Biomedical subjects

Li-Chan Lin

Publications and source records attributed to Li-Chan Lin.

17 recordsLinked to original sources

PubMed2007

Effects of a range-of-motion exercise programme.

AIM: This paper reports an evaluation of a range-of-motion exercise programme aimed at improving joint flexibility, activity function, perception of pain, and depressive symptoms in a sample of stroke survivors in long-term care facilities. BACKGROUND: The benefits of physical rehabilitation for stroke survivors have been well established. There is, however, little empirical data on the effects of a simple nurse-led range-of-motion exercise programme in improving function for these people. METHOD: A randomized controlled trial was conducted in 1999 with 59 bedridden older stroke survivors in residential care. Participants were randomly assigned to usual care or one of two intervention groups. The 4-week, twice-per-day, 6 days-per-week range-of-motion exercise protocols were similar in both intervention groups, and consisted of full range-of-motion exercises of the upper and lower extremities. To test the effect of different degrees of staff involvement, in intervention group I, a Registered Nurse was present to supervise participants performing the exercises, while intervention group II involved a Registered Nurse physically assisting participants to achieve maximum range-of-motion within or beyond their present abilities. RESULTS: Both intervention groups had statistically significant improvement in joint angles, activity function, perception of pain and depressive symptoms compared with the usual care group (P < 0.05). Post hoc comparison revealed that the joint angles in intervention group II were statistically significantly wider than in both the other groups (P < 0.01). CONCLUSIONS: A simple nurse-led range-of-motion exercise programme can generate positive effects in enhancing physical and psychological function of bedridden older people with stroke. Further studies are needed to investigate the long-term effects of the programme in maximizing function, reducing care utilization and enhancing quality of life for this population.

Activities of Daily Living↗

PubMed2006

A programme of symptom management for improving quality of life and drug adherence in AIDS/HIV patients.

AIM: This paper reports an evaluation of the effect of symptom management programmed on drug adherence, CD4 count and virus load and the quality of life of patients with HIV/AIDS. BACKGROUND: Patients with HIV/AIDS have to face the long-term side effects caused by highly active antiretroviral therapy regimens. There has been little research to evaluate the influence of drug intervention side effects on self-care. METHODS: Sixty-seven patients with HIV/AIDS were randomly assigned to one-on-one teaching, group teaching, or control groups. All those in the one-on-one and group teaching groups attended a symptom management programme once a week, followed by 3 weeks of continuity and telephone counselling. Those in the control group were offered experimental intervention at the conclusion of data collection. The Customized Adherence Self-Report Questionnaire, CD4 count and virus load, and Quality of Life Index were used to evaluate the effectiveness of the symptom management programme before and at 3 months after the intervention. RESULTS: Median differences on the Customized Adherence Self-Report Questionnaire, CD4 count and virus load, and quality of life in both experimental groups were statistically significantly better than in the control group. CONCLUSIONS: The symptom management programme can increase self-care ability in managing medication side effects in patients with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed2006

[Sexual expression among the institutionalized elderly with dementia, and strategies for sexual care].

Despite the general reduction in sexual needs with aging, human beings have sexual needs which are life long. This study looks at the overall lack of privacy, as well as at the biological, psychological and social changes that occur among the institutionalized elderly with dementia, and addresses the appropriateness of sexual expression. Conflicts involving social values, a lack of policies regarding sexual issues, and a lack of in-service training in institutions result in caregivers experiencing difficulty with the sexual issues faced by patients. It is essential to develop strategies which are consistent with culture and institutional philosophy. Through the understanding of sexual expression and its influencing factors among residents with dementia, caregivers can develop a care plan that allows residents to express appropriate sexual behavior.

Aged↗

PubMed2005

Depressive symptoms in long-term care residents in Taiwan.

