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1.
Artigo em Inglês | MEDLINE | ID: mdl-38727819

RESUMO

Previous studies have shown that aerobic exercise has beneficial effects on executive function in adolescents with attention-deficit hyperactivity disorder (ADHD). The underlying mechanisms could be partially due to aerobic exercise-induced cortical excitability modulation. The aim of this study was to explore the effects of acute aerobic exercise on executive functions and cortical excitability and the association between these phenomena in adolescents with ADHD. The study was conducted using a complete crossover design. Executive functions (inhibitory control, working memory, and planning) and cortical excitability were assessed in twenty-four drug-naïve adolescents with ADHD before and after acute aerobic exercise or a control intervention. Inhibitory control, working memory, and planning improved after acute aerobic exercise in adolescents with ADHD. Moreover, cortical excitability monitored by transcranial magnetic stimulation (TMS) decreased after intervention in this population. Additionally, improvements in inhibitory control and working memory performance were associated with enhanced cortical inhibition. The findings provide indirect preliminary evidence for the assumption that changes in cortical excitability induced by aerobic exercise partially contribute to improvements in executive function in adolescents with ADHD.

2.
Hu Li Za Zhi ; 71(1): 60-71, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38253854

RESUMO

BACKGROUND: Women with gynecological cancers experience physical and mental distress due to their diagnosis, surgery, adjuvant chemotherapy, and radiotherapy, all of which have adverse physical, mental, social, and spiritual impacts on their quality of life. PURPOSE: This study was designed to examine the correlations among symptom distress, social support, spiritual well-being, and quality of life as well as the predictors of quality of life in women with gynecological cancers. METHODS: This was a cross-sectional correlational study. A total of 91 women with gynecologic cancer were recruited from a medical center in central Taiwan. A demographic characteristics questionnaire, the World Health Organization Quality of Life Brief Questionnaire Taiwanese version, the Chinese Modified Symptom Distress Scale, the Chinese Simplified Social Support Scale, and the Spiritual Well-Being Scale were used for data collection. Correlation and multiple regression analyses were performed on the data. RESULTS: Symptom distress was found to correlate negatively with spiritual well-being as well as with the physical health, psychological health, and environmental health domains of quality of life. Social support and spiritual well-being were found to correlate positively with all four domains of quality of life. Social support was identified as the main predictor of quality of life. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Symptom distress, social support, and spiritual well-being should be incorporated into nursing education to improve medical staff awareness of these issues and promote the timely evaluation of patient needs. Moreover, medical staff should provide appropriate social and spiritual support and multi-disciplinary care as well as make referrals when necessary to related support groups to improve clinical care quality to enhance patient quality of life.


Assuntos
Neoplasias dos Genitais Femininos , Qualidade de Vida , Feminino , Humanos , Estudos Transversais , Apoio Social , Saúde Ambiental
3.
Semin Dial ; 36(6): 454-461, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36726291

RESUMO

INTRODUCTION: Arteriovenous fistula or arteriovenous graft is essential to long-term survival and quality of life in patients receiving hemodialysis. To date, no research has examined the clinical impacts of different puncture methods. This study compared the rope ladder and area puncture techniques in terms of vascular patency, pain, and quality of life among patients receiving hemodialysis. METHODS: A prospective longitudinal study was performed with 6-month follow-up. A total of 98 participants recruited from a hemodialysis center in Taiwan were randomly assigned to receive the rope ladder technique (experimental group) or the area puncture technique (control group). Vascular patency was assessed by examining access flow and percutaneous transluminal angioplasty rate. Pain and quality of life were measured using the Numerical Pain Rating Scale (NPRS) and Kidney Disease Quality of Life Instrument (KDQOL-36™), respectively. All outcome variables were measured repeatedly and analyzed using a generalized estimating equation. RESULTS: Overall, quality of life was significantly better for the experimental group than for the control group (ß = 47.23, p < 0.001). The percutaneous transluminal angioplasty rate was lower for the experimental group than for the control group (12.0% vs. 18.8%). However, no significant differences were found in access flow and pain level between the two groups over time. CONCLUSION: Hemodialysis patients who received the rope ladder puncture technique had a lower percutaneous angioplasty rate and better quality of life than patients who received the area puncture technique, suggesting that the rope ladder technique could be implemented as a routine cannulation method in hemodialysis clinics.


