Evaluating effects of a prenatal breastfeeding education programme on women with caesarean delivery in Taiwan.

AIMS: The aims of this study were: (1) to evaluate the effectiveness of a prenatal breastfeeding education programme for primigravida women who have elected caesarean section as a model of delivery and (2) to evaluate its effectiveness for encouraging a positive attitude to breastfeeding and rooming-in and to increase exclusive breastfeeding rates within hospital and at one month postpartum. BACKGROUND: Prenatal preparation for pregnant women about breastfeeding enhances their practical knowledge and skills about breastfeeding techniques, which prepares them when encountering possible difficulties. DESIGN: A quasi-experimental design was used. METHODS: The targeted population was primigravidas at 36-39 weeks and who had chosen to deliver by caesarean section. The study consisted of approximately 100 individuals; the control group consisted of 46 subjects and the following 54 made up the experimental group. The study was conducted at a hospital in Taiwan. RESULTS: The results of the study show that the subjects of the experimental group exhibited a more positive breastfeeding attitude (88.9 vs. 79.8, t = 7.40, p < 0.001), a higher 24 hours rooming-in rate (87% vs. 63%, chi(2) = 16.06, p < 0.001) and a higher exclusive breastfeeding rate (79.6% vs. 52.2%, chi(2) = 8.38, p = 0.004) during hospital stays and a higher exclusive breastfeeding rate (75.9% vs. 34.7%, chi(2) = 16.98, p < 0.001) for the one month postpartum period. CONCLUSION: Results suggest that providing education booklets, videos and telephone interview on breastfeeding prior to a caesarean delivery may contribute to breastfeeding attitude and improved rooming-in and exclusive breastfeeding rates. RELEVANCE TO CLINICAL PRACTICE: This breastfeeding education programme has proven to be successful in aiding women breastfeeding after a caesarean delivery and provides health care professionals with an evidence-based intervention.

Validation and comparison of alcohol-screening instruments for identifying hazardous drinking in hospitalized patients in Taiwan.

AIM: The aim of this study was to validate the Mandarin Chinese version of different screening instruments and compare their performances for identifying hazardous drinkers in Taiwan. METHODS: We compared the performance of the Mandarin Chinese versions of AUDIT, AUDIT-C (AUDIT items 1, 2 and 3), AUDIT-4 (AUDIT items 1, 2, 3 and 10), AUDIT-3 (AUDIT item 3), TWEAK, SMAST and CAGE to detect hazardous drinking in hospitalized patients in Taiwan. The results of the test instruments were blindly compared with the reference standard Schedule for Clinical Assessments in Neuropsychiatry (SCAN). RESULTS: Of 404 patients evaluated, 100 were identified as having a hazardous drinking pattern. All screening instruments showed acceptable sensitivities (ranging from 85 to 93%) and specificities (ranging from 72 to 92%), but AUDIT and its short forms performed consistently better than the other instruments. CONCLUSIONS: The Mandarin Chinese versions of AUDIT and its derivatives perform well in screening hospitalized Taiwanese patients for hazardous drinking.

Fatigue and its associated factors in hospice cancer patients in Taiwan.

Fatigue is one of the most distressful problems faced by terminally ill cancer patients, but few studies have explored fatigue experiences in this population. The purpose of this descriptive correlational study was to examine fatigue status and its related factors in terminally ill cancer patients in an institutionalized hospice in Northern Taiwan. Data were collected using the Fatigue subscale of the Profile of Mood States, modified Symptom Distress Scale, Hospital Anxiety and Depression Scale, Karnofsky's Performance Status Index and a background information form. We found that patients generally had moderate to severe levels of fatigue. Fatigue was associated with the overall symptom distress, depression, anxiety, and performance status. Furthermore, fatigue was significantly correlated with 8 individual distressful symptoms: nausea, vomiting, lack of appetite, sleep disturbance, dyspnea, dry mouth, restlessness, and problems of concentration. These results suggest that fatigue is still a problem faced by terminally ill cancer patients. To provide better care to this population, the above-mentioned fatigue-related factors should be simultaneously assessed and cared for. The authors recommend examining the causal relationship between these factors and fatigue, using symptom cluster concepts and skills to examine the possible shared mechanisms among fatigue and related symptoms and developing interventions to decrease fatigue in terminally ill cancer patients.