ORCID Profile
0000-0003-3295-5373
Current Organisations
La Trobe University
,
Asialink, University of Melbourne
,
Victoria University of Technology
,
Deh-Yu College of Nursing and Management
,
National Taiwan University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Related Links
Publications
Effectiveness of mindfulness‐based intervention on psychotic symptoms for patients with schizophrenia: A meta‐analysis of randomized controlled trials
Publisher: Wiley
Date: 15-01-2021
DOI: 10.1111/JAN.14750
The experiences of family resilience from the view of the adult children of parents with bipolar disorder in Chinese society.
Publisher: Wiley
Date: 07-08-2022
DOI: 10.1111/JAN.15008
Abstract: This study explored how adult children perceived family resilience, barriers to develop family resilience and how cultural values influence their experience of parents with bipolar disorder in Chinese society. A qualitative design with an interpretive phenomenological analysis of data was employed. Twenty adults who had lived with parents with bipolar disorder during childhood were recruited from the acute psychiatric ward when their parents were admitted to the hospital. They described their experiences of perceived family resilience and barriers to resilience (October 2013-September 2015). Semi-structured interviews were conducted in the hospital meeting room or at a convenient location. Six themes were identified in family resilience: ill parents try to be good parents, parents' personal strengths, parents' positive attitudes towards mental illness, flexibility of family role, cohesive relationships between family members, and families' social connections. Three themes were identified in the barriers to develop family resilience: poor parenting/family function, conflict between parents and poor mental health literacy. Children's views of family resilience could transform their suffering from lived experiences with a mentally ill parent to a positive growth experience. Family resilience includes well and ill parents' efforts and social network's help to maintain family function. However, the conflicts between well and ill parents and poor family function result in a traumatic growth experience. To enhance a positive growth experience, family resilience programs for a parent with bipolar disorder aiming to cultivate both the ill and well parents' inner strength and their competence of parenting skills with connecting their social network to maintain family function is needed. Moreover, early stress-reduction intervention needs to be developed for children who did not experience family resilience.
The correlations of sexual activity, sleep problems, emotional distress, attachment styles with quality of life: comparison between gynaecological cancer survivors and noncancer women
Publisher: Wiley
Date: 08-05-2013
DOI: 10.1111/JOCN.12232
Abstract: To compare quality of life and its related factors, which include sexual activity, sleep problems, depression, anxiety and attachment styles in close relationships, between gynaecological cancer survivors and noncancer women. The majority of studies focus on examining the relationships between the late-treatment side effects and quality of life in gynaecological cancer survivors. As a result, there is insufficient information about what are the correlations between psychosocial factors and quality of life in gynaecological cancer survivors. Cross-sectional study. The quality of life of the 85 gynaecological cancer patients who had completed active treatments for at least six months was compared with the 85 age-matched women without cancer history. Measures included SF-12 Health Surveys, Medical Outcomes Study Sleep Scale, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Sexual Activity Questionnaire and Experiences in Close Relationships-Revised. There were no significant differences in the quality of life between gynaecological cancer survivors and noncancer women. However, higher attachment-related anxiety in close relationship was the main factor associated with the lower physical quality of life in the gynaecological cancer survivor group. In contrast, older ages were correlated with lower physical quality of life in noncancer women. Anxiety level was the main factor associated with lower mental quality of life for both groups. Different from noncancer women, the psychosocial factor of insecure attachment in close relationships was the main factor associated with physical quality of life for gynaecological cancer survivors. Anxiety status was the common factor correlated with mental quality of life for cancer and noncancer women. Developing psychosocial interventions focusing on secure attachment in close relationships and anxiety management could improve physical and mental components of quality of life among gynaecological cancer survivors.
Delaying surgery for patients with a previous SARS-CoV-2 infection
Publisher: Oxford University Press (OUP)
Date: 25-09-2020
DOI: 10.1002/BJS.12050
The comparison of effectiveness of two modalities of mental health nurse follow‐up programmes for female outpatients with depression in Taipei, Taiwan
Publisher: Wiley
Date: 18-05-2007
DOI: 10.1111/J.1365-2702.2007.01718.X
Abstract: This study compares the effectiveness of two modalities of mental health nurse three-month follow-up programmes: telephone counselling programme and group therapy programme for female outpatients with depression. The lifetime prevalence of major depression is 15% and is about twice as common in women as in men. Outpatients with depression often discontinue their treatment after the initial visits to their physicians. This study used a quasi-experimental, pre-post-test comparison group design. Twenty-six female outpatients with depression were assigned to one of follow-up programmes: telephone counselling programme or group therapy programme. To qualify for group therapy programme, potential participants were required to come to group sessions weekly. To be accepted into telephone counselling programme, potential participants had to be able to be contacted by phone regularly. Mental health nurse three-month follow-up programmes included care management and structured psychotherapy. Patients in telephone counselling programme received 10 regular telephone calls of 30-60 minutes each. Patients in group therapy programme received 12 sessions of weekly group meetings of 90-120 minutes each. Wilcoxon signed ranks tests provided evidence that the group therapy programme (S = -52.5, p < 0.001 S = 31.5, p = 0.046) and telephone counselling programme (S = -36, p = 0.002 S = 25, p = 0.050) follow-up programmes were effective in terms of relieving depressed symptoms and improving quality of life. According to Quade's analysis of covariance, telephone counselling programme and group therapy programme appeared to have similar effects of relieving depressed symptoms (F(1,24) = 0.06, p = 0.813) and increasing quality of life (F(1,24) = 0.07, p = 0.792). While there was no significant difference in using emergency services ( chi(2)(1)= 0.89, p = 0.539) between telephone counselling programme and group therapy programme, the rate of adherence to scheduled outpatient appointments with psychiatrists was higher among patients in group therapy programme than patients in telephone counselling programme (chi(2)(3) = 8.67, p = 0.034). Establishing two modalities of mental health nurse follow-up programmes in Taiwan could benefit patients with different needs. Mental health nurses specialized in management of depression could provide not only care management but also structured psychotherapy.
Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic
Publisher: Wiley
Date: 17-12-2020
DOI: 10.1111/CODI.15431
Abstract: This study aimed to describe the change in surgical practice and the impact of SARS‐CoV‐2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS‐CoV‐2 pandemic. This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS‐CoV‐2. Centres entered data from their first recorded case of COVID‐19 until 19 April 2020. The primary outcome was 30‐day mortality. Secondary outcomes included anastomotic leak, postoperative SARS‐CoV‐2 and a comparison with prepandemic European Society of Coloproctology cohort data. From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty‐day mortality was 1.8% (38/2073), the incidence of postoperative SARS‐CoV‐2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS‐CoV‐2 (14/1601, 0.9%) and highest in patients with both a leak and SARS‐CoV‐2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS‐CoV‐2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Surgeons need to further mitigate against both SARS‐CoV‐2 and anastomotic leak when offering surgery during current and future COVID‐19 waves based on patient, operative and organizational risks.
