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1.
Support Care Cancer ; 30(4): 3233-3240, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34977980

RESUMO

BACKGROUND: Pain is the most severe and commonest symptom for patients with cancer. Patients' pain management satisfaction is an essential indicator of quality care and further affects their willingness to seek care. PURPOSE: This study aimed to examine the correlations between patients' prescribed opioids, pain management satisfaction, and pain intensity. METHODS: This study adopted a cross-sectional correlation design, recruited a total of 123 patients with cancer pain through convenience sampling, and used two research scales, namely the Chinese version of the Pain Treatment Satisfaction Scale and the Brief Pain Inventory-Short Form. RESULTS: The findings indicated that the correlations of prescribed opioid dosage with pain management satisfaction (r = - .10, p > .05) and pain intensity (worst pain, least pain, average pain, and pain right now; r = - .05 to .01, p > .05) were nonsignificant. The correlations of pain management satisfaction with pain intensity (r = .24 to .32, p < .01), pain interference (r = .32, p < .01), and pain relief (r = - .25, p < .01) were all significant, but that with the worst pain (r = .06, p > .05) was nonsignificant. CONCLUSIONS: Medical professionals providing cancer pain management should focus on medicines strategies and individuals' pain relief requirements. In particular, patients with the worst pain require extra investigations into their needs, and their satisfaction with their level of pain should be further evaluated.


Assuntos
Analgésicos Opioides , Neoplasias , Estudos Transversais , Humanos , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Pacientes Ambulatoriais , Manejo da Dor , Medição da Dor , Satisfação Pessoal
2.
Support Care Cancer ; 30(1): 805-812, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34389908

RESUMO

PURPOSE: The purpose of this study was to explore the correlations between patients' opioid-taking self-efficacy, social support, and their pain management satisfaction, and to evaluate the effect of social support and opioid-taking self-efficacy in explaining the variance in pain management satisfaction. METHODS: We used a cross-sectional and correlational research design and recruited 123 cancer patients via convenience sampling. We used the following instruments: the Opioid-Taking Self-Efficacy Scale, the Inventory of Socially Supportive Behavior, and the Chinese version of the Pain Treatment Satisfaction Scale. RESULTS: There were significant and negative correlations between opioid-taking self-efficacy and pain management satisfaction (r = - .43, p < .001) and between social support and pain management satisfaction (r = - .47, p < .001). Using a hierarchical regression analysis, social support and opioid-taking self-efficacy explained 17.20% and 5.20%, respectively, of the variance in pain management satisfaction. CONCLUSIONS: The results of this study confirm the importance of social support and opioid-taking self-efficacy in influencing pain management satisfaction. We recommend that professional care providers develop relevant intervention aimed at improving patients' pain management satisfaction.


Assuntos
Dor do Câncer , Neoplasias , Analgésicos Opioides/uso terapêutico , Dor do Câncer/tratamento farmacológico , Estudos Transversais , Humanos , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Pacientes Ambulatoriais , Manejo da Dor , Satisfação Pessoal , Autoeficácia , Apoio Social
3.
Pain Manag Nurs ; 23(6): 885-892, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35922271

RESUMO

BACKGROUND: Up to 90% of patients still experience pain after abdominal surgery, which also affects their physical recovery and psychological anxiety. AIM: To evaluate the effects of guided imagery meditation on ameliorating anxiety, improving the quality of sleep, and relieving postoperative pain in patients after laparoscopic cholecystectomy surgery. METHOD: In the general surgical ward of a teaching hospital, patients were randomly assigned to usual care (n = 34) and guided imagery meditation intervention (n = 34) groups, using the method. The measuring outcomes included their anxiety score, quality of sleep, and pain control. RESULTS: In terms of the anxiety difference, the experimental group scored 0.42 (standard deviation [SD] = 0.97), while the control group scored 4.79 (SD = 7.56), which indicates a statistically significant difference (F = 8.04, p = .01, partial eta2 = 0.11). In terms of quality of sleep, the mean score of the experimental group was 2.67 (SD = 1.96), while the control group scored 7.55 (SD = 3.81), which indicates a significant difference (F = 39.99, p = .001, partial eta2 = 0.39). The mean of the degree of postoperative pain was 2.11 points (SD = 1.39), and the score of the control group was 4.00 points (SD = 1.62), which indicates a significant difference (p = .001). CONCLUSIONS: Guided imagery meditation is a simple, non-invasive, non-pharmacologic intervention measure. It can reduce anxiety and postoperative pain, and improve the quality of sleep. Thus, it should be promoted in clinical practice.


