The Short-Term and Long-Term Effects of Biofeedback-Assisted Relaxation Therapy in Patients With Heart Failure: A Randomized Control Study

Background: Relaxation techniques can reduce sympathetic nervous system activation and stress, potentially improving heart failure patients’ physical and psychological outcomes. Purpose: To examine the effects of biofeedback-assisted relaxation (BFAR) therapy in patients with heart failure. Methods: A prospective randomized control study was conducted. Participants in the treatment group received BFAR therapy, while participants in the control group received standard of care. Short-term outcomes were physical symptoms and psychosocial variables measured at baseline and 3 months; long-term outcomes were cardiac events and mortality assessed at 12 months. Results: Fifty-two heart failure patients participated in the study: 23 (mean age 60.0 ± 13.7 years; 60.9% male; 39.1% New York Heart Association III/IV) in the treatment group and 29 (mean age 59.2 ± 12.2 years; 72.4% male; 48.3% New York Heart Association III/IV) in the control group. Short-term effects of BFAR on outcome variables were not significantly different between treatment and control groups. However, longer event-free survival was found in the treatment group compared with the control group (p = .019). Conclusions/Implications for Practices: BFAR therapy is effective to improve cardiac event-free survival of heart failure patients and can be applied to clinical setting

Cultural and clinical factors associated with antihypertensive medication adherence in Vietnamese policemen

The purpose of this study is to characterize Vietnamese policemen with hypertension, to report the proportion of hypertension control and medication adherence in Vietnamese policemen, and to explore cultural and clinical factors related to antihypertensive medication adherence. A cross-sectional study design was used. A convenience sample of 100 policemen with hypertension was recruited in Vietnam. A total score of 80% or more on the Medication Adherence scale was defined as medication adherence. Medication adherence was reported in 64% of the participants, but hypertension control was found in only 53%. Medication adherence was higher in the participants with higher perceived susceptibility to hypertension-related complications, higher perceived benefit of Western anti-hypertensive medications, longer duration of time since diagnosis, and fewer prescribed blood pressure lowering medications. Vietnamese policemen are at high risk for poor medication adherence and hypertension management. Culturally and clinically appropriate nursing interventions for hypertension management in Vietnamese policemen are needed

Associations of exposure to noise with physiological and psychological outcomes among post‐cardiac surgery patients in ICUs

OBJECTIVES: This study sought to study the associations of noise with heart rate, blood pressure, and perceived psychological and physiological responses among post-cardiac surgery patients in ICUs. METHODS: Forty patients participated in this study after recovering from anesthesia. A sound-level meter was placed at bedsides to measure noise level for 42 hours, and patients' heart rate and blood pressure were recorded every 5 minutes. Patients were also interviewed for their perceived psychological/physiological responses. RESULTS: The average noise level was between 59.0 and 60.8 dB(A) at the study site. Annoyance and insomnia were the respective psychological and physiological responses reported most often among the patients. Although noise level, irrespective of measures, was not observed to be significantly associated with the self-assessed psychological and physiological responses, it was significantly associated with both heart rate and blood pressure. CONCLUSIONS: Our study demonstrated that the noise in ICUs may adversely affect the heart rate and blood pressure of patients, which warrants the attention of hospital administrators and health care workers

Factors associated with low bone mass in the hemodialysis patients – a cross-sectional correlation study

<p>Abstract</p> <p>Background</p> <p>Low bone mass is common in end-stage renal disease patients, especially those undergoing hemodialysis. It can lead to serious bone health problems such as fragility fractures. The purpose of this study is to investigate the risk factors of low bone mass in the hemodialysis patients.</p> <p>Methods</p> <p>Sixty-three subjects on hemodialysis for at least 6 months were recruited from a single center for this cross-sectional study. We collected data by questionnaire survey and medical records review. All subjects underwent a bone mineral density (BMD) assay with dual-energy x-ray absorptiometry at the lumbar spine and right hip. Data were statistically analyzed by means of descriptive analysis, independent t test and one way analysis of variance for continuous variables, Pearson product-moment correlation to explore the correlated factors of BMD, and stepwise multiple linear regression to identify the predictors of low bone mass.</p> <p>Results</p> <p>Using WHO criteria as a cutoff point, fifty-one subjects (81%) had a T-score lower than -1, of them 8 subjects (13%) had osteoporosis with the femoral neck most commonly affected. Regarding risk factors, age, serum alkaline phosphatase (ALP) level, and intact parathyroid hormone (iPTH) level had significant negative correlations with the femoral neck and lumbar spine BMD. On the other hand, serum albumin level, effective exercise time, and body weight (BW) had significant positive correlations with the femoral neck and lumbar spine BMD. Age, effective exercise time, and serum albumin level significantly predicted the femoral neck BMD (R²× 0.25), whereas BW and the ALP level significantly predicted the lumbar spine BMD (R²× 0.20).</p> <p>Conclusion</p> <p>This study showed that advanced age, low BW, low serum albumin level, and high ALP and iPTH levels were associated with a low bone mass in the hemodialysis patients. We suggest that regular monitoring of the femoral neck BMD, maintaining an adequate serum albumin level and BW, and undertaking an exercise program are important to improve bone health in the patients undergoing hemodialysis.</p