The effects of supportive care interventions on depressive symptoms among patients with lung cancer: A metaanalysis of randomized controlled studies
Publisher: Cambridge University Press (CUP)
Date: 16-05-2017
DOI: 10.1017/S1478951517000335
Abstract: Our aim was to examine the effect of supportive care interventions on depressive symptoms in patients with lung cancer. We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and the Chinese Electronic Periodical Services (CEPS) from their inception until September of 2015. We included randomized controlled trial studies that compared standard care with supportive care interventions. The standardized mean difference (SMD) (Cohen's d ) was calculated to estimate the effect of interventions. Subgroup analysis was conducted to identify possible sources of heterogeneity. A total of 1,472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms ( SMD = –0.74, CI 95% = –1.07 to –0.41), and the effects could be maintained at weeks 4, 8, and 12 of follow-up. Three types of supportive care interventions were identified: psychotherapy combined with psychoeducation, psychoeducation alone, and an exercise program. Both psychotherapy combined with psychoeducation and exercise significantly improved depressive symptoms, while psychoeducation alone did not yield significant effects. The moderating effects indicated that greater improvements in depressive symptoms were found in lung cancer patients with a severe level of depressive symptoms at baseline. Personalized supportive care interventions can be developed based on the main causes of depressive symptoms. Psychotherapy combined with psychoeducation can target the causes of depressive symptoms, including both physical distress and psychological trauma due to lung cancer, while exercise programs can effectively improve depressive symptoms for lung cancer patients with impaired respiratory function.
Patient-Related Barriers to Fatigue Communication in Cancer Patients Receiving Active Treatment
Publisher: Oxford University Press (OUP)
Date: 09-2009
DOI: 10.1634/THEONCOLOGIST.2009-0048
Abstract: To explore barriers to reporting fatigue in cancer patients receiving active treatment and the significant factors associated with those barriers from fatigue characteristics (i.e., intensity, duration, and interference with daily life), to demographic characteristics and disease/treatment variables. Patients with various types of cancer (n = 288) were recruited from an outpatient chemotherapy center, and from seven oncology and hematology units in a teaching hospital in northern Taiwan. Data were collected using the Fatigue Management Barriers Questionnaire to explore barriers to fatigue communication. Fear of distracting the doctor was rated as the highest barrier of reporting fatigue. The degree of fatigue interference with daily life by patients was associated with the willingness to report fatigue. Patients with gastrointestinal cancer experienced more barriers to reporting fatigue than those with hematological cancer. Patients without religion perceived the highest level of barriers to fatigue communication. Outpatients had higher levels of concern than inpatients. Discussion with patients about their high level of perceived fatigue barriers before implementing patient education is recommended. Assessing fatigue interference with daily life and identifying factors associated with barriers to reporting fatigue (i.e., type of cancer, religion, and the setting for receiving treatment) are suggested in order to provide better fatigue management in clinical settings.
Cultural attribution of mental health suffering in Chinese societies: the views of Chinese patients with mental illness and their caregivers
Publisher: Wiley
Date: 19-06-2006
DOI: 10.1111/J.1365-2702.2006.01331.X
Abstract: This study examined the cultural attribution of distress in the Chinese, the special role of the family in distress and the specific emotional reactions within distress dictated by culture. This phenomenological study illustrated the narrative representation of the experiences of suffering by the Chinese patients with mental illness. Twenty-eight Chinese-Australian patients and their caregivers were interviewed together in their homes. They were invited to talk about the stories of the patients' experiences of suffering from mental illness. The interviews were recorded and transcribed to be further analysed according to the principles of narrative analysis. The results of case narration indicated that (1) because of the influence of Confucian ideals, interpersonal harmony was the key element of maintaining the Chinese patients' mental health, (2) Chinese patients' failure to fulfil cultural expectations of appropriate behaviours as family members contributed to disturbance of interpersonal relationships and (3) Chinese patients' failure to fulfil their familial obligations contributes to their diminished self-worth and increased sense of guilt and shame. The findings of the present study suggest that Chinese people's well-being is significantly determined by a harmonious relationship with others in the social and cultural context. Psychotherapy emphasizing an in idual's growth and autonomy may ignore the importance of maintaining interpersonal harmony in Chinese culture. The results of this study contribute to the essential knowledge about culturally sensitive nursing practices. An understanding of patient suffering that is shaped by traditional cultural values helps nurses communicate empathy in a culturally sensitive manner to facilitate the therapeutic relationship and clinical outcomes.
Personality Trait and Quality of Life in Colorectal Cancer Survivors
Publisher: Oncology Nursing Society (ONS)
Date: 29-04-2011
The Long-Term Effects of Mindfulness Added to Family Resilience-Oriented Couples Support Group on Psychological Well-Being and Cortisol Responses in Breast Cancer Survivors and Their Partners
Publisher: Springer Science and Business Media LLC
Date: 16-07-2016
Exploration of Parental Smokers' Experience, Perceptions, and Family's Influences on Their Smoking in the Presence of Children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
Factors influencing patient-perceived quality of care in psychiatric hospitals in Taiwan
Publisher: Elsevier BV
Date: 02-2021
Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.GENHOSPPSYCH.2013.10.019
Abstract: The aims were to examine the effects of psychotherapy on depressive and anxiety symptoms, the occurrence of suicidal ideations and diurnal cortisol patterns in patients with adjustment disorder (AD) with depressed mood. Participants recruited from an outpatient department of psychiatry at a general hospital were randomly assigned to one of two groups: 34 in psychotherapy group and 37 in control group. The control group consisted of one-session psychoeducation. Psychotherapy included the eight-weekly body-mind-spirit (BMS) group psychotherapy. Measures included Beck Depression Inventory-II and State Trait Anxiety Inventory. Salivary cortisol s les were collected from the patients at their homes on awakening 30 and 45 min after awakening and at 1200, 1700 and 2100 h. Measurements were taken at baseline and at months 2 (end of intervention), 5, 8 and 14. There was no differential change over time between the BMS and control groups in self-reported depression or anxiety symptoms. However, suicidal ideation appeared to be reduced in the psychotherapy group. Changes in diurnal cortisol patterns were also significantly different in group × time interactions, in favor of BMS group. Psychotherapy likely provides improvements in psychobiological stress responses and decreases the occurrence of suicidal ideation in patients with AD.