AIM: This paper reports a study to investigate the prevalence of and risk factors for depressive symptoms in elders in long-term care facilities in Taiwan. BACKGROUND: Depression has been identified as a major health concern and is very common among frail elders in Western nursing homes. It is under-diagnosed, and may be associated with eating difficulties and subsequent malnutrition, functional ability and sociodemographic factors. There have been no previous studies of these issues in Taiwan. METHODS: Residents of 18 long-term care facilities were recruited. Those able to communicate in the Mandarin or Taiwanese dialect, resided in long-term care facilities including skilled nursing facilities and intermediate care facilities, and who scored three or above on the Short Portable Mental Status Questionnaire were selected. Data were collected using the Geriatric Depression Scale, Barthel Index and Masticatory Index, and age, duration of institutionalization, and level of impaired swallowing were also measured. RESULTS: The number of participants identified as depressed was 267 (52.05%). There was no significant difference noted relating to age, gender, duration of institutionalization, type of institution, mental status and masticatory ability between the depressed and non-depressed groups, but significant differences of functional status and impaired swallowing between the two groups were found. However, functional status, impaired swallowing, and type of institution were three independent factors associated with depressive symptoms after controlling for all other factors. CONCLUSIONS: Future studies on the detection of symptoms of depression should use a validated observational measure to overcome under-reporting of symptoms by the frailest residents.

Adult↗

PubMed2005

Effects of a feeding skills training programme on nursing assistants and dementia patients.

AIMS AND OBJECTIVES: The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. BACKGROUND: Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. DESIGN METHODS: A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in-service classes and one hour of hands-on training, whereas the control group did not receive any training. RESULTS: The treatment group had significantly more knowledge (F = 47.7, P < 0.001), more positive attitude (F = 15.75, P = 0.001) and better behaviours (t = 6.0, P < 0.001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2.7, P < 0.05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2.1, P < 0.05) than the control group. There was no significant difference on food intake between the two groups (t = 0.8, P = 0.49). CONCLUSION: This feeding skills training programme has been found to change nursing assistants' knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. RELEVANCE TO CLINICAL PRACTICE: This study raises attention regarding on-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.

Attitude of Health Personnel↗

PubMed2005

[Activities programs for institutionalized elderly patients with dementia].

Formal caregivers often play an important role in leading activities programs and arranging appropriate therapeutic activities in institutions. Studies have shown that, when elderly patients with dementia have participated in more structured activities, agitated behaviors have been significantly decreased. Also, structured activities have helped in the performance of ADL, as well as improved quality of sleep, decreased anxiety, improved self-expression and social interaction, enhanced caregiver's morale, and resulted in a more positive caring attitude on the part of caregivers. This article will discuss the categories and contents of activities programs for elderly patients with dementia and can be applied as a reference to assist formal caregivers in their efforts to arrange appropriate activities programs in institutions.

Aged↗

PubMed2004

Evaluating swallowing dysfunction using a 100-ml water swallowing test.

This study used comparison with videofluoroscopic examination of swallowing (VFES) to examine the validity of a 100-ml water swallowing test (WST) in assessing swallowing dysfunction. Fifty-nine consecutive outpatients (15 females, 44 males) with clinically suspected dysphagia were enrolled in this study. Each subject underwent a 100-ml WST followed by VFES. Data was obtained on swallowing speed and signs of choking (coughing and a wet-hoarse voice). The analytical results revealed that 49 subjects had abnormal swallowing speeds (< 10 ml/s) in the 100-ml WST, and 47 of them were identified as having dysphagia by VFES. Among the ten participants with normal swallowing speed (> 10 ml/s), eight were diagnosed with dysphagia by VFES. Notably, 14 participants choked in the 100-ml WST, 11 of whom exhibited aspiration or penetration in VFES. Among the 45 participants without choking in WST, 12 displayed aspiration or penetration in VFES. The sensitivity of swallowing speed in detecting the swallowing dysfunction was 85.5%, and the specificity was 50%. Moreover, the sensitivity of using choking or wet-horse voice in the 100-ml WST as the sole factor for predicting the presence of aspiration was 47.8%, while the specificity was 91.7%. Therefore, this study concluded that swallowing speed is a sensitive indicator for identifying patients at risk for swallowing dysfunction. Moreover, choking in the 100-ml WST may be a potential specific indicator for followup aspiration.

