[Nursing experience with an lymphangioleiomyomatosis patient with chylothorax].

This article discusses experience providing nursing care to a patient suffering from Lymphangioleiomyomatosis who was re-hospitalized for recurrence of chylothorax complications, which caused dyspnea, sterility and mental instability. Based on parameters provided by Roy's adaptation model, the patient was identified as suffering from respiratory impairment, acute pain, sleep pattern disturbance and low self-esteem. Data was collected through interviews, observation and physical assessments. During the course of providing nursing care, the author established a good relationship with the patient through devoted attention to the patient's needs and by actively caring, listening and accompanying. Increased family member visits and interaction, resulting from the author's urgings, gave the patient added support and consolation. Eventually, the author gained the trust of the patient, who, in turn, regained self-control as well as physical and sociopsychological adaptabilities. Clinical nursing must attend to the physical care needs of patients as well as patient mental wellness, the latter of which extends beyond the disease itself, in order to achieve a truly comprehensive quality of nursing care. We are glad to share this successful experience with others in the nursing profession.

Care needs and level of care difficulty related to hip fractures in geriatric populations during the post-discharge transition period.

The objective of this study was to understand the following: (1) the specific care needs of geriatric hip fracture patients; (2) the level of care difficulty during the transition period following discharge; and (3) the correlation amongst demographics, the physical function status of the elderly, and care needs. Purposive sampling was used, and a total of 71 hip fracture cases and their caregivers were selected. A survey was carried out to collect data just before discharge and one week following discharge. Statistical methods included descriptive statistics, correlation analysis, one-way ANOVA, and a paired t-test. Results were as follows: Most geriatric patients depended upon care from family members before discharge, with an average physical function status score of 6.99 (0 to 18) that improved significantly after one week to 10.27; paired t = -7.956 (p < .000). The mean age of primary caregivers was 51.72 years old (SD = 14.05). Most caregivers (47, or 66.2%) were female. The relationship between elderly participants and their primary caregiver was predominantly that of husband and wife (22 people; 31.0%). Participant care needs identified included return visit assistance, awareness of safety at all times, assistance with cleaning and maintaining living quarters, and so on. Caring tasks that were identified as more difficult for the primary caregivers includes providing stair climbing assistance, emotional problems management assistance, walking training assistance, rehabilitation assistance, and emergency disease management assistance. The care needs of the elderly in this study and level of execution difficulty for caregivers was found to be negatively related to the physical function status of the elderly. The study results suggest that providing patient-related home care knowledge to primary caregivers prior to discharge from the hospital and enhancement of the social support system are both needed.

[The effect of Tai-Chi-Qui-Gong exercises on patients' pulmonary function, exercise capacity, and quality of life after lobectomy].

The purpose of this study was to evaluate the effect of Tai-Chi-Qui-Gong (TCQG) practice on patients' pulmonary function, activity capacity, and quality of life after lobectomy. Subjects admitted at a chest surgical ward of a medical center in Taipei city were included voluntarily after signing informed consents. The first 20 subjects were assigned to the control group, and the next 20 were assigned to the experimental group. Subjects in the experimental group received a training class on 10 motions of TCQG two days before surgery. They began to practice the TCQG exercises twice per day from the first postoperative day. They started with three motions on the first day, increasing to 10 on the fifth day. The control group received standard post-lobectomy care, which did not include the TCQG exercises. All subjects received measures on pulmonary function and six-minutes walk distance (6MWD) two days prior to the operation, as well as one week, and one month after the operation. Quality of life was measured two days before the operation and one month after the operation. The major statistical procedures applied in data management included: Chi-square, two-way ANOVA, independent-T test, and repeated-measures ANOVA. The p value level of < .05 was used as the significant level. The results indicated that subjects in the experimental group had significant improvement in their tidal volume and 6MWD after lobectomy, while subjects in the control group did not. The 6MWD of the subjects in the experimental group reverted to the preoperative status at the end of the first week, and was even better one month later. The postoperative quality of life of the subjects in the experimental group was significantly better than that of in the control group. These findings indicate that 10 motions of TCQG exercise were effective in improving pulmonary function, activity capacity, and quality of life of patients after lobectomy.