Search

To explore the relationship between walking activity and sleep quality among elderly. A cross-sectional, correlation study with purposive sampling was conducted on participants with a walking habit but not regular moderate-intensity exercise. Data were collected by structured questionnaires, including the Walking Activity Questionnaire and the Pittsburgh Sleep Quality Index. The total walking time per week and frequency of walking per day were significant predictors of sleep quality. Walking can help older community-dwelling adults improve their sleep quality. Walking more than once per day and total walking time per week ≥210 minutes were associated with good sleep quality. [ABSTRACT FROM AUTHOR]

This study explored the gender differences in the relationship between walking activity and sleep disturbances. A cross-sectional study of 201 community-dwelling older adults with diabetes was conducted in southern Taiwan. Using the Taiwanese version of the International Physical Activity Questionnaire, self-administered short version (IPAQ-SS), information on physical activity and sleep disturbance conditions was collected. Among older female adults with diabetes, 54.2% reported sleep disturbance significantly higher than males (38.1%). Logistic regression analysis suggested that for women, in addition to the active group, older adults in the low-active, high-walking group exhibited a significantly lower rate of sleep disturbance than did those who walked less. [ABSTRACT FROM AUTHOR]

Investigates the essence of spirituality of terminally ill patients. Discussion of spirituality; Consecutive patterns that emerged; Implications for hospice palliative care.

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aims and objectives To inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. Background Making a patient the centre of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking. Design A qualitative study. Method In order to record and examine reasons for family involvement in adult patients' surgical decision-making, 12 different family members of 12 elective surgery patients were interviewed for collecting and analysing data. Results Three major reasons for family involvement emerged from the data analyses: (1) to share responsibility; (2) to ensure the correctness of medical information; and (3) to safeguard the patient's well-being. These findings also reveal that culture is not the only reason for family involvement. Conclusions Making decision to undergo a surgery is a tough and stressful process for a patient. Family may provide the patient with timely psychological support to assist the patient to communicate with his or her physician(s) and other medical personnel to ensure their rights. It is also found that due to the imbalanced doctor-patient power relationship, a patient may be unable, unwilling to, or even dare not, tell the whole truth about his or her illness or feelings to the medical personnel. Thus, a patient would expect his or her family to undertake such a mission during the informed consent and decision-making processes. Relevance to clinical practice The results of this study may provide medical professionals with relevant insights into family involvement in adult patients' surgical decision-making. [ABSTRACT FROM AUTHOR]

Objectives. This study examines the relationship between transitions in volunteering activity and physical and psychological health outcomes among older adults in Taiwan. Method. We used 3 waves of a longitudinal survey from Taiwan (1999, 2003, and 2007) including 1,847 older adults aged 58–74. We categorized volunteer activity over time into 5 categories and used generalized estimating equations to examine the relationship between volunteer transition group membership and health outcomes. Results. Approximately, 3% of older volunteers kept volunteering and 7% stopped or started their volunteering over time. Engaging in any volunteering, including continuous volunteering, discrete volunteering, active-to-inactive volunteering, and inactive-to-active volunteering, was significantly associated with better self-rated health and higher life satisfaction when compared with the nonvolunteering group. Only those in the continuous volunteer group and those who shifted from inactive-to-active volunteering showed a positive association with better physical function and less depression, compared with the nonvolunteering group. Discussion. The results suggest that the positive relationship between volunteering and health may decline when older adults discontinue or withdraw from volunteering. More research is needed to explore the mechanism behind older people’s desistance from, persistence in, and resumption of volunteer engagement. [ABSTRACT FROM PUBLISHER]

Aims and objectives. This study aimed to explore patient perception of the meaning of family involvement in elective surgery decision making in Taiwan. Background. Informed consent is based on respecting patient autonomy. However in cultures where family plays a key role in medical decision making, a patient's perspective of family involvement has not been fully investigated. Design and methods. Based on a phenomenological approach, this study conducted semistructured interviews to elicit the experiences of 10 elective surgery patients in southern Taiwan who had family present during their surgery decision making. An adapted version of Colaizzi's (1978) method was used to analyse narratives. Results. Three themes emerged from the elective surgery patients' perception of the meaning of family involvement in their surgery decision-making process: (1) Primacy of family well-being, (2) family as information broker, and (3) family as patient advocate. Patients articulated reciprocal relationships amongst family members, and they expressed overall family well-being as their ultimate concern when making their treatment decision. The essence of the elective surgery patients' perception of the meaning of family involvement in decision making was 'family as a whole'. Conclusions. Patients' concern for overall family well-being and their perspective that family plays a supportive role in transmitting information and acting as patient advocate during the decision-making process may both enhance and restrict individual patient autonomy. In cultures where family is central in decision making, appropriately involving the family in medical decisions should not be overlooked. Relevance to clinical practice. Understanding and acknowledging the important roles of family in medical decision making from the patients' perspective can enable health professionals to more effectively communicate with patients and their family. Then, health professionals can empower the individual who is making the medical decision based on his or her own needs. [ABSTRACT FROM AUTHOR]

