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1.
Support Care Cancer ; 32(3): 203, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38430411

RESUMO

PURPOSE: Nasopharyngeal carcinoma (NPC) patients may experience symptom distress and depression during and after radiation therapy, which negatively impacts quality of life (QOL). We sought to identify trajectories of symptom distress, depression, social support, and QOL in patients with NPC receiving intensity-modulated radiation therapy (IMRT) vs intensity-modulated proton therapy (IMPT). METHODS: A multicenter prospective longitudinal study recruited NPC patients from two leading medical centers in Taiwan. The 121 NPC patients were followed from before RT (T0), at 4 weeks after beginning RT (T1), at 6 weeks of RT or the end of treatment (T2), and at 4 weeks post-RT (T3). Generalized estimating equation analysis was used to identify the factors related to QOL. RESULTS: Patients' symptom distress and depression increased from T0, peaked at T2, and decreased at T3. Physical-QOL and psychosocial-QOL decreased from T0 to T2, then increased by T3. Patients who had early-stage cancer, received a lower RT dose, had less symptom distress, and had less depression were more likely to have better QOL. Greater physical-QOL was associated with IMPT receipt, higher education level, early cancer stage, lower radiation dose, less symptom distress, and less depression. Patients who had good physical performance, received a lower radiation dose, had less symptom distress, and had less depression were more likely to have better psychosocial-QOL. CONCLUSION: Radiation dose, symptom distress, and depression were the most important factors affecting QOL in patients with NPC. Understanding the factors associated with the trajectory of QOL can guide care during radiation treatment.


Assuntos
Neoplasias Nasofaríngeas , Terapia com Prótons , Radioterapia de Intensidade Modulada , Humanos , Carcinoma Nasofaríngeo/radioterapia , Radioterapia de Intensidade Modulada/efeitos adversos , Qualidade de Vida , Estudos Longitudinais , Estudos Prospectivos , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/patologia
2.
Int J Nurs Pract ; 30(2): e13190, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37596927

RESUMO

AIMS: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self-management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self-management in patients with type II diabetes mellitus treated with insulin therapy. METHODS: We adopted a cross-sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self-management using the barriers to insulin treatment questionnaire and the partners in health scale. RESULTS: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self-management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin-related outcomes, no diabetes-related complications, less fear of injection and self-testing, no hypoglycaemia within the previous year, and younger age. CONCLUSION: Insulin therapy injection by patient and no diabetes-related complications were the most common factors associated with overall self-management and with each domain of self-management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self-management.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Autogestão , Humanos , Insulina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Hipoglicemiantes , Estudos Transversais
3.
Asia Pac J Oncol Nurs ; 10(12): 100320, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38059206

RESUMO

Objective: The aim of the study was to evaluate the effects of a return to work (RTW) program on perceived health status, barriers to returning to work, fear of cancer progression, social support, physical function, and psychosocial function in head and neck cancer (HNC) patients. Methods: A randomized controlled trial with repeated measures was conducted. The 70 HNC patients were randomly assigned into two groups: 35 in the experimental group (RTW) and 35 in the control group (usual care). Patients were assessed at four time points: baseline (T0) (6 months after completing treatment), and then at 9-, 12-, and 15-months (T1, T2, and T3, respectively) after completing treatment. Patients completed a self-reported questionnaire, including measures of perceived health status, barriers to returning to work, fear of cancer progression, social support, physical function, and psychosocial function. Results: Patients in the experimental group had significantly greater perceived health status and better psychosocial function compared to those in the control group. Compared to T0, at T4, participants in both groups had significantly lower levels of barriers to returning to work, fear of cancer progression, social support, and higher levels of physical function. Conclusions: The RTW program effectively improved perceived health status and psychosocial function in HNC patients. Survivorship care should include a transitional return-to-work program to help patients transition back to work. Trial registration: NCT04322695.

