Anxiety, pain intensity, and decision regret of living liver donors during postoperative period.

AIM: The aim of this study was to explore and examine the relationship between anxiety, acute pain intensity, and decision regret of living liver donors in the postoperative stage. METHODS: This is a prospective correlational study. Data were collected consecutively for one year (from September 2017 to September 2018) at a medical center in northern Taiwan. Information about anxiety and acute pain intensity was collected preoperatively and on postoperative day (POD) 3 and POD 7. Satisfaction with pain management and decision regret was inquired about on POD 7. RESULTS: Data of 57 consecutive living liver donors (56.1 % male, mean age 34.12 ± 9.92 years) were analyzed. Living liver donors experienced moderate anxiety and acute pain levels in the postoperative period. The mean score of decision regret was 12.63 (range 0-60), indicating a low level of regret. The acute pain intensity decreased significantly between POD 3 and POD 7 (p < .001); however, the anxiety level slightly increased (p = .031). Older and married living liver donors had higher anxiety levels. The satisfaction level of pain management was negatively correlated with the POD 7 acute pain intensity (r = -0.26, p = .049) and decision regret (r = -0.37, p = .005), but it was positively correlated with POD 7 anxiety (r = 0.38, p = .004). CONCLUSIONS: The postoperative period was hard for living liver donors as they would experience moderate acute pain and anxiety. Although the decision regret was low, the satisfaction level of pain management would negatively affect it. Therefore, the effectiveness of pain management and anxiety management should be continually ensured in the postoperative period.

Factors associated with the intention to engage in care planning among persons with mild cognitive impairment and dementia.

This study examined factors associated with the intention to engage in advance care planning among persons with cognitive impairment. This cross-sectional study recruited 116 persons with cognitive impairment by convenience sampling from two teaching hospitals in Northern Taiwan from November 1, 2018, to December 31, 2020. Fewer than 50% of the participants intended to engage in advance care planning, and less than 10% signed the living will for hospice and palliative care. Multivariate linear regression determined factors influencing advance care planning intention included education level, a proxy signed do-not-resuscitate document, belief that family members would provide a signed do-not-resuscitate at their end-of-life, and necessity of explaining future care in advance. It is recommended to popularize advance care planning education and ensure the rights of persons with cognitive impairment to enable them to fully participate in their own care plans through family-centered advance care planning.

The impact of symptom distress on health-related quality of life in liver cancer patients receiving arterial chemoembolization: the mediating role of hope.

BACKGROUND: Trans-hepatic arterial chemoembolization (TACE) is a treatment option for liver cancer patients. It can prolong patients' survival but can also cause symptom distress. Symptom distress (SDs) can directly impact quality of life (QOL) and may indirectly influence QOL by lessening hope. In this study, we wanted to explore the mediating effect of hope on the relationship between SDs and QOL among patients with liver cancer receiving TACE. METHODS: A cross-sectional study was conducted from December 20, 2017, to August 6, 2018, at a gastroenterology ward of a medical center. The participants were 92 liver cancer patients (69.6% male, mean age 67.8) who were admitted for TACE treatment. Information on SDs, hope, and QOL was collected by questionnaire on discharge day. Hayes' PROCESS model was used to test the mediating effect of hope on the relationship between SDs and QOL. RESULTS: The mean score and standard deviation (SD) of SDs, hope, and QOL were 32.08 (SD = 6.22), 27.09 (SD = 3.51), and 55.16 (SD = 17.33), respectively. SDs negatively impacts quality of life. The total effect of SDs on QOL was - 1.41 (95% confidence interval [CI]: - 1.96, - 0.86). The indirect effect via the mediation of hope was - 0.95 (95% CI: - 1.7, - 0.45). Hope partially mediated the effect of SDs on QOL. CONCLUSION: SDs after TACE is vital; it directly reduces a patient's overall QOL and can indirectly hinder it by reducing the patient's hope. In addition to symptom management, interventions that help patients maintain their hope are key to improving QOL among patients receiving TACE.

Mediating effect of self-efficacy on the relationship between social support and self-management behaviors among patients with knee osteoarthritis: a cross-sectional study.

