[Nursing Experience Caring for a Female Teenager With Superior Mesenteric Artery Syndrome].

Superior mesenteric artery syndrome (SMAS) is a rare and life-threatening disease that affects women more frequently than men. SMAS is characterized by extensive compression of the 3rd part of the duodenum between the aorta and the superior mesenteric artery. This compression results in chronic, intermittent or acute obstruction of the small bowel due mainly to the lack of fat between the aorta and the superior mesenteric artery, which increases the angle between the aorta and superior mesenteric artery and the end of the duodenum, causing intestinal obstruction. The goal of supportive treatment is to increase both body weight and the angle between the mesenteric artery and the abdominal aorta. This case involved a 14-year-old girl with low body weight who suffered from SMAS. Her symptoms included recurrent, severe vomiting and bloating, which necessitated her taking time off from school, causing further anxiety and leading to agitation, resistance to further treatment and care, and more-severe symptoms. During the period of nursing care from August 14th to August 30th, 2017, the author identified symptoms of nutritional imbalance and anxiety. Care initiated to improve nutritional status included: (1) improving nutritional intake, (2) promoting comfort, and (3) maintaining caloric intake. Care initiated to reduce anxiety included: (1) increasing self-control, (2) providing opportunities to participate in treatment planning, and (3) refocusing attention on self-worth. At the end of care, the patient had gained weight, the angle between the upper mesenteric artery and the abdominal aorta had increased, the symptoms had subsided, and anxiety had been alleviated. This nursing experience offers a reference for nurses facing similar cases of clinical care.

Factors Associated With Levels of Risky Drinking in Adolescent Alcohol Users in Taiwan: A Secondary Data Analysis.

BACKGROUND: Drinking is largely viewed as a socialized behavior; however, our understanding of factors associated with levels of risky drinking is limited in cultures where underage drinking is relatively unacceptable. PURPOSE: The aims of this study were to define the different levels associated with risky drinking and to examine the factors that are associated with these levels. METHODS: We used data from the Child and Adolescent Behavior in Long-Term Evolution project. Of the 2184 students who participated in the 2006 Child & Adolescent Behavior in Long-Term Evolution survey, 1591 self-reported prior use of alcohol and had complete questionnaire data that could be used in secondary data analysis. The main study variables that were used in this study to assess levels of risky drinking included frequency of drinking, amount of drinking, and frequency of intoxication. We used ordinal logistic regression to analyze the relationships between levels of risky drinking and associated factors. RESULTS: In the study sample, 9.55% were classified with high-risk drinking behavior, 22.51% were classified with medium-risk drinking behavior, and 67.94% were classified with low-risk drinking behavior. Having a mother or peers who used alcohol, being encouraged to consume alcohol by older adults or peers, high alcohol availability, high positive alcohol expectancies, low negative alcohol expectancies, and low alcohol refusal efficacy were all associated with higher levels of risky drinking. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Decreasing the availability of alcohol, developing appropriate alcohol expectancies, and increasing alcohol refusal skills may help decrease the development of high-risk drinking behavior in adolescents. Our study furthers the understanding of underage alcohol use in societies with low alcohol consumption.

Reciprocal relationship between unhealthy eating behaviours and depressive symptoms from childhood to adolescence: 10-year follow-up of the Child and Adolescent Behaviors in Long-Term Evolution study.

OBJECTIVE: To investigate the reciprocal relationship between unhealthy eating behaviours and depressive symptoms from childhood to adolescence. DESIGN: Unhealthy eating behaviours were measured by the frequencies of eating foods with excess salt, sugar or fat in the past week. Depressive symptoms in the past two weeks were measured using a seven-item scale. Hierarchical linear growth models were used to analyse longitudinal associations between unhealthy eating behaviours and depressive symptoms. Time-fixed variables (sex, parents' education level and household monthly income) and time-varying variables (parents' marital status, family activities, body weight, vegetable or fruit consumption, exercising and smoking) were controlled for. SETTING: The Child and Adolescent Behaviors in Long-Term Evolution study, which commenced in 2001 and has annual follow-up. SUBJECTS: Students (n 2630) followed from 2nd grade (8 years old in 2002) to 11th grade. RESULTS: The frequency of unhealthy eating behaviours in the previous year and the difference between the frequency in the previous and successive year were positively associated with the initiation and growth rate of depressive symptoms. Depressive symptoms in the previous year and the difference in depressive symptoms between the previous and successive year were positively associated with the initial state and growth rate of unhealthy eating behaviours. CONCLUSIONS: Our results suggest a reciprocal relationship between depressive symptoms and unhealthy eating behaviours. This relationship should be considered when developing programmes targeting depressive symptoms and unhealthy diet in children and adolescents.