Assuntos
Colecistectomia Laparoscópica , Meditação , Humanos , Imagens, Psicoterapia/métodos , Colecistectomia Laparoscópica/efeitos adversos , Ansiedade/prevenção & controle , Ansiedade/psicologia , Dor Pós-Operatória/prevenção & controle
4.
J Clin Nurs ; 31(15-16): 2287-2295, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34558131

RESUMO

AIMS: The study compares the differences in self-care knowledge, self-efficacy, psychological distress and self-management between patients with early- and end-stage chronic kidney disease (CKD), and predicts the influential factors of self-management. DESIGN: A cross-sectional study. METHODS: A total of 185 subjects by using convenience sampling from one teaching hospital were collected. The research instruments included the Chronic Kidney Disease Self-Care Instrument Knowledge, the Chronic Kidney Disease Self-Efficacy Instrument, the Hospital Anxiety and Depression Scale, and the Chronic Kidney Disease Self-Management Instrument. Descriptive statistics is used frequency, percentage, mean and standard deviation. Inferential statistics is used independent t-test, one-way ANOVA and multiple linear regression analysis. STROBE checklist was used as the guideline for this study. RESULTS: Our results showed that a significant difference was found in the age (p = 0.005), systolic pressure (p = .006), self-care knowledge (p = .011) and depression level (p = .003) between patients with early- and end-stage CKD. Furthermore, patients with early-stage CKD have less self-care knowledge and lower depression levels compared with patients with end-stage CKD. However, self-efficacy is the most significant predictor of self-management for patients with early- and end-stage CKD. For patients with early-stage CKD, self-efficacy explained 69.1% of the variation in self-management. CONCLUSION: According to our results, the management of depression in patients with CKD may improve their outcomes. Improving self-care knowledge of patients with end-stage CKD may improve their self-management. Therefore, our findings suggest various interventions with different necessary and prioritised precision care at early- and late-stage of CKD. RELEVANCE TO CLINICAL PRACTICE: Nurses should strive to improve the self-care knowledge of patients with early-stage CKD to delay the progression of the disease to end-stage. Screening for depression among patients with end-stage CKD is relevant, and these patients should be referred to professional counsellors when necessary.


Assuntos
Falência Renal Crônica , Angústia Psicológica , Insuficiência Renal Crônica , Autogestão , Estudos Transversais , Humanos , Falência Renal Crônica/terapia , Insuficiência Renal Crônica/psicologia , Autocuidado , Autoeficácia
5.
Int J Nurs Pract ; 28(4): e13033, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34913227

RESUMO

AIM: This study explored the association between social support, resilience and coping strategies among patients with liver cancer and evaluated the extent to which patients' use of various coping strategies can be explained by social support and resilience. METHODS: This cross-sectional study comprised 119 patients who experienced transarterial chemoembolization related to liver cancer and who completed the Social Support Scale, the Resilience Scale and the Ways of Coping Checklist-Revised. RESULTS: Results indicated a significant positive correlation between social support and use of problem-focused coping strategies and overall coping strategies. In addition, results showed a significant positive correlation between resilience and use of problem-focused strategies, emotion-focused strategies and overall coping strategies. Social support accounted for 14% of variance in use of problem-focused strategies and 7.6% of the variance in overall coping strategies. Resilience accounted for 30.5% of the variance in use of problem-focused strategies, 8.5% in use of emotion-focused strategies and 21.6% of overall coping strategies. CONCLUSION: Results of this study highlight the importance of social support and resilience in patients' coping strategies related to liver cancer treatment.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Resiliência Psicológica , Adaptação Psicológica , Estudos Transversais , Humanos , Neoplasias Hepáticas/terapia , Apoio Social , Inquéritos e Questionários
6.
Int J Nurs Pract ; 28(6): e12957, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33987956