Assuntos
Derivação Arteriovenosa Cirúrgica , Diálise Renal , Humanos , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Qualidade de Vida , Estudos Longitudinais , Estudos Prospectivos , Grau de Desobstrução Vascular , Punções , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/métodos , Dor , Resultado do Tratamento , Oclusão de Enxerto Vascular
4.
Eur J Oncol Nurs ; 55: 102060, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34763206

RESUMO

PURPOSE: This study aims to explore the level of stress perceived and quality of life (QOL) by gynaecologic cancer (GC) patients and family caregivers' dyads. METHODS: In this cross-sectional study, 86 dyads were recruited from the gynaecological oncology department of a general hospital in Taichung City, Taiwan. The patients and family caregivers completed a sociodemographic information sheet, the Perceived Stress Scale, and the Taiwanese version of World Health Organization Quality of Life-BREF questionnaire. Data were analysed using descriptive statistics and Pearson's correlations. This study used the actor-partner interdependence model (APIM) with distinguishable dyads to examine the effect of patients' and caregivers' perceived stress on QOL in patient-caregiver dyads. RESULTS: GC patients' and caregivers' level of QOL was influenced by their own stress level (actor effect). Caregivers' stress was statistically negatively associated with the patients' QOL (partner effect); however, there were no partner effect from GC patients to caregivers. Both patients and family caregivers with higher perceived stress had poorer QOL. Therefore, we identified that stress has some level of actor and partner effects on QOL in GC patient-family caregiver dyads. CONCLUSIONS: Family caregivers' stress displayed both actor and partner effects within the first year of the cancer diagnosis; therefore, patient-and caregiver-based interventions, such as stress reduction strategies, should be developed to enhance patients' and caregivers' QOL and stress management ability.


Assuntos
Cuidadores , Neoplasias dos Genitais Femininos , Estudos Transversais , Feminino , Humanos , Qualidade de Vida , Estresse Psicológico
5.
Nurse Educ Today ; 95: 104579, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33059277

RESUMO

BACKGROUND: Clinical teaching is the most important element in the development of students' nursing competencies. However, students' learning modalities in clinical settings are unclear. OBJECTIVE: To analyse path relationships affecting students' learning outcomes in clinical practicum using LISREL software. DESIGN: A cross-sectional survey was administered. SETTINGS AND PARTICIPANTS: Participants were 392 senior students who had completed their final internship recruited from two nursing programmes in central Taiwan. METHODS: Administration and completion of the following structured questionnaires: the Competency Inventory of Nursing Students, the Teaching Competence of Nurse Preceptor questionnaire, the Student Evaluation of the Clinical Education Environment, Level of Reflective Thinking, and the Metacognitive Inventory for Nursing Students. RESULTS: The results suggested that teaching competence may indirectly affect nursing competence through metacognition and reflection. The clinical learning environment may directly affect nursing competence or indirectly affect nursing competence through metacognition. Both metacognition and reflection have direct effects on nursing competence, and reflection exerts indirect effects on nursing competence through metacognition. The path relationships differed according to the employment plan group. CONCLUSIONS: Reflection and metacognition are essential skills for the development of nursing competence in clinical settings. Clinical instructors must facilitate student learning by fostering a positive learning environment and teach students the reflective and self-regulation skills necessary to achieve favourable learning outcomes in clinical settings.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Competência Clínica , Estudos Transversais , Humanos , Análise de Classes Latentes , Preceptoria , Inquéritos e Questionários , Taiwan
6.
Zhongguo Zhong Yao Za Zhi ; 45(6): 1342-1349, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32281346

