Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the q...Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.展开更多
Objective: This study aimed to determine the lifestyle of older adults with dementia living at home, how their families perceive them, and how care providers support their desired lifestyle. Methods: Semi-structured i...Objective: This study aimed to determine the lifestyle of older adults with dementia living at home, how their families perceive them, and how care providers support their desired lifestyle. Methods: Semi-structured interviews were conducted with 12 pairs of older adults with dementia, their families, and care providers followed by a qualitative descriptive study. Results: Older adults with dementia described their lifestyle as follows: “I continue to take pride in the way I have lived so far,” “I want to do what I can now even if I cannot do it well,” “I live peacefully with my family,” “I go out and interact with people,” and “I live this time today with care.” Families regarded the lifestyle of older adults with dementia as a desire “to continue living at home peacefully,” “to live on their own,” and that they “probably do not want anything.” Care providers’ support was based on “respect (for an older adult with dementia) as a person,” “drawing out and making use of what they can do with their current abilities through providing care,” “supporting families and confirming their sense of satisfaction with life,” and “predicting the future course and supporting decision-making.” Conclusions: To support the lifestyle of older adults with dementia, it is important to ensure that they continue to have dignity and are comfortable living with their families and in their communities without intimidation.展开更多
Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these chi...Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.展开更多
Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their abilit...Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their ability to synthesize and demonstrate basic medical knowledge and clinical skills but offers little assessment of the maturation of attitudes or their values. The University of New England College of Osteopathic Medicine (UNECOM), immerses second year medical students in a hospice home for 48 hours to enhance students’ perspectives in interprofessional palliative and end of life care. Methods: This project utilized qualitative ethnographic and autobiographic research designs. Two female second year medical students (27 y/o & 26 y/o) were immersed for 48 hours into a local hospice home, sleeping in a bed where others had died, to answer the question: “What is it like for ME to live in the Hospice Home for 48 hours and how does this contribute to my future as a practitioner?” Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and patient/family encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Themes common to both students that factored in the research question and their prior stated interest areas of medical humanities and person-centered care at end of life were identified. Three themes were selected for this article: 1) Person-Centered Experiences, 2) Spectrum of Communication, and 3) Introspection: Attitudes and Values. The process of living in the hospice home for 48 hours revealed students’ attitudes about various disease processes, their personal experiences with death and dying, and their assumptions about how patients approach death. Conclusion: This Hospice Home Immersion project provided both an educational approach and learning environment that was effective in advancing medical students’ attitudes, skills, and knowledge as evidenced by their self-reported life altering learning about end of life and palliative care.展开更多
The aim of this study is to clarify how well-being correlates with autonomic nervous system (sympathovagal) balance in healthy elderly males at home at night awake and resting. The RR-interval and body acceleration of...The aim of this study is to clarify how well-being correlates with autonomic nervous system (sympathovagal) balance in healthy elderly males at home at night awake and resting. The RR-interval and body acceleration of 39 healthy elderly male subjects were recorded with an ambulatory device for 72 hours. The normalized high-frequency (0.15 - 0.4 Hz) power (HFnu) of RR-interval variability (sympathovagal balance index) was calculated from 10 min long data sets that satisfied all of the following conditions: 1) average body acceleration was less than 30 mG, 2) the subject was at home, 3) the subject was awake, and 4) more than 95 percent of the time-series of instantaneous heart rate was within 40 to 160 [bpm]. Subjects recorded their subjective well-being level, including life satisfaction level, on a Visual Analogue Scale (VAS) questionnaire. We investigated the correlation between the subjective well-being level and mean HFnu. A significant negative correlation between life satisfaction level and mean HFnu (r = –0.47, p = 0.004) was observed. This result implies that sympathovagal balance becomes the predominant state of the sympathetic nervous system in healthy elderly males with relatively high life satisfaction while at home at night awake and resting.展开更多
We set out to investigate how satisfied the poor elderly Singaporean households in social housing are with their lives, especially in relation to their housing, in an attempt to find measures to improve, where possibl...We set out to investigate how satisfied the poor elderly Singaporean households in social housing are with their lives, especially in relation to their housing, in an attempt to find measures to improve, where possible, the life satisfaction of this group of elderly Singaporeans. We use archival and empirical research for our investigation. The results from 403 respondents to our survey are analyzed through logistic regression and factor analysis. We find that the life satisfaction of the elderly residents of social housing is very low. Furthermore we find that home modification that meets the requirements of the respondents will substantially improve their life satisfaction. Given that these elderly households neither have the right nor financial means to modify their housing units and precincts, it is incumbent upon the government, through the relevant authorities such as HDB, Town Councils and BCA to effect the necessary home modifications to create a more elderly-friendly physical environment to improve the life satisfaction of the elderly households in social housing in Singapore. This arguably is a social imperative which should not be subjugated to economic niceties as social housing is not a luxurious housing choice but the last safety net for basic shelter.展开更多
