Yun-Fang Tsai

Chang Gung Memorial Hospital, T’ai-pei, Taipei, Taiwan

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Publications (79)145.32 Total impact

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    ABSTRACT: Suicide is common among the elderly worldwide. However, no literature could be found on the beliefs/expectations that protect young-old people from attempting suicide. The purpose of this study was to explore young-old outpatients' reasons for not killing themselves in Taiwan. Data for this qualitative descriptive study were extracted from a large research series. From the 83 elderly outpatients in the original sample, 31 were chosen for this study because they were young-old (65-74 years old) and from two randomly selected medical centers in northern Taiwan. Data on participants' reasons for not killing themselves in unhappy situations were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Analysis of interview data identified six major themes: satisfied with one's life, suicide cannot resolve problems, fear of humiliating one's children, religious beliefs, never thought about suicide, and living in harmony with nature. These identified protective factors (reasons for living) could be added to suicide-prevention programs for the elderly. Our findings may also serve as a reference for geriatric researchers in western countries with increasing numbers of elderly ethnic minority immigrants.
    BMC Public Health 04/2014; 14(1):372. · 2.08 Impact Factor
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    ABSTRACT: Suicide is a global issue among the elderly, but few studies have explored the experiences of suicide ideation in older Asian psychiatric outpatients. Older psychiatric outpatients (N = 24) were recruited by convenience from one medical centre and one regional hospital in northern Taiwan. Participants were recruited if they met these inclusion criteria: 1) ≥65 years old, 2) without severe cognitive deficit, 3) outpatients in the psychiatric clinics at the selected hospitals, and 4) self-reported first episode of suicidal ideation within the previous year. Data were collected in individual interviews using a semi-structured guide and analysed by content analysis. Suicide ideation was triggered by illness and physical discomfort, conflicts with family members/friends, illness of family members, death of family members/friends, and loneliness. Participants' reasons for not executing suicide were family members' and friends' support, receiving treatment, finding a way to shift their attention, fear of increasing pressure on one's children, religious beliefs, and not knowing how to execute suicide. Understanding these identified triggers of suicide ideation may help psychiatrists open a channel for conversation with their elderly clients and more readily make their diagnosis. Understanding these identified protective factors against executing suicide can help psychiatrists not only treat depression, but also enhance protective factors for their clients.
    BMC Psychiatry 01/2014; 14(1):269. · 2.23 Impact Factor
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    ABSTRACT: Objectives: The purposes of this study were to explore elderly outpatients' perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan.Method: Elderly outpatients (N = 83) were recruited in 2011-2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis.Results: Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities.Conclusion: Since television news was the main source for participants' information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately.
    Aging and Mental Health 12/2013; · 1.68 Impact Factor
  • Mei-Hua Kao, Yun-Fang Tsai
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    ABSTRACT: To understand the illness experiences of middle-aged adults with early knee osteoarthritis. Knee osteoarthritis is one of the most common causes of lower limb disability in middle-aged adults and older people. Nurses lack understanding of the illness experiences of middle-aged patients who were confirmed to have early knee osteoarthritis and of how they manage the disease in Taiwan. A qualitative descriptive design was applied. Participants with knee osteoarthritis, aged 40-55 years, were recruited by purposive sampling (n = 17). The data were collected through semi-structured interviews from July-December 2010. All interview transcripts were analysed using qualitative inductive content analysis to identify key themes. Illness experiences of the seventeen participants were classified into three major themes: (i) unfamiliarity with osteoarthritis; (ii) effects on daily life; and (iii) protection and alleviation. The three main themes occurred repeatedly and affected the life experiences of the patients. This study indicates that patients with osteoarthritis have insufficient knowledge related to disease process and they do not know how to cope effectively. They need healthcare providers to supply them with adequate osteoarthritis disease information. Nurses should also develop interventions in their practices and guide patients to use suitable techniques to improve the functional status of their knee joint(s).