BACKGROUND: Good self-management behaviors in patients with knee osteoarthritis can improve disease awareness, treatment effectiveness, quality of life, and reduce medical costs. However, there is a paucity of studies focusing on patients with knee osteoarthritis. Therefore, the purpose of this study was to explore the mediating effect of self-efficacy on aspects of social support and self-management behaviors in this population. METHODS: This study employed a cross-sectional design and convenience sampling to survey patients with knee osteoarthritis in an outpatient department of a regional hospital in northern Taiwan from February 22, 2021, to April 15, 2021. The inclusion criteria for patients were (1) those diagnosed by a physician with knee osteoarthritis and (2) who could communicate in Chinese or Taiwanese. Participants were asked to complete a demographic questionnaire, the Arthritis Self-Efficacy Scale (ASE), the Inventory of Socially Supportive Behavior (including enacted support and perceived social support), and the Arthritis Self-Management Assessment Tool (ASMAT). In addition, the Kellgren-Lawrence Grading Scale was obtained from a chart review. Data were analyzed with descriptive statistics, t-test, one-way analysis of variance, Pearson product-moment correlation, and mediation analysis. RESULTS: A total of 140 patients met the inclusion criteria. The mean age of participants was 70.21 ± 10.84years; most (73.6%) were female. The mean total score of the ASMAT was 64.27 ± 14.84. Scores for the ASE, enacted support, and perceived social support were significantly positively correlated with ASMAT (all p < .001). The standardized coefficient for total effect and direct effect of perceived social support on ASMAT was 0.899 (p < .001) and 0.754 (p < .05), respectively. After introducing the ASE into the model, the indirect effect was 0.145 (p < .05), which indicated that ASE had a partial mediating effect on the relationship between perceived social support and ASMAT. CONCLUSION: Our findings might suggest that perceived social support indirectly affected ASMAT through ASE. Therefore, interventions designed to increase self-efficacy and social support could enhance self-management behaviors for patients with knee osteoarthritis.

Exploring physical activity behavior in middle-aged Taiwanese women based on the theory of planned behavior.

The study aimed to apply the theory of planned behavior (TPB) to understand middle-aged women's behavior of physical activity (PA). We recruited 185 women between 45 and 64 years (mean: 53.2 ± 5.6) for this cross-sectional study. Participants complete demographic data and an exercise behavior questionnaire including attitudes, subjective norms, perceived behavioral control (PBC), and intention. Means, frequencies, and t-tests were used. To test TPB, we used structural equation modeling. Fit indices for this model demonstrate a good fit: chi-square and degree of freedom ratio X2/df = 2.14 (p = .34), goodness of fit =.97, comparative fit index =.99, root mean square error of approximation =.019, and Akaike information criterion = 28.14. Significant positive correlations between subjective norms and intention (ß=.18, p < .05) and between PBC and intention (ß=.48, p < .01). Women believed that close family and friends promoted their intention to perform PA. Increased PBC would positively enhance their intention. Findings showed that PBC was the strongest predictor. Enhancing women's PBC over their PA can improve their intention. Future researchers are encouraged to examine the barriers to and benefits of improving PBC so that a useful and effective intervention can be designed to promote PA.

Association between surgical volumes and hospital mortality in patients: a living donor liver transplantation single center experience.

BACKGROUND: Many factors cause hospital mortality (HM) after liver transplantation (LT). METHODS: We performed a retrospective research in a single center from October 2005 to June 2019. The study included 463 living donor LT patients. They were divided into a no-HM group (n = 433, 93.52%) and an HM group (n = 30, 6.48%). We used logistic regression analysis to determine how clinical features and surgical volume affected HM. We regrouped patients based on periods of surgical volume and analyzed the clinical features. RESULTS: Multivariate analysis revealed that donor age (OR = 1.050, 95% CI 1.011-1.091, p = 0.012), blood loss (OR = 1.000, 95% CI 1.000-1.000, p = 0.004), and annual surgical volumes being < 30 LTs (OR = 2.540, 95% CI 1.011-6.381, p = 0.047) were significant risk factors. A comparison of years based on surgical volume found that when the annual surgical volumes were at least 30 the recipient age (p = 0.023), donor age (p = 0.026), and ABO-incompatible operations (p < 0.001) were significantly higher and blood loss (p < 0.001), operative time (p < 0.001), intensive care unit days (p < 0.001), length of stay (p = 0.011), rate of re-operation (p < 0.001), and HM (p = 0.030) were significantly lower compared to when the annual surgical volumes were less than 30. CONCLUSIONS: Donor age, blood loss and an annual surgical volume < 30 LTs were significant pre- and peri-operative risk factors. Hospital mortality and annual surgical volume were associated with statistically significant differences; surgical volume may impact quality of care and transplant outcomes.

