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To investigate the efficacy of the "Life Adaptation Skills Training (LAST)" program for persons with depression.Sixty-eight subjects with depressive disorder were recruited from psychiatric outpatient clinics in Taipei city and were randomly assigned to either an intervention group (N=33), or a control group (N=35). The intervention group received 24-sessions of the LAST program, as well as phone contact mainly related to support for a total of 24 times. The control group only received phone contact 24 times. The primary outcome measure utilized was the World Health Organization Quality of Life-BREF-Taiwan version. Secondary outcome measures included the Occupational self-assessment, the Mastery scale, the Social support questionnaire, the Beck anxiety inventory, the Beck depression inventory-II, and the Beck scale for suicide ideation. The mixed-effects linear model was applied to analyze the incremental efficacy of the LAST program, and the partial eta squared (ηp(2)) was used to examine the within- and between- group effect size.The subjects who participated in the LAST program showed significant incremental improvements with moderate to large between-group effect sizes on their level of anxiety (-5.45±2.34, p0.05; ηp(2)=0.083) and level of suicidal ideation (-3.09±1.11, p0.01; ηp(2)=0.157) when compared to the control group. The reduction of suicidal ideations had a maintenance effect for three months after the end of intervention (-3.44±1.09, p0.01), with moderate between-group effect sizes (ηp(2)=0.101). Both groups showed significant improvement on overall QOL, overall health, physical QOL, psychological QOL, level of anxiety, and level of depression. The within-group effect sizes achieved large effects in the intervention group (ηp(2)=0.328-0.544), and were larger than that of the control group.A small sample size in the study, a high dropout rate, lower compliance rates for the intervention group, and lacking of true control group.The occupation-based LAST program, which focuses on lifestyle rearrangement and coping skills enhancement, could significantly improve the level of anxiety and suicidal ideations for persons with depression.

Objective/Background To investigate the efficacy and feasibility of the Quality of Life Enhancement Programme (QOLEP) for individuals with mood disorder. Methods Twenty-one individuals with mood disorder were recruited from psychiatric rehabilitation centres in Taipei City and were randomly assigned to either the treatment group (N = 11) or the control group (N = 10). The treatment group received an 8-week QOLEP. The control group received only “phone contact”, which included support for everyday situations pertaining to daily life and emotions. The primary outcome measure was evaluating improvements in quality of life using the World Health Organization Quality of Life-BREF-Taiwan version questionnaire. The feasibility of the intervention was assessed by the recruitment rate, dropout rate of the participants, and by its content and delivery. The content and delivery were assessed by the group satisfaction questionnaire. The mixed-effects linear model was applied to analyze the efficacy of QOLEP. Results The individuals who participated in the eight-session QOLEP showed significant improvement in their level of depression compared with the control group [pre vs. post, treatment group: 25.8 (19.2) vs. 17.8 (13.1); control group: 13.3 (17.3) vs. 13.3 (14.4)]. The criteria of feasibility were met in this study. Most of the participants were satisfied with engaging in the QOLEP activities within a supportive environment. Conclusion The participants who received the 8-week QOLEP demonstrated significant improvement in the level of depression. Studies with a sample size of at least 104 participants are recommended in the future.

This study examines the reliability and validity of the Mastery Scale-Chinese version (MS-C) when applied to three groups diagnosed with major depression, schizophrenia, or HIV/AIDS.The individuals participating in the study were recruited from outpatient units of a medical center and a municipal hospital in northern Taiwan. The study sample (n = 2009) included 237 patients with depressive disorders, 160 with schizophrenia, and 1612 with HIV/AIDS. The reliability and construct validity of the MS-C was evaluated by confirmatory factor analysis (CFA) and Rasch analysis.The results of the CFA showed that the MS-C has adequate construct validity with all indices meeting the criteria, except for chi-square values. The Rasch analysis supported the four-point rating scale structure and a unidimensional construct of the MS-C. The DIF analysis showed that all items demonstrated stable measurement properties among the different diagnosis groups (major depression, schizophrenia, HIV/AIDS).This study found that MS-C has acceptable psychometric qualities in terms of reliability, construct validity, rating scale performance, and item characteristics when applied to patients with depression, schizophrenia, and HIV/AIDS in Taiwan.

