Yu-Hua Lin

Effects of early pelvic-floor muscle exercise for sexual dysfunction in radical prostatectomy recipients.

Background: Sexual dysfunction is common after radical prostatectomy (RP). Although pelvic-floor muscle exercise (PFME) has been recommended for sexual dysfunction, the optimal time for starting exercises after this surgery and the effects of exercise still need to be examined. Objectives: The present study was intended to explore the prevalence of sexual dysfunction and to assess the efficacy of PFME in sexual dysfunction following RP. Methods: Participants were randomly distributed into an experimental group (n = 35) or a control group (n = 27). The experimental group took part in PFME as part of regular daily activities after catheter removal post-RP. The control group was taught the exercise in the third month after RP. We followed up the participants at 1, 3, 6, 9, and 12 months. Results: All of the patients experienced a severe degree of sexual dysfunction after receiving RP. A t test showed a significant difference in the sexual function mean score between the experimental and control groups at 6 and 12 months. A mixed-model analysis indicated that, after a controlled surgical approach, there was a significant difference in group effect. The experimental group’s sexual function was better than the control group’s sexual function. Conclusion: This study demonstrates that early PFME is an effective intervention for sexual dysfunction in prostatectomy patients. The results can help healthcare providers to include this intervention in patients’ discharge plans. Implications for Practice: Patient sexual dysfunction after an RP is common. Nurses should evaluate and manage patients’ sexual dysfunction and promote the early return of patients’ potency.

The Effects of a Diet and Exercise Program for Older Adults with Metabolic Syndrome

Background:The prevalence of metabolic syndrome is high among older adults in Taiwan. However, few studies have studied the effect of a combined diet and exercise program on managing metabolic syndrome (MetS) in individuals 65 years and older and living in Taiwan’s rural areas. Purpose:This study tests the effectiveness of a diet and exercise program on the MetS biomarkers in older community residents with MetS. Methods:This study used a quasiexperimental study design. All participants were 65 years and older and were diagnosed with MetS. The outcome variables included biomarkers (blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglycerides) and demographic characteristics. The participants were distributed into a diet-and-exercise group (n = 163) and a nondiet-and-nonexercise group (n = 138). The outcome variables were examined 3 months after the start of the intervention program. Results:The participants in the diet-and-exercise group had lower values than the nondiet-and-nonexercise group for blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglyceride (all ps < .001). Conclusions/Implications for Practice:The diet and exercise program is an effective intervention for treating older individuals with MetS. Clear and concise information concerning the effects of diet and exercise in promoting the health of older residents with MetS is helpful to improve the health of the older adults inTaiwan.

Comparison of professional values between nursing students in Taiwan and China

Background: People in both Taiwan and China originally descended from the Han Chinese, but the societies have been separated for approximately 38 years. Due to different political systems, variations exist in healthcare and nursing education systems in Taiwan and China. Objective: The purpose of this study was to examine the professional values of nursing students in Taiwan and China. Design: A cross-sectional design was applied in this study. The Nursing Professional Value Scale–Revised was used to measure the professional values of the students. The questionnaire was distributed to eligible undergraduate students in a classroom setting. Ethical considerations: This study was approved by the Institutional Review Board at the first investigator’s university. Participants were informed that completion and return of the questionnaire was voluntary, and confidentiality was ensured by keeping the responses anonymous. Participants: A convenience sample included 292 Taiwanese students and 654 Chinese students. Findings: A total of 11 individual Nursing Professional Value Scale–Revised items showed significant differences between the two groups. These results reflect the differences in the perceived importance of these items between the groups. There was no significant difference between the two groups in the mean overall scores for the Nursing Professional Value Scale–Revised (p = .766) and three subscales (all p > .05). Conclusion: There are some differences in professional values between nursing students in Taiwan and China. Given the increasingly frequent and close interactions between Taiwan and China and the globalization of nursing, understanding these differences may help nursing educators identify students’ perceptions of their professional values and support the development of strategies to improve weaknesses in professional values.