    Journal of Advanced Nursing 11/2013; · 1.53 Impact Factor
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    ABSTRACT: Communication conflicts are inevitable in nursing homes. Understanding communication conflicts experienced by practising nurses could provide insights to guide the development of sound communication education programmes. The purpose of this study was to explore the experiences of nurses in nursing homes of communication conflict in encounters with nursing home residents and their families in Taiwan. Data were collected from April 2010 to December 2011 through audiotaped, individual, in-depth interviews with 26 nurses at five nursing homes in Taiwan. Data were analysed according to van Manen's interpretive phenomenological method. Data analysis revealed that nurses' experiences of communication conflicts during encounters with nursing home residents and their families could be categorised under three themes: differences in perspectives of nursing home services; differences in views of nurturing health, and mediation between family members and others. The findings of this study can be considered by clinical educators and policymakers when designing communication education programmes for nurses and other clinicians. These programmes should include ways to increase nurses' independent thinking in settings in which power differences exist, as well as their cultural sensitivity as embodied in Leininger's culture care theory. These programmes should also include education in telephone communication and alternative methods of communication (e.g. videoconferencing).
    Medical Education 10/2013; 47(10):990-1000. · 3.55 Impact Factor
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    ABSTRACT: Background The information exploring the falls, recurrent falls, and injurious falls simultaneously in a large scale of aged people was limited. This study investigated the prevalence and frequency of falls and identified the associated factors of fall among aged Chinese men. Methods A cross-sectional study was carried out in four veteran homes in eastern Taiwan from 2009 to 2010. The investigated sample consisted of 940 elderly men. A questionnaire was used for collecting demographic background, comorbid medical conditions, and fall characteristics. Depression status was evaluated by the Geriatric Depression Scale-Short Form. Results The prevalence of fall and recurrent falls were 17.2 % and 6.9%, respectively. The injury rate after falls was 51.9%.The advanced age [odds ratio (OR): 1.04; confidence interval (CI): 1.01–1.07), depression status (OR: 1.05; CI: 1.01–1.10), stroke (OR: 2.16; CI: 1.18–3.96), gouty arthritis (OR: 1.96; CI: 1.36–2.81), and cataract (OR: 1.48; CI: 1.03–2.15) were independent variables associated with falls. We also found that the greater the number of variables, the higher the risk of falling (χ2 for linear trend = 31.98, d.f.= 4, p < 0.001). Furthermore, depression was the only independent variable for predicting recurrent falls (OR: 1.22; CI: 1.12–1.32). However, no variable was found to be capable of predicting injurious falls. Conclusion This study demonstrated that the advanced age, depression status, stroke, gouty arthritis, and cataract are independent variables for predicting falls; depression is the only clinical factor capable of predicting the recurrent falls. These variables were potential targets for effective prevention of falls.
    International Journal of Gerontology 06/2013; 7(2):80–84. · 0.24 Impact Factor
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    ABSTRACT: Objectives. Asthmatic children and their parents constantly need to adjust their lifestyles due to asthma attacks. We evaluated the effectiveness of a self-management interactive support (SMIS) program for caregivers of asthmatic children. Methods. Children with persistent asthma were randomized into two groups, one receiving self-management interactive support and the other usual care (the control group). The SMIS program involved a three-month multifaceted behavioral intervention. Changes in the caregivers' knowledge and attitude regarding self-management, children's lung function, and number of emergency department visits and hospital admissions were examined at 12 months post enrollment. Results. Sixty-five asthmatic children and caregivers (78% follow-up) completed the study. Primary caregivers in the SMIS group had significant improvements in knowledge and attitude regarding asthma compared to those in the control group (p < 0.05). Most importantly, knowledge about asthma medications and exacerbations significantly improved and attitudes towards medication adherence and dealing with asthma care became more positive in the SMIS group. The FEV1 was significantly improved in the SMIS group after 12 months (p < 0.05), and performance on the methacholine challenge test at the end of the study was significantly better in the SMIS group (p < 0.05). Participants in the SMIS group also had a lower rate of emergency room use (p < 0.05). Conclusion. The SMIS program for the self-management of asthma in children by their caregivers improved lung function and reduced the number of visits to emergency departments. Interactive support interventions reinforce learning incentives and encourage self-care and maintenance of therapeutic regimens.
