Lily Yeh

A preliminary study on the health promotion outcomes of high-risk hypertensive freshmen.

This preliminary study identified the outcomes of a health promotion program encompassing health education (2 hours) and case management for 4 weeks applied to high-risk hypertensive freshmen (systolic blood pressure, > or = 160 mmHg, or diastolic blood pressure > or = 100 mmHg) at a university located in Southern Taiwan. Twenty-two freshmen participated and data were collected at baseline and 4 weeks later, after the program. Outcome indicators included biologic (blood pressure, body weight and body fat composition) and healthy lifestyle characteristics (assessed using the Health Promotion Lifestyle Profile [HPLP] and case management documentation). The Wilcoxon signed rank test showed that systolic blood pressure, body weight, and four subscales of the HPLP, health responsibility, interpersonal support, nutrition, and exercise, had improved significantly. This program could be used as a reference to refine further health promotion programs in the university.

Clients' outcomes of home health nursing in Taiwan.

The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.

Use of Home Nursing Service in Southern Taiwan

Andersons behavioral model was applied to examine predisposing, enabling, and need components that influence the use of home nursing services in southern Taiwan. The authors collected data from 10 hospital-based, profit-oriented home nursing agencies. There were 449 participants, and the mean of their ages was 71.9. The services provided were related to periodic indwelling catheter replacement and wound care. It was found that the mean of enrollment per client was 185.1 days and that about 60% of them received services within 4 months. Most of the clients (61.0%) received services less than five times, and the mean of total visits was 9.5 (range = 1 to 108). The intensity of the visits showed that about half of the clients (51.2%) received service every 14 to 30 days. Results of this study can be used as a reference in policy making to refine the national health insurance system in Taiwan.

Using SAS/GENMOD Procedure to Fit GEE Regression Models

Researchers are often interested in analyzing data that arise from longitudinal studies. And estimating equations for generalized linear modeling of longitudinal data have attracted a great deal of attention over the last two decades. Liang and Zeger (1986) presented an approach, generalized estimating equations (GEEs) which extended from generalized linear models (GLMs) to a regression setting with correlated observations within subjects, to these problems. This paper provides briefly review the GLM and GEE methodologies, and illustrate its implementation with a home-care example using the GENMOD procedure in SAS/STAT software to solve GEE in the analysis of correlated data.