Adult↗

PubMed2004

Effectiveness of acupressure in improving dyspnoea in chronic obstructive pulmonary disease.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) suffer from dyspnoea in their daily life and this may be increased by anxiety. Acupressure may promote relaxation and relieve dyspnoea. Thus, it is appropriate to explore the effectiveness of acupressure on dyspnoea in patients with COPD. AIMS: To compare outcomes of acupressure using sham acupoints on different meridians and ganglionic sections with that using true acupoints, in patients with COPD who are living at home. METHODS: Patients diagnosed with COPD were selected from a medical centre and three regional hospitals in Taipei. A randomized block experimental design was used. Using age, sex, pulmonary function, smoking, and steroid use as matching factors, 44 patients were randomly assigned either to a true acupoint acupressure or a sham group. The true acupoint acupressure group received a programme to decrease dyspnoea. Those in the sham group received acupressure using sham pressure points. Both acupressure programmes consisted of five sessions per week lasting 16 minutes per session, extending over 4 weeks for a total of 20 sessions. Before acupressure was initiated and at the conclusion of the 20th session, the Pulmonary Functional Status and Dyspnoea Questionnaire-modified scale and the Spielberger State Anxiety scale were administered, and a 6-minute walking distance test was performed. Physiological indicators of oxygen saturation and respiratory rate were measured before and after every session. RESULTS: The results of this study showed that the pulmonary function and dyspnoea scores, 6-minute walking distance measurements, state anxiety scale scores, and physiological indicators of the true acupoint acupressure group improved significantly compared with those of the sham group. CONCLUSIONS: The findings suggest that acupressure can be used as a nursing intervention to improve dyspnoea in patients with COPD.

Acupressure↗

PubMed2004

A program of symptom management for improving self-care for patients with HIV/AIDS.

The purpose of this study was to investigate the effect of a symptom management program on self-care of medication side effects among AIDS/HIV-positive patients. Sixty-seven patients from a sexually transmitted disease control center, a medical center, and a Catholic AIDS support group in Taipei were randomly assigned to three groups: one-on-one teaching, group teaching, and a control group. All subjects in each teaching group attended a 60- or 90-minute program on highly active antiretroviral therapy (HAART) side effect self-care education and skill training once per week for 3 weeks; subjects also underwent counseling by telephone. A medication side effect self-care knowledge questionnaire, Rosenberg's Self-Esteem Scale (RSES), and unscheduled hospital visits were used to evaluate the effectiveness of the symptom management program. The results revealed there were significant differences in mean difference of knowledge and unscheduled hospital visits between baseline and post-testing at 3 months for symptom management in the two groups. The mean difference of the self-esteem scale was not significant between the two groups. In summary, the symptom management program effectively increased the ability of AIDS/HIV-positive patients to self-care for medication side effects. We recommend that this program be applied in the clinical nursing practice.

Adult↗

PubMed2003

Identification of 2,5-dimethoxy-4-ethylthiophenethylamine and its metabolites in the urine of rats by gas chromatography-mass spectrometry.

A simple and specific method based on gas chromatography-selected ion monitoring-mass spectrometry (GC-SIM-MS) for the analysis of in vivo metabolism of 2,5-dimethoxy-4-ethylthiophenethylamine (2C-T-2) in rats is described. Three male rats were administered 20 mg/kg of 2C-T-2 by intra-peritoneal injection, and 24 h urine fractions were collected before and after the administration for analysis. After acidic hydrolysis of the urine samples, the metabolites were liquid-liquid extraction and analyzed by a quadruple mass spectrometer in the selected ion monitoring mode. The findings show that four metabolites of 2-(4-ethylthio-2,5-dimethoxyphenyl)-ethanol (Mw: 242), 4-ethylthio-2,5-dimethoxyphenyl acetic acid (Mw: 256), 1-acetoamino-2-(2-hydroxy-4-ethylthio-5-methoxyphenyl)-ethane (Mw: 269) and 1-acetoamino-2-(2-methoxy-4-ethylthio-5-hydroxyphenyl)-ethane (Mw: 269) are present and the metabolic pathway for 2C-T-2 in the rat is proposed.

Animals↗

PubMed2003

Optimization of a simple method for the chiral separation of methamphetamine and related compounds in clandestine tablets and urine samples by beta-cyclodextrine modified capillary electrophoresis: a complementary method to GC-MS.

The chiral separation of (+/-)-methamphetamine, (+/-)-methcathinone, (+/-)-ephedrine and (+/-)-pseudoephedrine by means of beta-cyclodextrine modified capillary electrophoresis is described. The distribution of enantiomers in clandestine tablets and urine samples were identified. Several electrophoretic parameters such as the concentration of beta-cyclodextrin, temperature, the applied voltage and the amount of organic solvent required for successful separation were optimized. The method, as described herein, represents a good complementary method to GC-MS for use in forensic and clinical analysis.

Central Nervous System Stimulants↗

PubMed2003

A pilot study on a home-based caregiver training program for improving caregiver self-efficacy and decreasing the behavioral problems of elders with dementia in Taiwan.