This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL. [ABSTRACT FROM PUBLISHER]

Aim: To examine the effects of a simplified reablement program on physical function and quality of life in hospitalized older patients. Methods: The randomized controlled trial enrolled 114 older patients aged ≥65 years who, 2 weeks before admission, had been able to walk independently. Patients randomized to the reablement group received supervision and assistance to carry out the simplified reablement program 30 min daily during their hospital stay. Patients in the reminding group received only oral encouragement to continue the reablement program for 30 min daily. The control group received only usual care that included medical intervention consistent with the patient's diagnosis. The main outcome was improvement in physical function, including the modified version of the Katz Activities of Daily Living (ADL) score, Timed Up and Go test (TUG) and Hand Grip Strength (HGS). Secondary outcomes included the EuroQoL 5 Dimension (EQ‐5D) Questionnaire and Visual Analog Scale (VAS). Results: The intervention had no significant effect on the Katz ADL score. However, a significant within‐group improvement in TUG occurred in the reminding group and reablement group. In addition, a significant time‐dependent improvement in HGS occurred only in the reablement group. With respect to secondary outcomes, the EQ5D score improved significantly only in the reablement group at 3 months after discharge. Conclusions: The simplified reablement program may be beneficial to optimize physical function and improve quality of life in hospitalized older patients. It is recommended that health professionals should assist or encourage older patients to do simplified reablement during their hospital stay. Geriatr Gerontol Int 2020; 20: 436–442. [ABSTRACT FROM AUTHOR]

Older ICU survivors are often challenged with clusters of geriatric syndromes and functional decline. The purpose of this study was (a) to assess patterns of geriatric syndromes and functional status from admission to 6 months post discharge and (b) to examine the predictors of longitudinal functional status. This is a prospective cohort study. Demographic information, clinical variables, geriatric syndromes, and functional status were collected longitudinally. A total of 192 medical ICU older adult survivors were included in the analysis. Factors associated with reductions in functional status over 6 months were (a) institutionalized prior to hospitalization, (b) pressure sore before admission, (c) existing delirium, (d) impaired mobility at baseline, (e) increased APACHE II score upon ICU admission, and (f) use of mechanical ventilation during the ICU stay. Importantly, overweight was the only factor that was associated with increased functional level over 6 months. [ABSTRACT FROM AUTHOR]

This study investigated the incidence, rationales, and associated factors of inappropriate urinary catheter use among hospitalized older patients by gender. A longitudinal study of 321 patients with urinary catheter was conducted. Demographic factors, present health factors, urinary catheter factors, and indications of catheter use were collected. A total of 53.7% of urinary catheter-days were inappropriate. For both men and women, there was no significant difference in the incidence and common rationales of inappropriate use. Women, however, have another associated factor with inappropriate use. More tailored alternatives are needed for women to increase comfort to avoid inappropriate catheter use. [ABSTRACT FROM AUTHOR]

Objectives: To investigate incidence, rationales, related factors and outcomes for changing from appropriate catheter placement to inappropriate use among hospitalized older patients in the emergency department. Methods: A secondary analysis was adopted from a longitudinal study that was designed to follow the lifecycle of the urinary catheter among hospitalized older patients. Patients aged 65 and older with a urinary catheter that had been placed in the emergency department were included. Demographic factors, present health conditions, conditional factors of catheter placement, and rationales for daily urinary catheter use were collected from the original data. Inappropriate urinary catheter days were evaluated as an outcome. Results: Appropriate urinary catheters were placed in the emergency department in 117 of the 156 patients (75%). Of these patients, 77 patients (65.8%) experienced a change from appropriate placement to inappropriate use, with a mean duration of 2.88±1.56 days. The common rationales were post-operation for hip fracture (36.3%) and no longer needing to monitor urine output (27.2%). A hierarchical regression model shows that a change from appropriate catheter placement to inappropriate use was associated with a diagnosis of urinary tract infection (OR = 0.15; 95% CI = 0.03–0.77; p = 0.02) and no record of the indication for catheter placement (OR = 4.76; 95% CI = 1.20–18.90; p = 0.02), and all variables together explained 35.9% of the variance. In addition, a change from appropriate placement to inappropriate use was further associated with prolonging inappropriate catheter-days (β = 5.34; 95% CI: 3.72–6.97; p <0.001). Conclusions: The study highlights a considerable percentage of change from appropriate placement to inappropriate use. Efforts to construct reminder intervention, to improve the record of catheter placement and continued attention to catheter use are necessary to reduce inappropriate urinary catheter use. [ABSTRACT FROM AUTHOR]

