The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains.

BACKGROUND: Pharmacological interventions combined with nonpharmacological treatments such as patient-centered care (PCC)-related activities are widely used to enhance outcomes in patients with schizophrenia. However, few studies have examined and identified the PCC factors essential to achieving better outcomes in patients with schizophrenia. PURPOSE: This study was designed to identify the Picker-Institute-identified PCC domains associated with satisfaction and to determine which of these domains are most important in the context of schizophrenia care. METHODS: Data were collected using patient surveys in outpatient settings and record reviews at two hospitals in northern Taiwan between November and December 2016. PCC data were collected in five domains: (a) support of patient autonomy; (b) goal setting; (c) collaboration and integration of healthcare services; (d) information, education, and communication; and (e) emotional support. The outcome measure was patient satisfaction. The study controlled for demographic factors, including age, gender, education, occupation, marriage, and urbanization level in the respondent's area of residence. Clinical characteristics included the Clinical Global Impressions severity and improvement index scores, previous admission, previous emergency department visit, and readmission within 1 year. Methods were adopted to prevent common method variance bias. Multivariable linear regression with stepwise selection and the generalized estimating equation were used to analyze the data. RESULTS: After controlling for confounding factors, the generalized estimating equation model found only three PCC factors significantly associated with patient satisfaction, which differed slightly from the results of the multivariable linear regression. These three factors are as follows, in order of importance: information, education, and communication (parameter = 0.65 [0.37, 0.92], p < .001); emotional support (parameter = 0.52 [0.22, 0.81], p < .001); and goal setting (parameter = 0.31 [0.10, 0.51], p = .004). CONCLUSIONS: The three critical PCC-related factors were evaluated in terms of enhancing patient satisfaction in patients with schizophrenia. Practicable strategies related to these three factors should also be developed for implementation in clinical settings.

Exploring the Workplace Bullying of Indonesian Caregivers and Its Influencing Factors in Taiwan.

Background: Bullying can pose a risk to the health and safety of humans, including the risk of damage to the emotional, psychosocial, mental, or physical health of employees in the workplace. In this study, we aimed to understand the personal characteristics, mental health, sleep quality, and workplace bullying status of Indonesian caregivers and explore the influencing factors of workplace bullying among them. Methods: This cross-sectional study was based on a structured questionnaire in Indonesian, which was designed to collect the data of essential personal characteristics, workplace bullying, sleep quality, and mental health using the Indonesian versions of the Negative Acts Questionnaire−Revised (NAQ-R), Pittsburgh Sleep Quality Index (PSQI), and the Brief Symptoms Rating Scale (BSRS-5). Results: A total of 60.9% of Indonesian caregivers never experienced workplace bullying in Taiwan. A multiple regression analysis revealed that being a household caregiver (ß = 0.14, p = 0.021), sleep quality (ß = 0.18, p = 0.031), and mental health (ß = 0.44, p < 0.001) were significantly correlated with the overall workplace bullying scores of the respondents and revealed that these three variables explained 45% of the variance. Conclusions: Taiwan Indonesian caregivers have a similar workplace bullying rate to Indonesian employees in the workplace. This study indicated the relationships among the workplace bullying of foreign caregivers and demonstrated that being a household caregiver, sleep quality, and mental health were closely related.

[Cinema Teaching in Mental and Psychological Education: An Example Using RN-BSN Nursing Students].

Movies can be an effective tool for increasing the depth and breadth of learning. In this era of continuously advancing knowledge and technology, it is essential to design curricula that shorten the learning time of RN-BSN nursing students and arouse and stimulate their interest and potential. Designing an in-service nursing curriculum that enhances the self-reflection capabilities of students is challenging. Cinema teaching and the development of the plots model facilitate student engagement with movies. Through emotional development and the setting of background contexts, cinema teaching helps transform and establish students' knowledge of mental and psychological healthcare and increases their understanding of patient behaviors. Mental and psychological education aims to enhance cognition and provide practical learning strategies for in-serving nursing students. By implementing the cinema teaching method, students come to empathize with the pain and helplessness of patients and their families and learn how to provide care and social support to these patients.

