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The aim of the current study was to evaluate the effects of a nurse-led hybrid teaching program on lower limb strength, knee function, and depression in older adults after total knee replacement (TKR). This was a single-blind, randomized controlled trial. Fifty-two patients who underwent TKR were randomly assigned to either the experimental group (EG; n = 26), which received routine care plus 16 weeks of home rehabilitation through a hybrid teaching program, or the control group (CG; n = 26), which received routine care only. The intervention included pre-discharge face-to-face education, video instructions to follow at home after discharge, and four monthly telephone-based follow ups during the 16 weeks post-surgery. After the 16-week intervention, participants in the EG exhibited improved quadriceps strength, hamstring strength, and Knee Injury and Osteoarthritis Outcome Score (KOOS) compared to those in the CG. Generalized estimating equation analyses revealed a significant group-by-time interaction effect on quadriceps strength, overall KOOS score, and Geriatric Depression Scale-Short Form score. Findings suggest that a nurse-led hybrid teaching program enhances physical and psychological function after TKR when compared to routine care. This hybrid teaching program, involving exercise and postoperative education, proves to be a feasible and cost-effective intervention for improving outcomes in older adults following TKR. Health care teams should consider it as a viable home rehabilitation option for older adults who undergo TKR. [Research in Gerontological Nursing, 17(1), 31–40.] [ABSTRACT FROM AUTHOR]

Objective: To determine acupuncture-related treatments' effects and duration on improving cognitive function, physical function, and quality of life in patients with Alzheimer's disease. Data sources: Eight electronic databases were searched for eligible randomized controlled trials from database inception to January 2021, including Medline, PubMed, EBSCO, Embase, Cochrane, Airiti Library, China National Knowledge Infrastructure, and China Journal Full-text Database. Review methods: A systematic review and meta-analysis were conducted on acupuncture types, cognitive function, activity of daily life, muscle strength and quality of life. Results: Sixty-six studies in total with 4191 participants, the overall risk of bias was classified 60% as low and 24% as high. Acupuncture-related treatments for cognitive function and self-care ability revealed a moderate effect size, with a significant difference in noninvasive and invasive remedies (p < 0.001). Cognitive function showed significant differences in 6, 8, 12, and 24 weeks while self-care ability in the latter two weeks (p < 0.001). Meta-regression analysis showed cognitive function increased by 0.05 points (p = 0.002) and self-care ability decreased by 0.02 points (p = 0.04) after weekly treatment. There was a significant difference in muscle strength (p = 0.0003). Conclusion: Acupuncture-related treatments effectively improved cognitive function with the treatment lasted 6 weeks at least, but self-care ability started showing effects after 12 weeks of treatment. The improvement of muscle strength was also confirmed. Acupuncture-related treatments, particularly noninvasive ones, have few complications and high safety, perhaps providing patients and caregivers diversified choices and clinical care guidelines for reference. [ABSTRACT FROM AUTHOR]

Background: Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. Objectives: This study was designed to evaluate the effect of a mind–body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. Methods: A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind–body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). Results: The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 (p <0.05) than the control group. Among the covariates, neurologic deficit (p =0.04), muscle strength (p =0.04), low frequency to high frequency ratio (p =0.02) and anxiety (p =0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life (p >0.05). Conclusions: This study supports the potential benefits of a 10-day mind–body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients. [ABSTRACT FROM AUTHOR]

Growing evidence link gut microbiome to the development and maturation of the central nervous system, which are regulated by microbiota potentially through stress response, neurotransmitter, neuroimmune, and endocrine pathways. The dysfunction of such microbiota-gut-brain axis is implicated in neuropsychiatric disorders, depression, and other stress-related conditions. Using affective disorders as our primary outcomes, we inspect the current evidence of microbiota studies mainly in human clinical samples. Additionally, to restore microbiome equilibrium in bacteria diversity and abundance might represent a novel strategy to prevent or treat mood symptoms. We reviewed findings from clinical trials regarding efficacy of probiotics supplement with or without antidepressant treatment, and adjuvant antimicrobiotics treatment. In microbiota studies, the considerations of host-microbiota interaction and bacteria-bacteria interaction are discussed. In conclusion, the roles of microbiota in depression and mania state are not fully elucidated. One of the challenges is to find reliable targets for functional analyses and experiments. Notwithstanding some inconsistencies and methodological limitations across studies, results from recent clinical trials support for the beneficial effects of probiotics on alleviating depressive symptoms and increasing well-beings. Moreover, modifying the composition of gut microbiota via antibiotics can be a viable adjuvant treatment option for individuals with depressive symptoms. [ABSTRACT FROM AUTHOR]

