Physical activity should be promoted in older Taiwanese adults. Positive behavior-specific cognitions and affect and better health status might impact the health-promoting behaviors of these adults.
This study is a longitudinal experimental design that examine the effects of aromatherapy on sleep quality in diabetes patients with restless leg syndrome (RLS). Patients in the experimental group received the aromatherapy intervention for 6 weeks, while those in the control group received only regular nursing care. The instruments included Pittsburg Sleep Quality Index and SureStep TM of blood glucose meters. Data were collected at pre-test, 2nd week, 4th week, and 6th week after the aromatherapy. Data analysis included descriptive analysis, chi-square, independent t test, Pearson correlation, repeated measure ANOVA and general linear mixed-effect models. Forty-four diabetes patients with RLS were randomly assigned to the experimental group (n=22) and the control group (n=22) at a hospital in northern Taiwan. Sleep quality of diabetes patients with RLS was poor in this study. Sleep latency of patients in the experimental group was improved at 2nd week after aromatherapy. Subjective sleep quality and sleep disturbance of patients was also improved at 4th week after aromatherapy. At 6th week, patients in the experimental group had increased their sleep duration, and improved their overall sleep quality. The level of blood sugar was decreased at 2nd week after aromatherapy on experimental group. Based on the analysis it was concluded that Aromatherapy can ameliorate both blood sugar and sleep quality of diabetes patients with RLS. Thus aromatherapy can be a safe, noninvasive, effective approach for clinical nurses as a therapy in routine care to improve sleep quality in diabetes patients with neuropathy.
Background
Postoperative delirium (POD) is a common complication that may occur from 24 to 72 h after cardiac surgery. Frailty is a chronic syndrome that leads to a decline in physiological reserve and to disability. The associations between frailty and POD are unclear.
Aims
To investigate associations between POD and frailty in patients undergoing cardiac surgery and to analyse predictors of POD.
Methods and results
Convenience sampling was used to recruit 152 patients who underwent cardiac surgery in two medical centres in northern Taiwan. Preoperative frailty in these patients was evaluated using Fried’s frailty phenotype. Delirium in patients was assessed from postoperative day 1 to day 5 using the confusion assessment method for intensive care units. A total of 152 patients who underwent cardiac surgery included 68 (44.74%) prefrail patients and 21 (13.81%) patients with frailty after the surgery. Ten patients (6.58%) developed delirium after cardiac surgery. The occurrence of delirium peaked at postoperative day 2, and the average duration of delirium was 3 days. A case–control comparison revealed a significant correlation between preoperative frailty and POD. Significant predictors of POD in patients undergoing cardiac surgery included the European System for Cardiac Operative Risk Evaluation II, preoperative arrhythmia, and preoperative anxiety and depression.
Conclusion
Preoperative frailty was correlated with POD. Preoperative arrhythmia, anxiety, and depression are predictors of POD. Nurses should perform preoperative assessments of surgical risk and physiological and psychological conditions of patients undergoing cardiac surgery and monitor the occurrence of POD.
Background
Patients with heart failure (HF) experience continuous changes in symptom distress, care needs, social support, and meaning in life from acute decompensation to chronic phases. The longitudinal relationship between these four factors and quality of life (QOL) was not fully explored.
Aims
To simultaneously investigate the relationship between all factors and QOL from hospitalization to 6 months after discharge,
and the impact of the changes in these factors on QOL at different time points.
Methods
A longitudinal design with panel research (4 time points) was used. From January 2017 to December 2019, patients hospitalized due to acute decompensated HF were consecutively enrolled and followed up for 6 months. Patients were interviewed with questionnaires assessing symptom distress, care needs, social support, meaning in life and QOL at hospitalization and 1, 3 and 6 months after discharge.
Results
A total of 184 patients completed 6 months of follow-up. From baseline to 6 months, QOL continuously improved along with decreases in symptoms and care needs, but increases in social support and meaning in life. Better QOL was associated with younger age, higher education level, economic independence, less symptom distress and care needs, and stronger meaning in life (p < 0.05). Compared with hospitalization, decreases in care needs and increases in meaning in life at 1, 3 and 6 months were associated with an increase in physical QOL (p < 0.01). The decrease in care needs and increase in meaning in life at 3 months were associated with an increase in mental QOL (p < 0.05). The increase in social support at 6 months was associated with increases in both physical and mental QOL (p < 0.01). Changes in symptom distress were not correlated with changes in QOL from baseline to all time points. In the multivariable analysis, these findings were independent of age, educational level and economic status.
Conclusions
Although symptom distress is associated with QOL after acute decompensated HF, QOL cannot be improved only by improvement in symptoms. With differential duration of improvement in each factor, the integration of alleviation in care needs and strengthening in social support and meaning in life might provide additional benefits in QOL.
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