Shu-Chuan Jennifer Yeh

Influence of social support on cognitive function in the elderly

BackgroundSocial support is important in daily activities of the elderly. This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting.MethodsFace-to-face interviews were conducted in a cross-sectional stratified random sample of 4,993 elderly (≥65 years) city residents. Using multiple regression analysis, we investigated the influence of social support on cognitive function.Results12% were over 80 years old. 53.28% were men. 67.14% were married. Higher Short Portable Mental Status Questionnaire (SPMSQ) scores (higher score means better cognitive function) were associated with strong social support, as measured by marital status and perceived positive support from friends. Lower cognitive function was associated with older and with female respondents. Only instrumental activities of daily living (IADL) were statistically and negatively related to SPMSQ. Lower functional status was associated with lower cognitive function. Elders with grade school educations had lower SPMSQ scores than did elders with high school educations.ConclusionsIn Taiwan, higher cognitive function in community-living elderly was associated with increased social support. Life-style management should provide social activities for the elderly to promote a better quality of life.

The effect of Qigong on menopausal symptoms and quality of sleep for perimenopausal women: a preliminary observational study.

OBJECTIVES The study objectives were to examine the effect of a 12-week 30-minute-a-day Ping Shuai Qigong exercise program on climacteric symptoms and sleep quality in perimenopausal women. DESIGN This was a prospective observational study. SETTINGS/LOCATION The subjects (N=70) from two communities were women aged 45 years and above who were experiencing menopausal symptoms. SUBJECTS Thirty-five (35) women from one community were assigned to a Ping Shuai Qigong intervention group, while 35 women from the other community were assigned to the control group. INTERVENTIONS This was a 12-week, 30-minute-a-day Ping Shuai Qigong program. OUTCOME MEASURES The Greene Climacteric Symptom scale and the Pittsburgh Sleep Quality Index were the outcome measures. METHODS Descriptive analysis and repeated-measures analysis of variance were used. RESULTS Pretest scores at baseline found no significant group differences in climacteric symptoms or sleep quality. Significant improvements in climacteric symptoms were found at 6 weeks and 12 weeks (t=4.07, p<0.001 and t=11.83, p<0.001) in the intervention group. They were also found to have significant improvements in sleep quality in those times (t=5.93, p<0.001 and t=10.58, p<0.001, respectively). CONCLUSIONS Ping Shuai Qigong improved climacteric symptoms and sleep quality in perimenopausal women at 6 weeks and 12 weeks. The longer a person practiced this form of meditative exercise, the greater the improvement in sleeping quality and climacteric symptoms.

Associations Between Tai Chi Chung Program, Anxiety, and Cardiovascular Risk Factors

Purpose. To examine the effects of a Tai Chi Chung (TCC) program, an efficiency approach, on anxiety and cardiovascular risk factors. Design. A quasi-experimental study. Setting. A community in Taipei City, Taiwan. Subjects. One hundred thirty-three adults aged 55 years and older. Intervention. Sixty-four participants (experimental group) attended a 60-minute Tai Chi exercise three times per week for 12 weeks, whereas 69 participants (control group) maintained their usual daily activities. Measures. Anxiety states, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist circumference (WC) were assessed at baseline, 6 weeks into the experiment, and 12 weeks into the experiment. Analysis. Generalized estimating equations were used to evaluate the changes. Results. Participants showed a greater drop in anxiety levels (β = −2.57, p = .001) and DBP (β = −7.02, p < .001) at the 12-week follow-up than did the controls. SBP significantly decreased in the 6-week follow-up and 12-week follow-up tests. The participants in the intervention achieved a greater drop in BMI at the 6-week and 12-week follow-up visits than the controls. The interventions demonstrated decreased average WC at the 6-week and 12-week follow-up visits as compared to the controls. Conclusion. The results highlight the long-term benefits of a TCC program in facilitating health promotion by reducing anxiety and risk factors for cardiovascular diseases.

Is rehabilitation associated with change in functional status among nursing home residents

Assessing functional status of residents in nursing homes is one way to evaluate the quality of care provided. The purpose of this study was to investigate whether rehabilitation interventions could lead to improved functional independence. A prospective study was carried out to examine the change in activities of daily living (ADL) of 310 residents aged 65 or above over a period of 6 months. About 41.3% (n = 128) received rehabilitation therapy. Functional improvement was observed in 30.6% of the participants. The corresponding figures for stabilization and functional decline were 45.2% and 24.2%, respectively. Using a multinomial logistic regression, we found that factors significantly associated with change in functional status included baseline ADL score, family visit, number of beds in the institution, and transfer to acute hospitals. After adjusting for these confounding variables, change in functional status of those who received rehabilitation and those who did not was not significantly different.

Ambulatory care visits and quality of care: does the volume-control policy matter?

Abstract Using claims data from the Bureau of National Health Insurance (BNHI) in Taiwan and primary data collected from 940 patients who visited their physicians at out-patient clinics to complete questionnaire, we investigated the effects of the hospital volume control policy on the frequency of visits, medical expenses and patient satisfaction. We found that the volume control policy on ambulatory care decreased physician fees and increased both the number of visits and co-payments. However, it did not result in any change in the total medical expenses. A shift in ambulatory care expenditure from BNHI to patients did not improve patient satisfaction. While the patients were comfortable with the waiting line, they were not satisfied with the providers’ strategy of limiting quota of visits during a period of time.

The influence of facility ownership structure on individual responding to stress: a multilevel model.

Few studies have investigated the effect of health-care facility ownership on the relationship between patient stressors and coping strategies. The purpose of this study was to investigate whether haemodialysis (HD) patient stressors and coping strategies differ by type of health-care facility ownership, and whether such ownership has a cross-level moderating effect between stressors and coping strategies. We used the Haemodialysis Stressor Scale and the Jalowiec Coping Scale; primary data were collected by interviewing 2642 HD patients 15 years or older on dialysis for at least three months from 27 HD centres. One-way analysis of variance and hierarchical linear modelling were used to attain the research purposes. HD patients from religious-based hospitals had higher stress related to their physical symptoms, dependency on medical staff, role ambiguity and blood vessel problems than those differently owned facilities. Patients in veterans and army (VA) hospitals had higher stress related to food and fluid restriction and dependency on medical staff than private centres. Patients in religious-based hospitals had significantly higher coping scores, followed by VA and private HD centres. Religion-based ownership might serve as a cross-level moderator for patients perceiving role ambiguity stress and using problem-oriented, support seeking and isolated thought-coping strategies.