    Journal of Asthma 04/2013; · 1.85 Impact Factor
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    ABSTRACT: AIMS AND OBJECTIVES: To develop and psychometrically test a Chinese-language instrument, the Motivations for Living Inventory, for use with older adult institutionalised males. BACKGROUND: While tools exist for testing reasons for living among English-speaking individuals, none are available to assess Chinese-speaking older adults' motivation for living. DESIGN: This study had three steps: cross-sectional survey to collect data on instrument items, instrument development and psychometric testing. METHODS: Participants were 247 older male residents of five veterans' homes, including 22 who had attempted suicide in the previous three months and 225 non-suicide attempters. The Chinese-language instrument, Motivations for Living Inventory, was developed based on individual interviews with older male residents of nursing homes and veterans' homes, focus groups with workers at nursing and veterans' homes, the literature and the authors' clinical experiences. The resulting Inventory was examined by content validity, construct validity, criterion-related validity, internal consistency reliability and test-retest reliability. RESULTS: The inventory had good content validity index (1·00). Factor analysis yielded a five-factor solution, accounting for 82·02% of the variance. Veterans' home male residents who had not attempted suicide tended to have higher scores than residents who had attempted suicide in the previous three months across the global inventory and all its subscales, indicating good criterion validity. Inventory reliability (Cronbach's α for the total scale was 0·86 and for subscales ranged from 0·80-0·94) and intraclass correlation coefficient (0·81) was satisfactory. CONCLUSIONS: The Chinese-language Motivations for Living Inventory can be completed in five to seven minutes and is perceived as easy to complete. Moreover, the inventory yielded highly acceptable parameters of validity and reliability. RELEVANCE TO CLINICAL PRACTICE: The Chinese-language Motivations for Living Inventory can be used to assess reasons for living in Chinese-speaking, institutionalised older male adults.
    Journal of Clinical Nursing 03/2013; · 1.32 Impact Factor
  • Hsiu-Hsin Tsai, Yun-Fang Tsai
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    ABSTRACT: PURPOSE: The purpose of this cross-sectional study was to understand the prevalence and risk factors for depressive symptoms among nursing home residents' family caregivers in Taiwan. METHODS: Family caregivers (n = 191) of nursing home residents were recruited by stratified random sampling from 16 nursing homes throughout Taiwan. Data were collected from caregivers in face-to-face interviews on depressive status (using the Center for Epidemiologic Studies Depression Scale; CES-D), on meaning ascribed to visiting nursing home residents (using the Family Meaning of Nursing-Home Visits scale), and on demographic data. Factors related to depressive symptoms were analyzed by multiple logistic regression. RESULTS: The prevalence of depressive status among family caregivers was 29.8 % as determined by the CES-D cutoff score of ≥10. The non-depressed group (CES-D <10) tended to visit residents for emotional maintenance (odds = 0.54), while the depressed group (CES-D ≥10) tended to visit due to sense of responsibility for monitoring care quality (odds = 3.25). These results demonstrate that risk factors for depressive symptoms in family caregivers were their age, self-perceived health status, education level, and being the resident's main caregiver before admission. CONCLUSION: These results fill a gap in knowledge by providing detailed, evidence-based data on family caregivers' priorities for visiting nursing home residents and it is related to depression. These results also provide useful information for designing intervention protocols to reduce depressive symptoms in family caregivers of nursing home residents, not only in Asian countries, but also in western countries with many Chinese/Asian immigrants.
    Social Psychiatry 01/2013; · 2.05 Impact Factor
  • I-Chen Yu, Yun-Fang Tsai
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    ABSTRACT: AIMS: This article is a report of a study that explored the perceptions of patients as they experienced their diabetes illness trajectory, and their initial decisions to undergo dialysis, in an effort to provide further complementary guidance for nurses and healthcare practitioners. BACKGROUND: Diabetes leads to higher morbidity and mortality when patients develop renal failure resulting from diabetic nephropathy. An effective self-care regimen and multidisciplinary team approach are required to avoid or delay the serious chronic complications of the disease. Patients and healthcare practitioners must be aware therefore of psycho-physiological adjustment when seeking to delay the onset of complications. DESIGN: A qualitative design was used for data collection through semi-structured interviews. METHOD: Data were analysed using content analysis. Participants were 25 diabetes patients undergoing initial haemodialysis who were recruited from diabetes and nephrology wards at a medical centre in northern Taiwan. Data were collected from December 2010-August 2011. FINDINGS: The core theme describing the illness trajectory derived from face-to-face interviews with people undergoing hemodialysis was 'from silence to storm'. There emerged also five phases of patient experience that resulted from the development of diabetic nephropathy: (1) diabetes onset stage; (2) stable stage; (3) burden stage; (4) shock stage; and (5) coping stage. CONCLUSIONS: Patients suffer with diabetic nephropathy for a long-term period. Our findings may enhance the understanding of nurses regarding the experiences of patients with diabetic nephropathy, and will help them provide diabetes care that promotes healthy life for those individuals.
