Biomedical subjects

Kwua-Yun Wang

Publications and source records attributed to Kwua-Yun Wang.

13 recordsLinked to original sources

PubMed2006

The efficacy of hyperbaric oxygen therapy in improving the quality of life in patients with problem wounds.

The unpredictable course followed by severe, chronic, non-healing wounds not only restricts the daily activities of affected patients, but also impairs their quality of life (QOL). Hyperbaric oxygen therapy (HBOT) treatment for such wounds elevates tissue oxygen content, increases cellular repair functions and the probability of wound healing, and improves the patient's QOL. This was a longitudinal, prospective study, and used a purposive sampling method. A total of 15 patients receiving HBOT at a medical center were enrolled. Data were collected by questionnaire before and after HBOT. The questionnaire included basic patient characteristics, self-perceived wound severity, wound physiological indices, and a QOL scale. The overall QOL score of the subjects after HBOT was higher than before HBOT. After HBOT, there was a positive correlation between the QOL of patients with problem wounds and the scoring of the Strauss wound classification system. After HBOT, there was a negative correlation between the QOL of patients with problem wounds and their self-perceived severity of the wound. The results were then used to provide suggestions for nursing care and additional research directions in order to effectively assist patients with problem wounds receiving HBOT, with the goal of achieving an optimal QOL.

Humans↗

PubMed2006

Postoperative sedation after major surgery with midazolam or propofol in the ICU: effects on amnesia and anxiety.

BACKGROUND: Propofol and midazolam are commonly used in the ICU to alleviate physical and psychological disturbances in consequence of anxiety. This study was conducted to assess and compare the impact of postoperative sedation after major surgery with midazolam or propofol on amnesia and anxiety in conscious patients under intensive care. METHODS: One hundred and two adult patients irrespective of sex and age, receiving thoracic, abdominal or other major truncal surgery necessitating close care at the ICU, were randomly allocated into midazolam or propofol group. Prior to surgery, all patients were subjected to evaluation of the levels of anxiety and amnesia, which was repeated on the following morning with the level of anxiety and the level of amnesia assessed just before and 30 min after cessation of midazolam or propofol medication, respectively. RESULTS: There were no significant differences between the two groups regarding gender, age, types of analgesics used, and anxiety. In both groups, the levels of anxiety (P < 0.001) and amnesia (P < 0.001) were improved significantly over the following day. Midazolam had more pronounced effects on amnesia than propofol (P < 0.001). There were no significant differences between the two groups in the pre- or post-drug anxiety (P = 0.189). CONCLUSIONS: Both midazolam and propofol are effective amnesic and anxiolytic drugs. Midazolam tends to have more favorable effects on amnesia. It is speculated that combination of propofol and midazolam may give better results for treating critically ill ICU patients, the confirmation of which necessitates further study.

Adult↗

PubMed2005

Manual hyperinflation improves alveolar recruitment in difficult-to-wean patients.

STUDY OBJECTIVES: To investigate the effect of manual hyperinflation (MH) in patients with atelectasis associated with ventilation support. DESIGN: Patients were randomized to either an experimental group or a control group. SETTING: Pulmonary ICUs from two hospitals. PATIENTS: Twenty-three patients with atelectasis associated with ventilation support. INTERVENTIONS: The MH technique was at a rate of 8 to 13 breaths/min for a period of 20 min each session, three times per day for 5 days. The control group received their standard prescribed mechanical ventilation without supplemental MH. Sputum contents (wet/dry weight ratio, viscosity), respiratory system capacity (spontaneous tidal volume [Vt], maximal inspiratory pressure, rapid shallow breathing index [f/Vt], chest radiograph signs, and Pa(O2)/fraction of inspired oxygen [Fi(O2)]) were measured just prior to the MH at day 0 as baseline, and at day 3 and day 6 of the study. MEASUREMENTS AND RESULTS: There were significant improvements in scores over the 6-day study in the experimental group compared to the control group in spontaneous Vt (p = 0.035) and chest radiograph signs (p = 0.040), and a trend toward improvement of f/Vt (p = 0.066) and Pa(O2)/Fi(O2) (p = 0.061) after adjustment for covariates. Other outcome variables did not differ significantly between the experimental and control groups. CONCLUSIONS: MH performed on patients with atelectasis from ventilation support significantly improved alveolar recruitment.

Aged↗

PubMed2005

[An experience nursing a patient with amyotrophic lateral sclerosis using the theory of self-care].

Amyotrophic lateral sclerosis (ALS) is a progressive and lethal motor neurodegenerative disease. The cause of the disease is unknown, and there is no cure current clinical treatment methods include Riluzole and supportive therapy. However, Riluzole only decelerates the patient's muscle strength loss and prolongs survival by about 3-5 months (Aventis Pharmaceutical, 2004). The patient will die eventually because of aspiration pneumonia or respiratory failure. This paper documents the use of Orem's self-care theory and holistic nursing assessment in a patient with amyotrophic lateral sclerosis. There are four areas of nursing concern: impaired self-care ability (dressing, feeding, toileting, and bathing), risk of falls, impaired verbal communication, and powerlessness. In terms of these problems suitable nursing activities are provided to develop the patient's ability to care for himself, prevent accidents, promote skills of non-verbal communication, and alleviate powerlessness in order to strengthen control.

