Factors influencing physical activity in institutionalized elderly patients with leprosy.

PURPOSE: The nursing literature has devoted little attention to the long-term influence of infectious diseases and the subsequent rehabilitation needs of the affected patients. This study was conducted to identify the factors associated with physical activity (PA) in older institutionalized adults with leprosy. METHOD: A cross-sectional research design was used. RESULTS: Data from 248 subjects (75.28 ± 8.64 years old) were analyzed. We found that fewer subjects in PA compared to older adults in general. Amputation, fear of falling (FF), the ability to perform activities of daily living, and instrumental activities of daily living (IADL) were the influencing factors of PA. Doing laundry, preparing a meal, taking medicines, and making telephone calls accounted for 23.4% of the PA variance. CONCLUSION: We suggest incorporating FF in the psychosocial indicators of the mobility assessment. The importance of promoting or maintaining four specific IADL abilities and participating in PA for leprosy patients living in a sanatorium is emphasized.

The prevalence of dementia and depression in Taiwanese institutionalized leprosy patients, and the effectiveness evaluation of reminiscence therapy--a longitudinal, single-blind, randomized control study.

OBJECTIVE: This study investigated the prevalence of depression and dementia in long-term institutionalized older leprosy patients in Taiwan. We then examined the effectiveness of reminiscence group therapy on depressive symptoms and cognitive function in this population. METHODS: We recruited 129 long-term institutionalized older leprosy patients in Taiwan and used the Geriatric Depression Scale-Short Form (GDS-SF), the mini mental state examination (MMSE), and the Clinical Dementia Rating (CDR) scale for outcome measurement. We then conducted a single-blind, randomized, longitudinal quasi-experimental analysis comparing the pre-test and post-test results of two equivalent groups at a 24-week intervention interval. The intervention in the experimental group was three sessions of reminiscence group therapy per week, whereas that in the control group was weekly individual supportive interviews. RESULTS: The prevalence of dementia was 45.7-50.4% according to a CDR score ≥ 0.5 and an MMSE score < 25, and the prevalence of depression was 25% based on a GDS-SF score ≥ 7. According to the Wilcoxon signed-rank test, the GDS-SF scores in the experimental group decreased significantly (p = 0.02) after intervention as compared with that in the control group (p = 0.22), whereas the MMSE scores in both groups remained steady. CONCLUSIONS: The prevalence of dementia and depression in long-term institutionalized older leprosy patients in Taiwan is high. Reminiscence group therapy has been confirmed effective on depression in this population, but its effectiveness on cognitive function requires further verification.

[Activity of daily living and life quality of patients with Hansen's disease in Taiwan].

BACKGROUND: Hansen's Disease incidence in Taiwan has declined to the goal set by the World Health Organization. However, this population does not receive adequate attention due to the stigma attached to the disease. PURPOSE: The purpose of this study was to investigate the demographic characteristics, activities of daily living, and quality of life of patients with Hansen's Disease in Taiwan. METHODS: A cross-sectional design was used. A structured questionnaire that incorporated a personal data survey form, basic activity of daily living (BADL) form, instrument ability of daily activity of living (IADL) form and quality of life (QOL) survey was used to collect data. Patients with Hansen's Disease in Taiwan who lived in the institution, rural villages, and communities were invited to participate. RESULTS: Four hundred and ninety-seven participants with an average age of 71.93 (± 12.8) years participated in this study. Institutionalized participants (76.97 ± 7.41) were older than those in the other two groups. Participants were found to have in general more than one chronic disease (2.05 ± 1.33), with more chronic diseases found amongst institutionalized subjects (2.70 ± 1.23). Activities of daily living scores were generally higher for urban community dwellers than those who were institutionalized. Relatively low BADL scores for personal hygiene, bathing, walking and climbing stairs were noted, as were poor IADL scores for cooking, shopping, washing clothes and riding public transportation. Results found that activities of daily living declined with participant age (p < .001). The QOL score was mid-range, while the mental dimension of QOL was poorer than the physical dimension. Higher QOLs were observed in participants who lived in villages, while poorer QOLs were observed in participants who lived in communities. CONCLUSIONS: The results of this study indicated activities of daily living scores declined among Hansen's Disease patients with age. In order to promote quality of life among patients with Hansen's Disease, several suggestions for health policy with regard to Hansen's Disease patients are raised in this paper, including helping maintain daily living activity functions in Hansen's Disease patients, hiring more assistants and nurses to help Hansen's Disease patients maintain daily living activities and personal hygiene, and enhancing living environment quality and medical service appropriateness.