Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial.

OBJECTIVE: To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). DESIGN: A randomised controlled trial with four repeated measurements. SETTING: Outpatient departments of a medical centre in northern Taiwan. PARTICIPANTS: Patients with mild to severe COPD. INTERVENTION: The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice. OUTCOME MEASURES: The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors. RESULTS: Compared with the control group (n = 40), the mindful walking group (n = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m; P = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 (P = 0.01), Week 8 (P = 0.002) and Week 12 (P = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D (P = 0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance (P = 0.02). CONCLUSION: The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.

Nurses' Attitudes Toward Electronic Clinical Quality Measures: A Descriptive Study.

BACKGROUND: Electronic clinical quality measures (eCQMs) are a method that automatically extract data from electronic health records (EHRs) and compute and generate the results to report and track the quality of care and patient outcomes. PURPOSE: The purpose of this study was to explore nurses' attitudes toward eCQMs and the factors influencing this attitude. METHODS: A descriptive cross-sectional study was conducted using a closed-ended questions survey of 92 nurses in a teaching hospital. RESULTS: The average score for nurses' attitudes toward eCQMs was 3.47 out of 4. Participants with a master's degree had more positive attitudes than those with a baccalaureate degree. Head nurses had more positive attitudes than staff nurses. CONCLUSIONS: The nurses in the study hospital have a positive attitude toward eCQMs. Health care organizations should strengthen the attitudes of nurses toward eCQMs.

Two-month breathing-based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: A randomised controlled study.

AIMS AND OBJECTIVES: To examine the effects of the two-month breathing-based walking intervention and its follow-up on anxiety, depression, dyspnoea and quality of life in patients with chronic obstructive pulmonary disease. BACKGROUND: Mind-body-related exercises improve bio-psychological symptoms and quality of life in chronic diseases, but these improvements are not proven for chronic obstructive pulmonary disease. DESIGN: This was a randomised controlled study and applied the Consolidated Standards of Reporting Trials (CONSORT) statement. METHODS: Outpatients diagnosed with chronic obstructive pulmonary disease were recruited from a medical centre in Taiwan and randomly assigned to two groups. The walking group (n = 42) received breathing, meditation and walking for two months, and the control group (n = 42) did not. Data from the outcomes of anxiety, depression, dyspnoea and quality of life were collected at baseline and in Month 1, Month 2 and Month 3. Clinical trial registration was done (ClinicalTrials.gov.: NCT03388489). FINDINGS: The results showed significant changes in anxiety, depression, dyspnoea and quality of life in the walking group across three months, compared to those in the control group and at baseline. CONCLUSION: This breathing-based walking intervention is promising to achieve bio-psychological well-being for patients with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: This breathing-based walking, as a mind-body exercise, could serve as an evidence-based nursing care that contributes to improving anxiety, depression, dyspnoea and quality of life in stable chronic obstructive pulmonary disease outpatients. The feasibility and acceptability of the breathing-based walking were met the requirement of the chronic obstructive pulmonary disease outpatients, which could be considered as home-based exercise.

Translation and Psychometric Testing of the Chinese Version of the Multidimensional Assessment of Interoceptive Awareness.

BACKGROUND: Mind-body interventions are used to alleviate physical and psychological symptoms. The multidimensional assessment of interoceptive awareness (MAIA), which is used to self-report the effects of mind-body interventions, is not currently available in Chinese. PURPOSE: This study aimed to translate the MAIA from English into Chinese (MAIA-C) and to examine the psychometric properties of the MAIA-C. METHODS: This was a methodological study. The MAIA was translated forward and backward systematically, and content validity was assessed by a panel of experts. A convenience sample of adult participants with mind-body practice was recruited from social clubs in Taiwan. The MAIA-C was administered to study participants. Internal consistency and test-retest reliability were tested using Cronbach's alpha and intraclass correlation coefficient. Construct validity was assessed in two ways: using confirmatory factor analysis and using the differences between the known groups to divide the sample into two groups of highly experienced and less experienced participants. RESULTS: The complete data for the 294 participants were analyzed. The eight-factor structure of the MAIA-C was confirmed. Cronbach's α was .91 overall and .46-.88 for the individual scales of the instrument. Intraclass correlation coefficient and composite reliability for the scales ranged from .60 to .85 and .55 to .87, respectively. The result of confirmatory factor analysis revealed a fair fit of the model to the data with a root mean square error of approximation of .076 and a comparative fit index of .95. Significant differences were found for the seven scales between the two groups. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The MAIA-C showed acceptable reliability and validity in psychometric testing. Therefore, this scale may be used in studies that assess interoceptive awareness in Chinese-speaking populations who are undergoing mind-body interventions.

[The nursing experience of a patient with parkinsonian type of multiple system atrophy].

This article describes the nursing experience of a patient with multiple system atrophy-parkinsonian type (MSA-P). The writer collected subjective and objective information using observation, interviews, and nursing care during the time period May 22 to June 3, 2006. A holistic nursing assessment and nursing problems were established as body image disturbance, risk for aspiration, constipation and family support, self-care deficit and risk for fall. Through individual nursing intervention and family support, the patient accommodated himself to the physical activities and mental situation. We hope that this complete nursing experience can in future serve as a reference for other nurses in the MSA-P field as they assist similar patients.