Assessment of the function and effect of diabetes education programs in Taiwan

A multi-center prospective study was conducted to assess the function and impact of diabetic education programs on diabetic control. A total of 208 subjects with type 2 diabetes were recruited. Diabetes self-care, assessed by questionnaire, was evaluated before, and 4 months after attending a diabetes education course. A total of 121 subjects who received advanced diabetes education courses were designated as the experimental group. A second group of 87 cases receiving a basic course served as controls. In addition to basic knowledge, the advanced education programs included dietary control, blood glucose monitoring, management of hypoglycemia, medication compliance, foot care and exercise. Diabetes self-care techniques were significantly improved in the experimental group. The overall score for diabetes self-care techniques improved in both groups at the 4th month over baseline values. The change was significant with the controls' (P < 0.001). Multiple regression analysis confirmed the intensity of diabetic education was the only significant variable correlated with the decrease of fasting blood glucose and systolic blood pressure. In conclusion, integrated and intensive diabetes education program in diabetes education centers provides an effective method for improving diabetes self-care techniques and metabolic outcome.

[The application of Roger's science of unitary human beings for an adolescent with mental illness]

The purpose of this paper is to report the application of Rogers' science of unitary human beings theory to exploring the influence of the environment and the nursing process on an adolescent with behavioral disturbance at a children's mental health outpatient. Rogers' theory is that the principles of resonancy, helicy and integrality explain the life process of human beings, and predict the development of the life process. In the paper, these principles were adopted throughout the nursing process to explore their relationship. We found that the nurse made use of varied nursing interventions, and that the interventions were influential in three aspects. In the aspect of integrality they could promote the interaction of client and environment energy field. In the aspect of helicy, they were able to reduce the complexity of the behavioral deviation. In the aspect of resonancy, they were able to slow down the evolution of acceleration of energy field between client and environment.

[Applying Peplau's theory in improving drug compliance of a schizophrenic patient]

The purpose of this paper is to report the application of Peplau's theory to helping a schizophrenic patient deal with drug noncompliance. It was found that the main reasons for noncompliance were poor insight and lack of illness and drug-related knowledge. Based on Peplau's theory of establishing a therapeutic relationship, giving guidance in medication and monitoring the effects of medication in order to improve drug compliance, the most important role of the nurse is as an assessor and educator. Nurse and patient were able to learn to achieve the common goal of drug compliance through the interactive human relationship.

[Family life events, maternal mental health status, and the problems of preschool children's behavior--a correlation study]

The purpose of this study was to explore the relationships of family life events and maternal mental health status to mothers' reports of the problems of their preschool children's behavior. Ninety children aged between 2.5 and 4 years old were sampled from 4 private kindergartens in Taipei. There was a positive correlation between family life events and the problems of preschool children's behavior, but "maternal mental health status" was the best predictor for the problems of preschool children's behavior by multiple regression analysis.

[The effects of management difficulty and family functions on metabolic control of insulin-dependent diabetes mellitus]

This study was designed as a quantitative study. Subjects ranging from the fourth grade of primary school to the third year of senior high school were drawn from the survey project of Taipei IDDM Registry and from the Kang-Tai IDDM Association. The mothers of these diabetic children were asked to complete questionnaires. The purpose of this paper was to explore the influences of maternal stress, management difficulties and family function on self-management of diabetes and HbA1c. Results indicated that family function was positively and significantly related with self-management. There was a significant correlation between the difficulty of diet control and self-management. The total self-management, blood glucose monitoring and preventive measures for hypoglycemia were negatively correlated with HbA1c. Forty-six point six percent of the variance of self-management could be explained by the family role function, paternal education, patient's school grade, religion and difficulty of diet control. Forty-two point six percent of the variance of HbA1c could be accounted for by total self-management, payment method, difficulty of blood glucose monitoring and frequency of hospitalization due to hypoglycemia.

Dimethylformamide-induced liver damage among synthetic leather workers

Prevalence of liver injury associated with dimethylformamide (DMF) exposure was determined. Medical examinations, liver function tests, and creatine phosphokinase (CPK) determinations were performed on 183 of 204 (76%) employees of a synthetic leather factory. Air concentrations of solvents were measured with personal samplers and gas chromatography. The concentration of DMF in air to which each worker was exposed was categorized. High exposure concentrations of DMF (i.e., 25-60 ppm) were significantly associated with elevated alanine aminotransferase (ALT) levels (ALT greater than or equal to 35 IU/l), a result that did not change even after stratification by hepatitis B carrier status. Modeling by logistic regression demonstrated that exposure to high concentrations of DMF was associated with an elevated ALT (p = .01), whereas hepatitis B surface antigen (HBsAg) was slightly but independently associated with an elevated ALT (p = .07). In those workers who had normal ALT values, there occurred still significantly higher mean ALT and aspartate aminotransferase (AST) activities, especially among those who were not HBsAg carriers. A significant association existed between elevated CPK levels and exposure to DMF. However, an analysis of the CPK isoenzyme among 143 workers did not reveal any specific damage to muscles. This outbreak of liver injury among synthetic leather workers is ascribed to DMF. It is recommended that the occupational standard for DMF and its toxicity among HBsAg carriers be evaluated further.