The Short- and Long-term Causal Relationships Between Self-compassion, Trait Mindfulness, Caregiver Stress, and Depressive Symptoms in Family Caregivers of Patients with Lung Cancer
Publisher: Springer Science and Business Media LLC
Date: 05-05-2021
The multiple mediating effects of cancer threat appraisal and quality of life on the association between mindfulness and depression for colorectal cancer survivors
Publisher: Wiley
Date: 20-02-2021
DOI: 10.1002/PON.5644
Abstract: This study explored the multiple mediating effects of cancer threat appraisal, functional status, and symptom distress on the association between mindfulness and depression in colorectal cancer (CRC) patients at the transition stage after completing cancer treatments. A total of 90 CRC survivors who received cancer treatments within 3 months participated in this cross‐sectional study. The functional status and symptom distress (EORTC‐C30 and EORTC CR29), dispositional mindfulness (Five Facet Mindfulness Questionnaire), cancer threat appraisal ( Constructed Meaning Scale), and depressive symptoms (Beck Depression Inventory‐II scale) were collected. The mediation and moderation analyses were conducted using the PROCESS macros for SPSS. Survivors' dispositional mindfulness ( γ = −0.49, p 0.001) and cancer threat appraisal ( γ = −0.59, p 0.001) were significantly associated with depressive symptoms. Simple mediation analysis indicated that cancer threat appraisal mediated the relationship between dispositional mindfulness and depression ( β = −0.02, 95% CI = −0.04 to −0.001). The multiple mediated analysis identified the path between dispositional mindfulness and depression via cancer threat appraisal and colorectal symptom distress ( β = −0.01, 95% CI = −0.03 to −0.01). In the mediated moderation model, the path between dispositional mindfulness and depression via colorectal function was moderated by cancer threat appraisal ( β = −0.02, 95% CI = −0.05 to −0.004). The two cognitive mechanisms of reducing CRC survivors' depression are as follows: (1) dispositional mindfulness reducing the appraisal of cancer as a threat and increasing positive perceptions of CRC symptoms and (2) the cancer threat appraisal buffered the impacts of CRC's mindfulness and colorectal function on depressive symptoms. Developing mindfulness with cognitive training is recommended for improving depressive symptoms among CRC patients in the transition period.
The partner’s insecure attachment, depression and psychological well-being as predictors of diurnal cortisol patterns for breast cancer survivors and their spouses
Publisher: Informa UK Limited
Date: 29-01-2014
DOI: 10.3109/10253890.2014.880833
Abstract: The purpose of this study was to explore whether stress from in idual's and partner's depression, anxiety, sleep disturbances, insecure attachment and meaning in life were predictors of diurnal cortisol patterns in breast cancer survivors and their spouses. Thirty-four couple dyads participated in this eight-month follow-up study. The breast cancer survivors and their spouses completed the Medical Outcomes Study Sleep scale, the Beck Depression Inventory-II, the State Trait Anxiety Inventory, the Experiences in Close Relationships-Revised scale and the Meaning in Life Questionnaire, and they collected salivary cortisol at home at the time of awakening, 30 and 45 min after waking and at 1200 h, 1700 h and 2100 h. Diurnal cortisol slopes of survivors and spouses are positively correlated. But the factors associated with diurnal cortisol patterns are different between survivors and spouses. For survivors, neither survivor in iduals' nor spouses' psychosocial factors were the predictors of survivors' diurnal cortisol patterns. For spouses, the survivors' higher anxious attachment style was the main predictor of spouses' flatter diurnal cortisol patterns. In conclusion, for spouses, psychophysiological stress responses are mainly influenced by breast cancer survivors' insecure attachment. Future couple supportive care interventions can address survivors' attachment styles in close relationships in order to improve neuroendocrine functions for both breast cancer survivors and their spouses.
The effectiveness of compassion-based interventions among cancer patients: A systematic review and meta-analysis
Publisher: Cambridge University Press (CUP)
Date: 18-11-2022
DOI: 10.1017/S1478951522001316
Abstract: This study examined the effects of compassion-based intervention on mental health in cancer patients by using systematic review and meta-analysis of randomized controlled trials (RCTs). Eleven bibliographic databases were searched from their earliest data available date up to March 1, 2022. The databases were PubMed, CINAHL, MEDLINE, PsycINFO, WOS, Cochrane, Embase, Scopus, ProQuest Dissertations, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan. Ten studies from 2015 to 2021 were included with a total of 771 cancer patients. Most were targeted at women with breast cancer. Brief compassion-based interventions of approximately 30 minutes were conducted by audio file, paper, and web-based self-guided writing prompts. Most were conducted after the completion of active treatment. Anxiety was the most measured outcome. Constructive compassion-based interventions with 4- to 12-week sessions were conducted by a trained facilitator. Most were conducted for patients who had undergone treatment, and depression was the most measured outcome. The meta-analysis indicated that compassion-based interventions had a significant effect of reducing depression and increasing self-compassion. Moderation analysis indicated that constructive intervention showed more benefits of increased self-compassion than brief intervention. Both face-to-face and non-face-to-face web-delivered formats had benefits for increasing self-compassion compared with the control condition. Compassion-based interventions might provide an effective strategy for improving self-compassion and depression among patients with breast cancer. Suggestions for further research and health-care providers follow.
Folk concepts of mental disorders among Chinese‐Australian patients and their caregivers
Publisher: Wiley
Date: 07-2006
DOI: 10.1111/J.1365-2648.2006.03886.X
Abstract: This paper reports a study of (a) popular conceptions of mental illness throughout history, (b) how current social and cultural knowledge about mental illness influences Chinese-Australian patients' and caregivers' understanding of mental illness and the consequences of this for explaining and labelling patients' problems. According to traditional Chinese cultural knowledge about health and illness, Chinese people believe that psychotic illness is the only type of mental illness, and that non-psychotic illness is a physical illness. Regarding patients' problems as not being due to mental illness may result in delaying use of Western mental health services. Data collection took place in 2001. Twenty-eight Chinese-Australian patients with mental illness and their caregivers were interviewed at home, drawing on Kleinman's explanatory model and studies of cultural transmission. Interviews were tape-recorded and transcribed, and analysed for plots and themes. Chinese-Australians combined traditional knowledge with Western medical knowledge to develop their own labels for various kinds of mental disorders, including 'mental illness', 'physical illness', 'normal problems of living' and 'psychological problems'. As they learnt more about Western conceptions of psychology and psychiatry, their understanding of some disorders changed. What was previously ascribed to non-mental disorders was often re-labelled as 'mental illness' or 'psychological problems'. Educational programmes aimed at introducing Chinese immigrants to counselling and other psychiatric services could be made more effective if designers gave greater consideration to Chinese understanding of mental illness.