We set out in this study to examine a longitudinal dataset using a linear mixed effects model. Our ultimate aim is to identify predictors of the quality of life (QOL) domains and items amongst patients suffering from major depressive disorders. Four categories of variables are included in our analysis, composed of ‘personal predisposition’, ‘psychosocial’, ‘illness-related’ and ‘time’, while the outcome variables for this study are the ‘physical’, ‘psychological’, ‘social’ and ‘environmental’ domains of QOL, in conjunction with all of the items within the scale. A total of 104 subjects from an outpatient clinic of a university-affiliated hospital participated in this longitudinal study, with a one-time follow up being carried out on 70 of these subjects (67.3%) who agreed to participate in the follow-up study. The ‘severity of depression’, ‘sense of competence’ and ‘sense of mastery’, ‘use of anti-depressant medication’ and ‘environmental resources’ are found to be significant predictors of the detailed aspects of QOL. Of these, ‘symptom severity’, ‘sense of competence’ and ‘sense of mastery’ were found to occur most often. Finally, the results of the present study demonstrate that ‘illness-related’ and ‘psychosocial’ categories are capable of predicting the various QOL domains for patients suffering from depression.

Objective To describe the outcomes of subjects with suspected pre-psychotic state in Taiwan. Methods A prospective clinical observation was performed on subjects recruited by referrals from a community-based population. Three pre-psychotic risk groups were established by means of clinical interviews: an ultra-high risk group (UHR; 59 subjects), an intermediate-risk group (IRG; 46 subjects), and a marginal-risk group (MRG; 48 subjects). Also recruited were 60 subjects with first-episode psychosis (FEP) and 144 normal controls (NC group). All subjects were aged 16 to 32 years. Results Of the 59 UHR subjects, 21 (35.6%) converted to FEP, including 15 with schizophrenia (6 had relatively brief positive yet persistent prominent negative symptoms), 2 with schizophreniform disorder, 1 with schizoaffective disorder, 2 with brief psychotic disorder, and 1 with bipolar disorder. The cumulative ± SE rate of conversion to psychosis was 21.7% ± 5.4% at 6 months, 28.2% ± 6.2% at 12 months, 30.4% ± 6.4% at 18 months, and 33.3% ± 6.8% at 24 months. The UHR subjects who converted had a higher rate of initial antipsychotic use than those who did not convert. Only half of the IRG and two-thirds of the MRG subjects received follow-up, and none of them developed FEP. Conclusions Our results lent support to both sides of the current debate regarding establishing a new diagnostic category of “psychosis risk syndrome.” The divergent trajectories of the UHR subjects deserve more clinical attention, especially with regard to the use of antipsychotics and the presence of a group with prominent negative symptoms.

People with depression suffer from persistent psychosocial and occupational impairments and diminished quality of life after recovering from acute episodes. The purpose of this study was to identify the links and pathways between these factors and examine their impact on quality of life for people with depression. One hundred and three subjects completed measures assessing their depression severity, level of anxiety, self care, occupational competence, and environmental support. Path analysis was utilized to decompose the interrelationship among variables. The results showed that the depression severity, occupational competence, and environmental support had direct or indirect effects, or both, on quality of life. The three largest direct effects were depression severity on quality of life and on occupational competence, as well as occupational competence on environmental support. The depression severity and environmental support directly affected quality of life, while the occupational competence had an ...

