An exploration of factors related to quality of life in Indonesian care workers in home-based care settings

Background Indonesians constituted 79% of foreign care workers for long-term care in Taiwan in 2015. Therefore, it is crucial to explore the effect of work stress and quality of life (QoL) on this population.Purpose This study aims to explore stress levels, social support requirements, and perceived QoL among Indonesian care workers (ICWs) who work in home care settings.Methods A cross-sectional design was used. Data were collected between 2014 and 2016 from a convenience sample of ICWs working in eastern Taiwan using a self-administered questionnaire that comprised the Stress Perception Scale (SPS), Social Support Scale (SSS), and World Health Organization Quality of Life-Brief scale. One hundred fifty-seven valid questionnaires were collected. The response rate was 80.51%. Data were analyzed using descriptive statistics, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis.Results The results found that the average SPS of the sample was 70.50, with low QoL scores and requirements for more social support. In addition, significant and positive correlations were found between QoL and SPS, SSS, duration of patient care, and hours of care per week. Stepwise regression analysis showed that the most predictive variables for QoL were time spent caring, preservice training, psychological stress, and emotional support, which together accounted for 60.9% of the total variance.Conclusions/Implications for Practice This study facilitated understanding of the stress on ICWs and the impact of social support on their QoL. The findings suggest that new immigrants in Taiwan should be introduced to foreign care workers or nursing attendants. Moreover, long-term-care-related teachers should work with home care institutions or agencies to develop a teaching model for innovative care skills to relieve the perceived stress of ICWs

Using Text Mining to Extract Issues for School: an Empirical Study of the Social Platform-Dcard

Nowadays, social network within sentiment analysis has become the main trend in text mining domain. There are many platforms have been analyzed, such as Facebook, Twitter, Instagram, and so on. In our manuscript, we attempt to extract the information about the sentiment polarity of messages (positive, neutral or negative) in a social platform “Dcard”. The users of Dcard are Taiwanese college students, and anonymous post is being used this in social platform, therefore, the user can express their opinion more freedom. We use Dcard to the sentiment polarity of messages in extract the information about the school; moreover, the school could get the feedback from this finding to improve their policy. In this paper, we used python to scrap the web page, and the sentiment lexicon would be built

Perceptions of acculturation and social identity construction among three Taiwanese/Chinese migrants in Australia

In recent years, increasing numbers of Chinese migrants have come to Australia to study or to live. In doing so, they have entered a new cultural space. They are faced with many challenges, not only to do with study experience, workplace experience and life-style practices, but also to do with language, communication, culture and identity. Such new challenges can feel dangerous, unstable and uncomfortable as they require moves out of the safety zone of primary cultural experience. This qualitative research study investigates the perceptions and narratives of three Taiwanese-Australian migrants in terms of their experience of this process of acculturation and social identity construction as migrant tertiary students in the new Australian context and of their subsequent experience professionally. Their accounts of where they see themselves to have 'landed' in terms of their acculturation process and identity construction might provide relevant insights to the experience of hybridity which is intercultural Australia

燒傷病 患增生性疤痕的復健護理

燒傷，乃指身體及體表接觸巨大能量，造成細胞及組織的傷害，此傷害最首當其衛的 是皮膚。隨著醫療科技進步，燒傷死亡率已大幅下降，醫療人員所面臨的挑戰，由降 低感染及死亡率，轉爲增生性疤痕的控制及預防。本篇由影響燒傷疤痕形成因 素的探討中，提出預防及控制疤痕增生的方法:正確擺位、副木使用、壓力治療、運 動及日常生活訓練，以期貫徹 正確及有效的復健護理，提昇患者居家生活品質

The Effectiveness of Silver-Releasing Dressings in the Management of Non- Healing Chronic Wounds: A Meta-Analysis

The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Systematic review and meta-analysis. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950 -June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI95: 0.16- 0.39, p < 0.001), reduced odour (CI95: 0.24-0.52, p < 0.001 ) and pain-related symptoms (CI 95: 0.18-0.47, p < 0.001), decreased wound exudates (CI95: 0.17-0.44, p < 0.001) and had a prolonged dressing wear time (CI95: 0.19-0.48, p = 0. 028 ) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI95: 0.04-0.33, p = 0.013) using silver dressings in wound management with no associated severe adverse events. This meta- analysis confirms the effectiveness of silver dressings in wound healing and improving patients' quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non -healing chronic wounds