RESUMO

The molecular markers(cpSSR, cpSNP and cpIndel) were developed based on the whole genome sequence of Panax notoginseng chloroplast genome, which provide a powerful tool for the evaluation and analysis of the future P. notoginseng germplasm resources. The 89 P. notoginseng samples from 9 groups were used for the experiment, and the data for the study were derived from NCBI and the GenBank numbers were: KJ566590, KP036468, KR021381 and KT001509. Through sequence alignment, 30 polymorphic sites(SNP and Indel) were identified, including 16 cpSNP and 14 cpIndel; cpSNP and cpIndel accounted for far more than the gene region in the intergenic region. The developed cpSSR reached 87-89, the repeat unit was mainly composed of trinucleotide, accounting for 70%-71%, and the dinucleotide was the least, accounting for 7%. Eighteen cpDNA molecular markers were developed, including 7 cpSSR primers, 6 cpIndel primers, and 5 cpSNP primers. The MatK gene and ycf1 primers were chosen as control. According to the results of DNA gel electrophoresis, cpSSR-5, pgcpir019 and pncp08 can be used to distinguish different cultivated populations of P. notoginseng. Among them, cpSSR-5 and pgcpir019 can also be used to distinguish the inter-species resources of ginseng by comprehensive sequence length, population π value and average nucleotide difference. However, pncp08 can only be used to distinguish different populations of P. notoginseng. In addition, the effect of distinguishing the groups of P. notoginseng, which the primer pncp-M(based on the MatK gene) is weaker than the cpSSR-5, pgcpir019 and pncp08.


Assuntos
DNA de Cloroplastos/genética , Mutação INDEL , Panax notoginseng/genética , Polimorfismo de Nucleotídeo Único , Marcadores Genéticos , Genética Populacional , Alinhamento de Sequência
8.
Omega (Westport) ; 80(4): 648-665, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29378478

RESUMO

This study investigates the subjective experiences of terminal cancer patients who expedite their corneal donation decisions. The percentage of cancer patients who donate their corneas postmortem is low in Taiwan. The reasons are complex and needs further exploration. A qualitative design using content analysis was used. A semistructured interview approach was adopted to interview cancer patients recruited from a cancer ward in northern Taiwan. The study findings show that the factors contributing to an aversive preference of cancer patients included the necessity to consider the emotions of family members, traditional perceptions, religious reasons, disease, and no reason at all. Most cancer patients maintain a negative stance toward corneal donation. The results obtained in the present study can be used as a reference for future in-service education and promotional efforts regarding corneal donation. Discussing cornea donation needs to become a routine end-of-life care discussion.


Assuntos
Córnea , Tomada de Decisões , Neoplasias/psicologia , Obtenção de Tecidos e Órgãos , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade
9.
Gastroenterol Nurs ; 41(6): 491-496, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30489406

RESUMO

The multidisciplinary team (MDT) model involves multiple medical professionals providing integrated medical care. Colorectal cancer (CRC) has the highest prevalence of cancer in Taiwan. This study examines and evaluates the survival rates of CRC patients treated under the MDT model. In this retrospective and prospective study, 651 CRC patients were recruited. They were divided into 2 groups: the MDT group and the traditional care (TC) group. The MDT group comprised 326 patients who received care from a MDT. The TC group comprised 325 patients who received care from a TC. The outcome variables were survival rates, follow-up appointment compliance, and 14-day readmission rates. Adopting the MDT model for CRC care increased patient follow-up appointment compliance rates at the first week, first month, and third month (p = .032, p = .007, p = .001, respectively). The model also effectively reduced patients' 14-day readmission rates. The results indicated that the survival rates of the MDT care were superior to those of TC. The adoption of the MDT model to treat CRC effectively enhanced clinical treatment adherence, increased survival rates, and reduced the 14-day readmission rate.


Assuntos
Neoplasias Colorretais/terapia , Prestação Integrada de Cuidados de Saúde/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida , Taiwan
10.
Cancer Nurs ; 41(6): E11-E18, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28753193

RESUMO

BACKGROUND: Males and females have significant differences in certain medical outcomes. However, little research has explored the gender differences in cancer patient perceptions of analgesics, the relationship between gender and analgesic adherence, or the effectiveness of pain management. OBJECTIVE: The objectives of this study were to compare gender differences associated with hesitancy to use analgesics, analgesic adherence, or pain management effectiveness and to examine whether gender can precisely predict analgesic adherence. METHODS: The study was conducted in the outpatient oncology department of a medical center in Taiwan. A descriptive and cross-sectional design was used. The study samples were collected from 362 cancer patients. The participants completed the short version of the Barriers Questionnaire-Taiwan, the Morisky Analgesics Adherence Measure-Taiwan version, the Brief Pain Inventory-Chinese version, the Pain Management Index, and a demographic and disease questionnaire. RESULTS: The pain intensity and hesitancy to use analgesics scores were significantly higher among females than among males. The Pain Management Index results indicated that a larger percentage of males had adequate pain management. In addition, being male was a significant predictor of higher analgesic adherence (odds ratio, 1.93; P < .05). CONCLUSIONS: Gender could precisely predict cancer patients' medication adherence. Women experienced significantly greater pain than did men but also had more hesitancy to use analgesics, lower adherence, and inadequate pain management. IMPLICATIONS FOR PRACTICE: Healthcare professionals should consider women as a high-risk group for inadequate pain control. It is crucial for health providers to consider the gender discrepancy when attempting to improve cancer pain management.