Do parents play different roles in drinking behaviours of male and female adolescents? A longitudinal follow-up study.

OBJECTIVE: Gender differences in the associations between adolescent drinking behaviour, and perceived parental drinking behaviours and attitudes towards underage drinking, were investigated. METHODS: Data were drawn from two cohorts in the Child and Adolescent Behaviours in Long-term Evolution project. We used data from 2009 to 2006, when cohorts 1 and 2, respectively, were in grade 9. No cohort effect was found, so the two cohorts were pooled; 3972 students (1999 boys and 1973 girls) participated in the study. The major variables included adolescent drinking behaviours over the last month, and perceived parental drinking behaviours and parental attitudes towards underage drinking. The effects of the combination of parental drinking behaviours, and attitudes on the drinking behaviours of male and female adolescents, were analysed by logistic regression. RESULTS: The drinking behaviour of boys was correlated with the drinking behaviours and attitudes of their fathers but not with those of their mothers. Among boys, having a non-drinking father who was against underage drinking (OR=0.27, 95% CI 0.16 to 0.46), a non-drinking father who was favourable towards underage drinking (OR=0.61, 95% CI 0.39 to 0.94), or a drinking father who was against underage drinking (OR=0.44, 95% CI 0.23 to 0.85) significantly decreased the likelihood of alcohol consumption, whereas maternal behaviour and attitude were not significant influences. Among girls, having a non-drinking father who was against underage drinking (OR=0.52, 95% CI 0.30 to 0.91) or a non-drinking father who was favourable towards underage drinking (OR=0.51, 95% CI 0.32 to 0.83) significantly decreased the likelihood of alcohol consumption, as did having a non-drinking mother who was against underage drinking (OR=0.23, 95% CI 0.09 to 0.60). CONCLUSIONS: The influences of fathers and mothers on the drinking behaviour of their adolescent children differed by offspring gender.

Development and psychometric testing of a chinese version of the caregiver burden index for parents of children with allergies.

UNLABELLED: BACKGROUNG: No specific instrument has thus far been developed for measuring the caregiver burden perceived by parents of children with allergies (CWA). OBJECTIVES: To determine the psychometric properties of the Caregiver Burden Index (CBI). METHODS: A mixed-methods design was adopted to evaluate the psychometric properties of the scale. RESULTS: The content validity index was 0.89, and the internal consistency was high with a coefficient alpha of 0.98. Three factors were extracted after exploratory factor analysis. CONCLUSION: The study findings suggest that the CBI has sufficient reliability and validity to evaluate the caregiver burden of parents of CWA.

The self-efficacy scale for preschool teachers regarding asthma care: instrument development and validation.

BACKGROUND: The purpose of this study was to develop and test the psychometric properties of a questionnaire that assesses preschool teachers' self-efficacy in providing asthma care. METHODS: A total of 407 teachers from 54 preschools in Taiwan participated in the study by completing the asthma management self-efficacy scale. We assessed validity of the scale through expert opinion, exploratory factor analysis, and confirmatory factor analysis. The reliability of the scale was assessed using Cronbach's alpha. RESULTS: A 10-items questionnaire was developed to assess self-efficacy concerning asthma treatment. On the basis of explorative factor analysis, 2 major factors emerged from the 10 self-efficacy items that together explained 61.68% of the total variance in teachers' self-efficacy with regard to asthma care. We named these factors "prevention of an asthma episode" and "the treatment of an asthma exacerbation." Confirmatory factor analysis revealed that the 2-factor model provided the best goodness-of-fit. CONCLUSIONS: This scale could provide health professionals with useful information concerning preschool teachers' self-efficacy with respect to the management of asthma in the preschool setting.