復健期燒傷病患主要照顧者壓 力感受、社會支持及其相關因素

燒傷造成病患身心煎熬甚鉅，居家復健期間主要照顧者壓力感受強度及社會支持足夠 與否，攸關 燒傷病患復健期的照護品質。國外有關此方面的研究相當少見，國內尚 缺乏文獻探討。本研究目的在探討復健期燒傷病患主要照顧者壓力感受、社會支持及 其相關因素。研究採描述性橫斷式調查法，以 立意取樣方式，收取兩所醫學中心燒 傷病房，二年內出院之135位病患主要照顧者為研究對象，研究工 具包括壓力感受及 社會支持量表。結果發現照顧者呈現中度壓力感受，對病患身體症狀的壓力最高， 尤其疤痕增厚、癢及疼痛是最困擾的事項。社會支持需要程度及足夠程度尚可，但其 協助程度略偏不 足。從逐步回歸分析中發現，對照顧者壓力感受最具預測力的變項 是社會支持需要程度、家庭每月固 定收入、病患活動功能、病患燒傷面積及協助家 屬人數，可解釋全部變異量的57%；整體壓力感受、 病患燒傷面積分別影響照顧者社 會支持的需要程度、協助程度及足夠情形。本研究結果，有助於了解 燒傷病患主要 照顧者在居家照護期間的壓力感受及社會支持需求，提供出院衛教及醫療照護之參考

A Systematic Review of Silver-Releasing Dressings in the Management of Infected Chronic Wounds

Aim. This paper is a systematic review with the objective of determining the effectiveness of silver-releasing dressing in the management of infected chronic wounds. Background. Chronic wounds exhibit increased bacterial burdens which not only result in a negative physical impact on patients, impairing their quality of life, but also increase treatment costs. Silver dressings are wound products designed to control and inhibit infection and provide a wound environment conducive to healing. However, there is limited evidence on their effectiveness in doing so. Methods. A systematic review of literature from 1950-May 2007 was conducted using the PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO Host, OCLC, Proquest and PsychInfo databases. The review included randomised or non- randomised control trials, published in English or non- English, of silver-releasing dressings in infected chronic wounds. Results. Of the over 1957 potentially releasing studies examined, 14 pertinent articles involving 1285 participants were identified. Almost all the participants reported one or more statistically significant outcomes. The main points to emerge from this review of studies are that silver-releasing dressings show positive effects on infected chronic wounds. The quality of the trials was limited by the potential for bias associated with inadequate concealment, no detailed description of the outcome measurement and no reported intention-to-treat analysis. Moreover, problems existed in some studies with confounding factors. Conclusion. The review clearly highlights the need for well-designed, methodologically standardised outcome measurement research into the effectiveness of silver- releasing dressings. It also points to the need for a comprehensive assessment of wound bed status in further studies. Relevance to clinical practise. This review strengthens the case for the use of silver dressings when managing infected chronic wounds. They appear more effective and are tolerated well by patients. However, their use should be accompanied by a comprehensive wound assessment

The Effect Wound Bed Status and Health related Quality of Life of a Ionic Silver Dressings in Cancer Patients with Malignant Fungating Wound