Assuntos
Analgésicos/uso terapêutico , Dor do Câncer/tratamento farmacológico , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Manejo da Dor/métodos , Manejo da Dor/psicologia , Medição da Dor/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pacientes Ambulatoriais , Fatores Sexuais , Inquéritos e Questionários , Taiwan
11.
Support Care Cancer ; 26(3): 989-996, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29019055

RESUMO

PURPOSE: Limited research has focused on women with lung cancer (LC) although they are recognized as the most vulnerable to psychological distress. This study explored in-depth the psychological distress experienced by women with incurable LC and analyzed the coping strategies with which they manage that distress. METHODS: A qualitative methodology with in-depth interviews was employed for 34 women with advanced or recurrent LC. An inductive data-driven thematic analysis was applied to analyze transcripts. RESULTS: Psychological distress was an iterative process for the women. Four themes were identified: shock regarding the diagnosis, distress regarding cancer treatment and its side effects, the facing of a recurrent or progressive disease, and persistent struggle with the life-limiting disease. Various coping strategies applied by the women to manage psychological distress were grouped into four themes: relying upon social support, focusing on positive thoughts, avoidance-based strategies, and religious faith and acceptance. CONCLUSIONS: Women with incurable LC experienced substantial iterative psychological distress throughout the illness, regardless of length of illness at time of interview. They applied multiple forms of coping. The findings enrich the limited existing literature on this understudied population and provide direction for the future development of interventions to improve their psychological well-being.


Assuntos
Neoplasias Pulmonares/psicologia , Apoio Social , Estresse Psicológico/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa
12.
Int J Qual Health Care ; 29(7): 935-940, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29087488

RESUMO

OBJECTIVES: Patient satisfaction can provide a measure of service quality and serve as a predictor of health-related behaviors. Little is known about how patients' satisfaction with clinician-patient interactions affects their adherence to taking analgesics. The purposes of this study were to (1) investigate the predictors of patients' satisfaction with clinicians, and (2) examine whether patients' satisfaction with their clinicians can improve adherence to analgesic use. DESIGN: A cross-sectional and descriptive design was used. SETTING: Outpatient oncology clinic at a medical center in Taiwan. PARTICIPANTS: A convenience sample (N = 309) was recruited. MAIN OUTCOME MEASURES: The Medical Interview Satisfaction Scale 21 - Chinese Version, Short Version of the Barriers Questionnaire - Taiwan Form, Taiwanese version of the Morisky Medication Adherence Measure, and Interpersonal Physician Trust Scale - Chinese version, and Brief Pain Inventory Chinese Version. RESULTS: Variables that could significantly predict patients' satisfaction were patient age and trust in clinicians, which together accounted for 33% of the total variance. Patients' satisfaction with their clinicians significantly predicted patients' adherence to medication use (OR = 3.10, P < 0.05). There was an interactive effect (OR = 0.12, P < 0.05) between patients' satisfaction and barriers to analgesic use. Correlation coefficients between barriers to analgesic use and patients' adherence are -0.52 (P < 0.001) and -0.13 (P = 0.20) in the higher satisfaction and lower satisfaction patients, respectively. CONCLUSIONS: Patients' satisfaction with their clinicians can have a positive effect on changing analgesics adherence behaviors when patients hold incorrect beliefs about analgesics. Patients' satisfaction has an important role in enhancement of analgesics adherence behaviors.