Hemorrhoidectomy is the current best treatment for severe hemorrhoids, but it causes significant postoperative pain and anxiety, which is associated with heart rate variability (HRV). Transcutaneous acupoint electrical stimulation (TAES) was assumed to alleviate pain and anxiety, and modify the autonomic nervous system. This study aimed to examine the effects of TAES intervention on postoperative pain, anxiety, and HRV in patients who received a hemorrhoidectomy. A randomized-controlled trial with five repeated measures was conducted. The TAES group (n = 39) received four 20-min sessions of electrical stimulation at chengshan (BL57) and erbai (EX-UE2) after hemorrhoidectomy, whereas the control group (n = 41) did not. Data were collected using Visual Analogue Scale (VAS), State Anxiety Inventory (STAI), and HRV physiological signal monitor. TAES resulted in a significant group difference in pain scores, anxiety levels, and some HRV parameters. The findings indicate that TAES can help reduce pain and anxiety associated with hemorrhoidectomy. TAES is a noninvasive, simple, and convenient modality for post-hemorrhoidectomy-associated pain control and anxiety reduction. [ABSTRACT FROM AUTHOR]

Objective: There has be a large body of evidence on the pharmacological treatments for psoriasis, but whether nonpharmacological interventions are effective in managing psoriasis remains largely unclear. This systematic review conducted pairwise and network meta-analyses to determine the effects of acupuncture-related techniques on acupoint stimulation for the treatment of psoriasis and to determine the order of effectiveness of these remedies. Methods: This study searched the following databases from inception to March 15, 2016: Medline, PubMed, Cochrane Central Register of Controlled Trials, EBSCO (including Academic Search Premier, American Doctoral Dissertations, and CINAHL), Airiti Library, and China National Knowledge Infrastructure. Randomized controlled trials (RCTs) on the effects of acupuncture-related techniques on acupoint stimulation as intervention for psoriasis were independently reviewed by two researchers. Results: A total of 13 RCTs with 1,060 participants were included. The methodological quality of included studies was not rigorous. Acupoint stimulation, compared with nonacupoint stimulation, had a significant treatment for psoriasis. However, the most common adverse events were thirst and dry mouth. Subgroup analysis was further done to confirm that the short-term treatment effect was superior to that of the long-term effect in treating psoriasis. Network meta-analysis identified acupressure or acupoint catgut embedding, compared with medication, and had a significant effect for improving psoriasis. It was noted that acupressure was the most effective treatment. Conclusions: Acupuncture-related techniques could be considered as an alternative or adjuvant therapy for psoriasis in short term, especially of acupressure and acupoint catgut embedding. This study recommends further well-designed, methodologically rigorous, and more head-to-head randomized trials to explore the effects of acupuncture-related techniques for treating psoriasis. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine the efficacy and safety of intradialytic exercises for haemodialysis patients, this study conducted a systematic review and meta-analysis of randomised controlled trials. Background Patients receiving haemodialysis have poor physical function, psychological status and quality of life than the general population. Exercise training may improve these parameters for haemodialysis patients. Design Systemic review was performed, and a meta-analysis was conducted. Methods Medline, PubMed, Cochrane Central Register of Controlled Trials, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature and Airiti Library were systematically searched for studies up to January 2015. In addition, the reference lists of eligible studies and relevant reviews were assessed. Results Seventeen studies with a total of 651 participants were included. Compared with no resistance exercise, nonexercise and walks at home, intradialytic exercises significantly improved the peak oxygen consumption ( SMD = 0·50, 95% CI: 0·26-0·74), haemoglobin ( SMD = 0·34, 95% CI: 0·13-0·55), depression ( SMD = −0·80, 95% CI: −1·10 to −0·50) and physical component of the quality of life ( SMD = 0·46, 95% CI: 0·20-0·73). Intradialytic exercises are safe with no adverse events. However, significant improvements were not observed in the albumin level and mental component of the quality of life. Conclusions The study results facilitate selecting intradialytic exercise that improves and provides safety with respect to the peak oxygen consumption, haemoglobin, depression and physical component of the quality of life. Furthermore, regular exercise should be considered a crucial therapeutic modality for patients undergoing haemodialysis. Relevance to clinical practice This study suggests that performing intradialytic exercises for 30 minutes per session three times a week for at least ≥8 weeks is beneficial. Regular exercise should be considered as a crucial therapeutic modality of managing patients undergoing haemodialysis, thus guiding in clinical practice. [ABSTRACT FROM AUTHOR]

