Use of traditional medicine and complementary and alternative medicine in Taiwan: a multilevel analysis.

As the selection of a medical modality is not completely independent, environmental and sociocultural contexts of ecological validity are desired. This study aimed to apply a multilevel analysis using the Hierarchical Linear Modeling software to examine predictors of traditional medicine (TM)/complementary and alternative medicine (CAM) use in Taiwan on both individual and division levels. Individual-level data were obtained from the government database involving TM/CAM use and its impact on the population, whereas division-level data were obtained from a government annual report. A total of 2310 individuals from 22 administrative divisions of Taiwan were evaluated in the data analysis, of which 86.9% had used at least 1 TM/CAM modality in the past year. The average division of TM/CAM use was 2.86 modalities in the null model and 4.15 in the full model. Significant relationships were found between TM/CAM use and individual-level variables of gender, educational level, monthly income, perceived health status, experience with Western medical treatment, and the cost, effect, and degree of satisfaction with TM/CAM. At the division level, TM/CAM use was significantly related to aging population, employment status, and the number of medical institutions. With a simultaneous evaluation of the individual-level and division-level influences, it was found that the average division of TM/CAM use increased significantly. The place of residence is an important predictor of TM/CAM use. The age factor in predicting TM/CAM use in this study may be overestimated in the population of 26 to 60 years of age, whereas an aging population is important in the average division of TM/CAM use. Efforts to reform health insurance to completely cover the costs of TM/CAM and to better facilitate equality of access of health care in rural and remote areas are deemed necessary.

The smoking behaviors of indigenous Taiwanese: individual and family/community factors of influence.

BACKGROUND: Smoking, a self-selected behavior, is the sixth leading cause of death worldwide. Factors related to smoking in Taiwan's indigenous Malayo-Polynesian population should be elicited and addressed. PURPOSE: This study examined the relationship between smoking behavior and individual and family/community factors in indigenous Taiwanese. METHODS: This study was a secondary analysis of data obtained from household visits in central Taiwan that included a population of 562 indigenous adults aged 20-50 years. Data were analyzed using the chi-square test and hierarchical logistic regression to determine individual and family/community relevant factors of smoking behaviors. RESULTS: The smoking rate in the population studied was 57.48% (39.15% men, 18.33% women). The odds ratio for smoking was markedly higher in men than in women. Smokers were 0.45 times more likely to have fixed sexual partners. The OR for smoking was 2.68 times in households with smokers and 7.03 times in people living in mountainous areas. CONCLUSIONS: The issue of smoking in indigenous Taiwanese deserves further attention and concern. Further interventions for the harmful effects of tobacco can focus on younger indigenous people living in mountain regions and on smokers' sexual partners. In addition, male adults, female adults, and heads of households should take a greater role in changing the smoking behaviors of smokers and their family members.

Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: a sham-controlled study.

BACKGROUND: Although it can be reduced, postoperative pain remains a problem. Acupressure with electric stimulation may be more effective for postoperative pain management than acupressure alone. OBJECTIVES: This study aimed to evaluate the effects of integrative acupoint stimulation (IAS) on the relief of postoperative pain and on the reduction of morphine-related side effects. DESIGN: A single-blinded, sham-controlled study with three groups. SETTING: An orthopedic ward in a 2900-bed teaching medical center. PARTICIPANTS: Forty-five subjects in each of three groups. METHODS: Each subject received a multimedia course on patient-controlled analgesia (PCA) before surgery to learn about the use of narcotic analgesics and the operation of the PCA device. Treatment was as follows: (1) for the IAS group, auricular acupressure combined with transcutaneous electric acupoint stimulation (TEAS) at the true acupoint; (2) for the sham group, acupoint stimulation in the same manner but at a sham acupoint or without embedding seeds and pressure; (3) for the control group, no IAS intervention. RESULTS: Pain scores were significantly lower in the IAS group than the other two groups at 2h and 4h after returning to the ward, and 24h after surgery. The analgesic requirement during the 72h after surgery and the overall incidence of morphine-related side effects were significantly lower in the IAS group. CONCLUSION: The study demonstrates that combined auricular acupressure and TEAS decreased postoperative pain, the use of equianalgesic morphine, and morphine-related side effects. IAS provides better analgesia when used in conjunction with PCA after lumbar spine surgery and can be regarded as a component of multimodal analgesia.

Acupoint stimulation to improve analgesia quality for lumbar spine surgical patients.