Psychological Distress and Sleep Disturbance Among Female Nurses: Anxiety or Depression?

Introduction: Sleep quality is an important issue in nurses' mental and general health. Long-term psychological distress leads to increased sleep disturbances among nurses. However, which forms of psychological distress are most associated with sleep disturbances is unclear among female nurses. Methodology: To determine which psychological distress factors are associated with sleep disturbances among female nurses. A total of 119 female Taiwanese nurses were recruited and surveyed using the Occupational Stress Indicator-2, Beck Anxiety Inventory, Beck Depression Inventory-II, and Pittsburgh Sleep Quality Index. Results: Overall, 68.9% of the nurses were poor sleepers, and 20.2% and 11.7% of them had more than moderate levels of anxiety and depression, respectively. A logistic regression analysis showed that sleep disturbances were associated with higher levels of depression and poorer general health. Discussion: Compared with anxiety, depression more heavily influences sleep disturbances among female nurses. Depression prevention should thus be a focus of mental health promotion for female nurses.

An exploration of the sleep quality and potential violence among patients with schizophrenia in community.

PURPOSE: Sleep quality in patients with schizophrenia is correlated with potential violence. However, few studies have conducted in-depth discussions on community patients with schizophrenia. The purpose of this study was to explore the influences of demographic characteristics, psychiatric symptom severity, and sleep quality in community patients with schizophrenia on the risks of potential violence and its subdimensions (ie, physical aggression, verbal aggression, anger, and hostility). DESIGN AND METHODS: This study adopted a cross-sectional research design. Using convenience sampling, 78 community patients with schizophrenia were recruited from psychiatric outpatient clinics, day wards, and those who received home-care services. FINDINGS: This study discovered that sleep quality is a crucial factor that influences the risks of potential violence. Analysis on the subdimensions revealed that having a violence history during the preceding month and sleep quality are crucial factors that influence physical aggression. In addition, sleep quality is a crucial factor that influences the occurrence of anger. Age and sleep quality substantially influence hostility. However, this study did not identify any crucial factors that influenced verbal aggression. PRACTICE IMPLICATIONS: In the future, community nursing professionals should collect data on the patients' age, whether the patients exhibited violence behavior during the preceding month, and their sleep quality to prevent risks of potential violence, physical aggression, anger, or hostility.

Relationship between heart rate variability and aggressive behavior among patients with schizophrenia hospitalized in acute wards.

PURPOSE: To explore the state of mental treatment, heart rate variability (HRV), level of aggressive behavior, and their relationships among hospitalized patients with schizophrenia. DESIGN AND METHODS: This study adopted a follow-up design and convenience sampling. Thirty-three subjects completed the questionnaire, and their HRV indices were measured. FINDINGS: Patients' psychiatric symptoms showed a significant downward trend after hospitalization (P = .003). The standard deviation of the normal-to-normal intervals in the morning was significantly correlated with overall aggression, physical aggression, and verbal aggression. PRACTICE IMPLICATIONS: HRV can be regularly monitored among inpatients with schizophrenia with a risk of high aggression as an indicator of possible aggressive behavior.

Alcohol Consumption as a Moderator of Anxiety and Sleep Quality.