Adult↗

PubMed2005

[An experience of taking care of an adolescent spinal surgery patient suffering from scoliosis].

This case report describes the experience of taking care of an adolescent (nineteen year-old) girl, who needed spinal surgical treatment because of scoliosis. The author assessed the patient's condition by observation, interview, and the Gordon 11-item functional health pattern assessment guide. Because she had had no previous surgical experience, and faced changes in her bodily appearance, the adolescent had physical and psychological problems, such as acute pain, self-care deficit, anxiety, and body image disturbance. Besides applying professional knowledge and technical ability, to alleviate the discomfort caused by the young lady's surgery, the author used caring, listening and empathy to encourage and support her in learning self-care, to accept her change in body image, and to overcome the impact of the disease. Through this nursing process, the author came to understand that nurses must concern themselves with both physical problems and mental needs in order to provide holistic health care.

Adult↗

PubMed2004

Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction.

This study's objective was to evaluate the effect of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Using a longitudinal research design, 69 participants whose scores on the Assertive Scale were < or = 50% (i.e., low assertiveness) and who were willing to participate were included and assigned to an experimental group (33 subjects) or comparison group (36 participants; participants were matched with the experimental group by grade and sex). Participants in the experimental group received eight 2-h sessions of assertiveness training once a week. Data were collected before and after training and again one month after the end of the training using the Rotter's Internal versus External Control of Reinforcement Scale, Sex Role Inventory, Assertive Scale, Esteem Scale, and Interpersonal Communication Satisfaction Inventory. The generalized estimated equation (GEE) method was used for statistical analysis. The assertiveness and self-esteem of the experimental group were significantly improved in nursing and medical students after assertiveness training, although interpersonal communication satisfaction of the experimental group was not significantly improved after the training program.

Assertiveness↗

PubMed2004

Health-related quality of life in Taiwanese patients with bronchial asthma.

BACKGROUND AND PURPOSE: Health-related quality of life (HRQOL) is primarily an assessment of how domains of life are affected by health. This study investigated the factors influencing HRQOL of Taiwanese patients with bronchial asthma. METHODS: A cross-sectional study was conducted to assess the factors influencing HRQOL. The sample consisted of 242 outpatients with bronchial asthma. The Chinese language version of the St. George's Respiratory Questionnaire was used to measure HRQOL. Data were analyzed using simple regression and multiple regression. RESULTS: Age, marital status, level of education, asthma severity, peak expiratory flow, and previous hospital admissions were found to be predictors of HRQOL. Gender, duration of disease, and history of emergency visits were not correlated with HRQOL. The variables entered in the HRQOL model accounted for 17.4% of the total variance (adjusted R(2)). The regression coefficients indicated that the mean scores increased 7.68 in patients with moderate to severe disease severity, and increased 7.34 in patients with a history of hospital admissions. The mean scores decreased 7.60 in married patients. CONCLUSION: This study found that marital status, asthma severity, and history of hospital admissions were major predictors of HRQOL in Taiwanese patients with bronchial asthma.

Adult↗

PubMed2004

[Pathophysiological changes in a lung cancer patient suffering from pleural effusion: a case analysis].

Pleural effusion--perhaps the most common and serious complication among lung cancer patients--causes dyspnea, chest pain, and coughing, leading to a painful series of examinations, treatments, and additional complications. This exerts a strong effect on the functional status and psychological well-being of cancer patients, requiring special treatment responses on the part of nursing professionals. The authors introduce concepts related to pathophysiology, etiology, and the clinical assessment of pleural effusion, using a single case study to compare clinical data with theoretical and empirical knowledge. An individualized nursing intervention developed for this particular case is presented and discussed.

Aged↗

PubMed2003

Depression and related factors in elderly patients with occlusion stroke.

The purpose of this study was to examine depression and the related factors in elderly stroke patients. Purposive sampling was used to recruit 106 participants from the outpatients department (OPD) of a teaching hospital in Taipei. The major findings of this study were: (1) Twenty-nine stroke survivors (27.4%) and eight stroke survivors (7.5%) were classified as having mild depression and moderate to severe depression, respectively. (2) There was no significant difference or correlation between the depression score and demographic characteristics, chronic illness condition, or disease characteristics. The depression scores in " worrying about nothing " were significantly lower than the depression scores in " worrying about disease " (t = -4.03, p =.03). (3) There was no significant correlation between the depression score and the Mini-Mental State Examination score, or the Barthel Index score. (4) Social support and depression were negatively correlated (r = -.306, p =.001). (5) Multiple regression analysis revealed that " worrying about disease, " " worrying about family, " and informational support from family, relatives and friends accounted for 22.1% of the variance in depression. The implications for clinical practice and further studies are suggested.