Factors Associated with Parents’ Perceptions of Parental Smoking in the Presence of Children and Its Consequences on Children
Publisher: MDPI AG
Date: 07-01-2013
The changes of parental functioning of the patients with bipolar disorder and major depression since discharging from hospital: A longitudinal study.
Publisher: Wiley
Date: 21-07-2022
DOI: 10.1111/JOCN.16462
Abstract: This study examined the changes in patients' parental functioning and the associated factors, including manic, depressive symptoms and social support from before discharge to 6 months post-discharge. For parents with bipolar disorder and major depression, parenting is a recovery factor for patients, but little research examines the dynamic parental functioning from acute hospitalisation to a remission stage. A longitudinal design was used. The STROBE Checklist were used in presenting this research. Participants were inpatients with bipolar disorder or major depression (n = 33) recruited within one week before discharge from the acute psychiatric ward in Taiwan. Data on parental functioning was collected four times: before discharge (T1), the 1st (T2), the 3rd (T3) and the 6th (T4) months of post-discharge. Baseline parental functioning before admitting to the acute word was retrospectively assessed at T0. The questionnaires included positive and negative domains of parenting practice, hypomanic/manic symptoms, depressive symptoms and social support. Generalised estimating equations were applied for data analysis. The negative parenting domains (poor monitoring, inconsistent discipline) decreased during hospitalisation but increased at one month post-discharge, except corporal punishment at 3-months discharge. The positive parenting domains (parental involvement and nurturance/responsiveness) did not recovery to baseline. While clinical symptoms remained stable during 6 months post-discharge, social support decreased at 3 and 6 months post-discharge. Higher depressive symptoms and low social support were associated with positive parenting domains but not related to negative parenting domains. Manic symptoms were not associated with positive or negative parenting domains. Positive parenting domains did not fully return to the usual situation during 6 months post-discharge. Parenting functioning recovery program targeting at the impacts of depressive symptoms on the parenting functioning and insufficient social support is needed from hospitalisation to post-discharge.
Prevalence and Predictors of Depression Among People Living With HIV/AIDS
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
The Effects of Psychotherapy on Psychological Well-Being and Diurnal Cortisol Patterns in Breast Cancer Survivors
Publisher: S. Karger AG
Date: 2012
DOI: 10.1159/000329178
Abstract: i Background: /i Neuroendocrine dysregulation influenced by psychosocial stress is related to breast cancer recurrence. Very few studies examine the impacts of psychotherapy on diurnal cortisol patterns among breast cancer survivors. i Methods: /i Forty-eight breast cancer patients who completed active cancer treatment were randomly assigned to receive either 8 weekly body-mind-spirit (BMS) group therapy sessions or 1 educational (EDU) session. Self-report measures included the Beck Depression Inventory-II (BDI-II), and the Meaning in Life questionnaire (MLQ) including two subscales: MLQ-Presence and MLQ-Search. Salivary cortisol levels were collected by the subjects in their homes at the time of awakening, 30 and 45 min after awakening, and at 12.00, 17.00, and 21.00 h. Measurement time points include baseline, the 2nd month (completion of BMS therapy), the 5th month, and the 8th month. i Results: /i There were no significant differences in BDI-II scores (p .05) and MLQ-Presence scores (p .05) between BMS and EDU groups at baseline or across the three follow-ups. Nevertheless, greater MLQ-Search scores were found in the BMS group compared to the EDU group during the 5th month of follow-up (p .01). The higher level of cortisol at 21.00 h (p 0.01) and a flatter diurnal cortisol pattern were more likely to occur in EDU than in BMS participants (p 0.05) at the 8th month of follow-up. i Conclusion: /i BMS group therapy likely contributed to enhancing an active search for meaning in life toward more opportunities for personal growth and to maintaining stable cortisol responses to everyday life stress for breast cancer survivors.
An increased risk of stroke among young schizophrenia patients
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.SCHRES.2007.12.485
Abstract: This study sets out to estimate the risk of stroke developing among young schizophrenia patients during a five-year follow-up period after hospitalization for episodes of acute exacerbation. Hospitalized schizophrenia patients under 45 years of age were identified from the Taiwan National Health Insurance Research Database for the year 1998 (n=5001). Two age-matched cases were randomly selected for each schizophrenia patient from among patients who underwent appendectomies in the same year (n=10,002). Each in idual patient was retrospectively followed up from 1998 until the end of 2003 to determine whether any had developed strokes. Cox proportional hazard regressions were carried out to compute the adjusted five-year survival rate. A total of 219 patients (1.46%) developed strokes during the five-year follow-up period, with the attacks occurring among 2.46% of schizophrenia patients and 0.94% of the comparison cohort. Following adjustment for patients' demographic characteristics, select comorbid medical disorders and substance abuse, schizophrenia patients were found to be 2.02 times (p<0.001) more likely to develop strokes during the follow-up period than age-matched appendectomy patients. The adjusted hazard ratios of developing stroke for male and female schizophrenia patients were, respectively, 1.64 (p<0.001) and 2.87 (p<0.001) times greater than their counterparts in the comparison group. As compared with the comparison group, young schizophrenia patients demonstrated a two-fold increased risk of developing stroke during the five-year period after hospitalization. The risk of developing stroke among schizophrenia patients was found to be much higher for females than males.
The validity of the three flows of compassion scales
Publisher: Cambridge University Press (CUP)
Date: 04-2021
Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
Publisher: Elsevier BV
Date: 11-2021
The changes of quality of life and their correlations with psychosocial factors following surgery among women with breast cancer from the post-surgery to post-treatment survivorship
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.BREAST.2018.12.011
Abstract: This 14-month study aimed to examine the changes of quality of life following breast cancer surgery and associations of such changes with depression and anxiety levels, and protective factors (attachment styles in close relationship, and meaning in life) based on positive psychology theory. Women with breast cancer were recruited within one week of completion of breast cancer surgery. They were asked to complete several questionnaires to measure the generic and breast cancer specific quality of life, depression and anxiety levels, attachment styles in close relationship, and meaning in life. Assessments were performed at baseline (T0), T1 (the 2nd month), T2 (the 5th month), T3 (the 8th month), and T4 (the 14th month). While the generic functions of quality of life improve after surgery, no significant changes of the breast-specific functions were found during the 14-month follow up period. While physical, role, and social functions improved immediately after surgery, the improvements of emotional and cognitive functions began to occur at the 5th and the 8th months after surgery. Depressive symptoms predicted almost all general and breast-specific QOL functions and symptoms. Avoidant and anxious attachment styles were associated with the negative scores for breast-specific functions and symptoms. Breast-specific functions, in particular body image and sexual function, remain unchanged with the passage of time following surgery. A psychological rehabilitation program aiming to reduce depressive symptoms and enhance secure attachment styles in close relationships needs to be established immediately following surgery and continue through the post-treatment survivorship stages.