Motivations for Family Members' Visits to Nursing Home Residents With Dementia in Taiwan: A Qualitative Study.

PURPOSE: The purpose of this study was to explore what motivates family members to visit a relative with dementia who has been transferred to a nursing home in Taiwan. DESIGN AND METHODS: Data were collected for this qualitative descriptive study using audiotaped, semi-structured, in-depth, face-to-face interviews. A total of 20 family members of elderly nursing home residents participated in the study. Nursing home residents were from four nursing homes in Taiwan and had been diagnosed with probable or possible dementia by a psychiatrist or neurologist. Transcribed audiotaped interviews were analyzed using thematic analysis. FINDINGS: Most family members were the children of the residents (n =17, 85%). The theme describing the core motivation for family members' visits to nursing home residents was "to maintain the unforgotten family affection." This motivation comprised four relevant categories: hoping to slow degeneration, providing a congruous environment, honoring filial and karmic duty, and ensuring the quality of care. CONCLUSIONS: Motivations for Taiwanese family members' visits to nursing home residents with dementia were similar to those in Western cultures. However, "hoping to slow degeneration" and "providing a congruous environment" were unique categories. CLINICAL RELEVANCE: Nurses and policymakers could use these findings to design interventions that might increase holistic care for both family members and nursing home residents with dementia. Providing programming focused on family members' unique priorities could address swallowing difficulties, management of dementia symptoms, nutritional needs, and selection of residents' roommates. These programs could improve the quality of family members' visits as well as the quality of staff-family relationships.

Pain Quality by Location in Outpatients with Cancer.

BACKGROUND: The McGill Pain Questionnaire (MPQ) pain quality descriptors have been analyzed to characterize the sensory, affective, and evaluative domains of pain, but have not been differentiated by pain location. AIM: To examine MPQ pain quality descriptors by pain location in outpatients with lung or prostate cancer. DESIGN: Cross sectional. SETTINGS: Eleven oncology clinics or patients' homes. SUBJECTS: 264 adult outpatients (80% male; mean age 62.2 ± 10.0 years, 85% White). METHODS: Subjects completed a 100 mm visual analogue scale of pain intensity and MPQ clinic or home visit, marking sites where they had pain on a body outline and circling from 78 verbal descriptors those that described their pain. A researcher noted next to the descriptor spontaneous comments about sites feeling like a selected word and queried the subjects about any other words to obtain the site(s). RESULTS: Pain quality descriptors were assigned to all 7 pain locations marked by ≥ 20% of 198 lung or 66 prostate cancer patients. Four pain locations were marked with pain quality descriptors significanlty (p < .05) more frequently for lung cancer (53% chest-aching, burning; 58% back-aching, stabbing; 48% head-aching, sharp; and 19% arms-aching, stabbing) than for prostate cancer, which had significantly more frequent pain locations in the abdomen (64%-aching, burning) and lower back/buttocks (55%-aching, burning). CONCLUSIONS: This type of pain characterization is innovative and has the potential to help implement targeted treatments for patients with cancer and other chronic pain conditions.

Factors associated with foot ulcer self-management behaviours among hospitalised patients with diabetes.

AIMS AND OBJECTIVES: To determine prehospitalised diabetes-related foot ulcer (DFU) self-management behaviours and explore the factors associated with these behaviours. BACKGROUND: Although there are many studies that explore DFU prevention and treatment, to our knowledge, there are no quantitative studies of DFU self-management behaviours. DESIGN: Cross-sectional design. METHODS: From June 2015-June 2016, 199 hospitalised patients with DFU were given a survey questionnaire at a medical centre in northern Taiwan. DFU self-management behaviours, diabetes foot self-care behaviours, beliefs in regard to barriers to DFU self-management behaviours, and knowledge regarding warning signs of DFU deterioration were assessed by well-designed measurement tools. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used to ensure quality reporting during this observational study (see Supporting Information Appendix S1). RESULTS: The results revealed that 62.8% of participants never monitored their blood glucose level when they had foot ulcers, and 63.8% never sought treatment for their wounds when their wounds were not painful. After controlling for demographic and medical variables, stepwise multiple regression analysis revealed that the following eight significant variables were associated with DFU self-management behaviours: two DFU self-management barrier beliefs, foot self-care behaviour, no treatment for diabetes, poor financial status, employment, knowledge regarding the warning signs of DFU deterioration, and number of DFU hospitalisations. CONCLUSIONS: Diabetes-related foot ulcer self-management behaviours were insufficient. Some modifiable factors and high-risk groups for insufficient DFU self-management behaviour were identified. RELEVANCE TO CLINICAL PRACTICE: Diabetes-related foot ulcer self-management behaviours should be promoted. Interventions that modify the risk factors that were identified in this study can be designed to promote the performance of DFU self-management behaviours.