4.
Semin Oncol Nurs ; 39(5): 151497, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37598022

RESUMO

PURPOSE: (1) To assess the levels of fear of cancer recurrence (FCR), social support, coping styles, and posttraumatic growth; (2) to identify factors associated with posttraumatic growth; and (3) to compare patient and primary caregiver characteristics by level of posttraumatic growth (no-to-little posttraumatic growth vs. moderate-to-high posttraumatic growth) in the primary caregivers of patients with an oncologic emergency. DATA SOURCES: A cross-sectional study design was adopted. Data were collected by convenience sampling of cancer patient-caregiver dyads who experienced an oncologic emergency within the last 6 months at a medical center in northern Taiwan. The patients, who had completed cancer treatment, were in an intensive care unit. They were assessed for disease severity, physical performance, and demographic and clinical characteristics. Primary caregivers were assessed for FCR, social support, coping styles, and posttraumatic growth using a set of questionnaires. We found that 80.8% of primary caregivers reported moderate-to-high posttraumatic growth and 19.2% reported no-to-little posttraumatic growth. CONCLUSION: Greater posttraumatic growth in primary caregivers was associated with experiencing more patient oncologic emergencies, younger caregiver age, a higher caregiver FCR score, and caregivers' use of active coping behaviors. Caregivers were less likely to report posttraumatic growth if they experienced fewer patient oncologic emergencies, were older, reported lower FCR, and used active coping strategies less frequently. IMPLICATIONS FOR NURSING PRACTICE: Developing scenario-based simulations to facilitate caregiving for an oncologic emergency and providing psychological counseling to encourage active coping can help primary caregivers recover emotionally from an oncologic emergency and facilitate growth.


Assuntos
Cuidadores , Crescimento Psicológico Pós-Traumático , Humanos , Cuidadores/psicologia , Estudos Transversais , Taiwan , Emergências , Adaptação Psicológica , Unidades de Terapia Intensiva
5.
Semin Oncol Nurs ; 39(4): 151425, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37055297

RESUMO

OBJECTIVES: The present study aimed to evaluate the effects of a nurse-led survivorship care program (SCP) on emotional distress, social support, physical health, mental health, and resilience in primary caregivers of patients with advanced head and neck cancer. DATA SOURCES: A randomized controlled trial was conducted. One hundred patient-primary caregiver dyads were randomized into the nurse-led SCP group (experimental) or the usual care group (control). Participants completed a self-reported questionnaire, including measures of emotional distress, social support, physical health, mental health, and resilience. After 6 months, the experimental group reported a significant improvement in emotional distress, social support, physical health, mental health, and resilience. Compared with the control group, measures of emotional distress, physical health, overall resilience, and the resilience aspects of equanimity and perseverance improved in the experimental group. CONCLUSION: An SCP may feasibly help alleviate emotional distress, improve social support, increase physical and mental health, and strengthen resilience in the primary caregivers of patients with head and neck cancer. Health care providers should encourage primary caregivers to join an SCP. IMPLICATIONS FOR NURSING PRACTICE: The nurse-led SCP can be applied before patients complete treatment, which may increase the positive effect on physical health and adaptation.


Assuntos
Neoplasias de Cabeça e Pescoço , Sobrevivência , Humanos , Cuidadores/psicologia , Papel do Profissional de Enfermagem , Qualidade de Vida/psicologia
6.
BMC Womens Health ; 23(1): 200, 2023 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-37118756

RESUMO

BACKGROUNDS: Gynaecological cancer survivors may develop lower limb lymphoedema after surgery, which negatively impacts quality of life. The purposes of this study were (1) to assess the levels of symptom distress, depression, body image, and health-related quality of life (HRQoL); (2) to recognize factors associated with HRQoL related in gynaecologic cancer survivors with lower limb lymphoedema. METHODS: A cross-sectional study was conducted with convenience sampling of gynaecologic cancer survivors with lower limb lymphoedema. Gynaecologic cancer survivors were assessed for symptom distress, depression, body image, and HRQoL. Multiple regression analysis was conducted to recognize the factors associated with HRQoL. Independent-samples t-test was used to compare symptom distress, depression, body image, and HRQoL by grade of lymphoedema. RESULTS: The most common distressing symptoms of lower limb lymphoedema were lower extremity oedema, lower extremity tightness, and lower extremity stiffness. Worse HRQoL was associated with more symptom distress, less satisfaction with body image, a high grade of lymphoedema, and a longer duration of lower limb lymphoedema. These factors explained 76.5% of the variance in HRQoL. Gynaecologic cancer survivors with late grade lymphoedema experienced lower HRQoL and higher levels of symptom distress, depression, and greater dissatisfaction with body image than those who had early grade lymphoedema. CONCLUSIONS: Symptom distress had the strongest association with overall HRQoL and with all individual domains of HRQoL, except mental function. These results suggest that educating gynaecologic cancer survivors to assess lower limb lymphoedema-related problems, providing symptom management, and guiding survivors in physical activity to relieve lower extremity discomfort can improve HRQoL.