PURPOSE: The purpose of this study was to explore the clinical manifestations of aggressive acts by schizophrenic patients during hospitalization. DESIGN AND METHODS: This prospective study followed 107 schizophrenic patients admitted to an acute psychiatric ward in Taiwan. The Chinese version of the Violence Scale was used to count and rate aggressive acts. The categories of the trend of aggressive acts were analyzed. FINDINGS: The highest incidence rate of aggressive acts (58.9%) occurred during the initial week of hospitalization and decreased through the fourth week (16.9%). Most were disturbing but not severe. The incidence and decrease patterns of aggressive acts were found. PRACTICE IMPLICATIONS: Aggressive acts can be prevented and managed. Language: en

Community care has been a paradigm shift for psychiatric treatment worldwide; however, it has not been successfully implemented in many developing countries, including Taiwan. This qualitative study aimed to explore the Taiwanese mentally ill persons' difficulties living in the community. Social disadvantages and illness adaptation were recognized as two domains of difficulties encountered by Taiwanese mentally ill patients living in the community, while six themes were identified: getting a "shameful" illness, unmet needs for community care, being overcome by a distorted world, denying the illness, living with the illness, and adapting to changed level of functioning. Related cultural issues were also discussed.

Aims and objectives. This study aims to understand the effects of culturally enriched body–mind–spirit group therapy on anxiety, depression and holistic well-being among women with breast cancer and to examine patients’ views on what aspects of group therapy worked to enhance their health. Design. The study was designed using multiple methods, which consisted of a randomised controlled trial and a focus group interview. Methods. A total of 16 subjects in the control group received the standard care of a physician’s treatment at the outpatient department. In addition to standard care, 12 subjects in the experimental group received 10 sessions of weekly body–mind–spirit group therapy for 180 minutes each. This therapy integrates concepts and practices of traditional Chinese medicine and Western medicine (e.g. positive psychology and forgiveness therapy). The subjects in the experimental group were invited to participate in a focus group interview regarding their perceptions of the change mechanisms that occurred in group therapy. Results. The results of analysis of covariance indicated that after a two-month trial, there was a similarity between the experimental and control groups in reducing the scores of Beck depression inventory and increasing the scores of body–mind–spirit well-being. However, subjects in the experimental group had a better reduction of the scores of state anxiety inventory than subjects in the control group. The qualitative analysis yielded eight domains: (i) imparting of information, (ii) interpersonal learning, (iii) catharsis, (iv) universality, (v) group cohesiveness, (vi) altruism, (vii) instillation of hope and (viii) existential factors. These domains illustrate how the therapeutic effects of group therapy worked to reduce patients’ anxiety. Conclusion. The culturally sensitive body–mind–spirit group therapy reduced anxiety among outpatients with breast cancer. Relevance to clinical practice. The involvement of mental health nurses in providing group therapy for cancer patients could enhance the quality of care in psycho-ontological nursing.

As stigmatization has a large impact on patients, therapists need a measure of this impact to provide patients with adequate services. This study, therefore, examined the reliability and validity of the Social Impact Scale (SIS) when applied to three groups of individuals diagnosed with major depression, schizophrenia, or HIV/AIDS. The study sample (N=580) included 237 patients with depressive disorder, 119 with schizophrenia, and 224 with HIV/AIDS. Of these, 56% were men, 45.5% had an elementary school education or less, 48% were employed, and 56% were single. The Rasch measurement model, an item-response theory, was used to analyze the SIS structure and quality. The Rasch model solves several statistical problems of traditional measurement theory, such as misuse of ordinal data as interval data and sample dependence. Rasch analysis indicated that the 24 items of the SIS fit the measurement model. The match between item difficulties and person abilities was adequate. All items showed acceptable rating scale structure. The separation reliability of the scale reached 0.99. The SIS had acceptable psychometric qualities in terms of internal consistency, item validity, person validity, sensitivity, and concurrent validity when applied to patients with depression, schizophrenia, and HIV/AIDS in Taiwan.

Having contact and interacting with HIV/AIDS patients has long been recognized as a means for improving AIDS-related knowledge and attitudes among physicians and hence for increasing their intention to provide AIDS care. To investigate the impact of one-month residency training in an AIDS inpatient unit on internal medicine residents, this quasi-experimental, pre-post, two-group study, conducted from April 2000 to April 2001, used questionnaires. At follow-up, residents who received training in the AIDS unit (experimental group) were significantly more knowledgeable about HIV/AIDS, had more positive attitudes and greater intention to care for HIV-infected patients than residents who did not receive this training (control group). Results suggest that a one-month AIDS residency training intervention can effectively enhance residents' HIV-related knowledge, attitudes and intention to care for patients infected with HIV.