    Journal of Advanced Nursing 11/2012; · 1.53 Impact Factor
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    ABSTRACT: AIM: The aims of this study were to explore: (1) the prevalence and predictors for hazardous alcohol-drinking problems; and (2) previous assessments and interventions for alcohol-drinking problems in hospitalized Chinese patients. BACKGROUND: Alcohol is legally accessible and widely used in Taiwan, but few studies have addressed alcohol-drinking problems in hospital settings. DESIGN: A cross-sectional design was used. METHOD: Self-report data were collected in 2009 from 484 patients at five randomly selected general teaching hospitals. FINDINGS: The prevalence of hazardous alcohol-drinking problems was 19·2%. Logistic regression analysis revealed that predictors for hazardous drinking problems were being male, smoking, and chewing betel quid. Only 29·1% of participants had been assessed for drinking problems in the past year. Only 38·7% of participants with drinking problems had received a drinking intervention in the past year. CONCLUSION: These findings suggest that alcohol problems in Taiwanese general teaching hospitals are insufficiently assessed and targeted with interventions. Targeting high-risk groups in general teaching hospitals is important to prevent patients' drinking problems.
    Journal of Advanced Nursing 11/2012; · 1.53 Impact Factor
  • Yea-Pyng Lin, Roger Watson, Yun-Fang Tsai
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    ABSTRACT: This review aimed to explore nursing literature and research on dignity in care of inpatients and to evaluate how the care patients received in the hospital setting was related to perceived feelings of being dignified or undignified. Studies conducted between 2000 and 2010 were considered, using Cumulative Index to Nursing and Allied Health Literature and MEDLINE, and the search terms 'patient dignity', 'dignity in care', 'human dignity and nursing' and 'dignity and nursing ethics'. Findings revealed, from the perspectives of nurses and patients, that dignity in care in the hospital setting is seen to be influenced by physical environment, staff attitude and behaviour, organisational culture and patient independence. This review can help nurses to better understand dignity in care, and for policy makers, there are implications about determining the physical environment, staff attitude and behaviour and organisational culture needed to promote patient dignity in nursing. By identifying the most important factors from patients' and nurses' perspectives that contribute to dignity in care, nursing interventions, such as campaigns and education in clinical practice, can be developed.
    Nursing Ethics 11/2012; · 1.21 Impact Factor
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    ABSTRACT: To explore (1) the prevalence and risk factors for hazardous alcohol-drinking problems and (2) previous assessments and interventions for alcohol-drinking problems among family members of Chinese problem-drinker patients. Self-report data were collected from 517 family members of problem-drinker patients at five randomly selected general hospitals in Taiwan. Family members' prevalence of hazardous alcohol-drinking problems was 13.3%. Logistic regression analysis revealed that risk factors for hazardous drinking were male gender, low education level, heart disease, smoking, and chewing betel quid. Only 11.8% of participants had been assessed for drinking problems in the past year. Only 5.2% of participants with drinking problems had received a drinking intervention in the past year. Alcohol problems among family members of problem-drinker patients in Taiwanese general hospitals are insufficiently assessed and targeted with interventions. Targeting this high-risk group is important to prevent drinking problems in family members of problem-drinker patients.
    General hospital psychiatry 07/2012; 34(6):633-8. · 2.67 Impact Factor
  • Hsiu-Hsin Tsai, Yun-Fang Tsai, Tzu-Shin Huang
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    ABSTRACT: The purpose of this study was to develop and test a Family Meaning of Nursing-Home Visits Scale that can be used to assess and document family members' rationale for visiting nursing home residents. Understanding the meaning ascribed by families for visiting nursing home residents is necessary to develop intervention programmes that facilitate the quality of families' nursing home visits. No valid and reliable instrument is available in Taiwan or elsewhere to accurately document the meaning of family visits to nursing home residents. A cross-sectional design was used to collect survey data from family members of nursing home residents as the quantitative component of a mixed-methods study. Items were developed based on qualitative data from our previous research and that of others. This initial pool of items was used to develop and validate the scale. The validity of the scale was confirmed by exploratory factor analysis and criterion-related validity testing. Internal consistency reliability was assessed by Cronbach's alphas. Factor analysis yielded a six-factor final solution (32 items), accounting for 66·76% of the variance. For criterion-related validity, 'responsibility for care quality' was negatively correlated with satisfaction with nursing home caregiving (r = -0·23, p < 0·01) and nursing home rehabilitation activities (r = -0·17, p < 0·05). Cronbach's α for each subscale ranged from 0·68-0·98, and Cronbach's α for the total scale was 0·83. The Family Meaning of Nursing-Home Visits Scale has acceptable internal consistency reliability, good content validity and acceptable construct validity. The Family Meaning of Nursing-Home Visits Scale provides nurses and healthcare providers an objective and consistent method to explore the priority of meanings family members assign to nursing home visits. Based on this priority for visiting, interventions could be designed to increase the quality of visits, thus promoting families' continued incentive to visit in person.
