The Relationship between Coping, Anxiety, and Quality of Life for Taiwanese Post-Coronary Artery Bypass Graft Surgery Patients

Coronary artery bypass grafting surgery (CABG) is a stressful event and requires coping strategies to achieve adaptation. In Taiwan, despite the fact that the incidence of CABG is increasing in both men and women, research on post-CABG adaptation is very limited and no research focuses on outcomes for women. This can lead to problems for health care providers who lack effective interventions to help these patients. The purpose of the study was to examine the relationship between coping, anxiety, and quality of life in Taiwanese post-CABG patients. A cross-sectional correlational design was used; the sample consisted of 50 female and 50 male patients. A post-hoc analysis was employed to understand whether the patients understood the words used in the instruments. To provide more depth to the findings, semi-structured interviews with three male and three female participants were conducted. The literature indicated that the variables\u27 effect on quality of life varied across studies. In the present study, ways of coping, anxiety, and quality of life interacted and influenced each other. Post-CABG patients who were male and had more role responsibility, experienced lower levels of anxiety and used problem-focused coping; as a result, were more likely to obtain a better quality of life. Anxiety was a good predictor of adaptation outcome and was negatively associated with problem-focused coping. Additionally, mental health predicted greater use of problem-focused coping. The results of the semi-structured interview indicated that the quantitative findings were valid and reliable. Men still adapted better than did the women. Both men and women were concerned about their physical recovery following CABG, but men tended to make plans to take control of their health, while women tended to seek help to overcome their stress. The semi-structured interviews provided richness to the study that could not have been captured by quantitative findings alone. The interview responses raised questions about the effect of personality, worldview, culture, anxiety, coping, and perceptions on quality of life that need to be further explored

The role of adherence in the relationship between self-efficacy and self-management in diabetic patients undergoing CABG in Taiwan

[[abstract]]To determine the role of adherence and its significance in the relationship between self-efficacy and self-management of diabetic patients undergoing coronary artery bypass graft (CABG) in Taiwan. Descriptive and correlational survey design. Three outpatient clinics in Taiwan. Patients diagnosed with diabetes undergoing CABG at least 6 months before the study, 18 years of age or older, able to communicate verbally without any psychiatric problems, and with a life expectancy longer than 1 year. Self-management assessment (self-efficacy for managing disease and adherence to guidelines and medication measured on a scale of 0-8), the higher aspects of self-management (keeping appointments, taking medication properly and keeping follow-up appointments) and the lower aspects of self-management (inability to share decisions with primary physician, inability to take correct actions when symptoms worsen and inability to adapt habits to improve health). The mean score obtained for self-management among the 166 participants was 6.48, with 57 (34.3%) of them showing non-adherent behaviour. Self-efficacy accounts for 38% (R(2)=0.380, F(1,103)=63.124, p < 0.001), and 54% of good self-management was explained by self-efficacy and adherence in managing disease (R(2)=0.540, F(2,102)=56.937, p<0.001). Adherence accounts for 16% of better self-management, age and education combined account for 4.9% (R(2)=0.589, F(6.98)=23.399, p<0.001), and lifestyle items account for 5.2% (R(2)=0.641, F(14,90)=11.457, p<0.001). Disease-related variables contribute 3.4% (R(2)=0.674, F(17,87)=10.599, p<0.001). Thus self-efficacy, adherence, age, education, primary care provider and systolic pressure are considered significant predictors of self-management. With the exception of adherence, none of the variables had a statistically significant mediating effect. The results confirm strong relationships between self-efficacy, adherence and self-management, with adherence having a significant mediating effect in post-CABG patients with diabetes in Taiwan. The role of adherence in the relationship between self-efficacy and self-management in diabetic patients undergoing CABG in Taiwan (PDF Download Available). Available from: http://www.researchgate.net/publication/236182441_The_role_of_adherence_in_the_relationship_between_self-efficacy_and_self-management_in_diabetic_patients_undergoing_CABG_in_Taiwan [accessed Dec 4, 2015]

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Food pattern and quality of life in metabolic syndrome patients who underwent coronary artery bypass grafting in Taiwan

