Severity of Yin deficiency syndrome and autonomic nervous system function in cancer patients.

OBJECTIVE: To evaluate the distribution of symptoms related to Yin deficiency syndrome (YDS), and to analyze the relationship between the severity of YDS and the function of the autonomic nervous system (ANS) in cancer patients. SETTING: Outpatient clinic in a teaching hospital in central Taiwan. SUBJECTS: Eighty (80) patients had been diagnosed with cancer by pathologic and clinical findings. METHOD: The severity of YDS in each subject was evaluated by a questionnaire consisting of 12 items concerning symptoms and signs related to YDS, scored from 1 to 4 points. OUTCOME MEASURES: The total score for all 12 items represented the severity of YDS. ANS function in each subject was evaluated by measuring heart rate variability (HRV), including time-frequency analysis. We coded the collected questionnaire material and performed statistical analysis (description analysis, ANOVA, and Pearson's correlation coefficients) using SPSS v.12.0 software. RESULTS: The highest total YDS score was 36 points and the lowest was 10 points. The 3 most common YDS signs were dry mouth (58.8%), sleeplessness with annoyance (56.3%), and flush over face in the afternoon (22.5%). The total YDS scores had a significantly positive correlation with heart rate (HR), but had significantly negative correlation with the standard deviation of the 5-minute mean R-R intervals (SDANN), total HRV power, power in the very low frequency band, and in the low frequency band. CONCLUSIONS: The above results suggest that the severity of YDS in cancer patients was associated with increased HR and decreased ANS activity. There is a possibility that the disturbance of ANS function may contribute to the occurrence of YDS in cancer patients.

Use of folk remedies among families of children hospitalised in Taiwan.

AIMS: To describe the attitudes toward and the use of folk remedies among caregivers of children who were hospitalised in Taiwan. BACKGROUND: Parents incorporate folk remedies into the care of sick children in many cultures, including Taiwan. Twelve common folk remedies are commonly used in the Taiwanese culture for the care of sick children. DESIGN: The study employed a descriptive, exploratory design using survey methods. Participants were 92 caregivers (parents) whose children were hospitalised for at least three days in a hospital in the middle district of Taiwan. RESULTS: Sixty per cent of the participants used some form of folk remedies in the care of their hospitalised children. The most frequently used remedies were: spirit-calling (63%); carrying a cross or incense bag (47%), praying a Buddhist mantra (36%). There was a positive relationship between a positive attitude towards folk remedies and current use with children (p < 0.05). Logistic regression analysis revealed that parents' previous experience of using folk remedies (odds ratio = 0.272, p = 0.037), and parents' knowledge of the care of disease (odds ratio = 18.044, p = 0.015) were the strongest predictors of use of folk remedies. Almost three-fourths (73%) of all participants expected that health care providers would respect and not interfere with their use of folk remedies; 72% of parents stated that they would not tell healthcare providers about the use of folk remedies. CONCLUSIONS: The majority of the parents of hospitalised children in Taiwan can be expected to use folk remedies for the purpose of psychological and spiritual support during child hospitalised. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers need to be aware of the folk remedies used within various cultural groups so that culturally appropriate and safe care can be provided for the child and family.

The distribution of Yin-Deficient symptoms and their relationship on survival rate in cancer patients with Yin-Deficiency.

Yin-Deficiency (YD), representing a status of the human body under lack of nutrition and fluid in traditional Chinese medicine, is commonly seen in late stage of cancer patients. It is not known whether the severity of YD related symptoms/signs can predict the survival rate of cancer patients. This study evaluated the distribution of Yin-deficiency symptoms/signs (YDS) in cancer patients with YD, and investigated whether the severity of YDS can predict the survival rate of cancer patients with YD. From 5 January 2007 to 5 May 2007, we selected 43 cancer patients with diagnosis of YD from hospitalized patients and outpatients. The severity of YD was evaluated by a questionnaire. We further estimated the cumulative probabilities of the survival rates over 4 months since the start of study by the Kaplan-Meier product-limit method, and compared the differences among groups with various severities in each symptom/sign with the use of the log-rank test. The results revealed that, the 3 most common YDS were sleeplessness with annoyance, less or non-coated tongue with or without redness and dry mouth. In the survival rate analysis, only 2 parameters, rapidly small pulse (p = 0.002) and less-or non-coated tongue with paleness (p = 0.017), were found to be related to the decrease of cancer patients with YD. This suggests that, both rapidly small pulse and less-or non-coated tongue without redness may be used as predictors for the estimation of survival rate in cancer patients with YD.

The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

AIM AND OBJECTIVES: The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. DESIGN: Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. METHODS: Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. RESULTS: A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. CONCLUSION: In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. RELEVANCE TO CLINICAL PRACTICE: The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

Positive psychological measure: constructing and evaluating the reliability and validity of a Chinese Humor Scale applicable to professional nursing.

The nursing profession has generally accepted humor as beneficial to health care. As nursing has always emphasized holistic care and the importance of individual needs, the profession values the ability of humor to positively affect all aspects of a patient's well being. The purposes of this study were to develop a "Chinese Humor Scale (CHS)" for the nursing profession and then test its reliability and validity. The 405 individuals selected for participation in this study included nursing on-the-job students from a medical university and professional nurses practicing at four hospitals in north Taiwan. Researchers developed a list of 57 key humor measures which were filled out and returned by study participants. An evaluation of results using Cronbach's alpha coefficients demonstrated good consistency (alpha=.93) for the developed CHS. Intercorrelations amongst the four sub-scales were generally quite low, indicating each sub-scale measures dimensions relatively distinct from one another (r=.24 approximately .48, both p's<.001). The CHS was tested using item analysis. The scale was constructed in accordance with exploratory factor analysis (EFA) (K.M.O.=.92). Thirty CHS items, categorized under the four indices of "humorous creativity", "tendency to laugh", "perceptivity to humor", and "humorous attitude", were found to explain 55.42% of total variances. The CHS was found to provide good validity using a content validity index (CVI) developed by five experts. The results of this study provide encouraging evidence for the construct validity and reliability of the proposed humor scale and support its application by nursing educators and clinicians to further test and assess concepts related to humor. Further research is needed to explore more fully the implications of humor in nursing.

[Nursing in traditional Chinese medicine in Taiwan: policies and future development].

Traditional Chinese medicine is popular in Taiwan. There are more resources for the practice of the discipline, more regulations governing it, and more users of it in Taiwan than in other countries. Chinese medical teams have already developed in a systematic way in Taiwan. The roles of nursing staff in traditional Chinese medical teams become ever more important; the field is consolidating itself and maturing. The purpose of this paper is to describe the current status of nursing in traditional Chinese medicine in Taiwan and to make some proposals as to its future development.