BACKGROUND: Although people who sleep poorly may attempt to relieve anxiety for better sleep quality, whether daily alcohol consumption is a factor that moderates anxiety and sleep disturbance is not known. PURPOSE: The aim of the study was to explore (a) the association between anxiety and sleep quality and (b) whether daily alcohol consumption acted as a moderator between anxiety and sleep quality in those who reported sleeping poorly. METHODS: Eighty-four participants aged 20-80 years who reported poor sleep (Pittsburgh Sleep Quality Index > 5) in northern Taiwan were enrolled in this cross-sectional study. A structured questionnaire covering demographics (including daily alcohol consumption), level of anxiety, level of depression, and perceived sleep quality was used to collect data. RESULTS: The participants were mostly women (72.6%). The mean age was 41.81 (SD = 12.62) years; 51.2%, 19.0%, 13.1%, and 14.3%, respectively, had minimal, mild, moderate, and severe anxiety. After adjusting for factors related to sleep quality using multiple regression analysis, receiving sleep therapy, consuming alcohol on a daily basis, and having anxiety were found to be predictors of poor sleep quality. Moreover, daily alcohol consumption was found to moderate the relationship between anxiety and sleep quality. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: People who sleep poorly should avoid misusing alcohol to self-treat poor sleep quality or anxiety and should instead utilize sleep hygiene education and mental healthcare. Daily alcohol consumption may be a moderator between anxiety status and sleep quality.

Effects of Auricular Acupressure on Sleep Quality, Anxiety, and Depressed Mood in RN-BSN Students With Sleep Disturbance.

BACKGROUND: Students in 2-year registered nurse to Bachelor of Science in nursing (RN-BSN) programs usually work full-time and study part-time. Sleep disturbance, anxiety, and depression are known to be common health problems among these students.Prior research has described the effectiveness of auricular acupressure (AA) in reducing sleep disturbance and improving mood. PURPOSE: The aim of this study was to evaluate the effect of using a 4-week AA program that adheres to a magnetic pellet on the shenmen acupoint on sleep quality, anxiousness, and depressed moods in nursing students with sleep disturbance. METHODS: This study used a one-group, quasi-experimental design with repeated measures. Eligible students were recruited from an RN-BSN program offered by a university in northern Taiwan, and all were currently experiencing sleep disturbance. A 4-week AA intervention that applied a magnetic pellet on the shenmen acupoint was used. The Pittsburgh Sleep Quality Index, Beck Anxiety Inventory, and Beck Depression Inventory-II were used to measure sleep quality and mood outcomes each week during the 4-week intervention. Improvements in sleep quality, anxiety, and depressed moods were analyzed using the generalized estimating equation. RESULTS: Thirty-six participants with a mean age of 32 years were enrolled as participants. After adjusting for confounding factors, continuous and significant improvements in sleep quality, anxiety, and depressed mood (p < .05) were observed throughout the intervention, with 4-week improvements in sleep quality, anxiety, and depressed mood averaging 26.7%, 43.5%, and 25%, respectively. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study showed the efficacy of using a 4-week AA that applies a magnetic pellet on the shenmen acupoint in terms of improving sleep quality, anxiousness, and depressed mood in RN-BSN students experiencing sleep disturbances. Especially, the emotional mood of participants improved significantly as early as the first week. The 4-week AA for reducing sleep disturbance, and improving students' anxiety, and depressed moods may be applied on primary healthcare.

Somatic symptoms, sleep disturbance and psychological distress among women undergoing oocyte pick-up and in vitro fertilisation-embryo transfer.