Predictors of advance directives among nursing home residents with dementia.

ABSTRACTBackground:Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan. METHOD: Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator. RESULTS: Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation. CONCLUSIONS: Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study.

AIMS: To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan. BACKGROUND: Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self-reported medication adherence in kidney transplant recipients warrant investigation. DESIGN: The study used a cross-sectional and correlation design. METHODS: A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012-2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence. RESULTS: Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7-35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self-efficacy was positively associated with adherence. Therapy-related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence. CONCLUSIONS: Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients' self-efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen.

Predictors of self- and caregiver-rated quality of life for people with dementia living in the community and in nursing homes in northern Taiwan.

BACKGROUND: Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings. METHODS: For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs' data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers' data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship. RESULTS: QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality. CONCLUSION: Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers' depressive status and mutuality with PWD must be also carefully assessed.

Effect of social support and donation-related concerns on ambivalence of living liver donor candidates.

Ambivalence in the decision-making process for living liver donors has the potential to result in their experiencing a negative mental status. To promote donor candidates' well-being, it is important to study the factors related to ambivalence. Thus, the aim of this study was to explore the ambivalence of living liver donor candidates and to investigate the effect of social support and donation-related concerns on their ambivalence. A cross-sectional design was used. In total, 100 living liver donor candidates who underwent a preoperative evaluation between April and October 2009 were recruited for the study. Participants completed a self-administered questionnaire that contained items related to ambivalence, donation-related concerns, and social support. The mean score for ambivalence was 3.14 (standard deviation = 1.8), and the median was 3. Only 7% of the study sample reported no ambivalence during the assessment stage. Ambivalence was positively correlated with donation-related concerns (physical concerns, r = 0.39; psychosocial concerns, r = 0.43; financial concerns, r = 0.29) and negatively correlated with social support (r = -0.16 to -0.33). Those with psychosocial concerns had significantly worse ambivalence (ß = 0.29, P = 0.03), but social support mitigated ambivalence (ß = -0.34, P = 0.01). When intimacy and social support were included in the model, the effect of psychosocial concerns on ambivalence became nonsignificant (ß = 0.24, P = 0.08). Ambivalence is common among living liver donor candidates, but instrumental social support can mediate the negative effect of donation-related concerns. Recommendations include providing appropriate social support to minimize donation-related concerns and, thus, to reduce the ambivalence of living liver candidates.

The effect of self-efficacy, depression and symptom distress on employment status and leisure activities of liver transplant recipients.

AIM: To examine the effect of self-efficacy, subjective work ability, depression and symptom distress on and to provide a description of, the employment and leisure activities of liver transplant recipients. BACKGROUND: Return to work and leisure activities have become an important aspect of life for liver transplant recipients worldwide. An investigation of the factors that influence the employment status and leisure activities has been recommended as a means to help transplant recipients restore their productivity. DESIGN: This was a cross-sectional, descriptive and correlational study in 2010. METHODS: A convenience sampling method was used. Data were collected using a set of questionnaires that were administered retrospectively. A total of 106 liver transplant patients were included in this study. RESULTS: The post-transplantation employment rate was 45.2%. The positive predictors of employment were higher subjective work ability and higher symptom distress. Gender (female), monthly family income (

More than communication skills: experiences of communication conflict in nursing home nurses.