RESUMO

AIM: The aim of this study was to develop and initially assess the psychometric properties of the Caregiver Caregiving Self-Efficacy Scale-Oral Cancer (CSES-OC). METHODS: In total, 28 items in the Caregiver Caregiving Self-Efficacy Scale-Oral Cancer were originally employed for a reliability and validity test based on expert suggestions and qualitative findings. The Cronbach's alpha coefficient and test-retest reliability were evaluated with the pilot sample, which included 30 caregivers. The main test, which included 107 caregivers during May 2016 to 2018, was used to execute the exploratory factor analysis (EFA) and concurrent validity. RESULTS: The results of the main test showed a Cronbach's alpha coefficient of .95 for the revised 18-item total scale after EFA. Four factors (acquiring resources, managing sudden and uncertain patient conditions, managing patient-related nutritional issues and exploring and making decisions on patient care) were classified from EFA of the Caregiver Caregiving Self-Efficacy Scale-Oral Cancer. The r coefficient was .59 (P < .01), which supported the concurrent validity between CSES-OC and General Self-Efficacy Scale. CONCLUSION: The study results show appropriate psychometric properties for the Caregiver Caregiving Self-Efficacy Scale-Oral Cancer that was constructed for evaluating caregiver caregiving self-efficacy in caring for family members with oral cancer.


Assuntos
Cuidadores , Neoplasias Bucais , Humanos , Psicometria , Reprodutibilidade dos Testes , Autoeficácia , Inquéritos e Questionários , Família
7.
Semin Dial ; 34(4): 292-299, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33533048

RESUMO

BACKGROUND: Taiwan has the world's highest prevalence of end-stage kidney disease, as well as the world's third highest incidence. The study investigated the effectiveness of a self-management program for enhancing health-related quality of life, self-care behaviors, and self-efficacy in patients with end-stage kidney disease undergoing hemodialysis. METHODS: This was a quasi-experimental design with convenient sampling, and allocated 32 participants in the control group (conventional program) and 32 participants in the experimental group (self-management program). The self-management program intervention lasted 4 weeks, and a posttest was administered 3 months later. The questionnaire included the 36-Item Short Form Health Survey, a Chronic Kidney Disease Self-Care Instrument, and a Chronic Kidney Disease Self-Efficacy Instrument. RESULTS: Three months after the intervention, the self-management program had improved patients' health-related quality of life in the mental health components (p < .001), but not in the physical health components. The program also promoted patients' self-care behaviors (p < .001) and self-efficacy (p < .05). CONCLUSIONS: This study's findings confirmed that self-management programs should be promoted in clinical practice where they will provide clinical care personnel with an alternative to conventional health education.


Assuntos
Qualidade de Vida , Autogestão , Humanos , Qualidade de Vida/psicologia , Diálise Renal , Projetos de Pesquisa , Autocuidado , Autoeficácia
8.
Arch Womens Ment Health ; 24(3): 413-421, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33161489

RESUMO

The purpose of the study is to explore changes in resilience and physical and psychological distress and their related factors over time in women with endometrial cancer. This study adopted a repeated measures design using purposive sampling and was conducted in a hospital in Taiwan. Data were collected before surgery, 2 weeks after surgery, and 3 months after surgery. The measured variables consisted of demographic and disease characteristics, social support, resilience, and physical and psychological distress. A total of 48 women participated in the study, of whom 42 (mean age = 54.2 years old) completed all of the questionnaires. The results showed that resilience and physical distress in women with endometrial cancer was not statistically significantly changed over time. Rather, their psychological distress was significantly alleviated 2 weeks and 3 months after surgery as compared to before surgery. Women with less social support showed a lower level of resilience. In addition, those with a lower level of resilience experienced greater psychological distress. Compared with those who received only surgical treatment, women who had undergone surgery combined with chemotherapy and radiotherapy had more physical distress. Clinical medical staff should conduct continuing assessments of the resilience, physical distress, and psychological distress of women with endometrial cancer. Interventions related to resilience-enhancing and self-care should be implemented to avoid worsening or to improve women's resilience and distress.


