Hui-Ling Lai

Effects of music intervention with nursing presence and recorded music on psycho-physiological indices of cancer patient caregivers

AIMS AND OBJECTIVES To compare the effects of music intervention with nursing presence and recorded music on blood volume pulse amplitude, the low/high frequency ratio component of heart rate variability, depression, anxiety and sleep quality in cancer patient caregivers; to compare the participants evaluation of these two forms of musical intervention. BACKGROUND Presence is one of the activities of caring. However, little is known about the effect of music intervention with nursing presence on psycho-physiological indices. DESIGN Randomised crossover controlled trial. METHOD Thirty-four female participants were randomly assigned to a music intervention with nursing presence/recorded music sequence or recorded music/music intervention with nursing presence sequence. Each intervention lasted 30 minutes and was held at the participants home. The music intervention with nursing presence consisted of an erhu and recorder performance. In the recorded music session, participants listened to prerecorded music for 30 minutes. Continuous measurements of blood volume pulse and low/high frequency ratio were taken throughout the procedure. Depression, anxiety and sleep quality were measured before and after each intervention. RESULTS Both music intervention with nursing presence and recorded music interventions had beneficial effects on anxiety, depression and blood volume pulse amplitude. Significant differences between the two interventions were also observed for anxiety. Music intervention with nursing presence was more effective in lessening anxiety and on improving the ease of getting to sleep compared with recorded music (p < 0·05). All participants reported that they preferred music intervention with nursing presence to recorded music. Significant differences were found in music evaluation scores between the two interventions in terms of harmony and friendliness (p < 0·05). CONCLUSIONS Both music interventions were beneficial, as measured on psycho-physiological indices. The music intervention with nursing presence provided a more friendly music experience to the listeners. RELEVANCE TO CLINICAL PRACTICE The findings provide evidence for nurses that the therapeutic use of music and nursing presence as a research-based nursing intervention for the welfare of caregivers.

Risk Factors and Coping Style Affect Health Outcomes in Adults With Type 2 Diabetes

Objective: Most psychosocial interventions among individuals with Type 2 diabetes mellitus (T2DM) target depressive symptoms (DSs) rather than causal antecedents that lead to DSs or affect health-related quality of life (HrQoL). This research investigated a conceptual model of the effects of risk factors and coping styles on HrQoL and DSs in patients with T2DM. Method: A descriptive, correlational design was used with a convenience sample of 241 adults with T2DM aged ≥ 20 years recruited from a hospital metabolic outpatient department. Data were collected using a demographic questionnaire, the modified Ways of Coping Checklist, the Center for Epidemiological Studies Depression Scale, the Short Form 36 Health Survey, and physiological examination. HbA1C was collected from participants’ medical records. Structural equation modeling techniques were used to analyze relationships among risk factors, mediators, and HrQoL. Results: Younger age, more education, and longer duration of diabetes predicted better physical quality of life. Duration of diabetes and three coping styles predicted DSs. Longer duration of diabetes and lower fasting glucose predicted better mental quality of life. Three coping styles acted as mediators between risk factors and health, that is, active and minimizing styles promoted positive outcomes, while avoidance promoted negative outcomes. Conclusions: This integrated model provides a holistic picture of how risk factors and coping style influence HrQoL and DSs in individuals with T2DM. Nurses could use active coping strategies in cognitive behavioral therapy to enhance glycemic control in patients with T2DM.

Effects of music videos on sleep quality in middle-aged and older adults with chronic insomnia: a randomized controlled trial.

Listening to soothing music has been used as a complementary therapy to improve sleep quality. However, there is no empirical evidence for the effects of music videos (MVs) on sleep quality in adults with insomnia as assessed by polysomnography (PSG). In this randomized crossover controlled trial, we compared the effects of a peaceful Buddhist MV intervention to a usual-care control condition before bedtime on subjective and objective sleep quality in middle-aged and older adults with chronic insomnia. The study was conducted in a hospital’s sleep laboratory. We randomly assigned 38 subjects, aged 50–75 years, to an MV/usual-care sequence or a usual-care/MV sequence. After pretest data collection, testing was held on two consecutive nights, with subjects participating in one condition each night according to their assigned sequence. Each intervention lasted 30 min. Sleep was assessed using PSG and self-report questionnaires. After controlling for baseline data, sleep-onset latency was significantly shorter by approximately 2 min in the MV condition than in the usual-care condition (p = .002). The MV intervention had no significant effects relative to the usual care on any other sleep parameters assessed by PSG or self-reported sleep quality. These results suggest that an MV intervention may be effective in promoting sleep. However, the effectiveness of a Buddhist MV on sleep needs further study to develop a culturally specific insomnia intervention. Our findings also suggest that an MV intervention can serve as another option for health care providers to improve sleep onset in people with insomnia.