Assuntos
Sobreviventes de Câncer , Neoplasias dos Genitais Femininos , Linfedema , Feminino , Humanos , Qualidade de Vida , Estudos Transversais , Taiwan , Linfedema/etiologia , Sobreviventes , Neoplasias dos Genitais Femininos/complicações , Extremidade Inferior , Inquéritos e Questionários
7.
BMC Oral Health ; 23(1): 88, 2023 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-36782200

RESUMO

BACKGROUND: Betel quid (BQ) chewing is associated with poor oral hygiene, psychological impairment, and acute and long-term addictive effects, resulting in worse oral-related quality of life (OHRQoL). The purpose of this study was to characterize the factors associated with OHRQoL among BQ users receiving oral mucosal screening. METHODS: A cross-sectional study was conducted. Data were collected by random sampling of BQ users who visited outpatient departments receiving oral mucosal screening in a medical center Taiwan. The oral health assessment tool, the state anxiety inventory, the betel quid dependence scale, and the oral health impact profile were used to measure oral health status, anxiety, BQ dependence, and OHRQoL, respectively. Pearson's product-moment coefficient was used to examine the relationship between OHRQoL and the selected independent variables. Independent-samples t-test was used to compare OHRQoL by annual family income, the presence of chronic disease, and BQ dependence. Hierarchical multiple linear regression analysis was used to identify factors associated with OHRQoL. RESULTS: A total of 175 BQ users were surveyed. Factors associated with OHRQoL included oral health status, anxiety, and BQ dependence. BQ users reporting low oral health status, greater anxiety, and more BQ dependence were more likely to have worse OHRQoL. CONCLUSIONS: Poor oral health status, anxiety, and BQ dependence negatively impact on OHRQoL among patients with BQ use receiving oral mucosal screening.


Assuntos
Areca , Mucosa Bucal , Saúde Bucal , Transtornos Relacionados ao Uso de Substâncias , Humanos , Areca/efeitos adversos , Estudos Transversais , Qualidade de Vida , Taiwan , Detecção Precoce de Câncer , Mucosa Bucal/patologia
8.
Nat Hazards (Dordr) ; 116(3): 3427-3445, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36685108

RESUMO

The Federal Emergency Management Agency (FEMA) divides the United States (US) into ten standard regions to promote local partnerships and priorities. These divisions, while longstanding, do not adequately address known hazard risk as reflected in past federal disaster declarations. From FEMA's inception in 1979 until 2020, the OpenFEMA dataset reports 4127 natural disaster incidents declared by 53 distinct state-level jurisdictions, listed by disaster location, type, and year. An unsupervised spectral clustering (SC) algorithm was applied to group these jurisdictions into regions based on affinity scores assigned to each pair of jurisdictions accounting for both geographic proximity and historical disaster exposures. Reassigning jurisdictions to ten regions using the proposed SC algorithm resulted in an adjusted Rand index (ARI) of 0.43 when compared with the existing FEMA regional structure, indicating little similarity between the current FEMA regions and the clustering results. Reassigning instead into six regions substantially improved cluster quality with a maximized silhouette score of 0.42, compared to a score of 0.34 for ten regions. In clustering US jurisdictions not only by geographic proximity but also by the myriad hazards faced in relation to one another, this study demonstrates a novel method for FEMA regional allocation and design that may ultimately improve FEMA disaster specialization and response.

9.
Clin Nurs Res ; 32(1): 197-208, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35833270

RESUMO

Head and neck cancer (HNC) patients who are unable to return to work after completing treatment might face financial loss and reduced self-esteem. The aim of this study was to identify factors influencing a return to work in HNC cancer patients in the first 6 months after treatment. This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Patients were assessed according to psychological distress, patient-perceived health status, barriers to returning to work, and facilitators of returning to work. Of the 106 HNC patients surveyed, 54.7% successfully returned to work. Barriers to returning to work included poor self-perception of health, greater psychological distress, and age ≥50 years. Patients who had higher psychological distress, returned to work after start of the pandemic, or received reconstruction surgery were less likely to experience a positive environment facilitating a return to work.