Assuntos
Neoplasias do Endométrio , Angústia Psicológica , Resiliência Psicológica , Feminino , Humanos , Pessoa de Meia-Idade , Apoio Social , Estresse Psicológico , Inquéritos e Questionários , Taiwan
9.
Women Health ; 61(6): 581-590, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34187330

RESUMO

This study aimed to assess health concerns after hysterectomy from different perspectives among Taiwanese women with uterine fibroids. A mixed-methods was used in this study. In a cross-sectional study, 95 patients completed a structured questionnaire (Health Concern Questionnaire-HCQ). Face-to-face interviews with 5 patients were implemented for the qualitative component from OBS-GYN outpatient departments at two hospitals in Northern Taiwan. Participants who met the following criteria, 20 years of age or older, conscious alert without mental disturbances were recruited to this study. Descriptive statistics were calculated for social demographic variables and HCQ. A content analysis was used to analyze the qualitative data. The mean age was 46.28 of 95 patients. Findings of the present study showed that the most health concerns among patients with UFs after hysterectomy are hysterectomy-related complications, follow by impacts on daily life, body image and female identity, and intimacy and sexual relations. The findings of qualitative interviews supported the above findings. In addition, the information needs of post-operative self-care were identify in this qualitative interviews. The results of this research study could help healthcare professionals to address women's health concerns and provide adequate care for Taiwanese women with uterine fibroids after hysterectomy.


Assuntos
Leiomioma , Neoplasias Uterinas , Estudos Transversais , Feminino , Humanos , Histerectomia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Inquéritos e Questionários , Neoplasias Uterinas/cirurgia
10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(3): 350-356, 2021 Jun 30.
Artigo em Zh | MEDLINE | ID: mdl-34238410

RESUMO

Objective To compare the performance of contrast-enhanced ultrasound(CEUS)and ultrasound(US)in the differential diagnosis between cholesterol polyps and gallbladder adenomas. Methods A total of 136 patients with gallbladder polyp lesions(GPLs)and undergoing cholecystectomy in the First Medical Center of Chinese PLA General Hospital from January 2019 to October 2020 were retrospectively analyzed.All the patients underwent US and CEUS examinations before cholecystectomy.US and CEUS images of cholesterol polyps and gallbladder adenomas were compared for the evaluation of the performance of CEUS in the diagnosis of gallbladder adenomas. Results The 136 cases of GPLs included 95 cases of cholesterol polyps and 41 cases of gallbladder adenomas.Cholesterol polyps and gallbladder adenomas showed significant differences in the maximum size of GPLs( Z=-5.189, P<0.001), polyp blood flow signal(χ 2=33.630, P<0.001), vascular stalk width(Z=-7.366, P<0.001), polyp enhancement time(χ 2=22.487, P<0.001), enhancement intensity in arterial phase(χ 2=44.371, P<0.001), polyp vascular morphology(χ 2=53.814, P<0.001)and gallbladder wall integrity(χ 2=13.277, P=0.001).The sensitivity, specificity and accuracy of CEUS in distinguishing gallbladder adenomas from cholesterol polyps were 85.37%, 89.47% and 88.24%, respectively, and the area under the curve was 0.874. Conclusion CEUS can effectively distinguish gallbladder adenomas from cholesterol polyps and help patients with GPLs to select the appropriate treatment.


Assuntos
Adenoma , Vesícula Biliar , Adenoma/diagnóstico por imagem , Colesterol , Meios de Contraste , Diagnóstico Diferencial , Vesícula Biliar/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Ultrassonografia
11.
BMC Nephrol ; 21(1): 243, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600283

