[Application of Mindfulness-Based Health-Promotion Behavior in People With Chronic Diseases: SMILE Strategy].

Chronic diseases often impact the quality of life of the patient, causing complications and increased mortality and medical costs. The World Health Organization proposed applying mindfulness as an important strategy to help transform the situation faced by chronic disease cases and to promote their mental flexibility and adaptability. The author reviewed the related literature on mindfulness and introduces the "SMILE" strategy in this article. This strategy includes several stages, including 1) Starting where I am, 2) Motivating patients to become self-aware of the experience of self and internal and external environment interactions, 3) Developing individual health beliefs, 4) Learning mindfulness-based health-promotion behaviors, 5) Evaluating the efficacy of mindfulness-based health-promotion behaviors and self-regulation. SMILE is a powerful strategy with the potential to promote patient wellbeing, acceptance of the need to coexist with chronic disease, and freedom. Mindfulness is an abstract concept. This article provides a reference on mindfulness intervention for healthcare providers.

Establishing a model to assess the effects of school support and self-care behaviors on life satisfaction in adolescents with type 1 diabetes in Taiwan.

BACKGROUND: Life satisfaction is associated with positive development in adolescents. Understanding a path model of life satisfaction can help healthcare providers design interventions to improve positive development in adolescents with type 1 diabetes. PURPOSE: The aim of this study was to construct a model that assesses the effects of school support and self-care behaviors on life satisfaction in adolescents with type 1 diabetes in Taiwan. METHODS: This study used a cross-sectional design. One hundred and thirty-nine adolescents aged 10-18 years and diagnosed with type 1 diabetes were recruited. Participants completed questionnaires that assessed perceived school support, self-care behaviors, and life satisfaction. The hypothesized model was tested using structural equation modeling. RESULTS: School support significantly and directly affected self-care behaviors (ß = .46, p = .022) and life satisfaction (ß = .39, p = .034), self-care behaviors directly affected life satisfaction (ß = .56, p = .048), and school support indirectly affected life satisfaction (ß = .26, p = .015) through the mediation of self-care behaviors. The fix indices were as follows: χ2 = 8.141, df = 11, p = .701, goodness of fit index = .984, normed fit index = .949, and root mean square residual = .001. The model explained 66.1% of total life satisfaction variance. CONCLUSIONS: School support and self-care behaviors positively influence the life satisfaction of adolescents with type 1 diabetes. Improvements in school support and self-care behaviors are necessary to improve life satisfaction in this vulnerable group.

Depressive symptoms in Taiwanese women during the peri- and post-menopause years: associations with demographic, health, and psychosocial characteristics.

OBJECTIVE: The purpose of this study was to evaluate the prevalence of depressive symptoms in peri- and post-menopausal Taiwanese women, and to investigate the relation between depressive symptoms and demographic variables, chronic disease status, health habits, stress management, menopausal symptoms, and attitudes toward menopause and aging. STUDY DESIGN: Cross-sectional study, using a purposive sample of 566 women between 45 and 60 years of age from a medical center and residential community in Southern Taiwan. MAIN OUTCOME MEASURES: Demographic and health habits questionnaire, Women's Health Initiative Symptom Scale, Attitudes Toward Menopause and Aging Scale, and Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS: The prevalence of depressive symptoms (CES-D score≥16) was 38.7% in peri- and post-menopausal Taiwanese women. Bivariate correlations and analyses of variance indicated that higher CES-D scores were related to lower family income, younger age, smoking for a greater number of years, consuming more alcohol, having multiple chronic diseases, not exercising regularly, consulting with a specialist for stress management, having more severe menopausal symptoms, and more negative attitudes toward menopause and aging. A stepwise multiple regression analysis indicated that the key predictors, accounting for 33.7% of the variance, were menopausal symptoms, attitudes toward menopause and aging, family income, and chronic disease status. CONCLUSIONS: Results highlight the importance of considering psychosocial factors, life style, and chronic disease management in providing health guidance for peri- and post-menopausal women to enhance their quality of life and reduce the risk of depressive symptoms.

The relationship between selected developmental assets and health-promoting behaviours of adolescents in Southern Taiwan.

