Mei Chang Yeh

Trends of ABC control 2006-2011: a National Survey of Diabetes Health Promotion Institutes in Taiwan.

AIMS To understand the trends of ABC control in 5 years interval in Taiwan. METHODS We compared two waves of nationwide surveys (n=7541 and n=5599, mainly type 2 diabetes) to examine the trends of ABC control across 5 years in accredited Diabetes Health Promotion Institutes in Taiwan. RESULTS The percentages of subjects who had HbA1c lower than 7% (A), both SBP and DBP lower than 130/80 mmHg (B), and total cholesterol lower than 160 mg/dl or LDL cholesterol lower than 100mg/dl (C) increased by 6.5% (from 32.4% to 34.5%), 22.0% (from 30.9% to 37.7%), and 57.8% (from 35.3% to 55.7%), respectively, with a resulting total ABC attainment rate from 4.1% to 8.6%. A subgroup of 720 diabetic subjects who participated in both surveys showed the same pattern of changes in B and C but had a slight deterioration of glycemic control. Logistic regression analysis revealed that diagnosis of type 1 diabetes, lower BMI and individuals not requiring insulin were independently associated with attainment of ABC goals in 2006 and 2011. An accountabilities examination revealed that annular tests of HbA1c, BP and lipids were all above 90% in both surveys. CONCLUSIONS We observed an improvement of individual and overall attainments of ABC goals across 5 years in Taiwan owing to recent implementation of several diabetes care models and initiatives. We anticipate that these improvements will translate into reductions of both macrovascular and microvascular complications.

The quality of life of adults with type 2 diabetes in a hospital care clinic in Taiwan.

PurposeTo assess the impact of diabetes on quality of life (QoL) and identify major determinants affecting that impact using a multiple regression model.MethodsThis was a cross-sectional design. The audit of diabetes-dependent quality of life (ADDQoL) was administered to assess QoL.ResultsA sample of 256 outpatients with type 2 diabetes was recruited. A negative impact of diabetes was observed on all life domains. The first three most impacted life domains were ‘future’, ‘freedom to eat’, and ‘self-confidence’. ‘Freedom to eat’ was also the domain the most frequently impacted in five previous ADDQoL studies conducted in Singapore, UK, India, the United States, and Slovakia. Factors negatively associated with some domain scores were younger age (future), being male (close personal relationship and sex life), more education (leisure activities, future, dependence, and freedom to drink), low income (leisure activities), having more diabetic complications (do physically and sex life), treatment with insulin (finances and living conditions), and higher HbA1c (freedom to drink).ConclusionQoL is impaired in patients with diabetes, especially for the ‘freedom to eat’ domain, indicating that an intervention to improve dietary freedom might be a good way of improving QoL. Greater negative impact of diabetes on QoL was associated with being younger, male, more educated with low income, more diabetes complications, higher HbA1c, and using insulin. These need to be considered in responding to patients’ individual needs.

Leisure-time physical activities for community older people with chronic diseases

AIMS (1) To explore the types and three components (frequency, duration and caloric expenditure) of leisure-time physical activity in community older people with chronic diseases. (2) To identify leisure-time physical activity-related factors in these community older people. BACKGROUND Previous research has focused primarily on measuring the actual physiological or psychological benefits of exercise or leisure-time physical activity, little is known about the factors that determine the frequency, intensity and duration of exercise or leisure-time physical activity. The identification of reliable predictors of the various components of leisure-time physical activity will enable healthcare providers to intervene and change the patterns of leisure-time physical activity in the sedentary older people more effectively. DESIGN A cross-sectional design was used for this study. METHODS Participants were recruited from the Xinyi District in Taipei, Taiwan. A total of 206 older people were recruited and were asked to complete three questionnaires during a face-to-face interview with a researcher at the activity setting. RESULTS The results showed that walking leisurely was the most frequent leisure-time physical activity for participants. The age, gender, living arrangement, affective feeling and environmental control were significant variables of leisure-time physical activity. CONCLUSIONS The study constructs accounted for moderate amounts of variance (22% for leisure-time physical activity frequency, 27% for leisure-time physical activity duration and 24% for leisure-time physical activity caloric expenditure). This study also showed that different variables play different influential roles in the different components of LTPA. RELEVANCE TO CLINICAL PRACTICE An effective intervention strategy for improving leisure-time physical activity of older people may involve tailoring the type, format, intensity, frequency and duration of a physical activity according to an individuals needs. This study described some environmental barriers to LTPA and recommended an increase in the accessibility to LTPA areas.

The experiences of diabetics on self-monitoring of blood glucose: a qualitative metasynthesis.

AIMS AND OBJECTIVES To interpret, describe and analyse the results of various qualitative studies and comprehensively elucidate the self-monitoring of blood glucose experiences of diabetic patients, and to make recommendations based on these findings for clinical practices. BACKGROUND Patients exhibited both positive and negative perceptions towards the self-monitoring of blood glucose. Numerous recent qualitative studies have explored the self-monitoring of blood glucose experiences of diabetic patients; however, no integrated results have been provided. DESIGN Qualitative metasynthesis. METHODS A systematic literature search of English and Chinese databases was undertaken, covering the period between January 2004 and April 2014. The following databases were searched: CINAHL, PubMed, MEDLINE, Cochrane Library, Airiti library and PsycInfo. Seven studies were assessed in the final analysis; the Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to evaluate these studies. RESULTS The self-monitoring experiences of patients with diabetes were divided into five themes: perceived disease severity, effects on daily life, lifestyle adjustments after becoming aware of blood glucose levels, determining the meaning of self-monitoring, and the differences between diabetic patients who use and do not use insulin. Individual differences in blood glucose self-monitoring vary widely among diabetic patients. CONCLUSIONS These differences result from personal cognition and feelings concerning blood glucose monitoring. Insights into and discussions regarding the self-monitoring of blood glucose experiences of diabetic patients enable health care professionals to understand the factors that influence the intentions of patients to perform self-monitoring of blood glucose and facilitate establishing customised self-monitoring of blood glucose treatment plans. RELEVANCE TO CLINICAL PRACTICE Health care professionals must adopt flexible and individualised criteria to determine patient cognitive misconceptions, understand negative emotional reactions and provide individualised assistance.

Occupational Health Nursing Practice, Education, and Research in Taiwan

This article describes occupational health nursing practice, education, research, and future perspectives in Taiwan. It also provides a brief overview of major occupational health and safety problems, laws and regulations, and organizations in Taiwan.