[Relationships among risk knowledge, attitudes and ability to resist substance abuse in adolescents].

BACKGROUND: The Ministries of Justice and Education have implemented adolescent substance abuse prevention programs for many years. Rates of substance abuse among high school students continue to rise in spite of such programs. PURPOSE: This study investigates adolescents' substance abuse-related knowledge and attitudes and self-confidence to resist substance use in order to identify predictive factors of poor adolescent resistance to substance use. METHODS: A cross-sectional study survey gathered data on substance abuse-related knowledge and attitudes and self-confidence to resist substance use from 243 second-year senior high school students studying at two schools in northern Taiwan. RESULTS: Participants were most knowledgeable about tobacco (80.2%), followed by alcohol (72.0%), ecstasy (56.0%), and marijuana (30.0%). Only 19.3% demonstrated an understanding of the harmful effects of using Ketamine. A 10-point Likert scale measured participant substance use attitudes. Alcohol was the substance participants were most willing to use (2.18 ± 3.27), followed by tobacco (0.66 ± 2.19), ecstasy (0.45 ± 1.88), Ketamine (0.43 ± 1.93), and marijuana (0.38 ± 1.83). Participants had higher awareness of the harmful effects of Ketamine (t = -2.37, p = .018), marijuana (t = -2.33, p = .021), and tobacco (t = -2.02, p = .044), with participants reporting greater self-confidence to resist using these three substances. Multiple regression analysis found the three most important factors affecting participant self-confidence to resist substance use to be gender (ß= .26, p < .001), knowledge about the substance (ß= .15, p = .028), and attitude toward substance use (ß= -.20, p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Level of harmful effects knowledge and attitudes toward use varied among the various substances considered in this paper. Being female, having strong knowledge about the substance, and negative attitude toward substance use correlated with higher levels of self-confidence to resist substance use. Study results will be used in ongoing research designed to establish an empirical basis for adolescent substance use prevention and research, the results of which may be used directly by school nurses and military training education nurses.

The effect of oral training on vital signs of premature infants.

AIMS AND OBJECTIVES: This study aimed to develop an applicable oral training protocol and test its effects on vital sign stabilisation in premature infants. BACKGROUND: Oral training improves the feeding behaviour of premature infants. However, the inconsistencies of oral training procedures in previous studies obscure the interventional effect of oral training on vital sign stabilisation in premature infants. DESIGN: True experimental design. METHODS: Sixty premature infants with a gestational age <33 weeks were recruited and randomly assigned to the oral training or control group. RESULTS: Heart rate, respiratory rate and oxygen saturation tended to improve in the oral training group compared to those in the control group. However, the intergroup differences with respect to vital signs before and after feeding were not statistically significant. CONCLUSIONS: Further studies comparing protocols with different measurement points and durations are suggested.

Path of socialization and cognitive factors' effects on adolescents' alcohol use in Taiwan.

OBJECTIVES: The purpose of this study was to explore the direct and indirect effects of alcohol-related socialization factors and cognitive factors on adolescent alcohol use in a country with a low prevalence of drinking. METHODS: Data were obtained from the 2006 phase of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project, at which time the study participants were in grade nine (aged 14-15 years). Data from 1940 participants were analyzed. The main study variables included the current alcohol use of each adolescent, alcohol expectations, alcohol refusal efficacy, alcohol use among parents and peers, attitudes of the parents toward underage drinking, and peer encouragement of drinking. Path analysis was conducted to examine whether parental and peer socialization factors had direct effects on adolescent alcohol use, or whether they acted indirectly via cognitive factors. RESULTS: Among the participants, 19.54% had used alcohol in the previous month. Path analysis demonstrated that father, mother and peer alcohol use directly influenced alcohol use in adolescents. Attitudes of mothers toward underage drinking, peer drinking and peer encouragement of drinking had indirect effects on adolescent alcohol use that were mediated by cognitive factors. CONCLUSIONS: This study demonstrated that alcohol-related socialization factors could directly influence adolescent drinking behavior and had indirect effects on alcohol use that were mediated by cognitive factors partially. Parents and peers play important roles in preventing adolescent alcohol use. Establishing appropriate alcohol expectations and strengthening alcohol refusal skills could aid in decreasing alcohol use in adolescents.