Assuntos
Neoplasias de Cabeça e Pescoço , Angústia Psicológica , Humanos , Pessoa de Meia-Idade , Estudos Transversais , Neoplasias de Cabeça e Pescoço/terapia , Inquéritos e Questionários , Taiwan
10.
J Cancer Surviv ; 17(6): 1715-1724, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-35900687

RESUMO

PURPOSE: Return to work (RTW) is important for survivors of head and neck cancer (HNC). The purposes of the study were to investigate the RTW ratio among HNC survivors and identify factors significantly affecting RTW in this population. METHODS: A cross-sectional study with consecutive sampling was conducted in a medical center in Taiwan, with 111 patients with HNC who had completed major treatments within 5 years and were employed before their cancer diagnosis enrolled as participants. Cervical range of motion (CROM) functionality, handgrip and hip flexor strength, maximal mouth opening (MMO), selected symptoms, depression, and disease/treatment-related factors were assessed. All of the factors were analyzed using t-test, chi-square test, and multiple logistic regression. RESULTS: Less than half (44.1%, n = 49) of the participants had returned to work. The t-test/chi-square test results showed the RTW group to be younger in age and better educated; have better handgrip/hip flexor strength, MMO, and CROM; have less speech difficulty and pain; and have less-advanced cancer than the non-RTW group. Further analysis of the above significant variables by logistic regression revealed early cancer stage, dominant handgrip strength, and less speech difficulty were the robust factors related to RTW. CONCLUSIONS: The RTW ratio is low in HNC survivors. RTW in HNC survivors is a multifactorial and complicated issue and needs to be further examined. IMPLICATIONS FOR CANCER SURVIVORS: Assessing the factors related to RTW systematically and developing comprehensive interventions and rehabilitation programs to reduce related dysfunctions are necessary to enhance RTW ability in HNC survivors.


Assuntos
Sobreviventes de Câncer , Neoplasias de Cabeça e Pescoço , Humanos , Retorno ao Trabalho/psicologia , Estudos Transversais , Força da Mão , Sobreviventes de Câncer/psicologia , Neoplasias de Cabeça e Pescoço/terapia , Sobreviventes
11.
SN Comput Sci ; 3(6): 441, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35975091

RESUMO

With the introduction of new COVID-19 variants such as Delta and Omicron, small businesses have been tasked with navigating a constantly changing business environment. Furthermore, due to supply chain issues, shortages of various critical products negatively affect businesses of all sizes and industries. However, continued innovation in Computer Science, specifically in sub-fields of Artificial Intelligence (AI), such as natural language processing (NLP), has created significant value for businesses through helpful data-driven features. To this end, we propose a platform utilizing AI-driven tools to help build an effective business-to-business (B2B) platform. The proposed platform aims to automate much of the market research which goes into selecting products and platform users during times of distress while still providing an intuitive e-commerce interface. There are three primary novel components to this platform. The first of these components is the Buyer's Club (BC), which allows customers to pool resources to purchase bulk orders at a reduced cost. The second component is an automated system utilizing Natural Language Processing (NLP) to detect trending disaster news topics. Disaster topic detection can be applied to inform buyers and suppliers on adapting to changing market conditions and has been shown to match closely with Google Trends data. The third component is a regulation matching system, using a custom data set to help inform customers when purchasing products. Such guidance is necessary to comply with a regulatory environment that will be irregular for the foreseeable future.

