Huey-Shyan Lin

Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trial

BACKGROUND Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults. OBJECTIVE To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status. DESIGN Cluster randomized trial. SETTINGS Eight senior activity centers, southern Taiwan. PARTICIPANTS A sample of 139 participants was recruited, and 128 of them completed the study. INCLUSION CRITERIA (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 +/- 6.23 years, and the average number of chronic illness was 0.83 +/- 0.90. The average BI score of the participants was 99.92 +/- 0.62, and the mean SPMSQ score was 9.90 +/- 0.30. METHODS Participants were randomly assigned into either the experimental (n=62) or the control (n=66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group. RESULTS Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p<.05). CONCLUSIONS After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.

Effects of motivational interviewing intervention on self-management, psychological and glycemic outcomes in type 2 diabetes: A randomized controlled trial

BACKGROUND Type 2 diabetes is a serious and growing problem in Taiwan where it is the fifth leading cause of death, and health care costs are 4.3 times higher than for people without diabetes. OBJECTIVES The purpose of this study was to determine whether participation in a motivational interview for people with type 2 diabetes would improve their self-management, psychological and glycemic outcomes. DESIGN A randomized controlled trial to assess the effects of the motivational interviewing intervention. SETTINGS Participants were drawn from the diabetes outpatient clinic of a large teaching hospital in South Taiwan. PARTICIPANTS A sample of 250 type 2 diabetes people. METHODS Type 2 diabetes people were randomly allocated into either the motivational interview group or the usual care group from baseline to 3 months follow-up. The intervention was based on motivational interviewing which encompassed a variety of interviewing techniques, and reflected each persons readiness stage to change. The control group was provided with usual care by nursing staff. RESULTS A total of 250 type 2 diabetic participants were randomized. The retention rate in the intervention group was 83% (n=104). The motivational interview did improve participants significantly in self-management, self-efficacy, quality of life, and HbA1c among diabetes people with appropriate baseline value (<121.24, <174.57, <107.18, and >7.62, respectively) but not in depression, anxiety and stress (F=0.13, p=0.72) compared to the control group at 3 months follow-up. CONCLUSION The findings provided important evidence concerning the positive effect of motivational interventions in self-management, psychological and glycemic outcomes. This research provided evidence for future clinical practices in diabetes care.

Silver yoga exercises improved physical fitness of transitional frail elders.

Background:Promoting the health of transitional frail elders (e.g., through therapeutic-based yoga exercises) is essential to reduce healthcare expenditures caused by chronic health problems. Objective:The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga (SY) exercise program for transitional frail elders. Methods:A convenience sample of 69 elders in assisted living facilities were assigned randomly to the SY group (n = 38) or to the control group (n = 31) on the basis of the facilities where they resided, and 55 of them completed this quasi-experimental pretest and posttest study. Intervention was conducted three times per week, 70 minutes per session, for 24 weeks. Physical fitness (body composition, cardiovascular-respiratory functions, body flexibility, muscle power and endurance, balance, and agility) were examined at baseline, at 12 weeks, and at the end of the 24th week of the study. Results:At the end of the study, the physical fitness indicators of participants in the SY group had improved significantly, and they had better physical fitness than participants in the control group (all p values < .05). Discussion:It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders.

Development of the model of health for older adults

AIMS This study aimed to explore the pertinent health indicators and to form a model of health for older adults. BACKGROUND Health assessment and early detection are foundations for health promotion. Finding essential health indicators for older adults can better reflect the health status of this population and efficiently detect their health problems in a timely and economical manner. METHODS This study had two phases. Data were collected from July 2008 to January 2009. Phase I began with sending evaluation surveys to a panel of ten professional experts to generate health indicators for older adults. Phase II was a preliminary determination of the extent of health predictions using these indicators by conducting a descriptive survey involving a stratified random sample of 55 community-dwelling older adults. RESULTS The ten experts had fairly high agreement on the representativeness and importance of the proposed health model for older adults. The predictability of the health of older adults in the three domains (physical health, psychological health and social-economic health), four constructs (activities of daily living, physical status, emotional health and social engagement), and 47 indicators in this model was 84·50%. CONCLUSION Results of this study could be used for making health policy and/or to set the goals for intervention. In addition, nurses who care for the older adults may use the health indicators to plan and control the given quality of care. The researchers may further examine the effects of study programmes for health promotion.

The revised critical thinking skills scale for a life-and-death course: preliminary scale refinement.

Background: Death education involves acquiring knowledge, changing behavior, and developing proper views of life in both the affective and the value domains. Critical thinking that is honed through reflecting on life-and-death issues represents a way to reach these goals. Designing assessments able to measure college student content and critical thinking skills related to life-and-death issues is thus important. The Test of Critical Thinking Skills for Life-And-Death content (TCTS-LD) instrument requires the administration of additional tests to assess reliability and validity for future use in the assessment of perceptions on life and death. Purpose: The purpose of this study was to refine the TCTS-LD. Methods: A cross-sectional, descriptive design was used to recruit 715 college students in southern Taiwan. Three structured scales were administered in class to the participants. Data were collected in 2004 and 2006. Confirmatory factor analysis was applied to validate the structure of scales. Results: Examination of the reliability of the three-factor and 15-item scale revealed a Kuder-Richardson coefficient of internal consistency of .54. The split-half reliability coefficients were .47 in the Spearman-Brown correlation and .40 in the intraclass correlation coefficient (ICC). The test-retest reliability coefficients (n = 22) were .58 in Pearson correlation and .56 in ICC. In addition to content validity verification by experts and face validity by students, the validity of this test was assessed using three methods, including (a) a comparable validity rating between this test and the TCTS-A (r = .34, p < .001; (b) a contrast-group technique with different responses to the instrument between those in education and nursing majors (t = 2.71, p < .01), with scores of 10.98 (SD = 2.42) and 9.82 (SD = 2.25), respectively; and (c) a confirmatory factor analysis confirming that TCTS-LD is related to the three dimensions of assumption, evaluation, and induction (&khgr;2 = 81.800, p = .158, normed chi-square &khgr;2/df = 1.169, comparative fit index [CFI] = .976, Tucker-Lewis index = .984, root mean square error of approximation [RMSEA] = 0.015). Three factors explained 31.19% of total variance for the revised TCTS-LD. Conclusions: The revised TCTS-LD scale improved performance and effectiveness to a certain degree. However, reliability and construct validity must be further tested to permit its use as an evaluation tool.