Influence of work values and personality traits on intent to stay among nurses at various types of hospital in Taiwan

AIM In this study, the influence of work values and personality traits on the intent to stay at work was examined among nurses in Taiwan. BACKGROUND No empirical studies in this area have been conducted in the nursing industry. METHODS A cross-sectional predictive study was performed during 2012 with 1246 nurses recruited from three different types of hospital located in northeastern Taiwan. A structured questionnaire based on the 5-factor model was used. Multiple regression analyses were used to investigate the various factors associated with the intent to stay at work among nurses. RESULTS The overall response rate was 85%. The nurses who had a high level of intent to stay at work were significantly more likely to be in senior roles; exhibited positive work values, conscientiousness, emotional stability; and worked at a non-religious hospital. CONCLUSION Age, the role of work values, personality traits and type of hospital were crucial in enhancing the level of intent to stay at work. IMPLICATIONS FOR NURSING MANAGEMENT The study findings provide evidence for managers to develop an optimal strategy for nurses with specific personality traits and highly positive work values, which can guide the recruitment and retention of nurses.

Comparing the effects of music and exercise with music for older adults with insomnia

AIM To examine the effects of a soothing music intervention before bedtime and a treadmill brisk walking exercise combined with music in the evening on sleep quality of sedentary older adults with chronic insomnia. BACKGROUND There is evidence to support the use of complementary interventions to improve sleep. They are rarely applied in Taiwanese elderly population. METHODS Using a crossover controlled trial, 38 participants aged 50 to 75 years were randomly assigned to a music intervention/brisk walking sequence or a brisk walking/music intervention sequence. Each participant completed two intervention sessions (separated by 1 week). Each intervention lasted 30 min. An actigraph extended with electroencephalography (EEG) and questionnaires were used to assess the sleep quality. RESULTS Both interventions exhibited beneficial effects on subjective sleep quality in adults with insomnia. Also listening to soothing music before bedtime significantly shortened the wake time after sleep onset measured by EEG, compared with brisk walking in the evening. CONCLUSIONS The interventions applied in this study could be applied as the evidence-based nursing interventions for insomnia older adults.

Effects of motivational enhancement therapy plus cognitive behaviour therapy on depressive symptoms and health-related quality of life in adults with type II diabetes mellitus: a randomised controlled trial.

AbstractObjective This paper evaluates the effectiveness of motivational enhancement therapy plus cognitive behavioural therapy on depressive symptoms, glycosylated haemoglobin, fasting glucose, body mass index (BMI), and health-related quality of life in type II diabetes patients. Methods A controlled trial was conducted to compare patients who received the behavioural intervention with untreated controls on measures of health outcomes. A total of 31 intervention group participants and 30 controls were selected from patients that met the inclusion criteria from a hospital-based endocrinology outpatient department. The outcome measures including depressive symptoms, glycosylated haemoglobin, fasting glucose, BMI, and both physical and mental quality of life were collected before (T1), after (T2), and after 90 days (T3) following the intervention.ResultsThe experimental group showed a significant reduction in glycosylated haemoglobin, fasting glucose, and depressive symptoms and a significant increase in physical quality of life and mental quality of life at T2 and T3, while patients in the control group with usual care showed no changes over time. Conclusion The behavioural intervention facilitated a significant improvement in psychological adjustment and glycemic control, thus strengthening diabetes control skills and leading to healthy outcomes. It is feasible that nurses and psychiatrists can deliver the behavioural intervention for diabetes patients to decrease their depressive symptoms. Sharing discussion and problem-solving experiences is particularly helpful method for self-control, and these will be beneficially influential on further research.

Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modeling

SummaryParticipants with physical limitation and high degree of pain had poor mental and physical health-related quality of life. In addition, the more support and exercise that the participants had, the more likely theywere to report better health-related quality of life.IntroductionOsteoporosis is a public health threat worldwide. The aim of this study is to examine the effects of individual demographics, disease characteristics, and social support on health-related quality of life (HrQoL) of adults with osteoporosis. Most psychosocial studies focused on the relationships but not the specific construct of social support on HrQoL.MethodsIn a correlational design, face-to-face, structured interviews were employed to collect information. Study questionnaires included a demographic sheet, the modified Social Support Inventory, and the Short-Form 36 scales on a convenience sample of 161 individuals recruited from four outpatient centers. Using the structural equation modeling approach, all relationships among factors, mediators, and HrQoL were analyzed.ResultsThe mean duration of osteoporosis was longer than 5 years. Participants who exercised more than three times per week had greater HrQoL than individuals who exercised less frequently. Participants with physical limitation and high degree of pain had poor mental and physical HrQoL. The more support that the participants perceived, the more likely they were to report better HrQoL. The best fitted structural equation modeling (SEM) model included individual demographics and physical function, and social support as significant predictors on HrQoL, with informational support and physical function acting as mediators in those relationships. Moreover, this structural model explained 35, 42, and 40 % of the variance on activity of daily living (ADL), physical, and mental health-related quality of life.ConclusionsThe more informational support that individuals have, the more likely they were to report better HrQoL. Individuals with osteoporosis who have lower pain and more exercise are considered having better HrQoL. Further longitudinal research will help clarify the direction of these relationships.

