variance. Cronbach's alpha coefficients and intra-class correlation coefficients for overall and subscale were above 0.8. Goodness-of-fit test for the final model of SF-CTDI-CV revealed an acceptable result in the overall fit (χ(2)/df = 4.04, p < 0.05, GFI = 0.93, AGFI = 0.91, SRMR = 0.076, RMSEA = 0.059). CONCLUSION On the basis of these results, the SF-CTDI-CV is a reliable instrument for assessing critical thinking disposition for nurses. RELEVANCE TO CLINICAL PRACTICE A short and valid critical thinking instrument for nurses will facilitate critical thinking research in the clinical practice arena. When designing continuing education activities, clinical educators will be able to efficiently and effectively evaluate the quality of critical thinking among practicing nurses.
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Affiliation(s)
- Shiow-Y Hwang
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
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Lin YC, Yen M, Chen CH. [Managing constipation in the elderly: an evidence-based approach]. Hu Li Za Zhi 2010; 57:95-99. [PMID: 20661862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Constipation is a common problem afflicting the elderly. When elderly patients complain of constipation to their healthcare providers, they are typically prescribed laxatives rather than given a clinical examination to explore the specific causes. This approach not only does not resolve the long-term problem of constipation, but may also lead to further complications (e.g., constipation alternating with diarrhea, abdominal distention, poor appetite, and ileus). Effective management of constipation in the elderly should in many cases be tailored to the symptoms and conditions of individual patients rather than simply applying evidence-based treatment. There is a lack of consistency amongst specialists on how best to deal with the problem of constipation. The aim of this article was to explore evidence-based management approaches to constipation in the elderly. A definition of constipation is given and relevant causes are first given. Pharmacological and non-pharmacological treatment approaches are then introduced with regard to effective approaches to conducting physical examinations, assessing patient medical history, and performing laboratory tests. In addition, this article also developed a constipation protocol as a reference tool in the clinical management of constipation in the elderly. The authors hope results can help reduce the problem of constipation in the elderly population.
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Affiliation(s)
- Yi-Chen Lin
- College of Medicine, National Cheng Kung University, ROC.
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Abstract
AIM This paper is a report of an examination of the validity and reliability of the Chinese version of the Health Promoting Lifestyle Profile. BACKGROUND The Health Promotion Lifestyle Profile, a well-known instrument measuring health promotion lifestyle behaviours and developed by Walker in 1987 and later refined, has been translated into several languages. The original Chinese translated version, based on Walker's 48-item 1987 version, detected six dimensions of health promotion lifestyle behaviours. The 52-item revised Health Promotion Lifestyle Profile-II has not been tested for Mandarin-speakers. METHOD After the English version of the Health Promotion Lifestyle Profile-II was translated into Chinese using established forward-backward translation procedures, the psychometric properties of the translated version were determined with 331 Taiwanese Mandarin-speaking adults. Data were collected from August 2007 to July 2008 at outpatient clinics for health screening in Southern Taiwan. The psychometric properties of the instrument were evaluated, including the internal consistency, test-retest reliability, item analysis and factor analysis. RESULTS Neither Walker's original 6-factor model nor a forced 6-factor solution of the 52 items of the Health Promotion Lifestyle Profile-II was supported. Parallel analysis suggested that five factors be retained, with the 5-factor solution statistically and conceptually satisfactory. The 5-factor Chinese version of the Health Promoting Lifestyle Profile explained 53% of the variance in healthy lifestyles. Thirty items were retained for the Chinese version of the Health Promoting Lifestyle Profile. DISCUSSION Deletion of 22 items from the Health Promotion Lifestyle Profile-II did not impair the ability of the Chinese version of the Health Promoting Lifestyle Profile to measure a healthy lifestyle among a sample of Taiwanese adults. The data support the fact that lifestyle is influenced by culture.
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Lee HF, Lin SC, Lu CL, Chen CF, Yen M. Revised Acute Physiology and Chronic Health Evaluation score as a predictor of neurosurgery intensive care unit readmission: a case-controlled study. J Crit Care 2010; 25:294-9. [PMID: 20189751 DOI: 10.1016/j.jcrc.2009.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 11/24/2009] [Accepted: 12/15/2009] [Indexed: 01/07/2023]
Abstract
PURPOSE Patients with neurologic system problems are among the most common patients readmitted to the intensive care unit (ICU). Readmission predictors for neurologic ICU patients have not been established. Previous research suggests that the Revised Acute Physiology and Chronic Health Evaluation (APACHE II) score is one indication of the critical status of ICU-admitted patients; however, the ability of the discharge APACHE II to predict readmission to the ICU requires further study. The purpose of this study was to investigate the ability of the APACHE II scoring system to predict ICU readmission of neurosurgical and ICU patients. MATERIALS AND METHODS A retrospective case-controlled comparison study and a review of patient records for all patients admitted to 8 ICUs from January 2003 to June 2005 (N = 753) were conducted. Readmitted neurosurgery ICU patients were matched with 58 randomly selected nonreadmitted patients. RESULTS Nine variables were significantly different between the readmission and case-controlled group. The APACHE II discharge score was the only significant predictor and was able to predict 18.6% of neurologic ICU readmissions. The risk of ICU readmission increased when the APACHE II score at the time of discharge exceeded 8.5 points. CONCLUSIONS The risk of ICU readmission of neurologic ICU patients can be predicted by determining APACHE II score upon ICU discharge.