[[abstract]]Metabolic syndrome is associated with poor operative outcomes of coronary artery bypass grafting surgery (CABG). A healthy food pattern for metabolic syndrome patients is necessary not only in the initial stage to prevent cardiovascular disease but for those who experience cardiovascular problems and undergo heart surgery. Empirical studies that explore food pattern and quality of life metabolic syndrome patients who undergo CABG are lacking. Therefore, the objectives of this study are to explore the food pattern and quality of life of metabolic syndrome patients who undergo CABG and to examine the relationship between these two variables. A descriptive, correlational and cross section design was conducted. Through convenience sampling, 104 patients were recruited. Data were collected through three instruments: a demographic questionnaire; the Chinese Food Frequency Questionnaire-Short Form (Short C-FFQ), used to assess food pattern; and the Taiwanese version of the Medical Outcomes Study Short Form 36-Health Survey (SF-36), used to assess quality of life. Descriptive analysis, one-way analysis of variance (ANOVA) and Pearson correlation were used to analyze the data. The results indicated that patients who ate fruit more frequently tended to have a better quality of life, while the intake of fried food was more frequently associated with a poor quality of life. The use of these data gives the health care provider a better understanding of food pattern and their impact on quality of life in this population. Such an understanding can be used to develop targeted interventions to promote health in this and in other populations

Health literacy impact on elderly patients with heart failure in Taiwan

[[abstract]]Background Advances in medical technologies and medical services require adequate health literacy from patients in order to improve quality of life. However, health literacy is inadequate in many places and instances, especially in the elderly living in remote areas. Purpose To determine the prevalence of inadequate health literacy in elderly patients suffering from heart failure in Taiwan: to examine the impact of health literacy on self-care and quality of life; and to identify sociodemographic factors associated with health literacy. Methods Ninety-eight individuals were recruited using convenience sampling in a large medical center in Taiwan from May 2011 to May 2012. Four instruments were used in this study: a demographic questionnaire, Taiwan Health Literacy Scale, Self-Care of HF Index V. 6, and Minnesota Living with Heart Failure Questionnaire. Results Findings reveal that 60% of patients with heart failure in this study have inadequate or low health literacy. Conclusion The factors associated with health literacy are hard to change and/or improve; therefore, developing innovative ways to help patients in dealing with their symptoms is needed

Coping, anxiety and quality of life after coronary artery bypass graft surgery

[[abstract]]Title. Coping, anxiety and quality of life after coronary artery bypass graft surgery Aim.  This paper is a report of a study to explore the relationship between ways of coping, anxiety level and quality of life for patients after coronary artery bypass grafting. Background.  Coronary artery bypass grafting requires appropriate coping strategies to achieve successful adaptation. In Taiwan, the incidence of this surgery is increasing, but research on adaptation following surgery is limited, with no research examining outcomes for women, who often have poorer adaptation outcomes than men. Methods.  An integrated research design, based on Lazarus and Folkman’s transaction coping theory, was used. The research employed convenience sampling with four instruments: the Revised Ways of Coping Checklist, State-Trait Anxiety Inventory, Short Form 36-Health Survey, and a demographic questionnaire, sent to 50 men and 50 women who were recruited from a medical centre in Taiwan. Additionally, qualitative data from interviews with three men and three women, who had completed the instruments, were analysed. Findings.  Better quality of life was associated with lower anxiety level, greater use of problem-focused coping strategies and those who had more gender role responsibility. Women scored lower on the physical dimensions of quality of life, used more self-blaming coping strategies and experienced slightly higher levels of anxiety compared to men. The qualitative analysis supported the conclusions of the quantitative analysis. Conclusion.  The results will help nurses design specific interventions intended to lower anxiety levels, promote the use of problem-focused strategies and identify patients’ values, necessary to achieve optimal quality of life

Self care behavior in patients with heart failure in Taiwan

[[abstract]]OBJECTIVE: The aim of this study was to describe the self-care behaviors and associated demographic factors affecting such behaviors in the heart failure population in Taiwan. METHODS: A descriptive, cross-sectional, correlational design was used in this study and 86 heart failure patients were sampled by convenience sampling. Demographic questionnaire and Self-Care of Heart Failure Index, V. 6 were used to collect these data. Descriptive statistic, correlation coefficient and multiple regression were used to analyze the data. RESULTS: The result indicated a low level of self-care maintenance and management although self-care confidence was adequate. Patients who were married had better self-care maintenance and self-care confidence than those who were single. Self-care confidence was a determinant of self-care maintenance. CONCLUSION: This study provided detailed information on self-care behavior status in heart failure patients in Taiwan

Leisure physical activity and quality of life after coronary artery bypass graft surgery for patients with metabolic syndrome in Taiwan.