Assuntos
Analgésicos/uso terapêutico , Adesão à Medicação/psicologia , Neoplasias/tratamento farmacológico , Satisfação do Paciente , Relações Médico-Paciente , Idoso , Dor Crônica/tratamento farmacológico , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Taiwan
13.
J Clin Nurs ; 26(23-24): 3784-3799, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28042919

RESUMO

AIMS AND OBJECTIVES: To synthesise concepts of distinct depressive-symptom trajectories in published studies by establishing a measurable standard and estimate the prevalence of recategorised trajectories for bereaved families of chronically ill patients. BACKGROUND: Grieving is a dynamic/individualised process. In studies treating depressive-symptom trajectories as heterogeneous, different criteria were used to identify distinct trajectories, resulting in inconsistent findings. DESIGN: A systematic review of research guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. METHODS: Five databases were systematically searched since each one's launch through June 2015. Two reviewers independently extracted data and assessed study quality using the qualsyst evaluation tool. Distinct depressive-symptom trajectories were narratively synthesised based on depressive-symptom level, duration and improvement over time. The prevalence of recategorised depressive-symptom trajectories was recalculated from published data. RESULTS: We identified six studies, published in 1994-2012, that followed 56-301 bereaved families from eight months to five years. We synthesised five new distinct trajectories (prevalence in synthesised sample): 'endurance' (54·2%), 'resilience' (8·8%), 'transient reaction' (7·7%), 'chronic grief' (19·4%) and 'chronic depression' (9·9%). The 'endurance' group experienced low depressive symptoms throughout the bereavement process. The 'resilience' group had severe depressive symptoms when they first transitioned into bereavement, but quickly recovered. The 'transient reaction' group's distress lasted 7-12 months postbereavement, gradually returning to prebereavement levels. After bereavement, the chronic grief and depression groups experienced prolonged periods of depressive symptoms, which improved gradually only in the 'chronic grief' group. CONCLUSIONS: Most bereaved families endured their grief and adjusted, returning to prebereavement depressive-symptom levels within one year postloss (represented by our synthesised 'endurance', 'resilience' and 'transient reaction' groups), with only 9·9% suffering 'chronic depression'. RELEVANCE TO CLINICAL PRACTICE: Guided by the synthesised distinct trajectories of depressive symptoms, clinicians should identify bereaved families' depressive-symptom trajectories and provide suitable interventions to facilitate adjustment of those with chronic depressive symptoms.


Assuntos
Doença Crônica , Depressão/epidemiologia , Progressão da Doença , Família/psicologia , Pesar , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Pesquisa Qualitativa , Resiliência Psicológica , Fatores de Tempo
14.
Nan Fang Yi Ke Da Xue Xue Bao ; 37(1): 138-140, 2017 01 20.
Artigo em Chinês | MEDLINE | ID: mdl-28109115

RESUMO

Invasion and metastasis are key factors contributing to the high mortality rate of patients with hepatocellular carcinoma (HCC) involving a complex mechanism. In the invasion and metastasis of HCC, miRNAs can serve as either oncogenes or tumor suppressor genes to regulate the differentiation and proliferation of tumor cells being and play important roles in tumorigenesis, angiogenesis, invasion and metastasis. This review summarizes the recent progress in research of the molecular mechanisms by which miRNAs targeting GSK-3ß regulate HCC invasion and metastasis and examines the roles of miRNAs in hepatocellular carcinoma cell proliferation, apoptosis, invasion, metastasis, and GSK-3ß regulation.


Assuntos
Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/secundário , Neoplasias Hepáticas/patologia , MicroRNAs/fisiologia , Neovascularização Patológica/metabolismo , Carcinoma Hepatocelular/irrigação sanguínea , Diferenciação Celular/genética , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica , Glicogênio Sintase Quinase 3 beta , Humanos , Neoplasias Hepáticas/irrigação sanguínea , MicroRNAs/genética , Invasividade Neoplásica , Neovascularização Patológica/genética
15.
Cancer Nurs ; 39(5): 383-92, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26378400

