Music, heart rate variability, and symptom clusters: a comparative study.

PURPOSE: This study aimed to explore the possible range of change of a single-session music intervention (SMI) on symptom clusters and neurological reactivity for women with breast cancer undergoing chemotherapy. METHODS: A parallel and randomized, controlled study with repeated measures design was used. A total of 100 women with breast cancer were randomly assigned to the SMI or a control group. The outcome measurements of symptom cluster were collected using the Multidimensional Fatigue Symptom Inventory, Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, and the neurological reactivity with heart rate variability at four time points: before commencement of the intervention (T0), immediately afterward (T1), 1 week later (T2), and 3 weeks after the intervention (T3). RESULTS: Of the 50 women in each group, 46 in the SMI and 48 in the control group completed the post-test at T3. Multivariate analysis of variance indicated that the SMI group had a medium effect in change of symptom clusters compared to the control group at T2. Moreover, after adjusting for baseline between normal and higher levels of sympathetic tone activity, significant differences existed in fatigue and depression at T2 and sleep disturbance at T3. CONCLUSIONS: A single-session music intervention can be effectively used to reduce symptom clusters for women with breast cancer. Targeting those who have a higher level of sympathetic tone activity is recommended.

Development of a new prototype for an educational partnership in nursing.

The purpose of this 2-year study was to evaluate a new educational partnership for a nurse-managed community center in Taiwan. This project provided care to senior residents in an apartment complex and was integrated into a nursing educational program in Taiwan. In collaboration with these organizations, an educational partnership model was developed and evaluated. Three goals were accomplished: to provide health care to elderly residents, practical learning experience for nursing students, and practical experience for nursing faculty. The findings indicated that teachers, students, and residents in the apartment complex presented a high level of satisfaction with this model. The model created a vivid, practical, community-based resource and applied the principles of service-learning into practical nursing education in Taiwan. The model not only facilitated the empowerment of involved organizations, but also served as a reference for developing other community center-based nursing educational partnerships.

The self-empowerment process of primary caregivers: A study of caring for elderly with dementia.

The purpose of this qualitative research was to explore and develop the process of self-empowerment for primary caregivers responsible for caring for elderly with dementia. Nine primary caregivers who lived in northern Taiwan were interviewed through a theoretical sampling procedure. In-depth, face-to-face interviews were tape-recorded and transcribed verbatim. The grounded theory method was applied for analyzing data. The six main components that emerged in this model: "filial piety", "feeling of out of control", "inner awareness", "care ability", "emotion reconstruction", and "life management". This model starts from "filial piety" and "feeling of out of control," then evokes caregivers' "inner awareness". The inner awareness powerfully influences caregivers' "care ability", "emotion reconstruction" and "life management," which account for the three inner mechanism parts in their caregiving experience. Each part comprises three stages that are influenced by "inner awareness". The lower stage of each part supports the next higher stage. The same stages in all parts parallel one another, and influence each other by providing support or creating barriers. On the other side, competition between support and barriers from the outside environment determines the completion of this self-empowerment process. Results of this research extend the knowledge in understanding the psychological processes related to caring for elderly with dementia. The findings also provide readers a positive viewpoint on the caring experiences of primary caregivers of elderly with dementia.

[A conceptual analysis of the process of empowering the elderly at the community level].

The World Health Organization's 1986 Ottawa Declaration (WHO/Europe, 2005, April 18) named the community as the best level at which to initiate health promotion activities and recognized "empowerment" as a main focus of modern health promotion activities. This implies that the success of health promotion initiatives relies on effective and creative community action, of which community empowerment is one of the three major influencing factors. Empowerment is a manner by which the resources of senior citizens can be reorganized and an awareness of their own capabilities cultivated. Moreover, empowerment is the best strategy to encourage senior citizen participation in the community as well as self-efficacy. Based on a review of the literature, this article introduces the definitions, concept development and vital components of community empowerment. Evidence-based research and examination instruments for the concept of empowerment are critically reviewed as well. In addition to discussing the application and effectiveness of senior citizen community participation and empowerment, this paper provides suggestions related to current community nursing care issues.

[Lassie's magic: animal-assisted therapy in Taiwan].

Animal-assisted therapy (AAT) is a goal-directed intervention, which involves placing appropriately qualified animals into the therapeutic environment of human patients. AAT is also a cross-professional cooperation model combining different health related disciplines, such as veterinary science, animal behavior, medicine, nursing, rehabilitation, and education. Based on concepts of concern for the welfare of both humans and animals, AAT provides an alternative route to comprehensive human health. This article describes the development and current state of canine Animal-Assisted Therapy in Taiwan. It covers the development of the relationship between humans and animals, a review of the literature about AAT, research, development, and outcomes in respect of the current AAT system in Taiwan. It also discusses practical issues concerning the AAT system, by means of examples. Suggestions regarding future services, professional development, education and research are also discussed.