12.
Support Care Cancer ; 30(9): 7313-7322, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35606476

RESUMO

PURPOSE: Spousal caregiving of head and neck cancer (HNC) patients challenges relationship quality and may negatively impact family function. Our purpose was to identify factors associated with family dysfunction in spousal caregivers (SCs) of HNC patients within the first 6 months after treatment. We explored whether patient or SC characteristics differ by level of family dysfunction. METHODS: We conducted a cross-sectional study of HNC patient-SC dyads in Taiwan from July 2020 to January 2022 using patient-reported outcomes. Patients were assessed using a set of structured questionnaires to measure performance status, demographic and clinical characteristics, physical function, and social-emotional function. SCs were measured on their hardiness, coping styles, spousal relationship, quality of life, and family function. RESULTS: Of the 132 dyads surveyed, 62.1% of SCs reported a functional family, 34.8% reported a moderately dysfunctional family, and 3.0% reported a highly dysfunctional family. Patient factors associated with family dysfunction (highly dysfunctional or moderately dysfunctional) included lower family annual income and worse social-emotional function. Associated SC factors were lower hardiness, less use of active coping, and worse spousal relationships. CONCLUSIONS: Lower family annual income, less patient social-emotional function, less SC hardiness, less SC active coping, and worse SC perceived spousal relationship were associated with perceived family dysfunction. Providing patient-SC dyads with sufficient social resources and problem-solving training may help them positively cope with cancer and enhance family function.


Assuntos
Cuidadores , Neoplasias de Cabeça e Pescoço , Adaptação Psicológica , Cuidadores/psicologia , Estudos Transversais , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Qualidade de Vida/psicologia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
13.
J Nurs Res ; 30(2): e194, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35323131
14.
Support Care Cancer ; 30(5): 4515-4525, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35112211

RESUMO

PURPOSE: To identify factors associated with posttraumatic growth (PTG) of head-and-neck cancer squamous cancer (HNC) patients with oncologic emergencies (OE) within the first six months post-treatment. METHODS: We conducted a cross-sectional study of HNC patients in Taiwan from May 2019 to April 2021 using patient-reported outcomes. Patients were assessed for symptom distress, anxiety, fear of recurrence (FCR), and PTG. Multiple regression analysis was conducted to identify factors associated with PTG. The independent-samples t-test was used to compare PTG and its five specific domains in patients with low FCR, high FCR, low anxiety, and high anxiety. RESULTS: Of the 114 patients surveyed, 46.5% reported little-to-no PTG, and 53.5% had moderate-to-high PTG. Greater PTG was associated with greater FCR, longer time since OE, less anxiety, having a cancer recurrence, and greater educational attainment. These factors explained 38.6% of the variance in PTG. CONCLUSION: A notable proportion of HNC patients with OE-reported PTG but almost half-reported little-to-no PTG. PTG occurred most in the domain of appreciation of life. The study results also suggest that training patients in coping skills and inviting them to group growth experiences can help them increase PTG and cope with cancer-related psychological threats related to OE.


Assuntos
Neoplasias de Cabeça e Pescoço , Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos , Adaptação Psicológica , Estudos Transversais , Emergências , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Recidiva Local de Neoplasia/psicologia
15.
J Nurs Scholarsh ; 54(2): 191-201, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34773378

RESUMO

PURPOSE: Primary caregivers (PC) of patients with advanced head and neck cancer (HNC) report stress during caregiving time post-treatment. We sought to identify the trajectories of resilience from initial completion of treatment to 1-year post-treatment in PC of patients with advanced HNC and to determine the factors associated with trajectories of resilience. DESIGN: In this prospective cohort study with convenience sampling, patient-PC dyads were recruited from a medical center in northern Taiwan between August 2015 and July 2020. METHODS: We recruited 120 patient-PC dyads and followed up at treatment completion and 1, 6, and 12 months post-treatment. Generalized estimating equation analysis was performed to identified factors related to resilience. FINDINGS: PCs' overall resilience increased from initial completion of treatment to peak at 1-year post-treatment. Patient factors associated with greater overall resilience included older age, higher performance status, and shorter time since cancer diagnosis; PC factors included reporting more social support, better physical health, and better mental health. CONCLUSIONS: PC mental health was the most important factor in the resilience trajectory of patients with advanced HNC cancer. CLINICAL RELEVANCE: Quantifying the relevant factors of trajectories of resilience will help to identify vulnerable PCs and guide survivorship care in the early stages of the post-treatment period.