AIMS AND OBJECTIVES: This study investigated the relationship between somatic symptoms, sleep disturbance and psychological distress in women who underwent oocyte pick-up and in vitro fertilisation-embryo transfer. BACKGROUND: According to worldwide research, women receiving assisted reproductive technologies may suffer from somatic and psychological symptoms and even experience sleep disturbance. Apparently, the guilt of infecundity forces Asian women to conceal this scenario and delay the time at which they accept medical assistance and mental support. DESIGN: A longitudinal study. METHODS: The subjects in this study were infertile female patients who received oocyte pick-up and in vitro fertilisation-embryo transfer therapies in a hospital in northern Taiwan. Data were collected via a structured questionnaire, including somatic symptoms, Pittsburgh Sleep Quality Index and a five-item brief symptom rating scale. Data were analysed using the McNemar's test, Wilcoxon Sign Rank and fully entered multiple regression with spss version 20.0 software. RESULTS: The mean age of 100 participants was 34·54 (SD = 3·94) years old. They experienced abdominal distention, breast engorgement, nausea, faintness, diarrhoea, sleep disturbance and psychological distress when they received in vitro fertilisation-embryo transfer; these results were apparently higher than those receiving oocyte pick-up. In addition, sleep disturbance was the most significant factor involved in psychological distress during oocyte pick-up and in vitro fertilisation-embryo transfer therapies. The most serious indicator of the women's psychological distress during oocyte pick-up and in vitro fertilisation-embryo transfer treatment is anxiety. CONCLUSIONS: Sleep disturbance was the most significant factor involved in the psychological distress of women having problems with conception. RELEVANCE TO CLINICAL PRACTICE: Assisted reproductive technologies nurses can assess women's psychological distress by caring for their sleep disturbance without directly exploring their mood state. Moreover, these medical personnel should understand infertile female patients' psychological distress is mainly associated with their sleep disturbance. Developing various strategies to improve both sleep quality and psychological distress for infertile female patients should be recognised in future studies.

Harmful alcohol use among Aboriginal people in southern Taiwan: the prevalence, correlates, and adverse drinking effects.

This cross-sectional study aims to examine the prevalence and correlates of harmful alcohol use among aboriginal people in southern Taiwan and to examine the associations between harmful alcohol use and adverse drinking effects. Four hundred forty-nine aboriginal adults were recruited from two townships in southern Taiwan to complete the questionnaires. Among the aborigines, 59.7% scored an 8 or above on the Alcohol Use Disorders Identification Test, including 26.7% who were found to be hazardous drinkers (AUDIT level II), 18.5% who were harmful drinkers (level III), and 14.5% who were with likely dependence (level IV). Male aborigines who participated less in religious activities, had stressful life events, were cigarette smokers, or were betel quid chewers were more likely to have harmful alcohol use. Harmful alcohol use was also associated with an inability to work and with arguments with other people. Our study suggests that aboriginal people in southern Taiwan experience alcohol-related risks at rates as high as other worldwide populations for which AUDIT results are available. Individuals with AUDIT scores at levels II and III are generally candidates for brief interventions delivered in generalist health settings. Individuals with AUDIT scores at level IV should be referred for an addiction specialty evaluation and possible treatment as well as lower-risk individuals (those with AUDIT levels II-III) if they have concurrent physical or psychiatric disorders.

Effectiveness of group reminiscence therapy for depressive symptoms in male veterans: 6-month follow-up.

OBJECTIVE: The purpose of this study was to use group reminiscence therapy (GRT) as a nursing intervention to evaluate the post-test, 3-month and 6-month effects on depressive symptoms for institutionalised male veterans after a 4-week intervention. METHODS: A quasi-experimental design and purposive sampling was conducted at a veteran's nursing home in Northern Taiwan. A total of 21 male veterans were studied to measure the effect of GRT. Eleven participants were in the experimental group and 10 in the control group. The experimental group activity was held twice weekly for 4 weeks. The Taiwan Geriatric Depression Scale was used to assess depressive symptoms and geriatric depression among male veterans. The generalised estimating equation was used for data analysis. RESULTS: The male veterans in this study had a mean age of 82 years (SD = 5.8); 47.62% were between 70 and 79 years old, 61.90% were illiterate and 90.48% were without a partner. After 4 weeks of GRT, the experimental group significantly improved their depressive symptoms and geriatric depression in the post-test, 3-month and 6-month follow-up data compared with the control group. These activities can reduce their depressive symptoms following the intervention. CONCLUSION: A 4-week, eight-session GRT can effectively reduce depressive symptoms among institutionalised male veterans for a 6-month period.

Somatic symptoms, psychological distress and sleep disturbance among infertile women with intrauterine insemination treatment.