Lumbar spine surgery has a high incidence of postoperative pain, but this pain is treatable through many methods, including patient-controlled analgesia (PCA). Acupoint stimulation could be considered an adjunct to PCA, improving the effectiveness of analgesia for patients recovering from lumbar spine surgery. The current study aimed to examine the effect of acupoint stimulation with PCA on improving analgesia quality after lumbar spine surgery. A single-blinded, sham-controlled design was used for the experimental, not control, groups. Data collection for the control group was completed first, followed by data collection for the other 2 groups. Participants were randomly assigned to the acupoint stimulation (AS) (n = 45) or sham group (n = 45). All participants received structural PCA multimedia information before lumbar surgery. The AS group received auricular acupressure combined with transcutaneuos electric acupoint stimulation (TEAS) at the true acupoint; the sham group received acupoint stimulation in the same manner but at a sham acupoint and without embedding seeds; and the control group received no acupoint stimulations. The analgesia quality, analgesic consumption, and postoperative nausea and vomiting (PONV) were used as measure of effects for the interventions. Significant differences were found between the AS and control groups in pain intensity but not in the belief and satisfaction subscales of analgesia quality. Also found a significant difference among the 3 groups in analgesic consumption and the severity of PONV in the first 72 hours after surgery. The current study shows that the combination of auricular acupressure and TEAS reduced pain intensity, morphine consumption, and PONV severity. Acupoint stimulation could be considered a multimodal analgesia method and an adjunct to PCA for lumbar spine surgery patients.

Auricular acupressure combined with an internet-based intervention or alone for primary dysmenorrhea: a control study.

Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors.

Measuring reliability and validity of a newly developed stress instrument: Newly Diagnosed Breast Cancer Stress Scale.

AIMS AND OBJECTIVES: To assess the reliability and validity of a developed instrument entitled Newly Diagnosed Breast Cancer Stress Scale. BACKGROUND: Distress, clinical anxiety and depression are evident in patients with cancer, leading to poor psychosocial and quality-of-life outcomes. DESIGN: Instrument development study with norm-referenced measurements. METHODS: Content validity was determined by expert review. Cronbach's α was used to assess internal consistency reliability and product-moment correlations were conducted. Exploratory factor analysis measured validity of items using varimax rotation method. Criterion-related validity testing used the Perceived Stress Scale and the convergent validity test of construct validity used the Hospital Anxiety and Depression Scale. A total of 125 women pathologically diagnosed with breast cancer were interviewed on the day prior to initial breast surgery. RESULTS: After testing, the Newly Diagnosed Breast Cancer Stress Scale consisted of four main factors with 17 items with acceptable reliability and good validity, and its length and time to complete the questionnaire were appropriate. Internal consistency reliability of the scale was shown by Cronbach's α = 0·84, the criterion validity of Perceived Stress Scale-10 was r = 0·46 (p < 0·001), the convergent validity of Hospital Anxiety and Depression Scale-14 was r = 0·57 (p < 0·001) for anxiety and r = 0·35 (p < 0·001) for depression. CONCLUSIONS: The Newly Diagnosed Breast Cancer Stress Scale has acceptable reliability and good validity to measure stress in newly diagnosed patients with breast cancer. RELEVANCE TO CLINICAL PRACTICE: The Newly Diagnosed Breast Cancer Stress Scale can provide healthcare workers with an instrument to better identify stress levels in newly diagnosed breast cancer patients and provide valuable information when defining psychosocial care interventions.

Auricular acupressure for pain relief in adolescents with dysmenorrhea: a placebo-controlled study.

OBJECTIVES: Primary dysmenorrhea is a common problem among menstruating adolescents and young women. It may cause physical distress and result in school absenteeism and reduced physical activity. This study aimed to evaluate the effects of auricular acupressure on menstrual pain and distress in adolescents with dysmenorrhea. DESIGN: A single-blind, placebo-controlled design was used. SETTING/LOCATION: Participants were obtained from one senior high school in northern Taiwan. SUBJECTS: One hundred and thirteen (113) adolescent participants with primary dysmenorrhea were recruited and assigned to the experimental or control group by a coin toss. INTERVENTION: The experimental group received auricular acupressure applied to six true acupoints (shenmen, Kidney, Liver, Internal Genitals, Central Rim, and Endocrine). The control group received six sham acupoints without effects on dysmenorrhea. All participants were instructed to press each acupoint for 1 minute, 4 times a day for 2 days. OUTCOME MEASURES: The outcomes were assessed by rating dysmenorrhea severity on a visual analogue scale (VAS) and using the Short-Form McGill Pain Questionnaire (SF-MPQ) and Menstrual Distress Questionnaire (MDQ). RESULTS: Between-group differences were found in VAS and MDQ after the interventions. Within-group differences were found in the score changes of VAS, MDQ, and SF-MPQ during the interventions for both groups. CONCLUSIONS: Auricular acupressure relieves menstrual pain and distress in high-school adolescents. The findings may serve as a basis for using auricular acupressure to treat dysmenorrhea in adolescents. There was pain reduction with sham as well as with true acupoint acupressure, but the latter was significantly greater. The sham acupoint may not be used as a control for auricular acupoint and qualitative evaluation of dysmenorrhea should be added to the evaluation by SF-MPQ in future studies.