Assuntos
Cuidadores , Neoplasias de Cabeça e Pescoço , Cuidadores/psicologia , Humanos , Estudos Longitudinais , Estudos Prospectivos , Apoio Social
16.
J Nurs Scholarsh ; 54(2): 152-160, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34747134

RESUMO

PURPOSE: After suddenly stopping smoking after an initial oral cancer (OC) diagnosis, patients may restart smoking and nicotine dependence. This study sought to identify factors associated with high nicotine dependence in OC patients who restarted smoking post-treatment. DESIGN: A cross-sectional study. METHODS: A group of 220 OC patients who restarted smoking post-treatment were recruited from the outpatient radiation department of a single cancer center in northern Taiwan. Demographic and clinical characteristics were recorded, and patients were assessed for nicotine and smoking dependence, physical activity and function, socio-emotional function, social support, and depression. RESULTS: Among patients who restarted smoking after treatment for OC, 75.9% reported low-to-moderate dependence on smoking, while 24.1% reported high nicotine dependence. Factors associated with high nicotine dependence included higher incidence of smoking per day, greater dependence on smoking, less physical activity per week, and poorer social-emotional function. Those highly dependent on nicotine were younger, unmarried, had less education, and had begun smoking earlier than those with low-to-moderate nicotine dependence. CONCLUSIONS: The amount of smoking per day, greater smoking behavioral dependence, less physical activity per week, and worse social-emotional function affected high nicotine dependence. CLINICAL RELEVANCE: Smoking cessation training and counseling for OC patients may help them better control their use of tobacco after treatment.


Assuntos
Neoplasias Bucais , Abandono do Hábito de Fumar , Tabagismo , Estudos Transversais , Humanos , Neoplasias Bucais/complicações , Neoplasias Bucais/terapia , Fumar/epidemiologia , Fumar/psicologia , Tabagismo/complicações , Tabagismo/psicologia , Tabagismo/terapia
17.
J Clin Nurs ; 31(9-10): 1389-1396, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34498323

RESUMO

AIMS AND OBJECTIVES: This study's purpose was to identify the correlates of sleep quality in older adults with chronic disease. BACKGROUND: Sleep quality is a common problem in older adults that may be affected by physical and mental status. DESIGN: A cross-sectional correlational design was employed. METHODS: The study was conducted between July 2019 and April 2020 in a teaching hospital of southern Taiwan. The Geriatric Depression Scale, Pittsburgh Sleep Quality Index and Numerical Rating Scale were used to assess depression, sleep quality and physical pain respectively. RESULTS: Of the 120 older adults (age >65 years) with chronic disease, the average Pittsburgh Sleep Quality Index score was 5.67. A total of 45.8% subjects had sleep disturbance. Older adults who were living with a partner and those who urinated at night were significantly more likely to report sleep disturbance. The presence of sleep disturbance was associated with greater levels of depression and higher levels of physical pain. CONCLUSION: Living with a partner, nocturia, physical pain and depression were associated with the presence of sleep disturbance in older adults with chronic disease. RELEVANCE TO CLINICAL PRACTICE: The results of this study can help healthcare providers understand the factors associated with sleep disturbance in older adults with chronic disease, thereby facilitating the early resolution of sleep disturbance issues in this population.


Assuntos
Depressão , Transtornos do Sono-Vigília , Idoso , Doença Crônica , Estudos Transversais , Depressão/epidemiologia , Humanos , Dor/epidemiologia , Sono , Qualidade do Sono , Transtornos do Sono-Vigília/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-34360415

RESUMO

Upper gastrointestinal (UGI) cancer treatment can cause physical and psychological distress and may result in unmet needs. The purposes of this study were to (1) examine the levels of gastrointestinal (GI) symptom distress, social support, and supportive care needs; (2) screen the priorities of unmet supportive care needs; and (3) identify the factors associated with supportive care needs among UGI cancer patients receiving chemotherapy. This cross-sectional study examined UGI cancer patients who received treatment from the outpatient chemotherapy department of a single cancer center in northern Taiwan. Questionnaires were used to collect data regarding GI symptom distress, social support, unmet needs, and supportive care needs. The top three unmet needs were "fears about the cancer spreading", "uncertainty about the future", and "being informed about things you can do to help yourself to get well". Descriptive statistics examined the levels of GI symptom distress, social support, supportive care needs, and priorities of unmet supportive care needs. Stepwise regression was conducted to determine significant factors related to supportive care needs. Greater supportive care needs were found to be associated with higher levels of disease-related worries, increased treatment-related symptoms, and a lower level of physical performance. These factors explained 48.0% of the variance in supportive care needs. Disease-related worries and treatment-related symptoms strongly influence overall supportive care needs and each domain of supportive care needs. Symptom management and psychological support for patients receiving outpatient chemotherapy may help patients meet needs.