The Effect of Psychotherapy Added to Pharmacotherapy on Cortisol Responses in Outpatients With Major Depressive Disorder
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2009
The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study.
Publisher: Wiley
Date: 21-12-2019
DOI: 10.1111/JAN.13883
Abstract: This study examined the changes and the predictors of suicide ideation/suicide attempt and the moderating effects of psychosocial factors on the suicide ideation/suicide attempts among human immunodeficiency virus (HIV)-positive patients at 6-12 months post-diagnosis. Suicide behaviours are prevalent among newly diagnosed HIV-positive patients, but the changes in suicide behaviours after diagnosis and the role of psychosocial factors in these behaviours are not well studied. This study used a prospective longitudinal design. A total of 113 participants diagnosed as HIV-positive for 6-12 months were recruited from the outpatient department. Data were collected from June 2015 - October 2016. They were asked to complete Beck's Scale for Suicide Ideation, the Beck Depression Inventory-II, the Body Image Scale, the Meaning in Life Questionnaire and the Multidimensional Scale of Perceived Social Support at baseline, the third month and the sixth month. The results showed the high occurrence rates for suicide ideation ranging from 27.2%, 21.6%, and 25.8% and suicide attempt ranging from 14.7%, 8.6%, and 13.3% at the baseline, the third month and the sixth month, respectively. The education level, social support from family and depressive symptoms were the predictors of suicide ideation. The history of depression disorders, depressive symptoms and social support from friends significantly predicted suicide attempt. Meaning in life-presence moderated the relationship between depressive symptoms and suicide ideation. After diagnosed for 6-12 months, HIV-positive patients remain the high-risk group for suicide ideation and attempt. Suicide intervention targeting the risk and protective factors are required for HIV-positive patients.
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study
Publisher: Elsevier BV
Date: 11-2022
Chinese inpatients’ subjective experiences of the helping process as viewed through examination of a nurses' focused, structured therapy group
Publisher: Wiley
Date: 10-09-2004
A longitudinal study of cortisol responses, sleep problems, and psychological well-being as the predictors of changes in depressive symptoms among breast cancer survivors
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.PSYNEUEN.2012.06.010
Abstract: This study examined whether the changes in sleep problems, attachment styles, meaning in life, and salivary cortisol over the course of 14 months were the predictors of changes in depressive symptoms in women with breast cancer at post-treatment stage. The study included 76 participants who completed active breast cancer treatment with longitudinal data collected at five points, including baseline assessment (T0) and the four follow-ups after baseline: T1 (in the 2nd month), T2 (in the 5th month), T3 (in the 8th month), and T4 (in the 14th month). The self-reported questionnaires included the Medical Outcomes Study Sleep (MOS-Sleep) scale the Beck Depression Inventory-II (BDI-II) the Experiences in Close Relationships-Revised (ECR-R) scale for measuring anxiety and avoidance dimensions of attachment style and the Meaning in Life Questionnaire (MLQ), consisting of the MLQ-Presence scale and the MLQ-Search scale. The participants collected their salivary cortisol at home at six time points: upon waking, 30 and 45 min after waking, and at 1200 h, 1700 h, and 2100 h. Higher scores on for anxiety-related attachment style and the sleep problems index at baseline were associated with more severe initial depressive symptoms after the age, BMI, cancer, and treatment variables were controlled. The presence of meaning in life at baseline was negatively correlated with initial depressive symptoms. Moreover, the decreases in the presence of meaning in life over the course of 14 months predicted more severe depressive symptoms. In addition, the persistent increases of cortisol level at 2100 h across 14-month follow-ups predicted worsening depressive symptoms. Lacking presence of meaning in life as a predictor for severe depressive symptoms demonstrates that breast cancer survivors who lack psychological well-being are more likely to be depressed. The persistent elevation of cortisol levels at night also indicates breast cancer survivors to be at high risk of depression.
Towards long-term mobility tracking in NTU hospital's elder care center
Publisher: IEEE
Date: 03-2011
Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
Publisher: Elsevier BV
Date: 11-2022
A longitudinal study of diurnal cortisol patterns and associated factors in breast cancer patients from the transition stage of the end of active cancer treatment to post-treatment survivorship
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BREAST.2017.06.016
Abstract: The aim of this study was to examine the changes in diurnal cortisol patterns and its associated factors among breast cancer patients over a 14-month follow up period. A total of 85 breast cancer patients were recruited to participate in this study. Assessments were performed at baseline (T0), T1 (the 2nd month), T2 (the 5th month), T3 (the 8th month), and T4 (the 14th month). Salivary cortisol was measured and the following questionnaires were administered: BDI-II depression scale, European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer-specific complementary measure (EORTC QLQ-BR23). Patients were grouped into flat and steep groups, according to the median of the diurnal cortisol slopes at the time of the transition period. Breast cancer patients in the flatter slope group at transition period demonstrated steeper slopes over the course of recovery from treatment and those in the steeper slope group at transition period continued with steeper slopes over the course of recovery. The greater breast cancer-related symptoms (side-effects, symptoms relating to breast and arm, and hair loss) were associated with the changes in flatter diurnal cortisol slopes during14-month follow up period. Diurnal cortisol patterns in flatter slope group at the transition period appear to have a trend of recovery with the passage of time over the course of recovery from treatment. Management of breast cancer symptoms could improve dysregulation of diurnal cortisol patterns among survivors.
The Association of Social Support and Symptomatic Remission among Community-Dwelling Schizophrenia Patients: A Cross-Sectional Study
Publisher: MDPI AG
Date: 09-04-2021
Abstract: Schizophrenia is a mental disease that often leads to chronicity. Social support could reduce the severity of psychotic symptoms therefore, its influence on remission should be examined. This study investigated the remission rates in community-dwelling schizophrenia patients and examined the association between social support and remission status. A cross-sectional study was conducted in 129 schizophrenia patients in Taiwan. Remission rates were evaluated, and the level of social support, clinical characteristics, sociodemographic variables, and healthy lifestyle status were compared between the remission and nonremission groups. The association between social support and remission was analyzed after adjusting for confounding factors. The mean illness duration is 12.9 years. More than 95% of the participants lived with their families, 63% were unemployed, and 43% achieved remission. Higher social support was observed in the remission group, and a significant correlation was observed between family domain of social support and remission status. Family support was a protective factor of symptomatic remission in community-dwelling schizophrenia patients in Taiwan. The results reflect the effects of a family-centered culture on patients during illness. Consequently, reinforcing family relationships and the capacity of families to manage the symptoms of patients and providing support to families are recommended.
