Biomedical subjects

Mei Chang Yeh

Publications and source records attributed to Mei Chang Yeh.

4 recordsLinked to original sources

PubMed2006

[Introduction to ethnographic decision tree modeling].

With rapid advances in healthcare technology, patients are increasingly compelled to make medical decisions in unfamiliar and highly stressful situations. Nurses, therefore, have a responsibility to understand the medical options, and consequences of each, in order to help patients make the best decisions for themselves. Ethnographic decision tree modeling is a research "triangulation" tool conducted in two stages. The first stage uses ethnographic fieldwork techniques to determine the criteria used by insiders (i.e., decision makers) to make a real-world decision. These criteria are combined into a decision tree. The second stage applies a quantitative research method to verify the degree of predictive accuracy of the decision tree. This method addresses the meaning and predictability of decision-making. This paper introduces ethnographic decision tree modeling and provides a perspective on inquiring about the bases of patient decision-making.

Anthropology, Cultural↗

PubMed2006

[Analysis and implementation of research findings on the decision making in institutionalization of the elderly: a family-centered perspective].

As the size of the population of the elderly increases, so does the incidence of chronic illness and disability. In addition, the rising prevalence of the nuclear family and rising unemployment among women, greatly reduce the resources available to families for caring. The institution placement rate among the elderly is increasing. The decision making process in relation to institutional placement, however, causes the utmost stress and suffering for the elderly and their families. The purpose of this paper is to review research articles concerning decision making in institutionalization, from the perspectives of type of decision, facilitating factors, the nature of the experience and the stress involved therein, the choice of institution, and the roles performed in the process by both the elderly person in question and by professionals, and then to propose recommendations for nursing research, nursing practice and health care policy. The researchers hope, by providing a family-centered perspective to nursing, to enable nurses to extend their concern and support to caregivers and the elderly facing decisions about institution placement.

Decision Making↗

PubMed2005

Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam.

An important issue for the nursing education system in Taiwan is to reinforce nursing education to enhance competence levels for entry to nursing specialties. Consequently, to meet the prospective demands of technical manpower, not only do nursing students in college and vocational schools pursue further studies, but they also take competitive entrance exams. Using a descriptive cross-sectional design, the study examined the following among nursing students in vocational high schools: (1) perception and sources of entrance exam stress and use of coping behaviors; (2) the effect of difference in entrance exam stress levels on coping behaviors used, and (3) measurement of coping function to determine which coping behavior works best for buffering the impact of stress on psychological health during a preparatory stage of a college and university entrance exam. The subjects were 441 third-year nursing students of vocational high schools in northern Taiwan, recruited by convenience sampling. Three measurements were adopted: Stress perceived scale, Coping behavior inventory, and a Chinese health questionnaire. Results showed that the five main stressors of entrance exam stress, in descending order, were taking tests, the student's own aspirations, learning tasks, teacher's aspirations and parent's aspirations. Students generally used problem-focused coping strategies including optimistic action and social support to deal with the entrance exam stress, but use of emotion-focused coping strategies including avoidance and emotional disturbance was significantly increased as perceived level of stress rose. Two-way analyses of variance (2-way ANOVA) revealed that problem-focused coping had a positive main effect of alleviating psychological distress. A significant interaction was observed between stress perceived and problem-focused coping used for psychological health. Further examination of the interaction effect showed that problem-focused coping behaviors were potentially more adaptive in relation to psychological health at the lower and moderate stress levels (25 - 75%T) than that at the extreme stress level (> 75%T). Conversely, emotion-focused coping had a negative main effect or impairing psychological health. No interaction effect was found between stress perceived and emotion-focused coping used, suggesting that the relationship between emotion-focused coping and psychological distress was consistent across various stress levels.

Adaptation, Psychological↗

PubMed2005

Exploring the associations between long-term care and mortality rates among stroke patients.

Information on types of long-term care received by stroke patients after hospital discharge is essential for the formulation of long-term care resource development policy. Comparisons of outcomes resulting from different types of long-term care can provide important considerations in the selection of long- term care services. The purpose of this study is to describe the patterns of long-term care received, and to explore if associations exist between long-term care services and mortality status among stroke patients after hospital discharge. Using a longitudinal quasi-experimental study design, this study collected information on the type of long-term care received at 1, 3, and 6 months after discharge for 714 patients. At one month after discharge, 4.5 % had died, and 22.1 % had regained all functions in activities of daily living and instrumental activities of daily living. The percentage of patients receiving institutional care, home or community-based care, and family care only were 10.4 % , 22.4 % , and 40.7 % respectively. The respective percentages at 3 months after discharge were 11.2 % , 18.7 % , and 38.0 % , and, at 6 months after discharge, 10.3 % , 19.4 % , and 30.9 % . After adjusting for age, sex, previous incidence of stroke, and physical functions, the odds of dying within 6 months after discharge for stroke patients receiving home or community-based care was significantly lower than those in institutions ( OR = 0.39; 95 % CI = 0.15 to 0.97 ). It is not clear why a lower mortality rate was observed among patients receiving home or community-based services. Differences in quality of care and quality of life among users of different types of long-term care services should be investigated. More research is needed to assess the causes of the disparity in mortality rates among users of different types of long-term care services.

Activities of Daily Living↗