AIMS AND OBJECTIVES: To explore sleep quality in infertile women and examine the factors that contribute to sleep disturbances during intrauterine insemination treatment. BACKGROUND: Sleep disturbance is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during intrauterine insemination treatment. Although many studies have focused on the high percentage of somatic symptoms and psychological distress in infertile women associated with their treatment, few studies have investigated factors linked to their sleep disturbances. DESIGN: A cross-sectional study. METHODS: The study was conducted during the period of September 2010-January 2011 in a teaching hospital in Taiwan. Infertile women (n = 117) who received assisted reproduction with intrauterine insemination treatment completed a questionnaire. Demographic data, somatic symptoms, psychological distress and perceived sleep quality were collected. RESULTS: More than one-third (35%) of the infertile women reported having sleep disturbances. Their nausea symptoms and psychological distress were risk factors that contributed to sleep disturbance. CONCLUSIONS: The variables of nausea and psychological distress significantly explained 30% of the sleep disturbances in the infertile women. The evaluation of nausea symptoms and/or psychological distress among infertile women is an important area of future research; such research should aim to identify the best compromise between infertility treatment and sleep quality. RELEVANCE TO CLINICAL PRACTICE: Clinical obstetrics and gynaecology nurses should develop strategies to help infertile women reduce their nausea symptoms and psychological distress during intrauterine insemination treatment to promote healthy sleep.

[Relationships among risk knowledge, attitudes and ability to resist substance abuse in adolescents].

BACKGROUND: The Ministries of Justice and Education have implemented adolescent substance abuse prevention programs for many years. Rates of substance abuse among high school students continue to rise in spite of such programs. PURPOSE: This study investigates adolescents' substance abuse-related knowledge and attitudes and self-confidence to resist substance use in order to identify predictive factors of poor adolescent resistance to substance use. METHODS: A cross-sectional study survey gathered data on substance abuse-related knowledge and attitudes and self-confidence to resist substance use from 243 second-year senior high school students studying at two schools in northern Taiwan. RESULTS: Participants were most knowledgeable about tobacco (80.2%), followed by alcohol (72.0%), ecstasy (56.0%), and marijuana (30.0%). Only 19.3% demonstrated an understanding of the harmful effects of using Ketamine. A 10-point Likert scale measured participant substance use attitudes. Alcohol was the substance participants were most willing to use (2.18 ± 3.27), followed by tobacco (0.66 ± 2.19), ecstasy (0.45 ± 1.88), Ketamine (0.43 ± 1.93), and marijuana (0.38 ± 1.83). Participants had higher awareness of the harmful effects of Ketamine (t = -2.37, p = .018), marijuana (t = -2.33, p = .021), and tobacco (t = -2.02, p = .044), with participants reporting greater self-confidence to resist using these three substances. Multiple regression analysis found the three most important factors affecting participant self-confidence to resist substance use to be gender (ß= .26, p < .001), knowledge about the substance (ß= .15, p = .028), and attitude toward substance use (ß= -.20, p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Level of harmful effects knowledge and attitudes toward use varied among the various substances considered in this paper. Being female, having strong knowledge about the substance, and negative attitude toward substance use correlated with higher levels of self-confidence to resist substance use. Study results will be used in ongoing research designed to establish an empirical basis for adolescent substance use prevention and research, the results of which may be used directly by school nurses and military training education nurses.

Psychological distress in women who have experienced intrauterine insemination.

BACKGROUND: Despite evidence that psychological distress manifests itself in underreported and atypical ways, few studies have assessed these symptoms in women who have experienced intrauterine insemination (IUI). PURPOSE: The aim of this study was to examine the prevalence of psychological distress and explore the relationships among psychological distress, various demographic characteristics, and somatic symptoms in women who had received IUI treatment in Taiwan. METHODS: A cross-sectional study design was used in this study. The 117 participants were recruited from a teaching hospital in northern Taiwan. The brief symptom rating scale (BSRS-5) was used as the measurement instrument, and scores of more than 5 on the BSRS-5 were used to mark the boundary between milder and more severe psychological distress. Demographic characteristics and somatic symptoms of IUI that contributed most significantly to psychological distress were identified from the data. RESULTS: Thirty-eight (32.5%) participants experienced psychological distress. Psychological distress was most common in participants (a) with husbands who were an only son, (b) who had taken medication during the previous week, (c) with an education level below college or university, and (d) who reported feeling faint. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The factors studied are important to understand psychological distress in women who have undergone IUI treatment.