RESUMO

BACKGROUND: To explore the potential value of three-dimensional ultrasonography (3DUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of diabetic nephropathy (DN) in Chinese diabetic patients with kidney injury. METHODS: Patients with type 2 diabetes mellitus and kidney injury in our hospital were enrolled, and the clinical characteristics as well as the laboratory data of patients were collected; 3DUS and CEUS were used to evaluate the morphological structure and blood perfusion of kidneys. Eligible patients were categorized into two groups based on renal biopsy results: DN group and non-diabetic renal diseases (NDRD) group. Correlation analysis and logistic regression analysis were applied to identify the risk factors of DN development. RESULTS: A total of 115 patients aged from 24 to 78 years old were recruited in the experiment, of which 64 patients (55.65%) and 51 patients (44.35%) were in the DN group and NDRD group, respectively. After correction to CKD stage, BMI and right kidney volume index were retained to identify patients with DN. The ROC of the logistic regression model had an AUC of 0.703 (95% CI: 0.591-0.815) and it was higher than both indicators. CONCLUSION: 3DUS has potential value in the diagnosis of diabetic nephropathy in Chinese diabetic population with kidney injury and may act as an auxiliary diagnosis for DN. More prospective and well-designed studies with larger samples are needed to verify the result.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Nefropatias Diabéticas/diagnóstico por imagem , Rim/diagnóstico por imagem , Insuficiência Renal Crônica/diagnóstico por imagem , Adulto , Idoso , Área Sob a Curva , Índice de Massa Corporal , China , Meios de Contraste , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/etiologia , Diagnóstico Diferencial , Feminino , Glomerulonefrite por IGA/diagnóstico por imagem , Glomerulonefrite Membranoproliferativa/diagnóstico por imagem , Glomerulonefrite Membranosa/diagnóstico por imagem , Glomerulosclerose Segmentar e Focal/diagnóstico por imagem , Humanos , Hipertensão/complicações , Imageamento Tridimensional , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Tamanho do Órgão , Curva ROC , Insuficiência Renal Crônica/etiologia , Ultrassonografia , Adulto Jovem
12.
J Clin Nurs ; 29(7-8): 1372-1380, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31970842

RESUMO

AIMS AND OBJECTIVES: The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. BACKGROUND: As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health-related quality of life. DESIGN: This study adopted a cross-sectional correlational research design. The STROBE checklist for cross-sectional studies was used as a reference for reporting the study. METHODS: A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. RESULTS: Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = -0.38), comorbidity index (ß = -0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. CONCLUSIONS: Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. RELEVANCE TO CLINICAL PRACTICE: The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias do Endométrio/epidemiologia , Fadiga/epidemiologia , Estilo de Vida Saudável , Sono/fisiologia , Comorbidade , Estudos Transversais , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários , Taiwan
13.
J Emerg Nurs ; 46(5): 633-641, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32622532

RESUMO

INTRODUCTION: Registered nurses have to adequately prepare to respond to disasters, as they have become increasingly frequent worldwide. The aim of this study was to identify the factors influencing registered nurses' disaster preparedness in Bengkulu, Indonesia. METHODS: This study used a descriptive correlational study design. A total of 130 registered nurses working in 2 governmental hospitals in Bengkulu, Indonesia, were recruited by using a convenience sampling technique. A self-administered questionnaire, the Disaster Preparedness Evaluation Tool, was used to determine their current levels of registered nurses' disaster preparedness. RESULTS: The registered nurses reported a moderate level of disaster knowledge, skills and preparedness. Their knowledge and skills were significantly correlated with disaster preparedness (r = 0.39-0.71, P < 0.01). Three significant factors associated with disaster preparedness were identified in this study: educational level, disaster knowledge, and disaster skills (R2 = 0.31, F = 12.60, P < 0.001). DISCUSSION: Continuing disaster drills training and implementing a formal disaster educational program into nursing curriculum and professional development are recommended to achieve effective disaster preparedness in the hospital setting.


Assuntos
Planejamento em Desastres , Enfermagem em Emergência , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Adulto , Estudos Transversais , Medicina de Desastres/educação , Feminino , Humanos , Indonésia , Masculino , Pessoa de Meia-Idade
14.
Eur J Cancer Care (Engl) ; 28(1): e12891, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30015996

