Experiences and coping behaviors of patients with psoriasis: a qualitative study.

BACKGROUND: Psoriasis is a complex, chronic, lifelong inflammatory skin disease characterized by the development of erythematous, indurated, scaly, pruritic, and often painful skin plaques, and it is currently incurable. It profoundly affects psychological wellbeing and social functioning and has significant associated co-morbidities. To improve clinical approaches, understanding of the experiences of patients with psoriasis is needed. OBJECTIVE: To explore the experiences and coping behaviors of patients with psoriasis. METHODS: A qualitative study approach was conducted. Through semi-structured interviews, 20 patients with psoriasis were recruited from general practices and specialist dermatology practices in a regional teaching hospital in Taiwan. Recorded interviews were transcribed and analyzed by content analysis. RESULTS: Three themes and nine subthemes were identified: (1) Symptoms distress: (a) trouble with scaling, (b) bothersome itching, and (c) complex pain experiences; (2) Psychological distress: (a) encountering discrimination and (b) feeling stigmatized; (3) Managing psoriasis: (a) coping with symptoms, (b) seeking alternative methods, (c) using biologic agents, and (d) changing thinking and coexisting with the disease. CONCLUSION: The experience of patients with psoriasis has significant negative impacts on their lives. The findings of this study can provide healthcare professionals with a reference for the care of patients with psoriasis.

The Application of Hyperspectral Imaging to the Measurement of Pressure Injury Area.

Wound size measurement is an important indicator of wound healing. Nurses measure wound size in terms of length × width in wound healing assessment, but it is easy to overestimate the extent of the wound due to irregularities around it. Using hyperspectral imaging (HIS) to measure the area of a pressure injury could provide more accurate data than manual measurement, ensure that the same tool is used for standardized assessment of wounds, and reduce the measurement time. This study was a pilot cross-sectional study, and a total of 30 patients with coccyx sacral pressure injuries were recruited to the rehabilitation ward after approval by the human subjects research committee. We used hyperspectral images to collect pressure injury images and machine learning (k-means) to automatically classify wound areas in combination with the length × width rule (LW rule) and image morphology algorithm for wound judgment and area calculation. The results calculated from the data were compared with the calculations made by the nursing staff using the length × width rule. The use of hyperspectral images, machine learning, the length × width rule (LW rule), and an image morphology algorithm to calculate the wound area yielded more accurate measurements than did nurses, effectively reduced the chance of human error, reduced the measurement time, and produced real-time data. HIS can be used by nursing staff to assess wounds with a standardized approach so as to ensure that proper wound care can be provided.

Assessment of Hyperspectral Imaging in Pressure Injury Healing.

OBJECTIVE: To analyze the blood oxygen concentrations (StO 2 ) of different stages of pressure injury (PI) tissue using hyperspectral images to serve as a guideline for the treatment and care of PIs. METHODS: This study used a prospective design. A total of 30 patients with sacral PIs were recruited from the rehabilitation ward of a teaching hospital. The authors used a hyperspectral detector to collect wound images and the Beer-Lambert law to estimate changes in tissue StO 2 in different stages of PI. RESULTS: The tissue StO 2 of healthy skin and that of stage 1 PI skin were similar, whereas the tissue StO 2 of the wound in stage 2 PIs was significantly higher than that of healthy skin and scabbed tissue (medians, 82.5%, 74.4%, and 68.3%; P < .05). In stage 3 PIs, StO 2 was highest in subcutaneous tissue and adipose tissue (82.5%) and lowest in peripheral scabs (68.35%). The tissue StO 2 was highest in subcutaneous tissue in stage 4 PIs, and this tissue was red in the hyperspectral spectrum. The scab-covered area of unstageable PIs had the lowest StO 2 of all PI tissue types (median, 44.3%). CONCLUSIONS: Hyperspectral imaging provides physiologic information on wound microcirculation, which can enable better evaluation of healing status. Assessing tissue StO 2 data can provide a clinical index of wound healing.

Factors Predicting Nurse Intent and Status Regarding Pap Smear Examination in Taiwan: a Cross-sectional Survey.

BACKGROUND: Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. MATERIALS AND METHODS: Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. RESULTS: Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. CONCLUSIONS: Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.