Assuntos
Detecção Precoce de Câncer , Neoplasias Gastrointestinais , Ansiedade , Estudos Transversais , Neoplasias Gastrointestinais/terapia , Necessidades e Demandas de Serviços de Saúde , Humanos , Avaliação das Necessidades , Apoio Social , Inquéritos e Questionários
19.
Artigo em Inglês | MEDLINE | ID: mdl-34065129

RESUMO

Breastfeeding knowledge, intention, and self-efficacy affect breastfeeding rates during the postpartum period. Insufficient knowledge, lack of intention, and poor breastfeeding self-efficacy reduce the likelihood of breastfeeding postpartum. The purposes of this study were to (1) assess women's intention to breastfeed and knowledge and self-efficacy regarding breastfeeding following childbirth, and to (2) identify the factors associated with postpartum breastfeeding during women's hospital stays. This longitudinal study with a pretest and posttest design study recruited pregnant women from the gynecology and obstetrics outpatient departments and inpatient wards at a medical center in northern Taiwan. Demographic and obstetric characteristics were recorded, and participants were assessed using the Numeric Rating Scale, the Breastfeeding Knowledge Questionnaire, the Breastfeeding Self-Efficacy Scale-Short Form, and breastfeeding status postpartum. Of the 120 participants, 25% reported breastfeeding during the postpartum hospital stay. Postpartum breastfeeding was associated with lower levels of education and higher prenatal levels of breastfeeding intention. Establishing a breastfeeding-friendly environment in the family and workplace may effectively increase continued breastfeeding.


Assuntos
Intenção , Autoeficácia , Aleitamento Materno , Feminino , Humanos , Tempo de Internação , Estudos Longitudinais , Mães , Período Pós-Parto , Gravidez , Inquéritos e Questionários , Taiwan
20.
Artigo em Inglês | MEDLINE | ID: mdl-34073174

RESUMO

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of neurotoxic anticancer drugs that may affect quality of life (QoL). Purpose: The purposes of this study were to: assess the levels of CIPN, anxiety, depression, CIPN-related QoL, and general QoL; and identify the factors related to CIPN-related QoL and general QoL in patients with advanced lung cancer (LC) receiving platinum-based chemotherapy. This cross-sectional study examined patients with advanced LC who received platinum-based chemotherapy from the thoracic oncology inpatient wards of a medical center in northern Taiwan. Structured questionnaires were used to measure patients' CIPN (European Organization for Research and Treatment of Cancer quality of life questionnaire-chemotherapy-induced peripheral neuropathy 20), anxiety (Hospital Anxiety and Depression Scale Depression Scale [HADS]), depression (HADS), CIPN-related QoL (Functional Assessment of Cancer Therapy /Gynecologic Oncology Group-Neurotoxicity subscale [FACT/GOG-Ntx]), and general QoL (Functional Assessment of Cancer Therapy-General Input [FACT-G]). Of 93 patients with advanced LC, 53.8% reported CIPN-sensory impairment and 47.3% reported CIPN-motor impairment. The most common CIPN symptoms were difficulty getting or maintaining an erection (only for men > 65 years) and difficulty in climbing stairs or getting up out of a chair. Poor CIPN-related QoL (FACT/GOG-Ntx) was associated with more CIPN-sensory and more CIPN-motor impairment. Poor general QoL (FACT-G) was associated with a higher level of depression, a higher level of anxiety, and receipt of more chemotherapy cycles. More than half of LC patients report impairment related to CIPN, calling for holistic treatment to improve QoL.


Assuntos
Antineoplásicos , Neoplasias Pulmonares , Doenças do Sistema Nervoso Periférico , Antineoplásicos/efeitos adversos , Estudos Transversais , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/epidemiologia , Platina , Qualidade de Vida , Taiwan/epidemiologia
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