Quality of life among patients with abdominal aortic aneurysm undergoing endografting in Taiwan.

BACKGROUND: The use of endovascular aneurysm repair (EVAR) as a treatment for abdominal aortic aneurysm (AAA) has started to become popular in Taiwan. Quality of life is considered an indicator of clinical outcome, and self-management and health literacy have been identified as significant contributors to quality of life. However, the research on these three variables, and relationships among them in AAA patients who have undergone EVAR, is limited. AIMS: The purpose of this study is to examine the relationship between self-management, health literacy and quality of life in AAA patients who have undergone EVAR in Taiwan. METHODS: This study uses a cross-sectional design with convenience sampling. A total of 105 patients were sampled in the outpatient clinic when they returned for a follow-up visit to a veterans' general hospital in Taiwan between May 2011 and June 2012. Four questionnaires (demographic, self-management, health literacy, quality of life) were used to collect data. Regarding the relationship among these variables, Pearson correlations and hierarchical logistic regression were used to analyze the relationship. RESULTS: Self-management has a 73% mediation effect and an indirect effect of 13.51 on the relationship between health literacy and quality of life, while education and exercise habit has a 57% mediation effect and an indirect effect of 6.20 on this same relationship. CONCLUSION: These findings can be used to identify specific populations who have more risk for worse outcomes. They can then be provided with education to promote exercise behavior and to enhance self-management to achieve better quality of life.

The role of adherence in the relationship between self-efficacy and self-management in diabetic patients undergoing CABG in Taiwan.

OBJECTIVES: To determine the role of adherence and its significance in the relationship between self-efficacy and self-management of diabetic patients undergoing coronary artery bypass graft (CABG) in Taiwan. DESIGN: Descriptive and correlational survey design. SETTING: Three outpatient clinics in Taiwan. PARTICIPANTS: Patients diagnosed with diabetes undergoing CABG at least 6 months before the study, 18 years of age or older, able to communicate verbally without any psychiatric problems, and with a life expectancy longer than 1 year. MAIN OUTCOME MEASURES: Self-management assessment (self-efficacy for managing disease and adherence to guidelines and medication measured on a scale of 0-8), the higher aspects of self-management (keeping appointments, taking medication properly and keeping follow-up appointments) and the lower aspects of self-management (inability to share decisions with primary physician, inability to take correct actions when symptoms worsen and inability to adapt habits to improve health). RESULTS: The mean score obtained for self-management among the 166 participants was 6.48, with 57 (34.3%) of them showing non-adherent behaviour. Self-efficacy accounts for 38% (R(2)=0.380, F(1,103)=63.124, p < 0.001), and 54% of good self-management was explained by self-efficacy and adherence in managing disease (R(2)=0.540, F(2,102)=56.937, p<0.001). Adherence accounts for 16% of better self-management, age and education combined account for 4.9% (R(2)=0.589, F(6.98)=23.399, p<0.001), and lifestyle items account for 5.2% (R(2)=0.641, F(14,90)=11.457, p<0.001). Disease-related variables contribute 3.4% (R(2)=0.674, F(17,87)=10.599, p<0.001). Thus self-efficacy, adherence, age, education, primary care provider and systolic pressure are considered significant predictors of self-management. With the exception of adherence, none of the variables had a statistically significant mediating effect. CONCLUSIONS: The results confirm strong relationships between self-efficacy, adherence and self-management, with adherence having a significant mediating effect in post-CABG patients with diabetes in Taiwan.

Effects of a preoperative individualized exercise program on selected recovery variables for cardiac surgery patients: A pilot study.

OBJECTIVE: Research on preoperative individualized exercise prescription (PIEP) for heart surgery patients in Taiwan is lacking. Thus, the purpose of this study was to examine the feasibility of a PIEP in the Taiwanese population. METHOD: A quasi-experimental design, using purposive sampling, was conducted. Thirty-five patients were recruited, of whom 15 chose to participate in the experimental (PIEP training plus usual care) group, and 20 chose to participate in the control (usual care) group. The effects of the intervention were determined by pulmonary complication-related parameters and quality of life. RESULTS AND CONCLUSION: The development and process of PIEPs suitable for cardiac patients was described in this study. The results reveal that the two-week exercise-training program contributed to a decreased peak respiratory exchange ratio (RER) after the surgery and earlier ambulation. The effectiveness of PIEPs in improving the quality of life in cardiac surgery patients was validated. This study may also contribute as a reference of the PIEP effect on patients to the healthcare providers.

Lithium plasma emitter for collisionless magnetized plasma experiment.

This paper presents a newly developed lithium plasma emitter, which can provide quiescent and low-temperature collisionless conditions for magnetized plasma experiments. This plasma emitter generates thermal emissions of lithium ions and electrons to produce a lithium plasma. Lithium type beta-eucryptite and lanthanum-hexaboride (LaB(6)) powders were mixed and directly heated with a tungsten heater to synthesize ion and electron emissions. As a result, a plasma with a diameter of ~15 cm was obtained in a magnetic mirror configuration. The typical range of electron density was 10(12)-10(13) m(-3) and that of electron temperature was 0.1-0.8 eV with the emitter operation temperature of about 1500 K. The amplitude fluctuations for the plasma density were lower than 1%.