One year study on the integrative intervention of acupressure and interactive multimedia for visual health in school children.

OBJECTIVE: This study used a larger sample size, added a long-term observation of the effect of intervention, and provided an integrated intervention of acupressure and interactive multimedia of visual health instruction for school children. The short- and long-term effects of the interventions were then evaluated by visual health knowledge, visual acuity, and refractive error. DESIGN: A repeated pretest-posttest controlled trial was used with two experimental groups and one control group. SETTING: Four elementary schools in northern Taiwan. PARTICIPANTS: 287 School children with visual impairment in fourth grade were recruited. METHOD: One experimental group received the integrative intervention of acupressure and interactive multimedia of visual health instruction (ACIMU), and another received auricular acupressure (AC) alone; whereas a control group received no intervention. Two 10-week interventions were separately given in the fall and spring semesters. The short- and long-term effects of the interventions were then evaluated by visual health knowledge, visual acuity, and refractive error. RESULTS: During the school year the visual health knowledge was significantly higher in the ACIMU group than the control group (p<0.001). A significant difference in the changing visual acuity was in the three groups (p<0.001), with the improvement in the ACIMU group. No difference in the refractive error was found between any two groups (p>0.05). CONCLUSIONS: This study demonstrated that a long-term period of acupressure is required to improve school children's visual health. School children receiving the intervention of acupressure combined with interactive multimedia had better improvement of visual health and related knowledge than others. Further study is suggested in which visual health and preventative needs can be established for early childhood.

Acupoint stimulation intervention for people with primary dysmenorrhea: Systematic review and meta-analysis of randomized trials.

BACKGROUND: Primary dysmenorrhea is a common gynecologic complain in women of reproductive age. Acupoint stimulation therapies might be an effective intervention for primary dysmenorrhea. OBJECTIVE: The aim of this study was to determine the effectiveness of acupoint stimulation for primary dysmenorrhea. DATA SOURCES: All searches in the Cochrane Library, MEDLINE, PubMed, CINAHL Plus with Full Text, and CEPS databases (inception to March 2011). STUDY SELECTION: Randomized controlled trials (RCTs) included were comparing acupoint stimulation with non-acupoint-related stimulation or medication. DATA EXTRACTION: Data were abstracted independently by two authors onto standardized forms, and disagreements were resolved by discussion. DATA SYNTHESIS: Thirty RCTs met the selection criteria, and 25 reported sufficient data for pooling. The main outcomes assessed were cure rate, total effective rate, pain intensity, menstrual pain, plasma PGF(2α)/PGE(2) ratio, and adverse events. According to the type of outcome, the strength of a relationship between two dichotomous variables was described by odds ratios and 95% confidence intervals, and continuous variables were expressed as mean±standard deviation. Fixed-effects models were used to perform meta-analysis. RESULTS: Twenty-five RCTs with a total of over 3000 participants were included for the meta-analysis. Acupoint stimulation when compared with non-acupoint-related stimulation or medication had significant effects. Moderator analysis further confirmed that invasive and noninvasive acupoint stimulation was effective separately, with the latter being more effective. The most common adverse events were hemorrhage and hematoma. LIMITATIONS: Papers written in language other than English or Chinese were not included. CONCLUSIONS AND IMPLICATION: This finding indicates that acupoint stimulation, especially non-invasive acupoint stimulation, could have good short term effects on pain of primary dysmenorrhea. Inference in some studies was somewhat restricted due to low methodological rigor. We suggest well-designed, methodologically rigorous, large trial, evaluating both short and long-term effects on pain and other outcomes in comparison with the available standard treatments.

Systematic review and meta-analysis of the effects of acupoint stimulation on smoking cessation.