The impact of hemorrhoidectomy on sexual function in women: a preliminary study

The purpose of this study was to explore the prevalence of sexual problems in post-hemorrhoidectomy females. The study consisted of a surgical group and a control group of women between the ages of 22 and 74 years, 39 with and 39 without hemorrhoidectomy. Female sexual function was evaluated using the Female Sexual Function Index (FSFI). The level of sexual function was calculated for each domain and compared across domains and demographic variables for each group. The prevalence of sexual dysfunction among the post-hemorrhoidectomy participants was 48.7% (19/39) and among the healthy women 7.7% (3/39). The average FSFI score was significantly lower in the surgical group (46.38±28.13) than in the control group (65.69±18.48) (P=0.001). All the FSFI domain scores, with the exception of the desire domain, were significantly lower for the surgical group relative to the healthy group (P<0.05). Logistic regression analysis revealed that group (P=0.001) and age (P=0.013) were predictors of problems in female sexual functioning. This preliminary study shows that women who have had a hemorrhoidectomy are at higher risk of sexual function problems. The sexual function of women with hemorrhoidectomy should be evaluated to provide them with a better quality of life.

Changes in quality of life among prostate cancer patients after surgery.

Background: Quality of life (QoL) often is impacted after radical prostatectomy (RP) procedures. Although patients’ QoL scores gradually improve after RP, changes in the QoL score over time after different RP procedures must be examined. Objective: The aim of this study was to compare the changes in QoL over time of prostate cancer patients who were treated with open RP (ORP) or laparoscopic RP (LRP) procedures. Methods: A longitudinal study design was used. A convenient sample of 67 prostate cancer patients was recruited after RP (ORP = 34, LRP = 33). QoL scores were assessed at 1, 3, and 6 months after RP using the University of California, Los Angeles, Prostate Cancer Index (UCLA-PCI). Results: With respect to the PCI mean score between the ORP and LRP groups, there were significant differences in overall PCI and urinary function at time 1 (1 month after RP). However, a mixed-design analysis of covariance on the overall PCI of the 2 groups over time indicated that, after controlling for nerve sparing, there were significant differences in the main effects for group and time, but no interaction effect. Conclusion: Results indicated that all patients’ QoL scores improved over time. Laparoscopic RP patients’ overall scores were better than ORP patients’ scores, but this may be due to unmeasured preoperative differences in this nonrandom sample, and thus, these findings cannot be attributed to treatment differences alone. Implications for Practice: Patients’ QoL after either RP surgery is likely to drop but is regained by 6 months. This information should be given to patients undergoing RP who are deciding between various RP procedures.

Effects of pelvic floor muscle exercise on faecal incontinence in rectal cancer patients after stoma closure

The purpose of this study was to examine the effects of pelvic floor muscle exercise (PFME) on the faecal incontinence (FI) of rectal cancer patients following stoma closure. Participants were randomly distributed into an exercise group (n = 27) and non-exercise group (n = 26). An experimental design and longitudinal approach were implemented for data collection. Baseline data were collected at 1 day before discharge, and then PFME was taught before the patients were discharged from the hospital. We collected data and followed up with the patients at their pre-discharge visit and at 1, 2, 3, 6 and 9 months after discharge. The Cleveland Clinic Faecal Incontinence (CCI) score was used to measure patient outcome. PFME proved to effectively decrease the degree of FI in stoma closure recipients. The FI score of the exercise group significantly decreased from 8.37 to 2.27 after PFME compared with that of the non-exercise group (from 8.54 to 2.58). The generalised estimation equation tests showed that both group and time were significantly different. The tests also indicated that although PFME appeared to hasten the decline of incontinence, this effect was no longer detectable at 9 months; thus, it may be an effective intervention for FI when implemented up to half a year after discharge.

Fecal Incontinence and Quality of Life in Adults With Rectal Cancer After Lower Anterior Resection.

