Yun-Fang Tsai

Chung Shan Medical University, 臺中市, Taiwan, Taiwan

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Publications (88)162.25 Total impact

  • Chiu-Yueh Hsiao · Yun-Fang Tsai
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    ABSTRACT: The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness.
    No preview · Article · Sep 2015 · Journal of Family Nursing
  • Yu-Ling Chang · Yun-Fang Tsai · Yin-Kai Chao · Meng-Yu Wu
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    ABSTRACT: Improving survival after esophagectomy is an important issue in treating patients with esophageal cancer (EC). In addition to standard hospitalization management, periodic assessment of quality-of-life (QOL) measures may be useful to detect disease progression from patients' subjective reports. Therefore, this prospective longitudinal study was undertaken to identify prognostic factors for 3-year survival of EC patients after esophagectomy and to evaluate the impact of QOL measures on these prognostic factors. Patients with EC (n = 67) who had a complete tumor resection and were alive 6 months after esophagectomy were followed in this study for 3 years. Data were collected on patients' sociodemographics, cancer characteristics, adjuvant therapy, general QOL and EC-specific QOL (before esophagectomy and 6 months afterward), cancer recurrence, and death. Patients' independent risk factors for 3-year survival were investigated by multivariate Cox regression analysis. Of the 67 participants with EC, 26 had late mortality, with a median survival for the whole cohort of 38.2 months (95 % CI 31.97-44.35). Independent predictors of early death were early cancer recurrence (within 6 months after surgery), poor cognitive function (95 % CI 1.020-1.041), and worse dyspnea (95 % CI 1.007-1.034). The most predictive factor for early death in EC patients after esophagectomy was cancer recurrence within 6 months after surgery. However, QOL measures could be a tool to provide clinical information from patients' perspective suggesting cancer recurrence.
    No preview · Article · Aug 2015 · Quality of Life Research
  • Hsiu-Hsin Tsai · Yun-Fang Tsai
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    ABSTRACT: Background: Videoconferencing with family members benefits nursing home residents by decreasing their depression and loneliness. Nevertheless, the rate of participation in videoconferencing by family members is low. The purpose of this study was to explore attitudes toward and factors related to videoconferencing by family visitors to nursing home residents in Taiwan. Materials and Methods: For this cross-sectional study, data were collected from 231 family members of residents at 16 medium to large (>70 beds) nursing homes in Taiwan. Data were collected on participants' and residents' demographic and clinical characteristics, acceptance of and attitudes toward using videoconferencing as a form of nursing home visit, and reasons for/roles during visits to nursing home residents. Factors related to the use of videoconferencing were analyzed by logistic regression. Results: Family members' acceptance rate of videoconferencing use was low (7.8%). The findings also showed that videoconference use was predicted by hiring a private caregiver (odds ratio=6.90), the role during/reason for family visits being to maintain residents' emotional status (odds ratio=5.46), and the frequency of in-person visits to the nursing home. Conclusions: We recommend encouraging family use of videoconferencing by available equipment such as smartphones or tablet programs that can address residents' emotional issues in a timely fashion. We also suggest developing more interactive content for videoconferencing, such as a family-oriented picture program to help broaden topics of conversation.
    No preview · Article · Jun 2015 · Telemedicine and e-Health
  • Kuo-Yao Hsu · Yun-Fang Tsai · Yea-Pyng Lin · Hsien-Tao Liu
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    ABSTRACT: To explore primary family caregivers' observations and perceptions of their older relatives' knee osteoarthritis pain and pain management. Osteoarthritis is one of the most common joint disorders in older people. Studies have mainly focused on spouses' or partners' perceptions of older individuals' osteoarthritis pain. Qualitative description. Primary family caregivers of older outpatients with osteoarthritis (N = 28) were recruited by convenience from one medical centre in northern Taiwan and two regional hospitals in northern and eastern Taiwan in 2012. Data were collected in individual interviews using a semi-structured guide and analysed by content analysis. Primary family caregivers observed that their older relatives commonly mentioned that osteoarthritis pain interfered with their walking ability, daily activities, moods, sleep and social activities. Older adults commonly shared their pain with their family members. Participants observed that their older relatives with osteoarthritis used limited pain-management strategies to relieve pain, but participants provided few pain-management strategies to help their relatives. Most participants had limited knowledge about osteoarthritis pain. Some participants and their older relatives held negative attitudes towards using pain medicines. Most participants suggested that other families should bring their older relatives with osteoarthritis pain to see a doctor as soon as possible. Our results show that family caregivers were the main support for older people with osteoarthritis. Interventions should educate patients and family members about osteoarthritis causes, common misconceptions about osteoarthritis, osteoarthritis pain medicines and treatment and encourage family members' support. © 2015 John Wiley & Sons Ltd.
    No preview · Article · May 2015 · Journal of Advanced Nursing
  • Sue-Hsien Chen · Jing-Long Huang · Kuo-Wei Yeh · Yun-Fang Tsai