The purpose of the study was to evaluate the reliability and validity of the two generic instruments, the WHOQOL and the SF-36, for assessing health-related quality of life in 224 patients with HIV infection. The internal consistency ranged from 0.75 to 0.86 across the WHOQOL-BREF domains and from 0.72 to 0.93 across the SF-36 scales. The scores of all WHOQOL-BREF domains and SF-36 scales correlated positively with the measure of happiness, Sat-HRQOL and self-perceived health status, and correlated negatively with the number and intensity of symptoms. Patients with higher CD4 cell counts scored significantly higher on G4 (general health), three WHOQOL-BREF domains, seven SF-36 scales, and PCS (physical component summary). Patients with fewer symptoms and with less intensity of symptoms had significantly higher scores on all four domains of WHOQOL-BREF, eight scales, PCS, and MCS (mental component summary) of the SF-36 scale. The correlations between the physical, psychological, and social domains of the WHOQOL-BREF and PF (physical functioning), MH (mental health), and SF (social functioning) of the SF-36 were 0.51, 0.75, and 0.54, respectively. There is also good correlation between PCS of the SF-36 and the physical domain of the WHOQOL-BREF (r = 0.48), and between MCS and all four domains of the WHOQOL-BREF (r range = 0.60-0.75). The WHOQOL-BREF domains showed fewer floor or ceiling effect than the SF-36 scales. We concluded that both the WHOQOL-BREF and the SF-36 are reliable and valid health related quality-of-life instruments in patients with HIV infection.

Symptoms are common in HIV-infected persons and occur at all stages of the illness. An effective symptom assessment tool can help health care providers quickly detect patients' problems and provide suitable care. Because no studies focusing on developing a sign and symptom checklist for persons with HIV can be found for Taiwanese patients or for those who speak Chinese, the purpose of this study was to validate a Chinese version of the Sign & Symptom Checklist for Persons with HIV (SSC-HIV-C). The Checklist first was translated from the English version into a Chinese version and then was back translated to examine accuracy. Both face and construct validity were used to examine overall validity of the instrument. Tests for internal consistency and test-retest reliability were used to examine the reliability of the instrument. The results indicated that the Chinese version of the SSC-HIV yielded highly acceptable parameters of validity and reliability. This Chinese version of the SSC-HIV can be used for measuring signs and symptoms of HIV-AIDS in persons in Taiwan who have HIV, as well as for other Chinese-speaking populations.

We studied the reliability and validity of the World Health Organization quality of life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. WHOQOL-BREF was used to assess 136 HIV-infected outpatients. The results were analyzed and compared with data from 213 healthy persons. The Cronbach's alpha for internal consistency ranged from 0.74 to 0.85 across domains in HIV-infected patients. The test-retest reliability ranged from 0.64 to 0.79 across domains at average 4-week retest interval. Factor analysis identified four major factors: social, psychological, environment, and physical, consistent with the four domains of the instrument. The scores of all four domains correlated positively with self-evaluated health status and happiness (r range: 0.52-0.60 and 0.55-0.73 across domains, respectively), and correlated negatively with the number and severity of symptoms (r range: -0.40 to -0.47 and -0.41 to -0.52, respectively). The scores of physical, psychological and social domains, but not the environment domain, discriminated between healthy persons and HIV-infected patients (all p < 0.01). We conclude that the WHOQOL-BREF can be a useful quality-of-life instrument in patients with HIV infection.

The purpose of the study was to gain insight into coping strategies of people with HIV/AIDS (PWHAs) in Taiwan who had negative health care experiences. This study used a phenomenological approach. Participants were 14 PWHAs with an average age of 35 years who had known their positive HIV status for an average of 24.9 months. Two coping strategies used to deal with negative health care experiences included, 'don't make a big fuss about it', and 'building defenses and finding alternatives'. Cultural aspects of PWHAs' coping strategies are discussed as they distinguish Chinese from western culture.