The Information Technology at Home has caught the attention of various industries such as IT,Home Appliances,Communication,and Real Estate.Based on the information technology acceptance theories and family consumption...The Information Technology at Home has caught the attention of various industries such as IT,Home Appliances,Communication,and Real Estate.Based on the information technology acceptance theories and family consumption behaviors theories,this study summarized and analyzed four key belief variables i.e.Perceived Value,Perceived Risk,Perceived Cost and Perceived Ease of Use,which influence the acceptance of home information technology.The study also summaries three groups of external variables.They are social,industrial,and family influence factors.The social influence factors include Subjective Norm;the industry factors include the Unification of Home Information Technological Standards,the Perfection of Home Information Industry Value Chain,and the Competitiveness of Home Information Industry;and the family factors include Family Income,Family Life Cycle and Family Educational Level.The study discusses the relationship among these external variables and cognitive variables.The study provides Home Information Technology Acceptance Model based on the Technology Acceptance Model and the characteristics of home information technology consumption.展开更多
Background: Home therapy for hemophilia reduces pain, deformity and incidence of complicationinduced hospitalizations. Therefore, it is an important component of comprehensive hemophilia care.Unfortunately, most hemop...Background: Home therapy for hemophilia reduces pain, deformity and incidence of complicationinduced hospitalizations. Therefore, it is an important component of comprehensive hemophilia care.Unfortunately, most hemophilic families in Shanxi province, China do not continue home therapy.Objective: To analyze the reasons that hemophilic families do not continue home therapy and to provide a foundation for formulating targeted interventions by the Hemophilia Treatment Center(HTC) in Shanxi Province.Methods: A qualitative phenomenological approach using purposeful sampling of 17 hemophilic families, two physicians, and one nurse from 11 branches across 11 cities in Shanxi Province. Interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis.Results: Four themes were identified:(1) home therapy was generally positively evaluated;(2) concerns about the safety of home therapy;(3) an imperfect social medical security system; and(4) inadequate continuous nursing of hemophilia.Conclusions: Home therapy for hemophilia remains in a preliminary stage in Shanxi Province, and inadequate family and social support systems have obstructed the implementation of home therapy. It is necessary to develop a home therapy model suitable for hemophilic families in Shanxi Province as soon as possible. Such a model would improve the community and home care medical systems for hemophilia and guarantee home therapy throughout the entire medical care system, thus enabling more hemophilic families to carry out home therapy. Achieving these goals requires urgent research and attention from medical staff.展开更多
文摘Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.
文摘Objective: This study aimed to determine the lifestyle of older adults with dementia living at home, how their families perceive them, and how care providers support their desired lifestyle. Methods: Semi-structured interviews were conducted with 12 pairs of older adults with dementia, their families, and care providers followed by a qualitative descriptive study. Results: Older adults with dementia described their lifestyle as follows: “I continue to take pride in the way I have lived so far,” “I want to do what I can now even if I cannot do it well,” “I live peacefully with my family,” “I go out and interact with people,” and “I live this time today with care.” Families regarded the lifestyle of older adults with dementia as a desire “to continue living at home peacefully,” “to live on their own,” and that they “probably do not want anything.” Care providers’ support was based on “respect (for an older adult with dementia) as a person,” “drawing out and making use of what they can do with their current abilities through providing care,” “supporting families and confirming their sense of satisfaction with life,” and “predicting the future course and supporting decision-making.” Conclusions: To support the lifestyle of older adults with dementia, it is important to ensure that they continue to have dignity and are comfortable living with their families and in their communities without intimidation.
文摘Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.
文摘Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their ability to synthesize and demonstrate basic medical knowledge and clinical skills but offers little assessment of the maturation of attitudes or their values. The University of New England College of Osteopathic Medicine (UNECOM), immerses second year medical students in a hospice home for 48 hours to enhance students’ perspectives in interprofessional palliative and end of life care. Methods: This project utilized qualitative ethnographic and autobiographic research designs. Two female second year medical students (27 y/o & 26 y/o) were immersed for 48 hours into a local hospice home, sleeping in a bed where others had died, to answer the question: “What is it like for ME to live in the Hospice Home for 48 hours and how does this contribute to my future as a practitioner?” Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and patient/family encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Themes common to both students that factored in the research question and their prior stated interest areas of medical humanities and person-centered care at end of life were identified. Three themes were selected for this article: 1) Person-Centered Experiences, 2) Spectrum of Communication, and 3) Introspection: Attitudes and Values. The process of living in the hospice home for 48 hours revealed students’ attitudes about various disease processes, their personal experiences with death and dying, and their assumptions about how patients approach death. Conclusion: This Hospice Home Immersion project provided both an educational approach and learning environment that was effective in advancing medical students’ attitudes, skills, and knowledge as evidenced by their self-reported life altering learning about end of life and palliative care.