Smoking represents a serious worldwide public health problem because of its close association with the development of chronic disease and cancer. Acupoint stimulation has been used as treatment mode for smoking cessation but its efficacy remains controversial. This systematic review and meta-analysis aimed to determine the effects of acupoint stimulation on smoking cessation rate and daily cigarette consumption. Electronic literature searches in eight electronic databases up to March 2011 were performed to identify acupoint stimulation for smoking cessation. The outcomes assessed were smoking cessation rate and cigarette consumption. We assessed abstinence from smoking at the earliest and last measured time points, and at the 3- and 6-month follow-ups. Meta-analysis was performed using CMA software. A total of 20 RCTs were included in the meta-analysis. A significant effect of acupoint stimulation was found in smoking cessation rates and cigarette consumption at immediate, 3- and 6-month follow-ups, with effect sizes 1.24 (95%CI = 1.07 ~ 1.43, p = 0.003), -2.49 (95%CI = -4.65 ~ -0.34, p = 0.02), 1.70 (95%CI = 1.17 ~ 2.46, p = 0.01), and 1.79 (95%CI = 1.13 ~ 2.82, p = 0.01), respectively. Multi-modality treatments, especially acupuncture combined with smoking cessation education or other interventions, can help smokers to eschew smoking during treatment, and to avoid relapse after treatment.

Case studies combined with or without concept maps improve critical thinking in hospital-based nurses: a randomized-controlled trial.

BACKGROUND: Critical thinking (CT) is essential to the exercise of professional judgment. As nurses face increasingly complex health-care situations, critical thinking can promote appropriate clinical decision-making and improve the quality of nursing care. OBJECTIVES: This study aimed to evaluate the effects of a program of case studies, alone (CS) or combined with concept maps (CSCM), on improving CT in clinical nurses. DESIGN: The study was a randomized controlled trial. The experimental group participated in a 16-week CSCM program, whereas the control group participated in a CS program of equal duration. METHODS: A randomized-controlled trial with a multistage randomization process was used to select and to assign participants, ultimately resulting in 67 nurses in each group. Data were collected before and after the program using the California Critical Thinking Skill Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI). RESULTS: After the programs, there were significant differences between the two groups in the critical thinking skills of analysis, evaluation, inference, deduction, and induction. There was also an overall significant difference, and a significant difference in the specific disposition of open-mindedness. CONCLUSIONS: This study supports the application of case studies combined with concept maps as a hospital-based teaching strategy to promote development of critical thinking skills and encourage dispositions for nurses. The CSCM resulted in greater improvements in all critical thinking skills of as well as the overall and open-minded affective dispositions toward critical thinking, compared with the case studies alone. An obvious improvement in the CSCM participants was the analytic skill and disposition. Further longitudinal studies and data collection from multisite evaluations in a range of geographic locales are warranted.

Vinegar for decreasing catheter-associated bacteriuria in long-term catheterized patients: a randomized controlled trial.

PURPOSE: The purpose of this study was to evaluate the effect of rice vinegar administered via nasogastric feeding tube on catheter-associated bacteriuria in patients with long-term urinary catheterization. METHOD: The authors conducted a randomized controlled trial (n = 60) to compare treatment with dilute vinegar and usual care. The authors recruited patients with chronic catheters from a long-term care facility in northern Taiwan. The experimental group received 100 ml of diluted rice vinegar each day for 4 weeks, whereas the control group received 100 ml of water. The authors analyzed urine weekly and cultured it on Day 28. RESULTS: The generalized estimating equation results showed significant between-group differences in urinary pH, bacterial titer, and turbidity. No patient in the experimental group, but three in the control group, exhibited symptomatic urinary tract infection (UTI). Rice vinegar may decrease bacteriuria. Medicinal use of vinegar may decrease the risk of symptomatic UTI, but further study is needed to determine the effects of ingesting vinegar for a longer period and with a larger sample size.

Pain reduction of acupoint electrical stimulation for patients with spinal surgery: a placebo-controlled study.

BACKGROUND: Acupoint electrical stimulation (AES) is commonly used for pain management. However, its true or placebo effect to achieve pain relief needs to be verified. OBJECTIVE: This study aimed to examine the true effect of AES to reduce postoperative pain in patients with spinal surgery receiving patient-controlled analgesia (PCA). METHOD: A placebo- and sham-controlled study was conducted. Participants were randomly assigned to intervention with AES at true acupoints (the AES group, n=30), AES at sham acupoints (the sham group, n=30), or no intervention with AES (the control group, n=30). Outcomes were assessed according to the amount of pain experienced and analgesics used. RESULTS: There were significant differences among the three groups in pain relief across time, and the occurrence of PCA button pushed and amount of analgesics used. The beneficial effects of AES were discernible when compared to the sham and the control. CONCLUSIONS: AES at the true acupoints effectively reduced postoperative pain and analgesic usage. AES has now been implemented into healthcare and it is recommended that nurses be provided with the opportunity to earn their AES skills. More studies evaluating the effects of AES over a longer period and on pain after different surgical procedures are suggested.