[[abstract]]OBJECTIVE: The purpose of this correlational study was to explore the physical activity and quality of life of postcoronary artery bypass graft patients with metabolic syndrome. METHODS: Seventy patients were recruited via purposive sampling. Data were collected through three instruments: a demographic questionnaire, the Modifiable Activity Questionnaire, and the Medical Outcomes Study Short Form 36-Health Survey. The data were analyzed using SPSS software, version 17.0 (SPSS, Inc., Chicago, IL), and data analysis included percentages, means, standard deviations, correlation coefficients, and forward regressions. RESULTS: Patients with a higher level of physical activity tended to have better quality of life. Our findings also indicated that the total Modifiable Activity Questionnaire score and age explained 15.1% of the variance in the physical component summary of quality of life, and 13.6% of the variance in the mental component summary of quality of life. CONCLUSION: Based on this research, nursing staff should develop physical activity-related interventions to promote quality of life

Classification and regression tree analysis in acute coronary syndrome patients

[[abstract]]Objectives: The objectives of this study are to use CART (Classification and regression tree) and step-wise regression to 1) define the predictors of quality of life in ACS (acute coronary syndrome) patients, using demographics, ACS symptoms, and anxiety as independent variables; and 2) discuss and compare the results of these two statistical approaches. Back- ground: In outcome studies of ACS, CART is a good alternative approach to linear regression; however, CART is rarely used. Methods: A descriptive survey design was used with 100 samples recruited. Result and Conclusions: Anxiety is the most significant predictor and also a stronger predictor than symptoms of ACS for the quality of life. The anxiety level patients experienced at the time heart attack occurred can be used to predict quality of life a month later. Furthermore, the majority of ACS patients experienced a moderate to high level of anxiety during a heart attack

[[alternative]]Scope of Practice for Nurse Practitioner in Taiwan

[[abstract]]目前國內專科護理師之臨床執業範圍界定不清，且缺乏現況之調查。本研究之目的為瞭解國內專科護理師執業現況。採橫斷性調查研究設計，以全國各級醫院領有專科護理師證照之專科護理師學會會員為研究對象進行自填問卷調查。問卷內容包含執業範疇及工作內容細項及人口學特性。資料收集以電子郵件方式寄送問卷，調查對象填寫完畢後以電子郵件回覆。本研究資料以SPSS15.0中文版套裝軟體進行資料建檔與描述性統計分析。總計發出714份，回收300份有效問卷，回收率42.02%。研究結果發現國內各醫院專科護理師實際執行之工作內容與衛生署所公告之執業範疇大多符合。各層級醫院專科護理師執行之自主性執業範疇皆較缺乏臨床教學，在侵入性治療之執行比例較其他非侵入性治療低。區域醫院與地區醫院之專科護理師在執行侵入性治療及安排病人床位比其他層級醫院來的高。此現況調查結果可作為相關單位及專業團體制定專科護理師政策及其培訓計畫之參考。[[abstract]]Currently, the scope of practice for nurse practitioner is not clearly understood and lack of research focused on this specific issue. The purpose of this study is to investigate the scope of practice of nurse practitioner (NP) practice in Taiwan. A cross section design and purpose sampling design were used in this study. The instruments include NP scope of practice questionnaire and demographic questionnaire. Descriptive statistics were used for the demography and data analysis was carried out using SPSS, version 15.0 statistical software. There were 714 questionnaires distributed, and 300 completed and valid, giving a return rate 42.02%. The results showed the scope of practice in reality were mostly conformed to the scope of practice announcement from Department of Health. The study found nurse practitioners spend less time to play bedside educator role than other roles. In addition, nurse practitioners did more non-invasive procedure compare to invasive procedure. The nurse practitioner who work in local hospital spend more time carrying out invasive procedure and arrange patients to different units, compare to the nurse practitioner who work in medical center and teaching hospital. Professional association and governments might develop related policy and design training program based on the results from this study