    Journal of Clinical Nursing 06/2012; 21(15-16):2108-17. · 1.32 Impact Factor
  • Li-Hui Pan, Yun-Fang Tsai
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    ABSTRACT: The purposes of this study were to examine how quality of life in colorectal cancer patients with diarrhoea changes with time after surgery and to identify variables influencing patients' quality of life three months following surgery. Colorectal cancer is one of the most common cancers in the world. Literature that focuses on the impact of the basic attributes, disease characteristics and diarrhoea distress on the quality of life in diarrhoea patients is quite rare. Survey. A longitudinal study design was employed with a three-month tracking period. Data were collected in structured, one-on-one interviews at one week and one, two and three months after surgery. Variance and effects of quality of life were analysed by repeated-measures analysis of variance and generalised estimating equation. Results showed that colorectal cancer patients (n = 35) with diarrhoea after surgery will over time be gradually satisfied with their overall quality of life. Physical health satisfaction is lowest at 1 week after surgery, and it will over time gradually increase. Satisfaction with mental health has the lowest score and does not improve with time. Satisfaction with social relationships is highest between one week and two months after surgery. Satisfaction of environmental relationship will improve with time after surgery. The study results also indicate that patients with lower quality of life satisfaction are younger, women, have had R hemicolectomy and experience higher diarrhoea distress. Colorectal cancer patients with diarrhoea after surgery will become more satisfied with their overall quality of life with time. Physical and environmental satisfaction will all improve with time. Younger patients will be more dissatisfied with their social and environmental health. More severe diarrhoea distress will impact patients' quality of life the most. These results can serve as reference for clinical care providers to patients with colorectal cancer after surgery.
    Journal of Clinical Nursing 05/2012; 21(15-16):2357-66. · 1.32 Impact Factor
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    ABSTRACT: Schizophrenia-related violent behavior is a social stigma borne by schizophrenic patients and a highly painful burden faced by caregivers. This study focused on how primary caregivers deal with schizophrenic patient violent behavior and factors that affect this burden. Researchers recruited a purposive sample from the acute wards of a psychiatric hospital in Taipei city. This cross-sectional study studied 100 primary caregivers of schizophrenic patients with a history of violent behavior. Socio-demographic data were collected using structured questionnaires on coping methods and caregiver burden. Results found an average primary caregiver burden score of 30.8 points, indicating a moderate degree of burden. Factors contributing to the total care burden were: patient occupation, caregiver level of education, emotional coping method, negative cognitive coping method and violent behavior type. After multiple regression analysis, the two significant factors affecting caregiver burden were identified as: Emotional coping method and violent behavior type. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study highlighted a higher burden in violent schizophrenic patient caregivers who use emotional coping methods. Researchers recommended that clinical staff voluntarily assess caregiver burdens and methods of coping with patients' violent behavior in order to help caregivers develop specific and efficient coping strategies to reduce care burden.
    Hu li za zhi The journal of nursing 04/2012; 59(2):29-39.
  • Mei-Hua Kao, Yun-Fang Tsai
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    ABSTRACT: The aim of this study was to understand the living experiences of middle-aged Taiwanese adults with early knee osteoarthritis (OA). A qualitative research design was used in this study. Participants (n = 17) were recruited by purposive sampling from orthopedic clinics at two medical centers in northern Taiwan. Data were collected through in-depth interviews from July to December 2010. The data were transcribed verbatim and summarized by content analysis. The results indicated that the lived experiences could be grouped into 4 main themes: awareness; surmise of causes; acquisition of strategies; and the search for confirmative diagnosis. This study found that patients' knowledge is insufficient for recognition of the presence of early OA. There is a need for clinicians to integrate knowledge of OA into the health education system and to develop interventions for early knee osteoarthritic patients. Patients' disease cognition must be promoted so that their ability to process early symptoms of this disease will improve.