Relationship between elderly depression and health status in male veterans.

BACKGROUND: Elderly depression affects the overall health and quality of life of institutionalized men. PURPOSE: This study explored the relationship between depression and health status in institutionalized male veterans in Taiwan. METHODS: This survey study used a cross-sectional research design and recruited 152 elderly male residents of a veterans' home in northern Taiwan. A validated questionnaire assessed depression, health status, and demographic characteristics. RESULTS: More than one fifth of the subjects (21.7%) exhibited depression. Those with poor general health status (odds ratio [OR] = 7.9, p < .001), relatively high levels of dependence on others for daily physical activities (OR = 4.6, p = .002), or self-perceived negative influences of chronic diseases on daily living (OR = 11.7, p < .001) faced the highest prevalence of depression. Subjects with hypertension (OR = 2.3, p = .034), cataracts (OR = 3.7, p = .007), or liver disease (OR = 8.1, p = .006) had the highest prevalence of depression. Identified risk factors of depression among the elderly male veterans included self-perceived negative influence of chronic diseases on daily living (adjusted OR = 10.2, p < .001) and cataracts (adjusted OR = 4.3, p = .023). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Geriatrician nurses should develop strategies to maintain general patient health and reduce the negative impact of chronic diseases and cataracts on daily life to reduce depression in institutionalized male veterans.

[Effects of a warming strategy on the temperature of patients waiting for surgery].

BACKGROUND: Patient hypothermia is a critical nursing problem in the preoperative room. Applying an appropriate temperature control strategy prior to surgery helps patients maintain body temperature and physical comfort. PURPOSE: This project assessed the temperature effects of a coat warming strategy on preoperative patients. METHODS: This quasi-experimental study invited 60 participants who were divided into two groups, namely an experimental group (n = 30) that used a coat temperature control strategy and a control group (n = 30) that used a routine strategy. We analyzed changes in patient-perceived temperature, auricular temperature, skin color at the distal end of extremities, and Dali lithosporic at the upper arm. Measurements were taken once at pretest and at 5 and 10 minutes after intervention. RESULTS: Compared with the control group, experimental group patients reported feeling significantly less cold (p < .001, 5 minutes after intervention; p = .001) and had lower Dali lithosporic (p < .001, 5 minutes after intervention), higher auricular temperature (p = .026, 5 minutes after intervention) and pinker skin color at the distal end of their extremities (p = .016, 5 minutes after intervention). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This evidence-based result offers nurses a suggested strategy for effective control of patient temperature.

Association between psychosomatic symptoms and work stress among Taiwan police officers.

The aim of the study was to explore the association between the severity of psychosomatic symptoms and perceived work stress among male police officers in southern Taiwan. By stratified random sampling, a total of 698 male police officers were recruited into this study (the response rate was 73.4%; 512 of 698). A structured self-administered questionnaire on demographic and working characteristics, the severity of psychosomatic symptoms, perceived work stress, and social support was used to collect data anonymously. The results of multiple regression analysis revealed that (1) the police officers who perceived high-work stress reported more severe psychosomatic symptoms than those who perceived low-work stress; and (2) perceived social support had a moderating effect on the association between severity of psychosomatic symptoms and perceived work stress. Perceived work stress is an indicator of psychosomatic symptoms in police officers. Strategies for reducing psychosomatic symptoms of police officers include police administrators taking into account the level of work stress as well as more attention being paid to the resources of social support.

Sleep hygiene education: efficacy on sleep quality in working women.