The Long-Term and Mediating Effects of Mindfulness Integrated with Body-Mind-Spirit Group Therapy on Depressive Symptoms and Quality of Life Among Non-small Cell Lung Cancer Patients
Publisher: Springer Science and Business Media LLC
Date: 25-11-2021
Motivating the motivators: Lessons learned from the design and evaluation of a social persuasion system
Publisher: Elsevier BV
Date: 02-2014
Dispositional mindfulness, self‐compassion, and compassion from others as moderators between stress and depression in caregivers of patients with lung cancer
Publisher: Wiley
Date: 06-06-2019
DOI: 10.1002/PON.5106
Abstract: The present study aimed to identify the most important protective factors predicting caregivers' depressive symptoms among factors of caregivers' dispositional mindfulness, self-compassion, compassion from others, and patients' dispositional mindfulness and their moderator effects on the relationship between caregiving stress and depressive symptoms. A total of 72 lung cancer outpatients and their family caregivers participated in this study. Family caregivers completed the Kingston Caregiver Stress Scale, Beck Depression Inventory-II (BDI-II), Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale, and Compassion from Others Scale. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), BDI-II, and FFMQ. After controlling for patients' factors (treatment status, symptom distress, and depressive symptoms) and caregivers' health status, caregivers' stress and dispositional mindfulness, the domain of mindful awareness, and self-compassionate action were significantly associated with their depressive symptoms. Further analysis indicated that mindful awareness or self-compassionate action could buffer the effect of caregiving stress on depressive symptoms. When the two moderators, mindful awareness and self-compassionate action, were tested simultaneously, only self-compassionate action remained as a significant moderating effect. Caregivers' mindful awareness and self-compassionate action were protective factors, which mitigate the impact of caregiving stress on their depressive symptoms. Therefore, the future supportive program aims at training the competencies of self-compassionate action with mindful awareness, which may enhance caregivers' coping resources.
Trait mindfulness and depressive symptoms in non-small cell lung cancer patients: the mediating roles of quality of life and meaning in life
Publisher: Informa UK Limited
Date: 30-09-2020
Effects of situational simulation and online first-aid training programs for nurses in general medical wards: A prospective study
Publisher: Elsevier BV
Date: 2021
Chinese-Australians' Knowledge of Depression and Schizophrenia in the Context of Their Under-Utilization of Mental Health Care: an Analysis of Labelling
Publisher: SAGE Publications
Date: 09-2007
Abstract: Background: Low knowledge of and discrimination regarding mental disorders (MDs) may underpin lower access to mental health care by ethnic minority groups. Aims: In Chinese-Australians, in relation to schizophrenia and depression, to assess (a) labels attached to MDs, (b) conceptual distinctiveness of MDs, (c) labelling accuracy against an Australian representative s le, (d) how syndrome variations may influence labelling, and (e) effects of exposure to MDs on labelling. Method: 418 subjects were asked to indicate the labels they would apply to vignettes of depression and schizophrenia and whether they were exposed to these disorders personally or socially. Results: The s le was broadly representative of the Australian-Chinese community: 51% and 47% `correctly' labelled the vignettes. Depression and schizophrenia labels were consistently discriminated and clustered with different other labels. Labelling accuracy surpassed Australians'. Labelling did not vary substantially between syndromes. Exposure related to increased labelling accuracy for depression. Conclusions: Accuracy in labelling major forms of MDs does not appear low in Chinese-Australians and seems higher than in the Australian community. MDs were discriminated although syndrome variations were not. Findings dispute that low mental health care access and uptake is due to low recognition and discrimination of MDs in Chinese-Australians.
Emergency nurses' burnout levels as the mediator of the relationship between stress and posttraumatic stress disorder symptoms during COVID ‐19 pandemic
Publisher: Wiley
Date: 21-03-2022
DOI: 10.1111/JAN.15214
Abstract: To examine the association of the working stress with posttraumatic stress disorder symptoms (PTSD), and burnout as the mediator for this association among emergency nurses during COVID‐19 pandemic. Longitudinal survey study. Online survey was used to collect data during the period from August to November 2020 with a s le of 169 emergency nurses. They were invited to complete the following questionnaires at the 6th and 9th months after COVID‐19 outbreak: Posttraumatic Symptom Scale (PTSS‐10), the emergency nurses' COVID‐19 stress questionnaire and Chinese version of 21‐item Copenhagen Burnout Inventory (CBI). During the 3‐month follow‐up, there were no changes in the number of suspected PTSD cases (6 and above symptoms): 41% at the 6th month and 33.3% at the 9th month. The increases of the personal burnout levels and living apart from families were the main factors associated with the PTSD symptoms. The risk for emergency nurses suffering from PTSD is through stress levels increasing their burnout levels. Over 30 percent of emergency nurses remained at high risk for suspected PTSD. The burnout levels mediated the relationship between the stress levels and the risks of PTSD. Little as know about the impact of COVID‐19 on emergency nurses' stress. This study found emergency nurses remained to be the high risk for the suspected PTSD cases. It is urged to develop a stress‐reduction program targeting at causes of stress and improving burnout for emergency nurses during COVID‐19 pandemic.
The self-perceived symptom distress and health-related conditions associated with morning to evening diurnal cortisol patterns in outpatients with major depressive disorder
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.PSYNEUEN.2009.08.019
Abstract: This study was an examination of 126 major depressive disorder (MDD) outpatients' morning to evening diurnal cortisol patterns to determine their association with family histories of mental illness, self-perceived depressive and anxiety distress, self-perceived health-related conditions, and healthy behaviors. 126 MDD outpatients and 106 healthy subjects were recruited. Self-reports of symptom distress, health-related conditions, and healthy behaviors and objective measures of salivary cortisol upon awakening, 45min after awakening, and at 1200, 1700, and 2100h were collected at subjects' homes. The in idual growth curve model was used to manage data and to analyze repeated observations of self-report data associated with diurnal cortisol patterns. For MDD outpatients, flatter diurnal cortisol patterns were more likely found in subjects with family histories of mental illness than in those without. Patient-reported shorter total sleep hours, more severe levels of depression and higher suffering levels were positively associated with flatter diurnal cortisol patterns. Less than 5 sleep hours was more likely associated with flatter diurnal cortisol patterns than above 7 sleep hours. Severe levels of depression were more likely related to flatter diurnal cortisol patterns than moderate and mild levels of depression. Higher anxiety levels, better sleep quality and higher levels of physical activity reported by patients were positively associated with steeper diurnal cortisol patterns. Unlike the MDD outpatients, the only trait associated with diurnal cortisol patterns in healthy subjects was total sleep hours. These results suggested that self-perceived good sleep quality, total hours slept of 7 or greater, and self-perceived higher levels of physical activity in the home environment could be positively related to positive stress endocrine outcomes seen as steep diurnal cortisol patterns in outpatients with major depressive disorder.