RESUMO

Family caregivers face multiple challenges when caring for patients with oral cancer at home. Understanding the difficulties they face may assist health professionals to better organise and provide support for family caregivers of oral cancer patients. The aim of this study was to describe the caregivers' primary tasks and the difficulties they encounter when caring for a family member with oral cancer. This qualitative study included a purposeful sample of 22 primary family caregivers ranging in age from 25 to 71 years old. The researchers used face-to-face, semi-structured and tape-recorded interviews to collect data and employed qualitative content analysis to elicit caregiving-related themes. Six task-related themes and associated challenges were identified. These included managing the patient's nutritional issues, investigating and making decisions about patient care, managing sudden and unpredictable changes in the patient's condition, managing emotional distress, adjusting their attitudes towards patient care, and seeking resources. Family caregivers handle such essential tasks when they care for patients in home settings and they face specific challenges related to them. This study identified several challenges related to each task. From the outset, healthcare providers should actively offer caregiving information and strategies. Health professionals can incorporate strategies for supporting caregivers' ability to carry out these tasks into their treatment model and can help caregivers manage difficulties that can impede them from doing so.


Assuntos
Atitude Frente a Saúde , Cuidadores/psicologia , Tomada de Decisões , Neoplasias Bucais/enfermagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/enfermagem , Estresse Psicológico/psicologia , Adulto , Idoso , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Taiwan
15.
Hu Li Za Zhi ; 66(1): 27-37, 2019 Feb.
Artigo em Zh | MEDLINE | ID: mdl-30648243

RESUMO

BACKGROUND: Children suffering from adrenoleukodystrophy (ALD) requires life-long care. Little is known about the care needs of parents of ALD children at different stages of their disease. PURPOSE: The purpose of this study was to understand the long-term care experiences and care needs of parents caring for their ALD children. METHODS: A descriptive qualitative study with 7 in-depth interviews was conducted with parents. RESULTS: The results of these care experiences were distinguished into three phases: "pathogenesis to diagnosis", "rapid deterioration of physiological functions", and "bedridden until the death". The long-term care experiences revealed five themes, including "chaos and helplessness to seek medical attention then being forced to accept", "self-accusation and guilt", "strengthening parents' toughness", "seizing the moment and facing the future", and "accompanying children through life without pain". Within the three phases, the care needs comprised the three themes of "integrating resources and providing immediate care", "obtaining information and support regarding ALD rapidly", and "establishing individualized long-term care". CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study revealed the long-term care experiences and care needs of the parents of ALD children. Providing individualized care, nursing instruction, and telephone consultation as well as connecting case managers with the hospice-care team will help facilitate and meet the care needs of these parents.


Assuntos
Adrenoleucodistrofia/terapia , Necessidades e Demandas de Serviços de Saúde , Relações Pais-Filho , Pais/psicologia , Criança , Humanos , Assistência de Longa Duração/psicologia , Pesquisa Qualitativa
16.
J Clin Nurs ; 27(1-2): e138-e146, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28543737

RESUMO

AIMS AND OBJECTIVES: To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. BACKGROUND: Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. DESIGN: A predictive correlational cross-sectional study design was used. METHODS: Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. RESULTS: The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. CONCLUSIONS: Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. RELEVANCE TO CLINICAL PRACTICE: When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis predialysis education, increase dialysis knowledge and provide professional support.


Assuntos
Conflito Psicológico , Tomada de Decisões , Falência Renal Crônica/psicologia , Diálise Peritoneal/psicologia , Idoso , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Autoeficácia , Apoio Social , Inquéritos e Questionários , Taiwan
17.
Nurs Health Sci ; 20(2): 197-205, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29316107

RESUMO

Cancer during adolescence increases the risk for bone mass deficiency later in life. Adolescents with cancer must learn to improve their bone health to avoid osteoporosis. In the present cross-sectional study, we developed and tested scales to assess the bone health self-efficacy and beliefs of adolescents with cancer in Taiwan. Test development followed three stages: item generation and scale formatting, examination of content validity, and validation of psychometric properties with a sample of 100 adolescents with cancer. Through the validation process, this research generated the seven-item Bone Health Self-Efficacy Scale and the 13-item Bone Health Belief Scale. Multiple indices demonstrated construct validity. Cronbach's alphas (0.809 and 0.705) demonstrated internal consistency. No items caused a drop in Cronbach's alpha of 10%, all inter-item correlations were <0.800, and the factor loadings for all items reached 0.400, demonstrating item appropriateness. The present study provides initial evidence of the scales' accessibility and feasibility for adolescents with cancer who speak Mandarin. These scales might also help clinical nurses evaluate the effectiveness of bone health education provided to adolescents with cancer.