BACKGROUND: Although sleep hygiene education represents a promising approach for patients with poor sleep quality, little research has been devoted in understanding the sleep hygiene behavior and knowledge of working women. PURPOSE: The purpose of this study was to investigate the efficacy of a short-term sleep hygiene education program on working women with poor sleep quality. METHODS: This pilot study was a prospective and an exploratory intervention study. The intervention was tested on 37 selected working women with poor sleep quality in the community. The Pittsburgh Sleep Quality Index (score > 5) was used to identify working women with poor sleep quality. After a pretest to assess sleep quality, researchers implemented a 5-week sleep hygiene education program that addressed good sleep environments/habits, emotional stress, the influence of diet/alcohol/tobacco on sleep, exercise, and alternative therapies. Tests administered midway through the program and after program completion provided the data used to analyze effective sleep quality changes. RESULTS: Results showed sleep hygiene education to improve participant sleep quality significantly (p < .001). The sleep quality of all participants improved over both the 3- and the 5-week education program. The six components of the Pittsburgh Sleep Quality Index (i.e., subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleeping medication, and daytime dysfunction) also improved. CONCLUSION/IMPLICATIONS FOR PRACTICE: A brief and effective sleep hygiene education program delivered by a nurse can improve sleep quality in working women with sleeping problems.

Poor sleep quality and alcohol use problems among elderly Taiwanese aboriginal women.

BACKGROUND: Little is known about sleep quality and alcohol use problems in the elderly minority population. This study aimed to identify a one-month prevalence of poor sleep quality and alcohol use problems among elderly Taiwanese aboriginal women and to examine the association between them. METHODS: A cross-sectional survey with stratified random sampling was conducted in eight aboriginal communities in Taiwan. The 1261 elderly aboriginal women (response rate 84%) completed all assessments. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), while the CAGE questionnaire was used to evaluate alcohol use problems. RESULTS: Of the study participants, 20.54% and 25.59% had poor sleep quality and alcohol use problems, respectively. Controlling for confounding factors, alcohol use problems were a risk factor for poor sleep quality (AOR = 1.44, p = 0.0433). Alcohol use problems were associated with three components of PSQI: sleep disturbances, subjective sleep quality, and daytime dysfunction. CONCLUSIONS: The elderly Taiwanese aboriginal women with problematic alcohol drinking experienced poorer sleep quality. Development of a program to reduce alcohol use problems might improve sleep quality among elderly Taiwanese aboriginal women.

Suicidal thoughts among elderly Taiwanese aboriginal women.

OBJECTIVES: The aims of this study were to investigate prevalence of suicidal thoughts among a population of elderly aboriginal women in Taiwan over a 1-month period and to examine the risk factors for suicidal thinking in terms of individual (self-perceived health, disability and financial difficulty), family (marital discord) and social (medical accessibility) aspects. The mediating effects of depression on the above risk factors were also investigated. Furthermore, we examined the buffer effect on suicidal ideation of emotional social support for dealing with marital discord. METHODS: One thousand three hundred and forty-seven elderly Taiwanese aboriginal women were enrolled. Suicide thoughts within the past month, demographic data, adverse life events, emotional social support and depressive state were assessed. The 1-month prevalence of suicide thoughts was calculated. The risks of suicide thought based on individual, family and community aspects were estimated. RESULTS: The 1-month prevalence of suicidal thoughts among the community-dwelling aboriginal elderly women was 17.8%. Those subjects with poorer self-perceived health, difficulty in accessing medical resources, or experiencing marital discord were at higher risk of having suicidal thoughts. After controlling for depression, the odds ratio of self-perceived health and marital discord remained statistically significant. The odds ratio of interaction of marital discord and emotional social support was 0.41. CONCLUSION: Suicidal thoughts are common among the community-dwelling aboriginal elderly women in Taiwan. Risk factors for suicidal thoughts comprise individual (depression and physical condition), family (marital discord) and community (medical resources) aspects. Better emotional social support can effectively buffer the effect of marital discord.