Self-Compassion for Burnout and Compassion Fatigue in Caregivers
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2023
Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
Publisher: American Society of Clinical Oncology (ASCO)
Date: 2021
DOI: 10.1200/JCO.20.01933
Abstract: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9% adjusted odds ratio [aOR], 0.62 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6% aOR, 0.53 95% CI, 0.36 to 0.76). Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.
Effects of a Parent–Child Interactive Program for Families on Reducing the Exposure of School-Aged Children to Household Smoking
Publisher: Oxford University Press (OUP)
Date: 17-05-2015
DOI: 10.1093/NTR/NTV105
Abstract: Parental smoking has been identified as the major source of children's exposure to environmental tobacco smoke (ETS). Therefore, parental involvement is critical in ETS exposure prevention programs. This study examined the effects of a parent-child interactive program on reducing children's exposure to ETS at home and enhancing parents' and children's prevention strategies. A clustered randomized controlled trial was administered to 75 families of school-aged children from six primary schools in New Taipei City, Taiwan. Families in the intervention group received a parent-child interactive intervention, and parents in the control group received written materials on tobacco hazards. Data on children's exposure and the prevention of children's exposure to ETS at home were obtained at baseline, 8-week, and 20-week or 6-month assessments. The percentage of children with urine cotinine levels greater than or equal to 6 ng/ml was significantly lower in the intervention group than it was in the control group at both the 8-week and 6-month assessments. The intervention significantly reduced parental smoking in the presence of children and increased parents' prevention of children's ETS exposure and children's ETS avoidance behavior from the baseline to the 20-week assessment. This is a preliminary study design aimed at creating a program for reducing children's ETS exposure at home. Further research to produce evidence supporting the application of the parent-child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs.
Head and neck cancer surgery during the COVID‐19 pandemic: An international, multicenter, observational cohort study
Publisher: Wiley
Date: 21-12-2020
DOI: 10.1002/CNCR.33320
Abstract: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID‐19) pandemic. This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID‐19–positive patients and infections in the surgical team were determined by univariate analysis. Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de‐escalation of neck management and reconstruction. Overall 30‐day mortality was 1.2%. Twenty‐nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) within 30 days of surgery 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS‐CoV‐2 within 30 days, with a high community incidence of SARS‐CoV‐2, with screened patients, with oral tumor sites, and with tracheostomy. Head and neck cancer surgery in the COVID‐19 era appears safe even when surgery is prolonged and complex. The overlap in COVID‐19 between patients and members of the surgical team raises the suspicion of failures in cross‐infection measures or the use of personal protective equipment. Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross‐infection controls and effective personal protective equipment.
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
Publisher: Wiley
Date: 24-04-2022
DOI: 10.1111/CODI.16117
Abstract: The SARS‐CoV‐2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non‐delayed surgery. This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January–April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90–1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69–1.27, P = 0.672). Longer delays were not associated with poorer outcomes. One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID‐19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long‐term survival attributable to delays is likely to be due to micro‐metastatic disease.
The Long-Term Effects of Psychotherapy Added to Pharmacotherapy on Morning to Evening Diurnal Cortisol Patterns in Outpatients with Major Depression
Publisher: S. Karger AG
Date: 2011
DOI: 10.1159/000321558
Abstract: i Background: /i Psychotherapy added to pharmacotherapy results in greater improvement in clinical outcomes than does pharmacotherapy alone. However, few studies examined how psychotherapy coupled with pharmacotherapy could produce a long-term protective effect by improving the psychobiological stress response. i Methods: /i The researchers recruited 63 subjects with major depressive disorder (MDD) in an outpatient department of psychiatry at a general hospital. The randomly assigned subjects formed 2 groups: 29 in combined therapy (COMB) and 34 in monotherapy (MT). The COMB included 8 weekly body-mind-spirit group psychotherapy sessions added to pharmacotherapy. MT consisted of pharmacotherapy only. The outcome measures, collected at the subjects’ homes, included the Beck Depression Inventory II (BDI-II), the State Trait Anxiety Inventory (STAI) and salivary cortisol on awakening, 45 min after awakening, and at 12.00, 17.00 and 21.00 h. Evaluation of outcome measures was at baseline condition, and at months 2 (end of additional psychotherapy), 5 and 8. i Results: /i While the decreases in symptoms of depression were similar between COMB and MT (p 0.05), the reductions in anxiety state were greater in COMB than in MT during the 8-month follow-up (p 0.05). A steeper diurnal cortisol pattern more likely occurred in COMB than in MT in the 3 follow-up periods (p 0.05, p .001 and p 0.01). i Conclusions: /i The superior outcomes of group psychotherapy added to pharmacotherapy for MDD outpatients could relate to decreasing the anxiety state and to producing long-term impacts on positive stress endocrine outcomes seen as a steeper diurnal cortisol pattern.
Habitual sleep–wake behaviors and lifestyle as predictors of diurnal cortisol patterns in young breast cancer survivors: A longitudinal study
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.PSYNEUEN.2014.12.014
Abstract: This study aimed to identify predictors of changes in diurnal cortisol patterns during the 8-month follow up period for young breast cancer survivors. Among the potential predictors were tumor size, lymph node metastasis, changes in sleep problems, habitual time of awakening and bedtime, physical activity levels, body mass index (BMI), and depressive levels across 8 months. The participants were 62 breast cancer women who were aged 40 years and below, and had completed active breast cancer treatment. The longitudinal data were collected at four points: baseline assessment (T0) and three follow-ups after baseline: T1 (in the 2nd month), T2 (in the 5th month), and T3 (in the 8th month). The participants collected their salivary cortisol at home at six time points: upon waking, 30 and 45min after waking, and at 1200h, 1700h, and 2100h. They also completed several questionnaires: the Medical Outcomes Study Sleep scale the Beck Depression Inventory-II, physical activity levels on a 10-point scale, time of going to bed, time of awakening, and total sleep hours. This study found that the main predictors of changes toward flatter diurnal cortisol patterns during the 8-month follow ups were greater tumor sizes, increases of BMI scores, and habitually later times of awakening. While greater tumor sizes represent biological vulnerability of disruption of cortisol circadian rhythm, maintaining an appropriate BMI and good sleep habits could be a protective factor for normal cortisol regulation, which likely helps to reduce early mortality in young breast cancer survivors.