Smoking represents a serious worldwide public health problem because of its close association with the development of chronic disease and cancer. Acupoint stimulation has been used as treatment mode for smoking cessation but its efficacy remains controversial. This systematic review and meta-analysis aimed to determine the effects of acupoint stimulation on smoking cessation rate and daily cigarette consumption. Electronic literature searches in eight electronic databases up to March 2011 were performed to identify acupoint stimulation for smoking cessation. The outcomes assessed were smoking cessation rate and cigarette consumption. We assessed abstinence from smoking at the earliest and last measured time points, and at the 3- and 6-month follow-ups. Meta-analysis was performed using CMA software. A total of 20 RCTs were included in the meta-analysis. A significant effect of acupoint stimulation was found in smoking cessation rates and cigarette consumption at immediate, 3- and 6-month follow-ups, with effect sizes 1.24 (95%CI = 1.07 ~ 1.43, p = 0.003), -2.49 (95%CI = -4.65 ~ -0.34, p = 0.02), 1.70 (95%CI = 1.17 ~ 2.46, p = 0.01), and 1.79 (95%CI = 1.13 ~ 2.82, p = 0.01), respectively. Multi-modality treatments, especially acupuncture combined with smoking cessation education or other interventions, can help smokers to eschew smoking during treatment, and to avoid relapse after treatment. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore the differences in the outcome between routine health education and health education delivered through telephone-based surveys on self-care, symptom distress, and quality of life among homecare patients with leukemia after a cycle of hospitalized chemotherapy. Design: A quasi-experimental research design. Setting: A medical teaching center in Taipei, Taiwan. Sample: 70 patients with leukemia. Methods: A nonrandomized trial of a clinical-based intervention. Patients were selected into either an experimental (n = 35) or control (usual care) group (n = 35) according to the timing of their discharge. In addition to routine education before discharge, patients in the experimental group received educational and emotional support through two telephone sessions after discharge. Self-administered questionnaires were completed four weeks after discharge. Main Research Variables: Self-care, symptom distress, and quality of life. Findings: Significantly different scores were found between the two groups in self-care, symptom distress, and quality of life. The experimental group had higher scores in the self-care and quality of life categories, but lower scores for symptom distress. Conclusions: The follow-up telephone calls, placed at the proper time, met patients' specific needs. The experimental group perceived a difference in self-care, symptom distress, and quality of life from the control group. Implications for Nursing: Individualized telephone intervention can deliver continuing care. The use of telephone-based education should be included in nursing students' training. [ABSTRACT FROM AUTHOR]

This four-week, randomized, double-blind, placebo-controlled study investigated the effects of Lactobacillus plantarum PS128 (PS128) on boys with autism spectrum disorder (ASD) aged 7–15 in Taiwan. All subjects fulfilled the criteria for ASD diagnosis of DSM-V and the Autism Diagnostic Interview-Revised (ADI-R). Questionnaires used for the primary outcome measure include the Autism Behavior Checklist-Taiwan version (ABC-T), the Social Responsiveness Scale (SRS) and the Child Behavior Checklist (CBCL). The Swanson, Nolan, and Pelham-IV-Taiwan version (SNAP-IV) and the Clinical Global Impression-improvement (CGI-I) were used for the secondary outcome measure. The results showed that PS128 ameliorated opposition/defiance behaviors, and that the total score of SNAP-IV for younger children (aged 7−12) improved significantly compared with the placebo group. Additionally, several elements were also notably improved in the PS128 group after 28-day consumption of PS128. Further studies are needed to better clarify the effects of PS128 for younger children with ASD on broader symptoms. [ABSTRACT FROM AUTHOR]