Assuntos
Desenvolvimento Ósseo/fisiologia , Nível de Saúde , Neoplasias/complicações , Psicometria/normas , Adolescente , Feminino , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Autoeficácia , Inquéritos e Questionários , Taiwan , Tradução
18.
Int J Nurs Pract ; 23(1)2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28066961

RESUMO

The purpose of this study was to understand the lifestyle; examine the relationships among lifestyle, medical factors, and stress status; and determine the predictors of better lifestyle in heart transplant recipients in Taiwan. A prospective design with convenience sampling was used. Data were collected through the Health-Promoting Lifestyle Profile-II and demographic questionnaires, which included personal information, stress status, and medical information. Pearson correlations, 1-way analysis of variance, independent t tests, paired t tests, and hierarchical regression were used to analyze the factors related to better lifestyle. A total of 80 heart transplant recipients participated. The mean score for lifestyle decreased from baseline to 3 months and was even lower at 6 months. Nevertheless, the trend for some participants was the opposite-their lifestyle improved over the 6-month period after baseline. Notably, the trend for each of the 6 subscales was not consistent with the mean of the total score. Stress status accounted for 12.8% of lifestyle. When stress status was combined with family income and creatinine, the 3 factors accounted for 32.2% of lifestyle. This study demonstrated that maintenance of a healthy lifestyle fluctuates after transplantation. Demographic factors and stress status can help to identify people who are more likely to have a poor lifestyle.


Assuntos
Transplante de Coração , Estilo de Vida , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Taiwan
19.
Hu Li Za Zhi ; 64(1): 17-24, 2017 Feb.
Artigo em Zh | MEDLINE | ID: mdl-28150255

RESUMO

This article describes the current situation in Taiwan with regard to the nurse-patient ratio and nursing fee payments, reviews the related policies and results in developed countries, and then proposes a plan for improving the domestic situation. Direct relationships exist between patient nursing quality and patient safety and the nurse-patient ratio as well as between nursing fee payments and the nurse-patient ratio. Therefore, in order to enhance the quality and safety of nursing care, it will be necessary to develop and institute a payment linkage system that links nursing fee payments to the nurse-patient ratio. This process requires public consensus and planning in order to institute an equitable and effective payment linkage system in the future.


Assuntos
Planos de Pagamento por Serviço Prestado , Relações Enfermeiro-Paciente , Humanos , Qualidade da Assistência à Saúde
20.
Support Care Cancer ; 23(7): 2113-20, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25547481

RESUMO

GOALS: Quality of life is an important indicator for evaluating the outcome of treatment for patients with cancer pain. Perceived self-efficacy has been reported to play an important role in controlling quality of life (QOL). Limited studies have focused on opioid-taking self-efficacy effects on the patients' QOL, which is caused by cancer pain. The purpose of this study was to evaluate how much of the variance in QOL among Taiwanese cancer patients with pain could be accounted for by opioid-taking self-efficacy. MATERIALS AND METHODS: This cross-sectional study included 109 cancer patients who had taken prescribed opioid analgesics for cancer-related pain in the past week and completed the Opioid-Taking sSelf-Efficacy Scale and European Organization for Research and Treatment of Cancer Quality of Life Group Questionnaire. MAIN RESULTS: There was a significant correlation between scores on self-efficacy total scale and functional QOL (r = 0.30, p < 0.01) and symptomatic QOL (r = -0.22, p < 0.05). The opioid-taking self-efficacy total scale accounted for 8% (R (2) = 0.08, p < 0.01) of the variance in predicting the patients' functional QOL and 7% (R (2) = 0.07, p < 0.01) of the variance in predicting the patients' symptomatic QOL. CONCLUSIONS: This study highlights the potential importance of a patient's opioid-taking self-efficacy beliefs in their quality of life, which is relevant to cancer pain.


Assuntos
Analgésicos Opioides/administração & dosagem , Neoplasias/complicações , Dor/tratamento farmacológico , Autoeficácia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Cultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/psicologia , Dor/etiologia , Dor/psicologia , Medição da Dor , Qualidade de Vida , Inquéritos e Questionários , Taiwan
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