Two-photon microscopy analysis of leukocyte trafficking and motility

During the last several years, live tissue imaging, in particular using two-photon laser microscopy, has advanced our understanding of leukocyte trafficking mechanisms. Studies using this technique are revealing distinct molecular requirements for leukocyte migration in different tissue environments. Also emerging from the studies are the ingenious infrastructures for leukocyte trafficking, which are produced by stromal cells. This review summarizes the recent imaging studies that provided novel mechanistic insights into in vivo leukocyte migration essential for immunosurveillance

兩種教育方案介入對工作場所婦女接受子宮頸抹片檢查之知識、健康信念及行爲的影響

子宮頸抹片檢查已被證實是早其偵測子宮頸癌的有效方法，但是台灣地區婦女的抹片 檢查率仍然不高。本研究的目的乃在比較兩種教育方案介入後對工作場所婦女接受子 宮頸抹片檢查之知識、健康信念及行爲的影響。本研究採類實驗法，以方便取 樣選北市某電子公司之已婚婦女爲研究對象，有效樣本爲250人。將研 究對象分成四組，即前測實驗組、前測控制組、無前測實驗組、無前測控制組。實驗 組給予團體衛教及衛教手冊，控制組予以郵寄衛教手冊。研究結果顯示教育介入後， 實驗組與控制組之知識、抹片行爲均有顯著差異，而實驗組又較控制組顯著， 健康信念無顯著差異。由此可推論，加強對子宮頸抹片檢查知識的認知，對促進婦女 接受抹片檢查將有所助益。 Cervical cancer continues to be a significant problem in Taiwan. Cytological screening and follow-up can reduce the mortality rate of cervical cancer by detection and removal of precursor lesions. The purpose of this research is to examine the effect of two teaching programs in the workplace on married women’s knowledge, health beliefs and behavior regarding cervical cancer screening. The research employed a four group quasi- experimental design. Two of the four groups were assigned to a group teaching program. The other two, the control groups , received a pamphlet teaching program. Total sample was 250 subjects in this research. The results indicated that (1) these two teaching programs led to a significant increase in knowledge of cervical cancer screening and screening rate but not in belief toward cervical cancer and screening. (2) The subjects of the group teaching program had better improvement in knowledge and cervical cancer screening than those of the pamphlet teaching program during post- intervention. This research suggests that enhancing understanding of cervical cancer screening through teaching programs is a relatively effective approach to increcsing women ’s partiaipation in cervical cancer screening

心臟手術病人手術前後克服壓力行為追蹤研究

　　 Heart surgery is a common treatment for patient with severe heart disease. However, it is also a stressful experience for patients undergoing this surgery. Patients use a lot of methods to cope with this situation. The purpose of this study was to understand the process that patients how to cope with heart surgery, and to investigate the characters that are correlated with coping behaviors. This is a descriptive and test -retest study. Forty subjects undergoing CABG or valve replacement surgery were interviewed with structured questionnaire prior to and after heart surgery. The study tool included basic characters and a coping behavior scale which was developed by the researchers. Results showed that heart surgery patients used 29.4 coping behaviors prior to surgery and 30.2 as well after surgery. &quot;Trust doctor*s treatment&quot;, &quot;face the fact&quot;, and &quot; cooperation with doctors and nurses&quot; at pre-operation, and &quot;cooperation with doctors and nurses&quot;, &quot;caring and support from family and friends&quot;, &quot; sick role&quot; and &quot;trust doctor*s treatment&quot; at post-operation were used most often for these patients during hospitalization. Problem-focused coping behaviors were used more often and with better effect than those of emotional-focused coping behaviors. Correlation analysis showed that patients who were younger, with high educational and occupational levels used more coping behaviors than the others, especially in problem- focused coping behaviors. Results of our study provides rich information in how patient cope with heart surgery and a guide to design stress management program for patient undergoing heart surgery

Impact of Liver Donation on Quality of Life and Physical and Psychological Distress

Our objectives were to assess the characteristics of donors for living- donor liver transplantation (LDLT) and to examine the impact of donation on LDLT donor quality of life (OOL) regarding physical and psychological distress. Methods. Data were collected from a mailed survey or an interview using a cross-sectional prospective study design. We used the abbreviated version of the World Health Organization Quality of Life ( WHOQOL-BREF), Physical Symptom Disturbance Scale, and Psychological Distress Scale. LDLT donors were recruited from a teaching hospital located in a metropolitan area of northern Taiwan. Results. The 35 LDLT donors have a mean age 34.0 +/- 8.6 years and were recruited at a median of 25.9 months after donation (range, 0.6-92 months). The average scores in the four domains of the WHOQOL-BREF scale ranged from 13.5 to 14.9. LDLT Donors reported higher QOL scores in social and environment domains but lower scores in physical and psychological domains than healthy adults . Numbers of physical symptoms experienced by each donor ranged from one( n = 4) to 27 (n = 2). Feeling throbbing, itching or numbness around the wound was the most common physical symptom disturbance reported by donors (n = 26, 74%). Approximately 40% of the donors reported having one to three metrics of psychological distresses. &quot;Easily feel distress and angry &quot; was the most common psychological distress reported by 57% ( n = 20) of donors. Conclusions. This study indicated that liver donation had a mild negative impact on donors physical and psychological facets of QOL. These results may assist professionals to provide appropriate clinical management