Effects of auricular acupressure on pain reduction in patient-controlled analgesia after lumbar spine surgery.

OBJECTIVE: This study aimed to examine the adjuvant effects of auricular acupres-sure in augmenting intravenous patient-controlled analgesia with morphine and droperidol for postoperative lumbar surgery patients in terms of postoperative pain relief satisfaction, and the incidence of postoperative nausea and vomiting (PONV). METHODS: In this single-blind experimental study, 94 subjects were randomly assigned to the experimental group in which patients received auricular acupressure to six auricular acupoints or a control group without acupressure. Data were collected using the American Pain Society Patient Outcome Questionnaire. Descriptive analyses, t tests, chi(2) tests, Mann-Whitney tests, and the generalized estimating equation model were used. RESULTS: The experimental group had lower average pain scores than the control group, but no between-group difference was found. Analgesic dose and satisfaction were similar in both groups. The incidence of PONV was low and similar in both groups. CONCLUSION: Although this study did not demonstrate adjuvant effects of auricular acupressure on postoperative pain, analgesic dose, analgesic satisfaction and PONV, most subjects were satisfied with the pain management even though they were subjected to moderate pain because of insufficient analgesia. Further studies should reconfirm the effects of auricular acupressure on analgesia provided by intravenous patient-controlled analgesia in postoperative patients, and its influence on the frequency and duration of analgesia administration.

Effects of ear acupressure in improving visual health in children.

Myopia is a major health problem, not only because of its high prevalence in Asia but also because it contributes to visual morbidity. This study aimed to evaluate the effect of ear acupressure for visual improvement on school children in Taiwan. Participants were fifth-grade school children with visual acuity between 6/37.5 and 6/9.6 in one eye. The experimental group (n = 35) received a 15-week ear acupressure intervention with seed embedding; the control group (n = 35) did not. Data for demographic factors, visual acuity, refractive error, and behavior toward visual health were collected before and after the intervention. The significant differences were observed between the two groups in visual acuity (p = 0.02), refractive error (p = 0.04), and behaviors toward visual health (p = 0.045). Performing ear acupressure may facilitate improved visual health for children. However, it requires more extended studies exploring its effects on elementary students in different grades. Longitudinal effects of this intervention also require further study.

Auricular acupressure combined with multimedia instruction or alone for quitting smoking in young adults: A quasi-experimental study.

BACKGROUND: Smoking plays a disease-related risk factor and is however the principal cause of preventable death. Many studies support the use of combined rather than single interventions to stop smoking. OBJECTIVE: This study aimed to evaluate the effects of auricular acupressure combined with multimedia instruction in comparison with auricular acupressure alone on smoking cessation in young adults. METHOD: A quasi-experimental research design was used and participants were assigned to experimental groups according to their preference. Group 1 received the 10-week program with auricular acupressure plus multimedia instruction; Group 2 received auricular acupressure alone. Thirty-two participants were in each group were recruited from universities in Taiwan. The physical and psychological data were collected right before and after the program. RESULTS: This study demonstrated the effects of smoking cessation on physical and psychological factors in each group. Statistical between-group differences existed in psychological factors of smoking cessation self-efficacy and nicotine dependence, but not in physical factors of carbon monoxide and cotinine. CONCLUSIONS: This study adds to the body of research on the benefits of using auricular acupressure combined with or without multimedia instruction for smoking cessation in adolescents. The combined intervention was more effective especially in increasing smoking cessation self-efficacy and decreasing nicotine dependence. Further study is suggested adding control groups such as placebo in order to understand a single effect of smoking cessation.

Acupoint electrical stimulation reduces acute postoperative pain in surgical patients with patient-controlled analgesia: a randomized controlled study.