CONTEXT: Communication conflicts are inevitable in nursing homes. Understanding communication conflicts experienced by practising nurses could provide insights to guide the development of sound communication education programmes. OBJECTIVES: The purpose of this study was to explore the experiences of nurses in nursing homes of communication conflict in encounters with nursing home residents and their families in Taiwan. METHODS: Data were collected from April 2010 to December 2011 through audiotaped, individual, in-depth interviews with 26 nurses at five nursing homes in Taiwan. Data were analysed according to van Manen's interpretive phenomenological method. RESULTS: Data analysis revealed that nurses' experiences of communication conflicts during encounters with nursing home residents and their families could be categorised under three themes: differences in perspectives of nursing home services; differences in views of nurturing health, and mediation between family members and others. CONCLUSIONS: The findings of this study can be considered by clinical educators and policymakers when designing communication education programmes for nurses and other clinicians. These programmes should include ways to increase nurses' independent thinking in settings in which power differences exist, as well as their cultural sensitivity as embodied in Leininger's culture care theory. These programmes should also include education in telephone communication and alternative methods of communication (e.g. videoconferencing).

Effect of Acupressure on Fatigue in Hemodialysis Patients: A Single-Blinded Randomized Controlled Trial.

Objectives: The objective of this study was to investigate the effect of acupressure on fatigue severity, sleep quality, and psychological status in patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) treatment. Design: A single-blinded parallel-group randomized controlled trial. Settings/Location: A medical center in central Java, Indonesia. Subjects: One hundred and six patients who had been receiving HD for at least 3 months were enrolled in this study and randomly assigned to two groups. Interventions: The experimental group received acupressure at K1, ST36, and SP6 acupoints. In contrast, the control group received sham acupressure at 1 cun from these three acupoints. Subjects received acupressure thrice per week for 4 weeks, and pressure on each acupoint was applied for 3 min bilaterally. Outcome measures: The primary outcome was fatigue severity, while sleep quality and psychological status (depression/anxiety) were evaluated as secondary outcomes. Outcomes were assessed using the Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Results: Acupressure induced a significant medium to large effect on improvement in fatigue (b = -1.71, confidence interval [95% CI]: -1.90 to -1.51, ΔR2 = 0.744), sleep quality (b = -5.81, 95% CI: -6.80 to -4.81, ΔR2 = 0.525), and anxiety (Estimate = -3.213, 95% CI: -4.238 to -2.188, pseudo R2 = 0.292)/depression (Estimate = -3.378, 95% CI: -4.432 to -2.325, pseudo R2 = 0.268) in experimental group patients compared to controls. No adverse events of acupressure were reported during the study process. Conclusions: Acupressure significantly and independently improved fatigue, depression/anxiety, and sleep quality in ESRD patients receiving HD. Clinical Trial Registration: NCT05571007.

The effect of a web-based self-care instruction on symptom experience and quality of life in living liver donors: A randomized controlled trial.

Objective: Living liver donors need help to manage symptom distress and improve their quality of life. This study aims to test the effectiveness of a web-based symptom self-care instruction on symptom experience and health-related quality of life of living liver donors. Methods: This study was a randomized controlled trial. Participants were recruited from January 2019 to August 2020. Participants in the experimental group had access to a web-based symptom self-care instruction, which included text and video. The control group received routine care. The primary outcomes were symptom distress and quality of life. Results: A total of 90 living liver donors recruited in this study were assigned randomly to the web group (n = 46) and control group (n = 44). The symptom distress was significantly negatively correlated with quality of life at each data collection time. There was an interaction effect with the participants in the web group experiencing more symptom distress at three months after surgery than the control group (B = 3.616, 95% CI: 7.163-3.990, p = 0.046). There was no significant effect on the quality of life. Conclusion: Patients in the web-based self-care group had higher symptom distress than those in the control group three months after surgery, but there was no difference in quality of life. Future studies could add some interactive elements to the website and include a larger sample size. Registration: This study was registered at the Chinese Clinical Trial Registry (ChiCTR1900020518).

The early predictive value of frailty for health-related quality of life among elderly patients with cancer receiving curative chemotherapy.