PURPOSE: The purpose of this study was to explore the prevalence of fecal incontinence (FI) and its impact on health-related quality of life in rectal cancer patients following low anterior resection surgery for colorectal cancer. DESIGN: Descriptive, cross-sectional study. SUBJECTS AND SETTING: Patients who were diagnosed with rectal cancer and underwent low anterior resection were recruited from a 1264-bed hospital in southern Taiwan. Potential participants were mailed a questionnaire survey. They were followed up 8 to 16 months postoperatively. Some clinical data were collected via retrospective review of their medical records. METHODS: Questionnaires were mailed to 172 patients, and 71 with colorectal cancer underwent low anterior resection and agreed to participate and completed questionnaires in the research, reflecting a return rate of 41%. Data were collected on demographic characteristics and disease-related variables. Participants were asked if they had experienced FI during the past week. Fecal incontinence health-related quality of life was measured using the Cleveland Clinic Incontinence Score (CCIS) and the Fecal Incontinence Quality of Life Index. Completion of the questionnaire required approximately 15 minutes. RESULTS: More than half of the 71 participants (n = 45; 63.4%) experienced incontinence of flatus, 42.3% (n = 30) reported incontinence of liquid stool, and 14.1% (n = 10) stated that they experienced incontinence of solid stool. Based on mean CCIS scores, 35.2% (n = 25) experienced moderate to severe FI. One-third wore pads to contain FI and 21.1% changed daily activities because of FI. Nearly two-thirds reported FI during the week prior to completing the research questionnaire. The average Fecal Incontinence Quality of Life Index cumulative score was significantly lower in the FI group (2.62 ± 0.61) than in the without-FI group (3.32 ± 0.77; P < .001), as were all subscale mean scores (all P < .01-.001). CONCLUSIONS: Fecal incontinence is prevalent among persons undergoing low anterior resection for colorectal cancer. Persons with FI report poor health-related quality of life compared to persons who retained fecal continence. Health care providers should assess these patients for FI and treat or refer those who experience this common problem.

Lifestyle in Visually Impaired or Blind Massage Therapists: A Preliminary Study

Background: Lifestyle is among the most important factors affecting individual health status. Limited access to health information may limit the ability of people with visual impairment or blindness to practice healthy lifestyles. However, no studies have investigated how lifestyle practices affect health specifically in visually impaired and blind populations. Purpose: The aim of this study was to investigate the lifestyle behaviors of visually impaired and blind massage therapists (VIBMTs) in Taiwan. Methods: This exploratory study used a purposive sampling technique to recruit 50 VIBMTs who were employed at massage stations in southern Taiwan. All of the participants completed the Health-Promoting Lifestyle Profile II (HPLP-II) and a survey of demographic characteristics. Descriptive and inferential statistical tests, including the Mann–Whitney U test and the Kruskal–Wallis H test, were used. Statistical significance was defined as p < .05 in two-tailed tests. Results: Fifty participants completed both the HPLP-II and the demographic survey. The mean subscale score for the HPLP-II was 2.52 ± 0.37. The lowest scores were on the physical activity (2.09 ± 0.67) and nutrition (2.35 ± 0.39) subscales, and the highest scores were on the spiritual growth (2.89 ± 0.56) and interpersonal relations (2.79 ± 0.46) subscales. Scores on the stress management and physical activity subscales were significantly higher in men than in women (p < .05). In addition, mean HPLP-II scores were significantly higher in VIBMTs who exercised regularly compared with those who did not (p < .05). Compared with nonsmokers, current smokers had significantly higher scores on the stress management subscale (p < .05). Conclusions/Implications for Practice: The low physical activity scores in this population may be improved by developing physical activity programs for the home and workplace and by establishing community recreational and exercise facilities for visually impaired populations. The low scores for nutrition may be improved by establishing nutrition education programs that are designed specifically for VIBMTs to increase their consumption of fresh produce and other healthy foods and by requiring food manufacturers to use labels that may be easily read or understood by visually impaired populations.