研究目的：本研究目的在探討頭頸部癌症惡性蕈狀傷口病人應用銀離子敷料，其健康相關生活品質與傷口床狀況之成效。 研究背景：惡性蕈狀傷口是一非癒合性、慢性、複雜性傷口，容易導致出血、滲出液、惡臭和疼痛，引發病人生理、心理、社會、靈性等層面巨大衝擊。銀離子敷料於慢性傷口之系統性回顧及統合分析，文獻指出其可以促進傷口癒合、降低臭味、減少傷口滲液以及增進病人生活品質。然而，當前銀離子敷料應用於惡性蕈狀傷口病人研究付之闕如。 研究設計：本研究為一前瞻性、單一試驗場所、單盲、隨機分派的臨床試驗。 研究方法：研究對象主要收集北部某1000床教學醫學中心，六個病房之頭頸部癌症惡性蕈狀傷口病人，共32位研究對象隨機分派至銀離子敷料(SD)實驗組(n=14)或是非銀離子敷料(NSD)對照組(n=18)，介入處置時間為二星期；主要結果測量指標為傷口床狀況，採用惡性蕈狀傷口評估工具進行測量，次要結果指標則是健康相關生活品質，以McGill台灣版生活品質問卷進行評核。研究資料採用Wilcoxon配對組符號等級檢定、曼惠特尼U檢定及廣義估計方程式模式進行統計分析。 研究結果：本研究對象二組在基本屬性沒有顯著不同。採用無母數統計之魏可遜二獨立樣本檢定-曼惠特尼U檢定(Mann-Whitney U test)，在MFWAT-N之總量表(P=0.005)、壞死組織量( P=0.006)、傷口滲液量( P=0.028)、傷口滲液性質( P=0.001)、傷口出血量(P=0.025)及傷口滲液重量(P=0.042)等實驗組改善狀況明顯優於對照組；MFWAT-P總量表未呈顯著差異。此外，McGill-QOL皆未呈顯著差異( P=0.133)，僅身體症狀範疇(P=0.049)有統計顯著差異。本研究亦採用廣義估計方程式分析傷口床狀況及健康相關生活品質在介入期間二週的變化，MFWAT-N(P=0.014)、傷口滲液重量(P=0.018)、出血量(P=0.000)呈現顯著差異。 結論：惡性蕈狀傷口對病人生活品質影響甚劇。對於緩和照護期間，親水性纖維銀離子敷料可控制惡性蕈狀傷口之傷口滲液、出血、滲液重量。未來研究可以將本研究結果作為建構惡性蕈狀傷口照護指引時的依據，此外，需要評估銀離子敷料成本效益及進行長期追蹤性研究建構更完善的實證資料。 經費補助：本研究經費由慈濟技術學院提供Aim. This study examined the effectiveness of a silver ionic dressing on health related quality of life and wound bed status of head and neck cancer patients with malignant fungating wounds (MFW). Background. Malignant Fungating Wounds (MFWs) are chronic, slow-healing complex wounds that can bleed, generate exudates, become malodorous and painful, and cause both physical and psychological distress to patients. A systematic review and meta-analysis of the effectiveness of silver-containing dressings for management of various chronic wounds has demonstrated their effectiveness in wound healing, reducing odor, decreasing wound exudates and improving patients’ quality of life. However, few studies have empirically tested this treatment approach in managing MFWs. Design. A randomized control trial, single blind, and parallel experimental study design was developed and implemented to assess the impact on patient quality of life when using silver-containing dressings in the treatment of MFWs. Methods: Subjects were recruited from a 1,000-bed academically based medical center with six special units ward (palliative care, oncology ward) for head and neck cancer patients with MFW in north Taiwan. A total of 32 MFW participants were randomly assigned to silver dressing (SD) group (n=14) or non silver dressing group (NSD) (n=18) with a follow-up at two weeks after treatment. The primary outcome variable was wound bed status as measured by a malignant fungating wound assessment tool. The secondary outcome variable was health related quality of life as measured by the McGill quality of life questionnaire. Data were analyzed by Wilcoxon test , Mann-Whitney U-test and generalized estimating equations (GEE) using SPSS 17.0 software. Results: The intervention and control groups were comparable at baseline .There was no significant difference in demographic variables between SD and NSD groups (p>.05). This study shows that the MFWAT-N(P=0.005) , amount of necrotic tissues(P=0.006), amount of exudates(P=0.028), quality of exudates (P=0.001), bleeding(P=0.025), weight of exudates(P=0.042) in the experimental group saw a greater improvement than in the control group, as determined by the Mann-Whitney U-test. The SD group also reported significantly higher scores on the MQOL physical symptoms subscale than the NSD group (P=0.049). Also , GEE analysis showed that participants in the SD group had significant improvements in the MFWAT-N (P=0.014), amount of exudates (P=0.018) and bleeding( P=0.000) over those in the NSD group. Conclusions. MFWs have a negative impact on patients’ HRQOL. Hydrofiber dressings that contain silver can control malodor, exudates, and amount of bleeding in patients undergoing MFW palliative care, thereby improving HRQOL in these patients. Further research is needed in order to developed well-structured MFW management guidelines. A more comprehensive health economic evaluation needs to be undertaken. Further studies exploring a longer term follow up are also required. Declaration of in interest: The study was financially supported by TZU-CHI College of Technology project No.TCCT-961A10, Hualien, Taiwan