OBJECTIVE: To investigate the effectiveness of a home-based caregiver training program for caregivers of elders with dementia and behavioral problems. METHODS: A prospective study was conducted in the communities of Northern Taiwan. Forty-eight patients with dementia and their family caregivers were included. The experimental group (n = 24) received a two-session in-home caregiver training program, and the control group (n = 24) received only written educational materials. The Chinese version of Cohen-Mansfield Agitation Inventory (CMAI), community form, was used to measure the behavioral problems of patients with dementia. The caregiver's self-efficacy, for managing the demented person's agitation, was measured by the Agitation Management Self-efficacy Scale (AMSS). The CMAI and AMSS were administered before (baseline), three weeks (1st post-test), and three months (2nd post-test) after the two-session training program. RESULTS: Except for the physically aggressive behavior subscale, the scores of physically non-aggressive behavior, verbally aggressive and non-aggressive behavior subscales as well as the overall CMAI decreased significantly and continuously in the experimental group and differed significantly from the changed scores from those in the control group (p < 0.05). Physically aggressive behaviors showed a decreasing trend for both groups. Scores of the Agitation Management Self-Efficacy Scale and its subscales increased significantly and continuously in the experimental group in comparison to those in the control group (p < 0.05). CONCLUSIONS: This home-based caregiver training program is helpful for decreasing problematic behaviors of elder people with dementia and it improves the caregiver's self-efficacy for managing problematic behaviors.

Aged↗

PubMed2003

Efficacy of swallowing training for residents following stroke.

BACKGROUND: The presence of dysphagia is associated with an increased risk of mortality, malnutrition, dehydration, compromised pulmonary function, and disability. Appropriate swallowing training can establish optimal nutritional status and eliminate or reduce the risk of developing medical complications associated with swallowing impairment. AIM(S) OF THE STUDY: The aim of this study was to examine the functional swallowing and nutritional outcomes of swallowing training in institutionalized stroke residents with dysphagia. DESIGN AND METHODS: A quasi-experimental parallel cluster design was used. Seven institutions with similar bed sizes were selected. All subjects in the experimental group received a structured swallowing training programme. The subjects in the experimental group (n = 40) received 30 minutes of swallowing training each day for 6 days per week for 8 weeks. The control group (n = 21) did not receive any training. RESULTS: After swallowing training, mean differences in volume per second, volume per swallow, mid-arm circumference and body weight between pre- and post-training of the experimental group were significantly higher than for the control group, while mean differences in neurological examination and choking frequency during meals for the experimental group were significantly lower than in the control group. CONCLUSION: This study used objective timed swallowing tests, a swallowing questionnaire, and a neurological examination to evaluate the effects of swallowing training. However, videofluroscopy is generally considered the best method for evaluating the pharyngeal and esophageal stages of swallowing, and introducing this technique is recommended for future studies. Furthermore, it is recommended that nursing professionals should conduct swallowing training protocols in stroke patients to help prevent aspiration from dysphagia.

Adult↗

PubMed2002

The efficacy of acupressure to prevent nausea and vomiting in post-operative patients.

BACKGROUND: Post-operative nausea and vomiting is a common complication following general anaesthesia. Traditional Chinese medicine indicates that acupressure therapy may reduce nausea and vomiting in certain ailments. AIM(S) OF THE STUDY: The aim of this study was to examine the effect of stimulating two acupressure points on prevention of post-operative nausea and vomiting. DESIGN AND METHODS: A randomized block experimental design was used. The Rhodes Index of Nausea, Vomiting and Retching (INVR) questionnaire was used as a tool to measure incidence. To control the motion sickness variable, the subjects who underwent functional endoscopic sinus surgery (FESS) under general anaesthesia were randomly assigned to a finger-pressing group, a wrist-band group, and a control group. There were 150 subjects in total with each group consisting of 50 subjects. The acupoints and treatment times were similar in the finger-pressing group and wrist-band pressing group, whereas only conversation was employed in the control group. RESULTS: Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure, wrist-band, and control groups, with a reduction in the incidence rate of nausea from 73.0% to 43.2% and vomiting incidence rate from 90.5% to 42.9% in the former. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the former group. CONCLUSION: In view of the total absence of side-effects in acupressure, its application is worthy of use. This study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting.

Acupressure↗

PubMed2002

Prevalence of impaired swallowing in institutionalized older people in taiwan.