    Disability and Rehabilitation 03/2012; 34(21):1827-34. · 1.54 Impact Factor
  • Rung-Fen Feng, Yun-Fang Tsai
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    ABSTRACT: The aim of this study was to explore the socialisation experiences of new graduate baccalaureate nurses to practising nurses. How nurses contend with the stress of their professional role has been of interest to both researchers and healthcare administrators over the past 30 years. Work stress of clinical nurses comes mainly from organisational and professional factors. However, few studies have explored the professional and organisational socialisation experiences of new graduate nurses. A qualitative descriptive approach was adopted. Participants were graduates of a baccalaureate nursing programme and employed full time at four medical centres in Taiwan, their first full-time work experience. Data were collected through semi-structured, open-ended, in-depth interviews, which were transcribed verbatim and analysed by content analysis. Three themes were identified: overwhelming chaos, learning by doing and being an insider. Although the professional socialisation process was hard for the new graduate nurses, they needed much time to increase their knowledge and clinical skills to fulfil clinical needs. However, the hardest work was the organisational socialisation process, which involved fitting into the bureaucratic system, such as maintaining interpersonal relationships with colleagues and familiarising themselves with the ward rules and culture. Neophyte nurse participants were also frustrated by the conflict between professional and organisational values. The study findings show that the transition from new graduate nurse to practising nurse was stressful for these participants, particularly due to the clash between the professional value of patient-oriented nursing care and the organisational value of task-oriented nursing. Senior clinical nurses can consider this study's descriptions of new graduate nurses' experiences to help them become insiders and provide quality care.
    Journal of Clinical Nursing 03/2012; 21(13-14):2064-71. · 1.32 Impact Factor
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    ABSTRACT: Atrial fibrillation is one of the most important causes of ischemic stroke. The purposes of this study were to recognize the incidence of ischemic stroke, the use of antithrombotic agents, the predictors of ischemic stroke, and prescription of warfarin during the three-years after atrial fibrillation was diagnosed. This was a descriptive design and chart review study, comprised of 1211 subjects at two hospitals in Northern Taiwan who were aged ≥ 60 at their first diagnosis of atrial fibrillation. Chi-square and logistic regression were used for data analysis. The incidence of ischemic stroke was 46.2% during the three-years after atrial fibrillation was diagnosed, with 86.3% of those occurring in the first year. The prescription rate was 53.3% in antithrombotic therapy, which included 42.5% antiplatelet agents and 10.8% warfarin. The positive predictors of ischemic stroke were age ≥ 75 (odds ratio = 1.48) and a history of ischemic stroke (odds ratio = 3.19); the negative predictors were continued use of warfarin (odds ratio = 0.01), transient use of warfarin (odds ratio = 0.25), alternating use of warfarin and antiplatelet agents (odds ratio = 0.04), and use of antiplatelet agents alone (odds ratio = 0.13). The positive predictors of prescribing warfarin were a history of ischemic stroke (odds ratio = 2.32), thromboembolism (odds ratio = 31.06), mitral stenosis (odds ratio = 10.02), and mechanical valve replacement (odds ratio = 136.02). The negative predictor of prescribing warfarin was age ≥ 75 (odds ratio = 0.62). It is important in prevention of ischemic stroke to give antithrombotic therapy to newly diagnosed atrial fibrillation patients. Underuse of antithrombotic therapy and warfarin were more severe in our study than in Western countries.
    International Journal of Stroke 11/2011; 7(2):112-7. · 4.03 Impact Factor

Publication Stats

609 Citations
145.32 Total Impact Points

Institutions

  • 2005–2013
    • Chang Gung Memorial Hospital
      • Department of Psychiatry
      T’ai-pei, Taipei, Taiwan
  • 2003–2013
    • Chang Gung University
      • • School of Nursing
      • • Graduate Institute of Clinical Medicine Sciences
      Taoyuan, Taiwan, Taiwan
  • 2012
    • Fu Jen Catholic University
      • School of Nursing
      Taipei, Taipei, Taiwan
    • Chang Gung University of Science and Technology
      Chang-hua Pei-pu, Taiwan, Taiwan
  • 2010–2012
    • Mackay Memorial Hospital
      T’ai-pei, Taipei, Taiwan
    • Mennonite Christian Hospital
      Hua-lien, Taiwan, Taiwan
  • 2011
    • National Health Research Institutes
      Miao-li-chieh, Taiwan, Taiwan
  • 2007
    • East-Taiwan Veterans Hospital
      Hua-lien, Taiwan, Taiwan
  • 2006
    • University of Pennsylvania
      • Center for Community-Based Research and Health Disparities
      Philadelphia, PA, United States
  • 2004
    • National Taiwan University
      • School of Nursing
      Taipei, Taipei, Taiwan