AIMS AND OBJECTIVES: To examine the relationship between selected developmental assets and health-promoting behaviours of adolescents. BACKGROUND: Developmental assets can be considered as potential health assets for adolescents. Understanding the relationship between developmental assets and health-promoting behaviours among adolescents could provide nurses with a new approach to design intervention programmes for adolescent health-promoting behaviours. DESIGN: A cross-sectional study design. METHODS: Anonymous questionnaires were administered to 453 adolescents aged between 13-16 years. Canonical correlation analysis was used to examine the relationship between selected developmental assets and health-promoting behaviours. RESULTS: Canonical correlation analysis indicated two significantly meaningful variate pairs between selected developmental assets and health-promoting behaviour sets. The first pair variate accounted for 51.3% of the total variance, which showed that adolescents who had better self-esteem, future aspirations, responsible choices, family communication, non-parental adult role models, peer role models and community involvement had better behaviours of life appreciation, health responsibility, social support, stress management, nutrition and exercise. The second pair variate accounted for 9.6% of the total variance, which showed that adolescents who had better responsible choices had better stress management behaviours. CONCLUSION: Developmental assets are important to adolescents' health-promoting behaviours. Interventions focusing on strengthening developmental assets can potentially provide an innovative approach for nurses to improve health-promoting behaviours of adolescents. RELEVANCE TO CLINICAL PRACTICE: Strengthening developmental assets can potentially improve the health-promoting behaviours of adolescents. Individual and sociopolitical domains should be incorporated into programmes for enhancement of developmental assets. School nurses can cooperate with family and community and provide environments improving adolescents' developmental assets. Nurses should actively engage in developmental asset programmes for adolescents. The tools for measuring developmental assets modified and developed in this study were valid and reliable. They can be used for further examination of the developmental assets for adolescents in various subset populations.

Diabetes Empowerment Process Scale: development and psychometric testing of the Chinese version.

AIM: This paper is a report of the development and psychometric testing of the Chinese version of the Diabetes Empowerment Process Scale. BACKGROUND: In people living with diabetes, empowerment can improve metabolic and psychosocial outcomes. A scale for measuring empowerment processes can also help healthcare professionals to optimize their empowering actions and would improve their interactions with people living with diabetes. METHOD: Based on literature reviews and interviews with people living with diabetes, a 27-item Chinese Diabetes Empowerment Process Scale was developed. Fifteen items were produced after item analysis and content validity testing. To test construct validity, concurrent validity and internal consistency, 211 outpatients living with diabetes completed the Chinese Diabetes Empowerment Process Scale, a Self-care Behaviour Scale and a Diabetes Empowerment Scale. Test-retest reliability was also analysed with 30 patients. The study was conducted in 2008 and 2009 in Taiwan. RESULTS: Confirmatory factor analysis indicated that a second-order factorial model with four subscales and 15 items best fitted the data. The four subscales were Mutual participation, Raising awareness, Providing necessary information and Open communication. Scores on the Chinese Diabetes Empowerment Process Scale correlated statistically significantly with those on the Self-care Behaviour Scale (r=0.21-0.40; P<0.01) and Diabetes Empowerment Scale (r=0.35-0.65; P<0.01). Reliability was supported by acceptable Cronbach's α (range: 0.73-0.91) and test-retest reliability scores (range: 0.75-0.83). CONCLUSION: The Chinese Diabetes Empowerment Process Scale has satisfactory validity and reliability for measuring the empowerment process of health professionals. Further studies are needed to test the applicability of the scale to other populations.

[Applying the transtheoretical model to tobacco prevention education in adolescence: a literature review].

The Transtheoretical Model (TTM) is a contemporary psychological model of behavioral change employed to develop efficient interventions to promote healthy behavioral changes. Interventions can be individualized to the needs of individuals in order to achieve optimal results. No integrated plan currently exists in Taiwan for reducing cigarette use among children. This article presents a systematic review of TTM, with the goal of constructing a model for protecting teenagers against tobacco-related health risks. Analysis results are hoped to be useful as a reference for developing systematic interventions aimed at reducing the health risks posed to teenagers by cigarette smoking.

[An experience using the transtheoretical model of health behavior change to promote exercise in a type 2 diabetes patient].

This case report shares our experience using the transtheoretical model of health behavior change to promote exercise in a type 2 diabetes patient. The patient was under our care from May through July 2006, during which time the patient was under regular observation and interviewed to collect data. A total of two outpatient consultations and five telephone interviews were conducted. An analysis of results showed the subject to be in the preparation stage of behavior change. To help move the subject into the action stage, the author promoted regular exercise through a variety of strategies, including self-reevaluation, self-change plan development, self-liberation, contingency management, social support search and environmental reevaluation. After nursing intervention, the subject maintained an exercise journal and arranged his own exercise plan. His exercise regimen gradually increased the frequency and intensity of exercise and further extended the scope of exercise to include regular exercise with family members. The author hopes that this case report may provide a reference for health professionals on the use of the transtheoretical model of health behavior change in the care of this type of patient.