RESUMO

BACKGROUND: The relationships among napping and sleep quality, fatigue, and quality of life (QOL) in cancer patients are not clearly understood. OBJECTIVE: The aim of the study was to determine whether daytime napping is associated with nighttime sleep, fatigue, and QOL in cancer patients. METHODS: In total, 187 cancer patients were recruited. Daytime napping, nighttime self-reported sleep, fatigue, and QOL were assessed using a questionnaire. Objective sleep parameters were collected using a wrist actigraph. RESULTS: According to waking-after-sleep-onset measurements, patients who napped during the day experienced poorer nighttime sleep than did patients who did not (t = -2.44, P = .02). Daytime napping duration was significantly negatively correlated with QOL. Patients who napped after 4 PM had poorer sleep quality (t = -1.93, P = .05) and a poorer Short-Form Health Survey mental component score (t = 2.06, P = .04) than did patients who did not. Fatigue, daytime napping duration, and sleep quality were significant predictors of the mental component score and physical component score, accounting for 45.7% and 39.3% of the variance, respectively. CONCLUSIONS: Daytime napping duration was negatively associated with QOL. Napping should be avoided after 4 PM. IMPLICATIONS FOR PRACTICE: Daytime napping affects the QOL of cancer patients. Future research can determine the role of napping in the sleep hygiene of cancer patients.


Assuntos
Fadiga/psicologia , Neoplasias/complicações , Qualidade de Vida/psicologia , Sono , Fatores de Tempo , Adulto , Idoso , Estudos Transversais , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Autorrelato , Inquéritos e Questionários
16.
Hu Li Za Zhi ; 61(6): 93-7, 2014 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-25464961

RESUMO

Providing spiritual care to patients with advanced cancer may improve the quality of life of these patients and help them experience a good death. Cancer patients are eager for additional spiritual care and for a sense of peace at the end of their life. However, spirituality is an abstract concept. The literature on spiritual care focuses primarily on elaborations of spirituality theory. Thus, first-line medical care professionals lack clear guidelines for managing the spiritual needs of terminal cancer patients. The purposes of this article were to: 1) introduce a spiritual care model based on the concept of repair and recovery of relationships that addresses the relationship between the self and God, others, id, and objects and 2) set out a four-step strategy for this model that consists of understanding, empathizing, guiding, and growing. This article provides operational guidelines for the spiritual care of terminal cancer patients.


Assuntos
Neoplasias/terapia , Espiritualidade , Assistência Terminal , Humanos
17.
Asian Pac J Cancer Prev ; 15(14): 5835-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25081710

RESUMO

BACKGROUND: Gastric cancer is one of the most common causes of cancer death in Taiwan. The literature has previously shown that age, tumor site, T categories, and number of metastatic nodes significantly affect prognosis. The aim of this study was to determine the long-term survival of patients with gastric cancer, as well as the effect of particular prognostic factors on survival. MATERIALS AND METHODS: This was a survival analysis study with retrospective design. We reviewed the records of 64 patients with adenocarcinoma of the stomach who had undergone gastrectomy with curative intent between 2009 and 2012 at a teaching hospital in southern Taiwan. Data extracted from patient documents included age, gender distribution, tumor location, and pathological grading. RESULTS: The median follow-up time was 4 years, and there were 31 deaths attributed to gastric cancer. Kaplan-Meier analysis revealed that retrieval of less than 15 lymph nodes from a patient was a significant predictor of survival. A significant predictor of poorer survival was higher pathological grading. CONCLUSIONS: Our results indicate that the number of lymph nodes retrieved and pathological grading could be viewed as crucial prognostic factors affecting the survival of individuals with gastric cancer.


Assuntos
Metástase Linfática/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Estômago/patologia , Estômago/cirurgia , Neoplasias Gástricas/cirurgia , Análise de Sobrevida , Taiwan
18.
Asian Pac J Cancer Prev ; 15(2): 969-73, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24568527

RESUMO

BACKGROUND: The number of colorectal cancer (CRC) patients in Taiwan has increased in recent years; therefore, the effective dissemination of information related to symptom care has become especially important. Previous studies indicated that the physical and psychological status of cancer patients can be effectively improved by telephone counseling services (TCS). Thus, determining the most effective means of establishing a TCS to support the clinical practice of oncology has become a crucial goal for nursing. The purposes of this study were to analysis the content of the TCS for CRC and explore stratification of the TCS. MATERIALS AND METHODS: The study design was retrospective. A total of 850 calls were made to CRC patients in the cancer center of Southern Taiwan during the period of January 2007- December 2011. A structure questionnaire was adopted to analysis satisfaction. RESULTS: Responses provided by the TCS included information regarding nutrition, side effects resulting from chemotherapy and pain. Moreover, 28.7% of CRC patients needed advanced treatment. More than 90% satisfaction with all aspects of the calls was found. CONCLUSIONS: The TCS coulkd be shown to provide an effective means by which to expand the reach of nursing care to different times, places and patients, allowing for greater cost efficiency and more rapid service.


