Change Trajectory of Symptom Distress, Coping Strategies, and Spiritual Wellbeing in Colorectal Cancer Patients Undergoing Chemotherapy.

Impacts caused by cancer and associated treatment may change with time. The objective of this study is to examine the change trajectory of symptom distress, coping strategies, and spiritual wellbeing in colorectal cancer patients during chemotherapy and to further examine the predictors of spiritual wellbeing. A prospective longitudinal repeated measures study design was employed. A total of 97 patients undergoing chemotherapy for the first time were enrolled. A structured questionnaire was used to collect data at three timepoints, which were before chemotherapy (T0), during chemotherapy (T1: 3 months after T0), and after chemotherapy (T2: 6 months after T0). The results of this study show that patients have significantly lower spiritual wellbeing and significantly higher symptom distress during chemotherapy treatment (T1). Family support (B = 0.39, p = 0.007) and problem-focused coping strategies (B = 0.47, p = 0.001) are significant predictors of spiritual wellbeing before chemotherapy (T0). Symptom distress (B = -0.18, p = 0.048) and problem-focused coping strategies (B = 0.26, p = 0.028) are significant predictors of spiritual wellbeing during chemotherapy (T1). The results provide care recommendations for different stages of chemotherapy to help to achieve more precise patient care and improve care quality.

Relationships between health literacy and quality of life among survivors with breast cancer.

PURPOSE: During the survival period of breast cancer patients, an understanding of and ability to implement health knowledge may be important for survivors' physical and mental quality of life (QOL). This study aims to investigate the health literacy and predictors of QOL for survivors of breast cancer. METHOD: A cross-sectional design was used, and convenience sampling was performed. Eighty-six survivors with breast cancer were recruited from a general hospital in northern Taiwan from February to August 2017. Taiwan's health literacy scale and SF-12 questionnaire were used for data collection. RESULTS: The average health literacy score was 3.28. Education level and breast cancer stage were significant factors for the health literacy of survivors with breast cancer. Age, body mass index and health literacy were predictors of physical health-related QOL. Health literacy also was a predictor of mental health-related QOL. CONCLUSION: The results provide the factors associated health literacy as well as health-related QOL. Nurses should understand the health literacy among survivors with breast cancer and improve health literacy to optimize their quality of life.

Guillain-Barré syndrome in a heart transplantation recipient.

ABSTRACT: A rare case of a heart transplantation recipient with Guillain-Barré syndrome occurred, which was associated with peripheral nervous system damage. Based on a review of epidemiological research, the symptom development process, and diagnostic tools, the authors highlight the extreme rarity of this postinfectious immune disease. After diagnosis, plasma exchange and immunoregulatory therapy should be performed because they result in rapid recovery. If there is delayed diagnosis and treatment, there is a high risk of disability or death. When patients experience acute limb paralysis as the main symptom, nurse practitioners (NPs) should focus on the patient's history, particularly with regard to infectious agents. Closely monitoring the patient to detect respiratory failure and the need for early respiratory intervention can help the patient to avoid the severe complication of permanent brain injury. For NPs, performance of early differential diagnosis is important, especially among patients who have immunosuppressive dependence after transplantation.

Effectiveness of Yoga Interventions in Breast Cancer-Related lymphedema: A systematic review.

OBJECTIVES: To synthesize recent empirical evidence on yoga-based interventions for patients with breast cancer-related lymphedema. METHODS: We searched the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE databases for studies published between October 2007 and September 2018 in any language. Risk of bias and methodological quality were evaluated using the PRISMA statement and checklist and the Cochrane Collaboration tool. RESULTS: There was significant improvement in lymphedema status, range of shoulder motion and spinal mobility after an 8-week yoga intervention, whereas there was no consistency in quality of life following yoga intervention. Additionally, there was no difference in lymphedema status, extracellular fluid and tissue resistance outcomes in the affected arm following a long-term yoga practice. CONCLUSION: The current findings could not be clearly demonstrated that yoga programme intervention as an addition to usual care is superior to along usual care, and keep yoga exercise does not provide significant added benefits.

Nurse practitioners in Taiwan: today and tomorrow.

PURPOSE: To describe the barriers that nurse practitioners (NPs) face and their hopes for the future. DATA SOURCES: The study used a qualitative research design, with 10 certified NPs who were recruited through convenience sampling. Data were collected through a face-to-face semi-structured interview, and content analysis was used to analyze the data. CONCLUSIONS: NPs in Taiwan are challenged by a number of barriers; however, they remain positive that their circumstances will improve. IMPLICATIONS FOR PRACTICE: The results of this study suggest that there is a need for better communication between policymakers and NPs. Additionally, as recommended by the International Council of Nursing, there is a need for NPs to earn a master's degree and to have formal training prior to beginning work as an NP. Furthermore, to evaluate the NPs' performance, outcome studies need to be conducted. Implementing such recommendations should enable NPs to earn the respect and support of healthcare professionals and administrators.

[Self-role perception of nurse practitioners in northern Taiwan].

BACKGROUND: The Nurse Practitioners (NP) is a position title introduced into the Taiwanese nursing care system in 2006. NP perception of themselves is critical to successful development of the NP position as well as to good coordination with other healthcare team members. Understanding NP self-perception can help determine self- or policy deficiencies and facilitate necessary changes to ameliorate such in order to advance the NP system in Taiwan. PURPOSE: This study investigated the self-role perception of NPs in northern Taiwan. METHODS: Researchers used a qualitative research design. Participants comprised ten nurses recruited from a general hospital in northern Taiwan. Data were collected using a semi-structured interview format and analyzed using qualitative content analysis. RESULTS: Two themes that evolved from data analysis included negative and positive self-role perception. Negative self-role perception included feelings of regret, helplessness, frustration and volatility. Positive self-role perception included feelings of enjoying success, reflecting on the present, connecting with nursing, happiness, and self-improvement. CONCLUSION: Enhancing clinical, educational, and policy requirements for NPs can promote positive self-role perception. Based on the medical culture in Taiwan, NPs receive clearly defined roles and clear and specific job descriptions to expand their role functions. Continued self-growth and mutual respect among team members are essential to improving professional cooperation and medical care quality.