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Affiliation(s)
- Huan Fang Lee
- Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City (701), Taiwan
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Chang C, Yen M, Chang T, Wang K. P989 Tumor necrosis factor alpha promoter polymorphisms in neuroendocrine adenocarcinoma of the uterine cervix. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wang JJ, Yen M, OuYang WC. Group reminiscence intervention in Taiwanese elders with dementia. Arch Gerontol Geriatr 2009; 49:227-232. [DOI: 10.1016/j.archger.2008.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 08/15/2008] [Accepted: 08/18/2008] [Indexed: 11/29/2022]
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Yen M, Kuo CC. [Development and evaluation of a nursing database]. Hu Li Za Zhi 2009; 56:23-28. [PMID: 19472109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The progress of information technology (IT) has not only changed the way we live, but also made health instruments more user friendly and convenient. In recent years, the application of IT in nursing has increased, as has relevant research in the literature. It also has been verified in the literature that IT has improved clinical practice efficiency and effectiveness. However, the development of IT in nursing has progressed slower than expected in health care settings because nursing information system flows are complicated and the scope necessarily covered by nursing information systems is broad. In addition, with limited experience, the development of nursing information systems has posed a tremendous challenge, with nurse administrators facing significant barriers and difficulties. The purpose of this paper was to share our experience establishing a unit based on a nationwide nurses' information bank.
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Affiliation(s)
- Miaofen Yen
- College of Medicine, National Cheng Kung University, ROC.
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Abstract
Adherence with prescription medications among elderly patients with cardiac conditions is poor. Mechanisms underlying adherence behavior have not been fully investigated. The purpose of this study was to develop a substantive model that describes medication-taking behavior in elderly individuals with chronic diseases. The study was exploratory using grounded theory. Purposive sampling was used to recruit 19 elderly cardiac patients. Four major themes were delineated from the data to describe readiness to adhere: perceived effectiveness, perceived partnership, perceived reality, and interpersonal influences. To convert perceptions into actions, 2 influencing factors, facilitating and inhibiting factors, played pivotal roles. This model could provide a useful framework for health professionals to design valid interventions for elderly patients to increase medication adherence.
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Affiliation(s)
- Ching-Huey Chen
- Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
The purpose of this study was to evaluate the outcomes of a telephone call service (TCS) for ambulatory surgery patients. Three outcomes were evaluated: patient satisfaction, patients' perceptions of the value of a TCS intervention, and nurses' perceptions of difficulties in implementing it. The results indicated that patients were satisfied with the TCS intervention and were positive about its value. Nurses indicated that the main difficulties in implementing the TCS were their lack of knowledge in answering patients' questions and time limitations.
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Affiliation(s)
- Ching-Huey Chen
- Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
Cross-mapping the terms of International Classification for Nursing Practice (ICNP) with the handwritten nursing records of gynecological patients at one district of private teaching hospital in the south of Taiwan was conducted in July and August, 2004. The purpose of this study was to validate the applicability of ICNP for electronic nursing records in a gynecological setting. A Chinese version of the ICNP beta 2 browser was used to code nursing record sentences. Medical charts were reviewed until data were saturated. A total of sixty-two patient records were analyzed, producing 6,327 sentences, this included 1,918 sentences on nursing phenomena (30.3%) and 4,409 sentences on nursing action (69.7%). The ratio between the two was about 1:2.3. Coded sentences were compared according to the four levels of applicability with the original records, each was identified as a "perfect fit", "conceptual fit", "partial fit", or "unable to fit". Of the 6,327 sentences, 2,041 (32.3%) were designated as "perfect fit", 2,457 (38.8%) as "conceptual fit", 1,663 (26.3%) as "partial fit", and 166 (2.6%) as "unable to fit". The top ten most described nursing phenomena included: acute pain, high temperature, conscious change, potential infection risk, state of mind change, potential risk patient's mobility change endurance level, gastrointestinal function obstacles, changes in urination, anxiety, and diarrhea. The top ten most described nursing actions included: observe surgical wounds, monitor vital signs, changes of mentality, instruction on medication, arranging clinical check ups, wound infection prevention, urinary drainage tube and urine nature observation, checking for vaginal drainage, pre/post-operative healthcare, and discharge planning. Study results indicated that 71.1% of sentences could be cross-mapped. Further validation is suggested to validate ICNP in other gynecological hospitals.
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Affiliation(s)
- Chun-Hua Kuo
- Nursing Department, Kuo General Hospital, Tainan, Taiwan, ROC
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Yen M, Huang MC, Chen CH. Translating and Testing a Patient Assessment of Hospital Care Questionnaire in Taiwan. J Nurs Scholarsh 2006. [DOI: 10.1111/j.1547-5069.2006.00097.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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