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    ABSTRACT: Asthma is one of the most common chronic diseases in children. The unpredictability, frequency, and health risks associated with acute asthma attacks have a profound impact on the daily lives of affected children and their families. Understanding the experiences of primary caregivers may help nurses provide better care to children with asthma. This study explores the experience of primary caregivers in providing care to children with asthma. The study used exploratory and descriptive research methods and collected data using a qualitative research interview approach. Seventeen primary caregivers of children with asthma who visited the allergy clinics of two medical centers and one regional hospital in northern Taiwan participated in the study. An interview guide with a semistructured questionnaire was used, and verbatim transcripts of the audiotape-recorded interviews were analyzed using content analysis. The findings are described in three themes covering 10 categories. These themes and categories include feelings of uncertainty during illness (disease as perception related, lack of information), feelings of chaos and instability (worry, fear, frustration, helplessness, physical distress), and social tension and family conflict (disorientation of daily activity and burden of care, economic burden, family tensions and disagreements). Negative experiences with asthma care and the unpredictability of the disease outcomes impair the ability of caregivers to adapt successfully to their caregiving role and encourage perceptions that they cannot cope with this illness. Better understanding the caregiver experience may assist healthcare providers to better target support to these caregivers so that they are better able to care for children with asthma.
    No preview · Article · Apr 2015 · The journal of nursing research: JNR
  • Chiu-Yueh Hsiao · Yun-Fang Tsai
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    ABSTRACT: To assess the degree of caregiver burden and family functioning among Taiwanese primary family caregivers of people with schizophrenia and to test its association with demographic characteristics, family demands, sense of coherence and family hardiness. Family caregiving is a great concern in mental illness. Yet, the correlates of caregiver burden and family functioning in primary family caregivers of individuals with schizophrenia still remain unclear. A cross-sectional descriptive study. A convenience sample of 137 primary family caregivers was recruited from two psychiatric outpatient clinics in Taiwan. Measures included a demographic information sheet and the Chinese versions of the Family Stressors Index, Family Strains Index, 13-item Sense of Coherence Scale, 18-item Caregiver Burden Scale, Family Hardiness Index and Family Adaptability, Partnership, Growth, Affection, and Resolve Index. Data analysis included descriptive statistics, Pearson's product-moment correlation coefficients, t-test, one-way analysis of variance and a stepwise multiple linear regression.3 RESULTS: Female caregivers, additional dependent relatives, increased family demands and decreased sense of coherence significantly increased caregiver burden, whereas siblings as caregivers reported lower degrees of burden than parental caregivers. Family caregivers with lower family demands, increased family hardiness and higher educational level had significantly enhanced family functioning. Sense of coherence was significantly correlated with family hardiness. Our findings highlighted the importance of sense of coherence and family hardiness in individual and family adaptation. Special attention needs to focus on therapeutic interventions that enhance sense of coherence and family hardiness, thereby improving the perception of burden of care and family functioning. Given the nature of family caregiving in schizophrenia, understanding of correlates of caregiver burden and family functioning would help provide useful avenues for the development of family-focused intervention in psychiatric mental health nursing practice. © 2014 John Wiley & Sons Ltd.
    No preview · Article · Dec 2014 · Journal of Clinical Nursing
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    Shwu-Hua Lee · Yun-Fang Tsai · Ching-Yen Chen · Li-Bi Huang
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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.
    Full-text · Article · Dec 2014 · BMC Psychiatry
  • Chiu-Yueh Hsiao · Yun-Fang Tsai
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    ABSTRACT: Background: Caring for relatives with schizophrenia is complicated and has been associated with burden. Caregivers may also experience satisfaction, but these outcomes have not been simultaneously studied in family caregivers of relatives with schizophrenia. Objectives: The aim was to investigate the attributes of caregiver burden and satisfaction among individuals and families as well as the association of caregiver burden on caregiver satisfaction in the care of Taiwanese individuals with schizophrenia. Methods: A cross-sectional, descriptive, correlational design was used. A convenience sample of 140 families (243 individual family caregivers) was recruited from two psychiatric hospitals in Taiwan. Participants were interviewed individually to complete questionnaires regarding pileup of demands, sense of coherence, mutuality, caregiver burden, and caregiver satisfaction. Linear mixed modeling was used. Results: Female caregivers, greater family demands, decreased sense of coherence, and lower mutuality were associated with higher levels of caregiver burden, whereas being siblings or close relatives and being friends of the affected individuals were associated with lesser self-reported burden. Satisfaction was positively associated with caregiver age, sense of coherence, and mutuality. Burden and satisfaction were not significantly related. Discussion: Caring for family members with schizophrenia is burdensome but can also be a source of satisfaction. Correlates of caregiver burden appeared to be somewhat distinct from those of caregiver satisfaction. Further research on negative and positive aspects of caregiving is warranted to broaden the understanding of caregiving experiences and design therapeutic interventions to mitigate caregiver burden and enhance the sense of satisfaction with caregiving.
    No preview · Article · Jul 2014 · Nursing Research
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    Ying-Jen Chen · Yun-Fang Tsai · Shwu-Hua Lee · Hsiu-Lan Lee
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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.