文摘The aim of this study is to clarify how well-being correlates with autonomic nervous system (sympathovagal) balance in healthy elderly males at home at night awake and resting. The RR-interval and body acceleration of 39 healthy elderly male subjects were recorded with an ambulatory device for 72 hours. The normalized high-frequency (0.15 - 0.4 Hz) power (HFnu) of RR-interval variability (sympathovagal balance index) was calculated from 10 min long data sets that satisfied all of the following conditions: 1) average body acceleration was less than 30 mG, 2) the subject was at home, 3) the subject was awake, and 4) more than 95 percent of the time-series of instantaneous heart rate was within 40 to 160 [bpm]. Subjects recorded their subjective well-being level, including life satisfaction level, on a Visual Analogue Scale (VAS) questionnaire. We investigated the correlation between the subjective well-being level and mean HFnu. A significant negative correlation between life satisfaction level and mean HFnu (r = –0.47, p = 0.004) was observed. This result implies that sympathovagal balance becomes the predominant state of the sympathetic nervous system in healthy elderly males with relatively high life satisfaction while at home at night awake and resting.
文摘We set out to investigate how satisfied the poor elderly Singaporean households in social housing are with their lives, especially in relation to their housing, in an attempt to find measures to improve, where possible, the life satisfaction of this group of elderly Singaporeans. We use archival and empirical research for our investigation. The results from 403 respondents to our survey are analyzed through logistic regression and factor analysis. We find that the life satisfaction of the elderly residents of social housing is very low. Furthermore we find that home modification that meets the requirements of the respondents will substantially improve their life satisfaction. Given that these elderly households neither have the right nor financial means to modify their housing units and precincts, it is incumbent upon the government, through the relevant authorities such as HDB, Town Councils and BCA to effect the necessary home modifications to create a more elderly-friendly physical environment to improve the life satisfaction of the elderly households in social housing in Singapore. This arguably is a social imperative which should not be subjugated to economic niceties as social housing is not a luxurious housing choice but the last safety net for basic shelter.
文摘The Information Technology at Home has caught the attention of various industries such as IT,Home Appliances,Communication,and Real Estate.Based on the information technology acceptance theories and family consumption behaviors theories,this study summarized and analyzed four key belief variables i.e.Perceived Value,Perceived Risk,Perceived Cost and Perceived Ease of Use,which influence the acceptance of home information technology.The study also summaries three groups of external variables.They are social,industrial,and family influence factors.The social influence factors include Subjective Norm;the industry factors include the Unification of Home Information Technological Standards,the Perfection of Home Information Industry Value Chain,and the Competitiveness of Home Information Industry;and the family factors include Family Income,Family Life Cycle and Family Educational Level.The study discusses the relationship among these external variables and cognitive variables.The study provides Home Information Technology Acceptance Model based on the Technology Acceptance Model and the characteristics of home information technology consumption.
基金supported by the Dr Fund of the Second Hospital of Shanxi Medical University(No.201501-2)
文摘Background: Home therapy for hemophilia reduces pain, deformity and incidence of complicationinduced hospitalizations. Therefore, it is an important component of comprehensive hemophilia care.Unfortunately, most hemophilic families in Shanxi province, China do not continue home therapy.Objective: To analyze the reasons that hemophilic families do not continue home therapy and to provide a foundation for formulating targeted interventions by the Hemophilia Treatment Center(HTC) in Shanxi Province.Methods: A qualitative phenomenological approach using purposeful sampling of 17 hemophilic families, two physicians, and one nurse from 11 branches across 11 cities in Shanxi Province. Interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis.Results: Four themes were identified:(1) home therapy was generally positively evaluated;(2) concerns about the safety of home therapy;(3) an imperfect social medical security system; and(4) inadequate continuous nursing of hemophilia.Conclusions: Home therapy for hemophilia remains in a preliminary stage in Shanxi Province, and inadequate family and social support systems have obstructed the implementation of home therapy. It is necessary to develop a home therapy model suitable for hemophilic families in Shanxi Province as soon as possible. Such a model would improve the community and home care medical systems for hemophilia and guarantee home therapy throughout the entire medical care system, thus enabling more hemophilic families to carry out home therapy. Achieving these goals requires urgent research and attention from medical staff.