To evaluate neurodevelopmental outcomes after intravitreal bevacizumab (IVB) therapy in retinopathy of prematurity (ROP) infants compared with those not exposed to IVB. The primary concern regarding IVB treatment of ROP is the potential systemic side effects, especially the risk of causing severe neurodevelopmental impairment (sNDI). Results regarding neurodevelopmental outcomes after IVB therapy are conflicting. We conducted a meta-analysis and searched PubMed, Embase, and Web of Science for related publications from inception through March 12, 2020. The eligibility criteria were as follows: comparative studies of ROP patients that (1) included IVB as a treatment arm, (2) included a control group without bevacizumab treatment, and (3) reported on at least 1 neurodevelopmental outcome, such as sNDI, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), composition scores, or cerebral palsy (CP). The primary outcome was sNDI, with the odds ratio (OR) calculated. Secondary outcomes were mean differences (MDs) for cognitive, language, and motor scores (Bayley III) and OR for CP. The quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Eight studies, 6 including laser-controlled ROP infants and 2 including ROP infants not requiring treatment, were included. The weighted OR for sNDI in the IVB group was 1.39 (95% confidence interval [CI], 0.98–1.97). The weighted MDs were –1.92 (95% CI, –4.73 to 0.88), –1.32 (95% CI, –4.65 to 1.99), and –3.66 (95% CI, –6.79 to –0.54) for cognitive, language, and motor scores in Bayley III, respectively. The OR for CP was 1.20 (95% CI, 0.56–2.55). No differences were observed between the preset subgroups comprising laser-controlled ROP infants and ROP infants not requiring treatment. The current quality of evidence was rated as low (sNDI and all Bayley III scores) to very low (CP). Risk of sNDI was not increased in ROP patients after IVB treatment. Bayley III scores were similar in the IVB and control groups, except for a minor difference in motor performance. These findings suggest that the risk of additional sNDI after IVB treatment is low. Randomized trials are warranted to provide a higher quality of evidence. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) refers to permanent damage to the kidneys that occurs gradually over time. Further progression may be preventable depending on its stage., Purpose: This study was developed to evaluate the effect of a health literacy education program (HLEP) on mental health and renal functioning in patients with CKD., Methods: A single-blind, randomized controlled trial study was conducted. Data were collected from March 25 to December 18, 2021. Participants were randomly assigned to either the experimental group (n = 42), which received multidisciplinary care and HLEP, or the control group (n = 42), which received multidisciplinary care only. Data were collected at baseline (T1), Month 3 (T2), and Month 6 (T3), and the data included patient characteristics, estimated glomerular filtration rate, and responses to the Mandarin Multidimensional Health Literacy Questionnaire and Beck Depression Inventory., Results: After 6 months of the HLEP intervention, the results of generalized estimating equations analysis showed that, compared with the control group, the experimental group had significantly higher health literacy at Month 3 (β = -3.37, 95% CI [-5.68, -1.06]), significantly improved depression at Month 3 (β = -2.24, 95% CI [-4.11, -0.37]) and Month 6 (β = -4.36, 95% CI [-6.60, -2.12]), and a significantly higher estimated glomerular filtration rate at Month 6 (β = 5.87, 95% CI [1.35, 10.38])., Conclusions/implications for Practice: The findings of this study may provide a reference for healthcare providers to educate patients with Stage 3-4 CKD using the HLEP. Positive effects on health literacy, depression, and renal function in patients with Stage 3-4 CKD were observed in the short term. Findings from this study may facilitate the implementation of multidisciplinary and nurse-led strategies in primary care to reinforce patients' health literacy, self-care ability, and adjustment to CKD as well as delay disease progression., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Objective: This study used a larger sample size, added a long-term observation of the effect of intervention, and provided an integrated intervention of acupressure and interactive multimedia of visual health instruction for school children. The short- and long-term effects of the interventions were then evaluated by visual health knowledge, visual acuity, and refractive error., Design: A repeated pretest-posttest controlled trial was used with two experimental groups and one control group., Setting: Four elementary schools in northern Taiwan., Participants: 287 School children with visual impairment in fourth grade were recruited., Method: One experimental group received the integrative intervention of acupressure and interactive multimedia of visual health instruction (ACIMU), and another received auricular acupressure (AC) alone; whereas a control group received no intervention. Two 10-week interventions were separately given in the fall and spring semesters. The short- and long-term effects of the interventions were then evaluated by visual health knowledge, visual acuity, and refractive error., Results: During the school year the visual health knowledge was significantly higher in the ACIMU group than the control group (p<0.001). A significant difference in the changing visual acuity was in the three groups (p<0.001), with the improvement in the ACIMU group. No difference in the refractive error was found between any two groups (p>0.05)., Conclusions: This study demonstrated that a long-term period of acupressure is required to improve school children's visual health. School children receiving the intervention of acupressure combined with interactive multimedia had better improvement