OBJECTIVES: The purpose of this study was to evaluate the effect of acupoint electrical stimulation with patient-controlled analgesia (PCA) on reducing acute pain, nausea, and vomiting after surgery for nontraumatic spinal cord injury. METHODS: A randomized, controlled, repeated measures research design was used. Ninety-nine patients undergoing lumbar spinal surgery were randomly assigned to one of three groups. Patients in experimental group 1 (EG1) received true acupoint electrical simulation three times, whereas those in experimental group 2 (EG2) received sham acupoint manually. Patients in the control group (CG) received no acupoint intervention. All patients were measured for pain, initial demand for PCA, demand for opiates, opiate dose, vital signs, and postoperative nausea and vomiting (PONV). RESULTS: Significant differences were found in postoperative pain, respiratory rate, blood pressure, and opiate doses across time in the three groups with better outcomes observed in EG1 than in EG2. However, no between-group difference was found in initial demand for PCA or in PONV. CONCLUSIONS: The study demonstrates that acupoint electrical stimulation improves acute postoperative pain management without adversely affecting vital signs after surgery for nontraumatic spinal injury. More studies are needed to evaluate the effects ofacupoint electrical stimulation on PONV and postoperative pain following other surgical procedures.

A six-week acupoint stimulation intervention for quitting smoking.

This study creates a six-week acupoint stimulation program for quitting smoking by conducting an experimental research design and then evaluating its effects. A total of 59 smokers, 28 +/- 7.6 years of mean age, volunteered to participate and were randomly assigned to the experimental or sham group. The current investigation administered anti-smoking acupoints to the experimental group for six weeks, whereas the sham group used sham acupoints for six weeks. Before and after the six-week intervention, the participants completed questionnaires and offered blood samples. This research collected data of demographic factors, serum cotinine, carbon monoxide exhalation, daily tobacco consumption, and quit smoking rate of participants before and after the six-week intervention. After the intervention, it showed no significant differences in the serum level of cotinine and carbon monoxide exhalation between the two groups. The quit rate in the experimental group was 13.3% and 13.7% in the sham group. However, daily tobacco consumption was 10 cigarettes in the experimental group and 11.21 cigarettes in the sham group. This experimental study used the sham group as the control, resulting in no statistically significant findings. Future studies need more evidence-based research on the exact effect or placebo effect of acupoint stimulation and the appropriate design for sham acupoint, to examine quitting effect using acupoint stimulation in adult smokers.

A comparison of diabetes learning with and without interactive multimedia to improve knowledge, control, and self-care among people with diabetes in Taiwan.

OBJECTIVE: Given the increased popularity of complementary and alternative medicine (CAM) and traditional Chinese medicine (TCM), this study aimed to evaluate the effects of interactive media on self-directed learning in patients' knowledge of diabetes and related CAM/TCM strategies, the ability to control blood sugar levels, and self-care in people with diabetes. DESIGN: An experimental study design was used. The experimental group received patient education through interactive multimedia about diabetes for 3 months, while the control group received a routine 3-month patient education. SAMPLE: On completion, 60 subjects from Taiwan were evaluated-30 in an experimental group and 30 in a control group. MEASUREMENTS: Data were collected from both groups at baseline and at the completion of the patient education. The findings were then compared to evaluate the effects of the intervention on the subjects' knowledge of diabetes, blood sugar control, and self-care. RESULTS: The experimental group showed greater improvement in understanding diabetes than the control (t=3.29, p<.001). There was no significant difference in control of blood sugar levels (t=-1.72, p=.10) and self-care (F=1.03, p=.32). CONCLUSIONS: The use of an interactive multimedia device to intervene in diabetes self-care was effective only in raising the subjects' knowledge about the disease. Additionally, the subjects may need more time to implement more effective blood sugar control and self-care activities after receiving instruction.

Qigong improving physical status in middle-aged women.

Regular exercise has been shown to benefit its practitioners and prevent and control diseases. Muscle/Tendon Change Classic (MTCC) qigong, characterized by simple, slow, and full-body exercise, is appropriate for the middle-age population. This study aims to evaluate the effect of the MTCC qigong program in improving physical status for middle-aged women. A quasi-experimental design was used. The experimental group (n = 37) received an 8-week MTCC qigong program, whereas the control group (n = 34) received none. Physiological parameters of muscular performance, body composition, and bone strength were measured before and after the program. The average age was 49 +/- 4.13 years for the experimental group and 50 +/- 4.74 years for the control group. The demographic characteristics were homogeneous between the two groups. There were statistically significant differences between the two groups in muscular endurance, body fat, waist-to-hip ratio, and body mass index at the completion of 8-week MTCC qigong program. The MTCC qigong could improve muscle endurance and body composition but not bone strength for middle-aged women, thereby demonstrating the qigong practice has certain health-preserving effects on women in this stage of life.