The purposes of the study were to explore the differences in perceived exercise barriers across three age groups of Taiwanese rural women (30–50, 51–70, and >70 years old) and to examine the associations between perceived exercise barriers and regular exercise behavior. A total of 227 women completed the Self-Reported Exercise Behavior and the Perceived Exercise Barrier Scale. Women older than 70 reported higher physical and psychological barriers and lower administrative barriers than did the younger group. Women who did not exercise regularly tended to have a higher perception of exercise barriers. [ABSTRACT FROM AUTHOR]

Aim: To investigate incidence, reasons, risk factors and outcomes for inappropriate use of urinary catheters in hospitalized elderly patients. Methods: The prospective study enrolled 321 patients aged 65 years and older with a urinary catheter placed within 24 h of hospitalization. Collected data included characteristics of patients and catheter use, reasons for urinary catheter use, mortality, length of hospital stay, time to first removal of catheter, catheter remaining in place at discharge, catheter-associated urinary tract infections and complications, change of activities of daily living, and new admission to nursing home after discharge. Results: The use of 418 urinary catheters was observed. Among these patients with a total of 1958 urinary catheter-days, 1035 (52.8%) urinary catheter-days were inappropriate in hospitalized elderly patients. Inappropriate catheter use occurred mostly in women and surgical patients, and was associated with initially inappropriate catheter use and lack of medical documentation. "Convenience of care" was the most common reason for inappropriate catheter use. Inappropriate use was a significant predictor for longer hospital stay, delayed timing of first removal of catheter, increased rate of catheterization in place at discharge, increased incidence of catheter-associated urinary tract infections and catheter-related complications, and decline in activities of daily living. Conclusions: The study highlights a considerable percentage of inappropriate use of urinary catheters and its association with adverse outcomes in hospitalized elderly patients. Efforts to improve quality of documentation by clinicians and to emphasize catheterization education for patients and caregivers are necessary to reduce the incidence of inappropriate urinary catheter use. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the incidence, associated factors and adverse outcomes for initial inappropriate use of urinary catheters in hospitalised older patients. Background Urinary catheters can lead to substantial complications. The related factors and adverse outcomes associated with initial inappropriate urinary catheter use among hospitalised older patients have not been studied. Design Prospective cohort study. Methods A total of 321 older patients admitted to the hospital in southern Taiwan having urinary catheters placed within 24 hours of admission were recruited. Demographic factors, voiding function history, health conditions and care conditions of catheter placement were collected through a review of medical records, interviewing participants or their primary caregivers. Catheter-associated urinary tract infection during hospitalisation, transfer to a nursing home, length of hospital stay and change in activities of daily living determined as outcomes. Criteria for urinary catheter placement were developed to identify inappropriate use. Results The incidence of initial inappropriate use of urinary catheters among hospitalised Taiwanese older patients was 38·3%. The rationale most often reported for initial inappropriate use was 'convenience of care' (49·6%). Factors associated with initial inappropriate use were, chronic constipation, urinary tract infection history, medical treatment diagnosis, cognitive impairment, depressive symptoms and independence in activities of daily living and, insertion of catheter during evening and night shifts and lack of nursing documentation of the rationale for catheterisation. Patients with initial inappropriate use showed greater decline in activities of daily living function between admission and discharge. Conclusion Older patients with greater care needs may become the victims of initial inappropriate use of urinary catheters. Inappropriate use may devastate the activities of daily living in older patients. Nurses' awareness of indications for urinary catheters may prevent inappropriate use. Relevance to clinical practice A policy to strengthen nurses' awareness of the use of urinary catheters is needed in Taiwan. [ABSTRACT FROM AUTHOR]

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women. [ABSTRACT FROM AUTHOR]

Aims and objectives This study presents a discussion of the physiological and psychological efficacy of a self-regulation protocol in lowering acute exacerbation symptoms in patients with chronic obstructive pulmonary disease. Background Patients with chronic obstructive pulmonary disease are often troubled by acute exacerbation and must learn how to prevent this. Design A two-group, pretest-post-test experimental design was used in this study. Methods Data were collected between January- July 2008. Sixty-four participants were randomly assigned either to an intervention ( n = 33) or to a comparison ( n = 31) group. Both groups were assessed on four separate occasions, namely pretest, post-test 1 (5th week), post-test 2 (9th week) and post-test 3 (13th week). The intervention group received a four-week self-regulation protocol. The comparison group received the self-regulation guidebook only. The Borg Dyspnea Scale, the Symptom Distress Scale, the Pulmonary Functional Status Scale, the chronic obstructive pulmonary disease Self-Efficacy Scale and the peak expiratory flow were used to measure differences between pretest and post-test values. Results On the 5th, 9th and 13th weeks after the self-regulation protocol intervention, we found significantly better scores in the four scales in the intervention group compared to those in the comparison group. On the 9th and 13th weeks, there was a significantly greater peak expiratory flow in the intervention group. The intervention group also showed a lower rate of unscheduled physician visits because of acute exacerbation than the comparison group. Conclusion The findings indicate that the self-regulation protocol developed in this study could significantly assist participants to control their individual symptoms and avoid acute exacerbation. Relevance to clinical practice Healthcare professionals could apply the protocol developed in this study to assist patients to learn the strategies of self-regulation to prevent their acute exacerbation symptoms. [ABSTRACT FROM AUTHOR]