Gender differences in obstructive sleep apnea syndrome

A previous epidemiological study reported that males have higher prevalence rates of a diagnosis and severity of obstructive sleep apnea syndrome (OSAS) than females, with a ratio of 2:1 to 3:1 [1]. Gender differences in craniofacial shape and fat deposition seem to be the most important issues between males and females [2,3]. Obesity is a well-known risk factor for the development of OSAS in both genders [4–7]. Moreover, Yukawa et al. reported that Japanese females had lower apnea–hypopnea index (AHI) values than Japanese males after adjusting for body mass index (BMI) and that male patients with OSAS had a higher continuous positive airway pressure (CPAP) compared to female patients with OSAS [8]. The aim of this cross-sectional study was to clarify craniofacial and polysomnographic differences between Chinese male and female patients with OSAS. Ageand AHImatched male and female patients were also compared to minimize the effects of age and severity of OSAS. We enrolled 396 Chinese adult (≥20 years) patients with OSAS with complete craniofacial and polysomnographic evaluations from 2008 to 2013 from the SleepCenter of Hualien TzuChiGeneral Hospital. Patients who were unable to cooperate with clinical data collection or participate in craniofacial or polysomnographic studies were excluded. Other exclusion criteria included those who refused to sign informed consent, thosewhowere taking psychotropic drugs (including sedative drugs for insomnia), and those with other condition such as pain that would interfere with sleep. The hospitals Institutional Review Board approved the study, which had no external funding, and all of the participants provided informed consent. All statistical tests were two sided and statistical significance was set at p b 0.05. Male patients were younger than the female patients and had a higher neck circumference (40.6 vs. 36.5 cm). The BMI, ESS, waist, and hip circumference and waist-to-hip ratio were not significantly different between the males and the females. The ageand AHI-matched analysis showed only a higher neck circumference in the males than in the females (40.2 vs. 36.0 cm). In the polysomnographic studies, the males had more stage 1 non-rapid eye movement (non-REM)

Differences Between Sleep Logs and Actigraphy Combined With Electroencephalography in Adults With Sleep Disturbances

Background: Actigraphy plus single-channel electroencephalography (EEG) has a high agreement with polysomnography and is considered a simple method for monitoring sleep at home. No studies, however, have evaluated its agreement with sleep logs. Purpose: A sleep log was compared to a single-channel EEG in adults with sleep disturbances. The determinants of the agreement between the two recording methods were explored. Method: This prospective comparison substudy included 71 participants aged 22–67 years sampled from a previous study of nonpharmacological therapy for sleep disturbances. The participants concurrently used a sleep log and a single-channel EEG machine for 6 days to measure their sleep at home. Total sleep time (TST) and sleep onset latency (SOL) were compared. Results: Correlations between measurements were .43 for TST (p < .001) and .30 (p < .01) for SOL. Bland–Altman analysis revealed that the mean bias between methods was 81.54 min (standard deviation [SD] = 66.72 min) for TST and 5.58 min (SD = 25.38 min) for SOL. SDs for both TST and SOL were higher for the sleep log than for EEG. A multivariate linear regression model demonstrated that age (standardized coefficient β = .42, p = .001) was a significant predictor of the mean difference in SOL measurements, accounting for 13.7% of the total variance in the mean difference. Conclusion: Sleep log and single-channel EEG sleep measures are distinct from one another, and age predicts the mean level of disagreement between the two measures in adults with sleep disturbances.

Use of integrative medicine approaches for treating adults with sleep disturbances

AIM This study determined the prevalence, perceived efficacy, and influencing factors and evaluated the sources of information as well as the barriers and facilitators for the use of integrative medicine approaches (IMA) within the previous 12 months to treat adults with sleep disturbances. BACKGROUND No studies have assessed the use of integrative medicine approaches in adults with sleep disturbances. METHODS A cross-sectional postal survey was conducted. Adults with sleep disturbances were purposively selected from the sleep center of a hospital in Taiwan. Binary logistic regression was used to analyze and compare the differences between groups of use and non-use IMA. RESULTS The response rate was 94.5% (n = 515). The prevalence for the use of integrative medicine approaches was 53.4% (n = 275). The most prevalent IMA was music. However, the most perceivably efficacious integrative medicine approaches was acupressure, followed by music and meditation. Independent explanatory variables were educational attainment, the number of chronic diseases/symptoms, and healthy lifestyles for the use of IMA. The most common source of information was television/radio. The top facilitator and barrier for the use of integrative medicine approaches were side effects of sleeping pills and limited accessibility. CONCLUSIONS IMA are used by a considerable proportion of adults for treating sleep disturbances in Taiwan. The findings of this study identified the significant explanatory variables of IMA use and provided a fundamental understanding the aspects of IMA use in the adults with sleep disturbances is particularly important for health care providers in practice associated with their patients.