    Preview · Article · Apr 2014 · BMC Public Health
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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.
    No preview · Article · Dec 2013 · Aging and Mental Health
  • 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).
    No preview · Article · Nov 2013 · Journal of Advanced Nursing
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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).
    No preview · Article · Oct 2013 · Medical Education
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    Full-text · Dataset · Jul 2013
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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.
    No preview · Article · Jun 2013 · International Journal of Gerontology
  • Sue-Hsien Chen · Jing-Long Huang · Kuo-Wei Yeh · Yun-Fang Tsai
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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 SMIS and the other receiving 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 < .05). Most importantly, knowledge about asthma medications and exacerbations significantly improved and attitudes toward medication adherence and dealing with asthma care became more positive in the SMIS group. The forced expiratory volume in one second was significantly improved in the SMIS group after 12 months (p < .05), and performance in the methacholine challenge test at the end of the study was significantly better in the SMIS group (p < .05). Participants in the SMIS group also had a lower rate of emergency room use (p < .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 the emergency departments. Interactive support interventions reinforce learning incentives and encourage self-care and maintenance of therapeutic regimens.
    No preview · Article · Apr 2013 · Journal of Asthma
  • Yi-Wen Wang · Yun-Fang Tsai · Thomas Ks Wong · Yan-Chiou Ku
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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.
    No preview · Article · Mar 2013 · Journal of Clinical Nursing
  • Yu-Ling Chang · Yun-Fang Tsai · Yi-Cheng Wu · Ming-Ju Hsieh
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    ABSTRACT: BACKGROUND:: Little is known regarding the short-term quality of life (QoL) and predictive factors for QoL after esophagectomy for cancer in Eastern countries. OBJECTIVE:: The aims of this study were to assess QoL and symptoms within 1 and 6 months after surgery for esophageal cancer (EC) and to identify factors predictive of QoL within 6 months after esophagectomy in Taiwan. METHODS:: A longitudinal, prospective design was used, where convenience samples of 99 patients who had undergone esophagectomy for cancer were recruited from 2 medical centers in northern Taiwan. All participants responded to a questionnaire with a QLQ-C30 (Quality of Life Questionnaire-Cancer) core and a QLQ-OES18 (esophageal module of the European Organization for Research and Treatment [EORTC] QLQ-C30) module in structured interviews at baseline and 1 and 6 months after surgery. RESULTS:: The results showed significant decline in social function and global QoL; fatigue, insomnia, eating problems, reflux, and dry mouth were major problems within 6 months. Body mass index, body weight loss before surgery, activity performance status, and anastomosis site showed no significant association with the function and symptom aspect of QoL. Surgical complications, advanced cancer, neoadjuvant therapy before surgery, and tumor location other than at the EC junction had significant deleterious effects on several aspects of QoL. CONCLUSIONS:: This study describes the demographics of EC and short-term changes in QoL and also the predictive impact factor for QoL after surgery for EC. IMPLICATIONS FOR PRACTICE:: Knowledge of risk factors for poor postoperative QoL would be useful for health providers in detecting and prioritizing problems and treatment options in a busy clinical site.
    No preview · Article · Jan 2013 · Cancer nursing
  • Hsin-Ni Chen · Yun-Fang Tsai
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    ABSTRACT: Background: Lumbar disc herniation may influence patients' daily activities and social interactions; however, no predictive models of disability could be found for patients with lumbar disc herniation. We aimed to explore predictive factors for disability in patients with lumbar disc herniation. Methods: The sample included 216 patients recruited from the orthopedic outpatient clinics at a medical center in northern Taiwan. Data were collected on patients' pain, fatigue, depression, disability, and demographics. Hierarchical multiple regression analysis was used in model verification. Path analysis was used to investigate causal relationships between disability and other factors. Results: In path analysis, the most influential factor affecting the disability level was the pain level (standardized regression coefficient, b = 0.746), followed by the fatigue level (b = 0.138) and depression level (b = 0.100). The depression level was directly affected by the fatigue level (b = 0.416) and the pain level (b = 0.367), the fatigue level was directly affected by the pain level (b = 0.538), and the pain level was directly affected by age (b = 0.140) and previous surgery (b = 0.260). Conclusions: We recommend that health-care providers regularly assess and treat pain and depression to reduce/prevent disability among patients with lumbar disc herniation, even among those who are apparently functioning well in the community.
    No preview · Article · Jan 2013 · Journal of Orthopaedic Science
  • 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.
    No preview · Article · Jan 2013 · Social Psychiatry
  • 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.
    No preview · Article · Nov 2012 · Journal of Advanced Nursing

Publication Stats

1k Citations
162.25 Total Impact Points


  • 2015
    • Chung Shan Medical University
      臺中市, Taiwan, Taiwan
  • 2005-2015
    • Chang Gung Memorial Hospital
      • • Department of Internal Medicine
      • • Department of Psychiatry
      T’ai-pei, Taipei, Taiwan
  • 2003-2015
    • Chang Gung University
      • School of Nursing
      Hsin-chu-hsien, Taiwan, Taiwan