Activities of Daily Living↗

PubMed2003

Effect of head elevation on cerebral blood flow velocity in post-cerebral operation patients.

This pre-experimental research measured patients' mean blood velocity (MV), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the middle cerebral arteries by using transcranial Doppler (TCD) to understand the immediate changes in cerebral blood flow (CBF) when head elevation degree changed, and whether CBF will return to stability after 10 minutes of elevation. Ten patients who underwent cerebral surgery were selected from one medical centre by purposeful sampling within five months. One-way ANOVA was used to analyze the data. The study results showed that MV, PSV, and EDV had obviously changed when head elevation was 15 degrees, 30 degrees, or 45 degrees from the horizontal at 10 seconds, and then recovered gradually. This study examined four head elevation degrees that affected cerebral blood flow. The results are likely to help nurses in caring for these patients.

Analysis of Variance↗

PubMed2003

Quality of life and related factors for people living with HIV/AIDS in Northern Taiwan.

The purpose of this study was to identify the variables related to quality of life in the population of individuals living with HIV/AIDS (PLWHA) in Taiwan. Purposive sampling was used to identify subjects from the outpatient departments (OPD) of three teaching hospitals and one sexually transmitted disease (STD) clinic in the Taipei area. For this study, the questionnaire included a demographic data sheet, physical-symptom distress and mood-disturbance scales, a personal-resource questionnaire (PRQ85-II) and a quality-of-life index (QLI). A total of 114 subjects completed the questionnaire. The results revealed that higher quality of life was associated with less mood disturbance (r = -.72; p <.001), reduced physical-symptom distress (r = -.47; r <.001), and higher levels of social support (r =.57; p <.001). PLWHA life quality was reflected accurately by mood disturbance, social support, physical-symptom distress, self-perceived mode of HIV transmission, and major source of financial support. These variables accounted for 60.9 % of QOL variance. As mood disturbance was the strongest predictor of quality of life, psychosocial intervention for mood disturbance should be emphasized and developed in future studies.

Adult↗

PubMed2003

Effect of medical education on quality of life in adult asthma patients.

BACKGROUND AND PURPOSE: Previous studies revealed that many asthma patients did not understand how to manage their disease, which in turn affected their quality of life. This study investigated the effect of asthma education on quality of life in Taiwanese adults with asthma. METHODS: A before and after quasi-experimental design was used. A total of 85 asthma patients were recruited from the asthma clinic of a medical center in northern Taiwan using purposive sampling. Among these patients, 31 were assigned to the experimental group and 54 to the control group. The experimental group received four 1-hour sessions of group education, while the control group received no instruction. Data were collected at 2 different stages: enrollment (baseline), and at 1 month after enrollment. All subjects completed the Asthma Quality of Life Questionnaire and the Asthma General Knowledge Questionnaire for Adults. Data were analyzed using independent-samples t test and paired t test. RESULTS: After completing the asthma education sessions, the mean scores on asthma knowledge significantly increased from 19.65 to 23.06 (p < 0.001) in the experimental group. The mean scores for overall quality of life significantly increased from 5.06 to 5.42 (p < 0.01). The mean scores in the symptom domain and the exposure to environmental stimuli domain also significantly increased from 5.07 to 5.46 (p < 0.01) and 4.94 to 5.52 (p < 0.001) after education. However, the mean scores of the control group on the same questionnaire did not change significantly. CONCLUSION: Asthma education can significantly improve asthma knowledge and quality of life in adult asthma patients.

Adult↗

PubMed2002

Effect of a clinical pathway on selected clinical outcomes of pulmonary lobectomy.

BACKGROUND: North American hospitals use clinical care pathways to reduce length of stay, readmissions, and resource utilization and also to increase patient satisfaction. This study examined the effects of clinical pathways after pulmonary lobectomy in Taiwanese patients. METHODS: During 1997, a multidisciplinary team developed a lobectomy clinical pathway. The Program Evaluation Review Technique was used to analyze variances from the clinical pathway. Based on these findings, a standardized clinical pathway was implemented in late 1997. Forty patients participated. The variables of the study are length of hospital stay, readmission rates, spirometry usage, patient education and costs benefited from clinical care pathway use. RESULTS: Fourteen lobectomy patients following the clinical pathway had a mean length of stay of 17.9+/-4.18 days (p < 0.001) and 0% readmission (p < 0.001). Without a pathway, 26 lobectomy patients had a mean length of stay of 37.5+/-6.18 days and 18% were readmitted. Factors affecting clinical pathway success were preoperative days(p < 0.001), postoperative days (p = 0.033), spirometry usage (p = 0.043) and patient education (p = 0.02). Clinical pathway use reduced mean hospital costs by 16% for lobectomy. CONCLUSIONS: Length of hospital stay, readmission rates, spirometry usage, patient education and costs benefitted from clinical care pathway use. Factors critical to success appear to be multidisciplinary teamwork and communication.

Critical Pathways↗