The effects of the interventions on the DNR designation among cancer patients: A systematic review
Publisher: Cambridge University Press (CUP)
Date: 18-06-2018
DOI: 10.1017/S1478951518000196
Abstract: The aims of this systematic review were to examine the effects of the overall and the different types of the interventions on the do-not-resuscitate (DNR) designation and the time between DNR and death among cancer patients. Data were searched from the databases of PubMed, CINAHL, EMbase, Medline, and Cochrane Library through 2 November 2017. Studies were eligible for inclusion if they were (1) randomized control trails, quasi-experimental study, and retrospective observational studies and (2) used outcome indicators of DNR designation rates. The Effective Public Health Practice Project tool was used to assess the overall quality of the included studies. The 14 studies with a total of 7,180 participants were included in this review. There were 78.6% (11 of 14) studies that indicated that the interventions could improve the DNR designation rates. Three types of DNR interventions were identified in this review: palliative care unit service, palliative consultation services, and patient-physician communication program. The significant increases of the time between DNR designation and death only occurred in a patient-physician communication program. The palliative care unit service provided a continuing care model to reduce unnecessary utilization of healthcare service. The palliative consultation service is a new care model to meet the needs of cancer patients in non-palliative care unit. The share decision-making communication program and physician's compassion attitudes facilitate to make DNR decision early. The in idualized DNR program needs to be developed according to the needs of cancer patients.
The effects of an emergency nurse‐led stress‐reduction project during the first 120 days of the COVID‐19 pandemic in Taiwan
Publisher: Hindawi Limited
Date: 08-12-2021
DOI: 10.1111/JONM.13527
The lived experiences of spiritual suffering and the healing process among Taiwanese patients with terminal cancer
Publisher: Wiley
Date: 11-02-2008
DOI: 10.1111/J.1365-2702.2006.01854.X
Abstract: The purposes of this study were to explore the lived experiences of spiritual suffering and the change mechanism in healing processes among Taiwanese patients with terminal cancer. The approach to this study was phenomenological-hermeneutic. Twenty-one patients with terminal cancer were invited to participate in a semi-structured interview that dealt with their experiences of spiritual suffering and the healing process. This study was conducted in the inpatient unit of the oncology department in two general hospitals. The interviews were recorded, transcribed and later analysed using the approach of narrative analysis. According to the results of case narration, the causes of spiritual suffering included cancer, known as a life-threatening illness, physical pain, treatment complications, uncertain illness progression, disability problems and lack of support. Patients turned to internal resources (including regarding the suffering as a life challenge, volunteering to help other cancer patients and searching for life wisdoms) and external resources (including peer support groups and family support) as they endured spiritual suffering. Taiwanese patients turned to Eastern and Western philosophies of Taoism, Confucianism, Buddhism and Christianity as methods to interpret their spiritual suffering. Patients' positive views of misfortune because of cancer and sufficient social supports were the key elements of the healing process to alleviate spiritual suffering. Nurses who learn to participate in suffering assessment are better able to understand spiritual needs of cancer patients. Cancer patients' views on the change mechanism in healing processes could provide essential information for nurses in developing an effective intervention programme. If nurses consider cultural factors that shape patients' experiences of spiritual suffering and the healing process, they could learn how to meet the needs of patients better from different cultural backgrounds.
Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-050830
Abstract: Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Prospective, international, multicentre, observational cohort study. Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p .001), age years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with in idualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. NCT04323644
Somatization of Loss of Fatherhood: A Case Study of a Chinese Man with Major Depression
Publisher: SAGE Publications
Date: 04-2010
DOI: 10.2190/IL.18.2.F
Abstract: This case study reports on a 52-year-old man suffering from depression which was largely precipitated by loss of fatherhood after orce when his ex-wife took their son and migrated to Canada. In the presentation of his distress to the therapist, he mainly complained of “heart ache,” which could not be confirmed by a number of physicians as having any kind of physical disorder. The sense of psychological pain due to the loss of the love relationship with his son was hidden and was expressed in physical form. His self-identify as a strong man and as a manager of a pharmacy company were main barriers for him to reveal his psychological pain. His feelings of anger toward his ex-wife and grief from the separation from his son began to occur during an 8-week body-mind-spirit group therapy. Biological, psychological, and social aspects of pain were integrated into the healing process.
A study on the efficacy of body-mind-spirit group therapy for patients with breast cancer
Publisher: Wiley
Date: 17-09-2020
DOI: 10.1111/J.1365-2702.2008.02296.X
Abstract: This study aims to understand the effects of culturally enriched body-mind-spirit group therapy on anxiety, depression and holistic well-being among women with breast cancer and to examine patients' views on what aspects of group therapy worked to enhance their health. The study was designed using multiple methods, which consisted of a randomised controlled trial and a focus group interview. A total of 16 subjects in the control group received the standard care of a physician's treatment at the outpatient department. In addition to standard care, 12 subjects in the experimental group received 10 sessions of weekly body-mind-spirit group therapy for 180 minutes each. This therapy integrates concepts and practices of traditional Chinese medicine and Western medicine (e.g. positive psychology and forgiveness therapy). The subjects in the experimental group were invited to participate in a focus group interview regarding their perceptions of the change mechanisms that occurred in group therapy. The results of analysis of covariance indicated that after a two-month trial, there was a similarity between the experimental and control groups in reducing the scores of Beck depression inventory and increasing the scores of body-mind-spirit well-being. However, subjects in the experimental group had a better reduction of the scores of state anxiety inventory than subjects in the control group. The qualitative analysis yielded eight domains: (i) imparting of information, (ii) interpersonal learning, (iii) catharsis, (iv) universality, (v) group cohesiveness, (vi) altruism, (vii) instillation of hope and (viii) existential factors. These domains illustrate how the therapeutic effects of group therapy worked to reduce patients' anxiety. The culturally sensitive body-mind-spirit group therapy reduced anxiety among outpatients with breast cancer. The involvement of mental health nurses in providing group therapy for cancer patients could enhance the quality of care in psycho-ontological nursing.
Related Organisations
Deh-Yu College Of Nursing And Management
Location: Taiwan, Province of China
Related Funding Activities
No related grants have been discovered for FEI-HSIU HSIAO.