OBJECTIVES: To investigate the prevalence of impaired swallowing in residents at long-term care facilities (LTCFs) in Taiwan. DESIGN: A chart review, a structured questionnaire completed at interview, a neurological examination, and a timed swallowing test were used to assess impairment and to gather demographic data. SETTING: Nine skilled nursing facilities and nine intermediate-care facilities in metropolitan Taipei. PARTICIPANTS: One thousand two hundred twenty-one conscious and unconscious residents with a mean age of 77.07. MEASUREMENTS: Impaired swallowing was defined when a subject met two or more of the following criteria: self-report of swallowing difficulty, a score of 2 or more derived from a swallowing questionnaire combined with a neurological examination investigating symptoms and signs of impairment, and coughing/choking during a timed swallowing test or a measured swallowing rate (volume swallowed per second) below the 10th percentile as derived from a gender-based study of an older community in Taipei. RESULTS: Of the 1,221 subjects, 356 (29.2%) were fed by tube. The prevalence rates for impaired swallowing as estimated were 97.5% and 31.9% for tube-fed and non-tube-fed subjects respectively, whereas the overall prevalence for tube-fed and non-tube-fed subjects altogether was 51.0%. CONCLUSIONS: The findings may serve to increase awareness of this problem among healthcare professionals in LTCFs. Further research is contemplated to investigate whether early identification makes a difference in treatment choices and outcomes.

Aged↗

PubMedDate not supplied

A Chinese translation of the EdFED-Q and assessment of equivalence.

The purpose of this study was to translate the Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) from the original English into a Chinese language version and to assess the equivalence of the English and Chinese EdFED-Q versions. To use a directly translated instrument without minimal explanation of the procedures for determining the equivalence between the original and secondary language instrument is questionable. Ensuring equivalence of a translated Chinese version of the EdFED-Q for patients with dementia is an essential prerequisite for identifying culturally specific expressions of feeding difficulty under investigation. Phase 1 consisted of experts doing the initial translation into Chinese and then English back-translations of the questionnaire. Six experts determined the equality of the Chinese and English versions, and five monolingual nurses provided information for the C-EdFED-Q. In phase 2, two bilingual gerontological nurses rated 33 residents with dementia to determine equivalence across time. In phase 3, three groups of bilingual nurses used the Chinese, English, and finally both versions simultaneously to judge a model case's feeding behavior on the videotape. In phase 1, the rating on the equality of the items on the Chinese and English versions was 0.969. In phase 2, kappa coefficients for all items on the C-EdFED-Q and E-EdFED-Q ranged from 0.44 to 1.00. In determining the consistency of the scores for the C-EdFED-Q and E-EdFED-Q between the two raters across time, the intraclass correlation coefficient for the absolute agreement was found to range from 0.85 to 0.90. In phase 3, except for items 6 and 9, all items showed no significant difference among the three groups. Further studies to assess the relationship between constructs and to compare it with known and predicted relationships are recommended.

Dementia↗

PubMedDate not supplied

The efficacy of a home-based nursing program in diabetic control of elderly people with diabetes mellitus living alone.

The purpose of this study was to evaluate the efficacy of a home-based nursing program in the diabetic control of elderly people with diabetes mellitus living alone. Patients meeting the sampling criteria were recruited from a medical center and 10 health centers in Taipei for this quasi-experimental study. By matching the effects of age, sex, education, and history of diabetes, subjects were assigned semirandomly to two groups based on the intensity of home-based nursing care visitations. Group I was defined as daily visits to supervise diet, exercise, medication, and self-monitoring blood sugar (n = 15) and Group II as weekly visits to supervise diet, exercise, medication education, and self-monitoring blood sugar (n = 15). Patients who agreed only to receive blood examination were assigned to the control group (n = 14). The results of the study showed that reductions in fasting blood sugar, postmeal blood sugar, and hemoglobin A1c (HbA1c) in Groups I and II were significantly greater than those in the control group. The reduction in the total cholesterol and low-density lipoprotein in Groups I and II was significantly greater than that in the control group. There were no significant differences among the three groups in the improvement of high-density lipoprotein (HDL) and triglycerides (TGs). Group I revealed a significantly greater weight reduction compared to Group II. There was no significant difference between Groups I and II in the improvements of diabetes knowledge, depression level, or quality of life. From the research findings, based on cost-effectiveness, it is recommend that Program II be implemented.

Aged↗