Assuntos
Neoplasias Colorretais/terapia , Aconselhamento/métodos , Necessidades e Demandas de Serviços de Saúde , Assistência Centrada no Paciente/métodos , Telefone , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Inquéritos e Questionários , Taiwan
19.
Cancer Nurs ; 37(5): 382-90, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24201313

RESUMO

BACKGROUND: Light is an important cue for the entrainment of circadian rhythms, which can be related to sleep quality, fatigue, and depression in cancer patients. OBJECTIVES: The purpose of this study was to determine the effects of light exposure on sleep quality, fatigue, and depression in cancer patients, to test whether the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. METHODS: This was a cross-sectional study for which we recruited 163 cancer outpatients. For 3 consecutive days, they wore an Actiwatch to measure light exposure. Instruments included the Pittsburgh Sleep Quality Index-Taiwan form, the Brief Fatigue Inventory-Taiwan form, and the Beck Depression Inventory II-Taiwan version. RESULTS: The results indicated that the Pittsburgh Sleep Quality Index-Taiwan form score was significantly and negatively correlated with minutes of light exposure (MLE) of 1000 lux or greater (r = -0.61, P < .001) and the intensity of light exposure under activity (r = -0.59, P < .001). Fatigue was negatively correlated with MLE (r = -0.18, P = .03). Depression was also negatively correlated with MLE and intensity of light exposure (both r = -0.18, P = .02). Most important, the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. CONCLUSION: Light exposure appeared to be a shared factor for the co-occurrence of fatigue, sleep disturbances, and depression. IMPLICATIONS FOR PRACTICE: Light exposure has great potential for improving sleep quality as well as ameliorating fatigue and depression in cancer outpatients.


Assuntos
Depressão/etiologia , Fadiga/etiologia , Neoplasias/terapia , Fotoperíodo , Actigrafia/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Depressão/diagnóstico , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/enfermagem , Pacientes Ambulatoriais/psicologia , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Sono/fisiologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários
20.
Support Care Cancer ; 21(9): 2593-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23653012

RESUMO

PURPOSE: Discussing end-of-life care with patients is often considered taboo, and signing a do-not-resuscitate (DNR) order is difficult for most patients, especially in Chinese culture. This study investigated distributions and details related to the signing of DNR orders, as well as the completeness of various DNR order forms. METHODS: Retrospective chart reviews were performed. We screened all charts from a teaching hospital in Taiwan for patients who died of cancer during the period from January 2010 to December 2011. A total of 829 patient records were included in the analysis. The details of the DNR order forms were recorded. RESULTS: The DNR order signing rate was 99.8%. The percentage of DNR orders signed by patients themselves (DNR-P) was 22.6%, while the percentage of orders signed by surrogates (DNR-S) was 77.2%. The percentage of signed DNR forms that were completely filled out was 78.4%. The percentage of DNR-S forms that were completed was 81.7%, while the percentage of DNR-P forms that were completely filled out was only 67.6%. CONCLUSION: Almost all the cancer patients had a signed DNR order, but for the majority of them, the order was signed by a surrogate. Negative attitudes of discussing death from medical professionals and/or the family members of patients may account for the higher number of signed DNR-S orders than DNR-P orders. Moreover, early obtainment of signed DNR orders should be sought, as getting the orders earlier could promote the quality of end-of-life care, especially in non-oncology wards.


Assuntos
Povo Asiático/psicologia , Família/psicologia , Neoplasias/etnologia , Neoplasias/mortalidade , Ordens quanto à Conduta (Ética Médica)/psicologia , Idoso , Idoso de 80 Anos ou mais , Povo Asiático/etnologia , Comunicação , Família/etnologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Prontuários Médicos/normas , Pessoa de Meia-Idade , Cuidados Paliativos/psicologia , Estudos Retrospectivos , Taiwan/epidemiologia
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