Changes in health-related quality of life (HRQOL) among elderly patients with cancer before and after receiving curative treatment, such as chemotherapy, have always been an important consideration in physician-patient treatment decision-making. Although frailty assessment can help predict the effects of chemotherapy, there is a lack of relevant literature on its effectiveness in predicting post-chemotherapy HRQOL. Therefore, this study investigated the early predictive value of pre-chemotherapy frailty assessment for post-chemotherapy HRQOL among elderly patients with cancer receiving curative chemotherapy. From September 2016 to November 2018, this study enrolled elderly patients with cancer aged ≥ 65 years (N = 178), who were expected to receive chemotherapy at three hospitals in Taiwan. The mean age of patients was 71.70 years (SD = 5.46 years) and half of them were female (n = 96, 53.9%). A comprehensive geriatric assessment was performed to measure frailty in 178 participants one week before receiving chemotherapy (T0). Further, the HRQOL of the elderly patients with cancer was assessed again, four weeks after chemotherapy (T1). After controlling for demographic variables, this study evaluated the predictive value of frailty for HRQOL using a hierarchical regression analysis. A total of 103 (57.9%) participants met the frailty criteria. The results showed that 31.1%-56.7% of the variance in the seven domains of HRQOL could be explained by demographic variables and the presence or absence of frailty. This suggests that the presence or absence of frailty is an important predictor of the illness burden domain (ß = 9.5; p < .05) of HRQOL. Frailty affects the illness burden domain of HRQOL in elderly patients with cancer. Finally, the administration of frailty assessments before treatment is recommended as a reference for patient treatment decision-making.

The coping experience of Taiwanese male donors in living donor liver transplantation.

BACKGROUND: Living donor liver transplantation is an option for effective treatment for patients with liver disease or a liver tumor. One disadvantage, however, is the risk of complications or death in a healthy donor. Thus, promoting the donor's safety and well-being is a major goal of transplantation care. In this regard, more research on physical and psychological complications and adjustment among donors is needed. OBJECTIVES: The aim of this study was to describe the experiences of living liver donors, focusing on their perceptions of living liver transplantation and corresponding coping strategies. METHODS: The data were analyzed using content analysis in this qualitative design. RESULTS: Seven of 12 donors, all men, agreed to participate in the study. The core theme that emerged in regard to adjustment was "maintaining peace of mind." In addition, there were 4 subthemes: (a) removing themselves from information, (b) viewing the surgery as common, (c) having overall confidence, and (d) assigning value to their decision. DISCUSSION: Living donor liver transplantation is a treatment option that requires acceptance by both the donor and his or her family. The process is enormously stressful, and the living liver donor needs adjustment strategies to maintain his or her peace of mind throughout the process.

Construction and evaluation of a 360 degrees panoramic video on the physical examination of nursing students.

AIM: The aim of this study was to construct and analyze the content validity and usability for a 360-degree panoramic video for physical examination. BACKGROUND: Acquiring techniques and ability on physical examination (PE) skill is often difficult. Immersion and simulation provide an opportunity for nursing students in the real situation focus on the PE techniques practice and to improve patient care. The combination of digital instructional materials and innovative teaching strategies is crucial to improving education. Therefore, effective and clear instruction of PE techniques that can enable students confidently to use their skills in clinical practice is an issue that nursing education must address. METHODS: This study used a descriptive research design and the technology acceptance model to create a 360-degree video to teach students to perform PE. Content validity and usability were analyzed by five nursing teachers and 53 nursing students who had completed a physical assessment course were invited to assess its usability. RESULTS: The results of the expert review indicated that the content validity of the video scored 0.98 in terms of content relevance, 0.95 in terms of convenience and 0.97 in terms of suitability, suggesting that the video was useful and appropriate for self-practicing. The experts' qualitative feedback indicated that the technical demonstrations in the video were clear and specific and that the video was easy to use. The video increased learning motivation and streamlined learning. The ability to change the video's perspective also increased learning interest. The results of a satisfaction survey were 8.94 points for perceived ease of use, 8.79 points for perceived usefulness, 8.56 points for user attitude toward the video and 9.02 points for continued intention to use the video, indicating that the participants were satisfied with the video. The participants' qualitative feedback indicated that each PE technique was clear and that the ability to change the video's perspective and zooming was useful and novel. CONCLUSIONS: The 360-degree panoramic videos were described as a positive learning method for physical examination of nursing students. It provides easy to use and useful to practice PE technique under realistic conditions. Among these outcomes, the 360-degree video can be learned best when teaching PE in nursing education. Accordingly, nursing educators should construct similar videos for the PE of other parts of the body as soon as possible, improve the videos convenience and usefulness and promote their ability to strengthen professional skills.