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel. [ABSTRACT FROM PUBLISHER]

Aims and objectives To delineate the trajectories of functional status over four time points and to examine predictors of functional decline ( FD) in hospitalised older patients. Background About 30-60% of the older patients develop new dependence in activities of daily living ( ADL) during a hospital stay, which results in progressive disability after discharge. The functional trajectories and risk factors of FD among hospitalised older patients require identification. Design A cohort study. Methods The study consecutively recruited 273 patients aged 65 and older admitted to a medical centre in southern Taiwan. Functional trajectory, by ADL score, was observed at four time points: two weeks before admission, admission, discharge and three months after discharge. The ADL score two weeks before admission was used as a baseline functional status. Results Eighty-three (30·4%) patients experienced FD at three months after discharge. Functional trajectory as shown by ADL scores indicated that all 273 patients dropped steeply at admission and that two-thirds were gradually restored three months after discharge. Logistic regression revealed that the number of falls in the past year, Instrument Activities of Daily Living (IADL) status before admission, comorbidity and ADL decline between preadmission and discharge were significant predictors of FD three months after discharge. The ADL score decline during hospitalisation was the mediator of FD three months after discharge. Conclusions Findings indicate that the ADL function of those hospitalised older patients who reported having fallen more often in the previous year had more comorbidity, had a lower IADL score, and had more ADL score decline before admission and discharge would continue to decline after discharge. Relevance to clinical practice Clinical nurses can integrate the finding of this study with Comprehensive Geriatric Assessment to tailor intervention to restore older patient's physical function during hospitalisation. [ABSTRACT FROM AUTHOR]

East Asia has historically unique concepts of health and well-being and thus is an appropriate setting for exploring the multicultural applicability of the North American Nursing Diagnosis Association’s Nursing Diagnoses (NANDA ND) system. This study aimed to explore how NANDA ND affect the growth and quality of professional nursing from the perspective of Taiwanese nurses. Grounded theory was employed in this interview-based investigation of 53 Taiwan-licensed nursing professionals at various hospitals in Taiwan. Data were analyzed using constant comparative analysis until theoretical saturation was reached. The core concept, Struggling with (the NANDA ND notion that) One Size Fits All, emerged after ongoing analysis of the effects of NANDA ND on good nursing, patient welfare, and professional development. The preliminary theoretical framework developed from this study provides evidence that NANDA ND may be incompatible with the cultural beliefs of the traditional Chinese health care setting in Taiwan, which emphasize holistic harmony and balance. [ABSTRACT FROM PUBLISHER]

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study examined health promotion behaviours of kidney transplant recipients, 1-5 years after transplant and identified the risk factors predicting non-adherence to post-transplant recommendations. Background. Non-adherence to health care recommendations and health promotion behaviours is one of the top three reasons for graft loss following kidney transplantation. Design. A cross-sectional study. Methods. Kidney transplant recipients ( n = 101) in southern Taiwan completed a self reported survey, the Kidney Transplant Health Promotion Behavior and Healthcare Provider Support survey. Results. Kidney transplant patients had better adherence with medication and least adherence with regular exercise health promotion behaviours. Age, post kidney transplant time, health care provider support and financial satisfaction accounted for 37·2% of the explained variance in monitoring and management for rejection and infection. Marital status, post kidney transplant time and gender accounted for 16·2% of the explained variance in infection prevention. Age was the sole predictor of exercise (odds ratio = 1·08, p = 0·025). Health promotion behaviours declined with time and perceived healthcare provider support decreased at the third ( p = 0·04) post kidney transplant year. Conclusion. In this study, young, single, males were identified as requiring specific strategies to improve post kidney transplant health promotion behaviours. The need for health promotion must be continually reinforce by healthcare providers throughout the lifespan of a kidney transplant recipient. Relevance to clinical practice. Understanding the changes of health behaviours of post kidney transplant recipients and their risk factors, healthcare providers can be more aware of the needs of patients in maintaining health promotion behaviours. [ABSTRACT FROM AUTHOR]