Association of parents' alcohol use and family interaction with the initiation of alcohol use by sixth graders: a preliminary study in Taiwan.

BACKGROUND: The family is the main environment where children are socialized and learn individual behavior. Although previous studies have examined predictors of preadolescent first alcohol use, few studies have analyzed factors associated with alcohol use in children in a country with low alcohol consumption. The aim of this study was to investigate the initiation of alcohol use by sixth graders and determine family factors associated with first alcohol use. METHODS: Data used in this study was collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project in 2002 (when study participants were in grade 5 and aged 10-11 years) and 2003 (when study participants were in grade 6 and aged 11-12 years). Data from a total of 1,183 participants was analyzed. Main study variables included children's alcohol use: (1) never user (never user in 2002 and 2003), or (2) first-time user (never user in 2002 but ever user in 2003); parents' alcohol use: (1) both parents ever users, (2) mother ever user and father never user, (3) father ever user and mother never user, (4) both parents never users; parental support; and family conflict. Correlates of first alcohol use were identified using logistic regression. RESULTS: There were 183 students (15.5%) who became first-time users of alcohol in the sixth grade. Having parents who both used alcohol, less parental support, and more family conflict were significant predictors of sixth graders' first alcohol use. Family interaction and parents' drinking were equally important predictors of preteen's first use of alcohol. CONCLUSION: Family factors influence children's initiation of alcohol use. It is important to educate parents about the effects of alcohol on children and to emphasize the importance of prevention.

Asthma care issues in kindergarten teachers: an evaluation on knowledge, attitudes, and self-efficacy of asthma.

As frequently there is no school nurse in a kindergarten setting, teachers receiving non-medical training take the primary roles of symptom assessment and management of young children with asthma. This article presents the knowledge, attitudes, and self-efficacy of asthma in kindergarten teachers in Taiwan. A total valid sample of 460 teachers was recruited from 70 kindergartens. Results showed most teachers understood the basic facts about asthma rather than the complex issues; they demonstrated positive attitudes toward having asthmatic children in class. Regarding self-efficacy, teachers lacked confidence in their ability to manage asthma attacks. Teachers' asthma knowledge showed a significant positive correlation with attitude (r = 0.27, p < 0.001) and self-efficacy knowledge (r = 0.23, p < 0.001). Given the need to help kindergarten teachers take care of children with asthma, the implications of kindergarten teachers' in-service education and training to asthma care are also discussed.

Effects of systematic nursing instruction of mothers on using medication and on health status of asthmatic children.

The purpose of this study was to investigate the effects of systematic nursing instruction for mothers of children with asthma on their knowledge of the medication, ability to use inhalation devices, self-efficacy of medication use, and on children's health status. A quasi-experimental study was conducted at the Pediatric Allergy Clinic of a major academically based medical center in Taipei, Taiwan. The sample consisted of 82 mothers and their children recruited by purposive sampling. The intervention group (n = 41) received systematic nursing instruction from the researchers and the control group (n = 41) received regular nursing care from staff nurses. The effects of systematic nursing instruction were evaluated two months later using four questionnaires: the mother's knowledge of medication, inhaling steps, self-efficacy of medication use, and child's health status. The results of this study showed that systematic nursing instruction of mothers of children with asthma significantly improved their knowledge of the medication, ability to use inhalation devices, and self-efficacy, as well as decreasing the number of episodes of respiratory disease of children over a two month period. To sum up, these findings demonstrate that systematic nursing instruction of mothers about asthma medication not only benefited mothers directly, but also improved children's health status indirectly.