of visual health and related knowledge than others. Further study is suggested in which visual health and preventative needs can be established for early childhood., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Primary dysmenorrhea is a common gynecologic complain in women of reproductive age. Acupoint stimulation therapies might be an effective intervention for primary dysmenorrhea., Objective: The aim of this study was to determine the effectiveness of acupoint stimulation for primary dysmenorrhea., Data Sources: All searches in the Cochrane Library, MEDLINE, PubMed, CINAHL Plus with Full Text, and CEPS databases (inception to March 2011)., Study Selection: Randomized controlled trials (RCTs) included were comparing acupoint stimulation with non-acupoint-related stimulation or medication., Data Extraction: Data were abstracted independently by two authors onto standardized forms, and disagreements were resolved by discussion., Data Synthesis: Thirty RCTs met the selection criteria, and 25 reported sufficient data for pooling. The main outcomes assessed were cure rate, total effective rate, pain intensity, menstrual pain, plasma PGF(2α)/PGE(2) ratio, and adverse events. According to the type of outcome, the strength of a relationship between two dichotomous variables was described by odds ratios and 95% confidence intervals, and continuous variables were expressed as mean±standard deviation. Fixed-effects models were used to perform meta-analysis., Results: Twenty-five RCTs with a total of over 3000 participants were included for the meta-analysis. Acupoint stimulation when compared with non-acupoint-related stimulation or medication had significant effects. Moderator analysis further confirmed that invasive and noninvasive acupoint stimulation was effective separately, with the latter being more effective. The most common adverse events were hemorrhage and hematoma., Limitations: Papers written in language other than English or Chinese were not included., Conclusions and Implication: This finding indicates that acupoint stimulation, especially non-invasive acupoint stimulation, could have good short term effects on pain of primary dysmenorrhea. Inference in some studies was somewhat restricted due to low methodological rigor. We suggest well-designed, methodologically rigorous, large trial, evaluating both short and long-term effects on pain and other outcomes in comparison with the available standard treatments., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Aims: The purpose of this study was to investigate the effects of a breast cancer screening educational program on women's knowledge and intention to seek breast cancer screening in Taiwan., Materials and Method: This study describes the knowledge and intention of breast cancer screening changes during the period pre and post group education. A pre-test and post-test were used in both the experimental and the control groups. A convenience sampling was used. Two structured questionnaires were used., Results: The mean knowledge of breast cancer screening scores (pre-test and post-test) of the experimental group participants were 12.6 and 14.0. Then the mean knowledge of breast cancer screening scores (pre-test and post-test) of the control group participants were 11.8 and 12.1. The mean intention of breast cancer screening scores (pre-test and post-test) of the experimental group participants were 11.4 and 13.5. And the mean intention of breast cancer screening scores (pre-test and post-test) of the control group participants were 11.6 and 12.4. An independent-t test was applied to examine the differences among the two groups, revealing that the average post-test knowledge score differ significantly between the two groups (t=4.18, p<.00); and the post-test intention also demonstrate a marked statistical difference (t=2.07, p<.05). A paired-t test was applied to examine the differences of each group, revealing that the total average scores of the experimental group participants on the knowledge of breast cancer screening scale clearly differ statistically (t=-5.54, p<.00); and the pre-test and post-test intention testing also demonstrate a marked statistical difference (t=-7.70, p<.00)., Conclusions: These findings are helpful in understanding the knowledge and intention of breast cancer screening changes during the period pre and post group education. It is expected that these results can offer a reference for clinical breast cancer prevention.

Objectives: The purpose of this study was to evaluate the effect of acupoint electrical stimulation with patient-controlled analgesia (PCA) on reducing acute pain, nausea, and vomiting after surgery for nontraumatic spinal cord injury., Methods: A randomized, controlled, repeated measures research design was used. Ninety-nine patients undergoing lumbar spinal surgery were randomly assigned to one of three groups. Patients in experimental group 1 (EG1) received true acupoint electrical simulation three times, whereas those in experimental group 2 (EG2) received sham acupoint manually. Patients in the control group (CG) received no acupoint intervention. All patients were measured for pain, initial demand for PCA, demand for opiates, opiate dose, vital signs, and postoperative nausea and vomiting (PONV)., Results: Significant differences were found in postoperative pain, respiratory rate, blood pressure, and opiate doses across time in the three groups with better outcomes observed in EG1 than in EG2. However, no between-group difference was found in initial demand for PCA or in PONV., Conclusions: The study demonstrates that acupoint electrical stimulation improves acute postoperative pain management without adversely affecting vital signs after surgery for nontraumatic spinal injury. More studies are needed to evaluate the effects ofacupoint electrical stimulation on PONV and postoperative pain following other surgical procedures.