The purpose of this study was to investigate internal medicine residents' HIV-related knowledge and their attitudes towards caring for HIV-infected patients, and determine the extent to which these variables influence their care-providing intention. A cross-sectional survey was conducted in 56 internal medicine residents at a university hospital in Taiwan. Results showed residents' lack of sufficient knowledge was reflected by their inaccurate assessment of HIV-associated risk and their tendency to overuse protective gear in unnecessary situations. In general, residents expressed slightly positive attitudes with a neutral intention to care for HIV-infected patients. Knowledge and attitudes were significantly correlated with intention. The use of stepwise regression analysis revealed attitudes accounted for 59% of the variance in intention. Future efforts should focus on designing, implementing, and evaluating educational programmes that address residents' needs to ensure a solid HIV-related knowledge base, support their positive attitudes, address their ambivalent feelings toward providing HIV care, and enhance their intention to care for HIV-infected patients.

According to the World Health Organization (WHO), the quality of life (QOL) of an individual is essentially defined as the subjective evaluation by such individuals of their own personal life embedded within the context of their culture and values. In the present study, we set out to examine the reliability and validity of the WHOQOL-HIV BREF, a newly-developed, multi-dimensional instrument comprising 31 items designed to assess the QOL of people in Taiwan infected with human immunodeficiency virus (HIV). We collected data on a total of 680 people in Taiwan infected with HIV; these study participants were found to have a mean age of 36.26±10.1 years. Based on our assessment of the psychometric (reliability and validity) properties of the WHOQOL-HIV BREF, we found that the internal consistency (Cronbach's α) ranged between 0.67 and 0.80 across the six domains of physical health, level of independence, psychological health, spirituality, social relations, and environmental health. We also found that the multi-dimensional instrument demonstrated good content, concurrent, and known-group validity, with the results of the construct validity further revealing that the original six-domain structure model was acceptable. The findings of the present study provide strong evidence in support of both the reliability and validity of the WHOQOL-HIV BREF for widespread use in the assessment of quality of life among HIV-infected patients in Taiwan, with the original factor structure of the instrument having been found to be appropriately valid for patients of a Chinese cultural background. We therefore contribute to the evidence on the cultural relevance of the WHOQOL-HIV BREF as a valid measure for cross-cultural comparative studies on QOL.

To examine both the reliability and the validity of the 'Medical Outcomes Study HIV' (MOS-HIV) health survey among HIV-infected patients in Taiwan.Data were collected from 619 HIV-infected outpatients, with the reliability and the validity of the MOS-HIV survey subsequently being examined by multi-trait scaling techniques, internal consistency, convergent validity, known-group validity and factorial validity.The MOS-HIV health survey was found to have excellent success rates in the item-consistency and discriminant-validity tests, as well as good convergent validity and known-group validity. An acceptable fit was found for three of the four indices in the original two-factor model (non-normed fit index = 0.92, comparative fit index = 0.94 and standardized root mean squared residual = 0.056).The findings of the present study provide strong evidence in support of the reliability and validity of the MOS-HIV health survey for the assessment of quality of life among HIV-infected patients in Taiwan. We find that the original factor structure of the MOS-HIV survey remains valid for patients from Chinese cultural backgrounds. This study therefore contributes to the existing evidence within the extant literature on the cultural relevance of the MOS-HIV health survey (a measure originally developed within a Western culture) as a valid measure for cross-cultural comparative studies on health-related quality of life.

The 'quality of life' (QOL) for patients suffering from depression is affected by four factors: stigma, social support, mastery and depressive symptoms. The purpose of this study was to develop and empirically validate an appropriate path model for the QOL of patients suffering from major depression. We recruited a total of 237 patients suffering from depression from the outpatient psychiatry department of a university-affiliated hospital in northern Taiwan. The sample was predominantly female (74.3%), had at least a high school level of education (79.7%), had a mean age of 46.95 years, and were living with their families (87.3%). Path analysis was used to identify the 'best fit' model for the QOL of the patients in four domains: physical, psychological, social and environmental. The key determinant for all QOL domains is found to be the intensity of the depressive symptoms, with social support also affecting QOL both directly and indirectly, whilst stigma is found to have an indirect effect on QOL mediated by the intensity of the depressive symptoms, mastery and social support. We conclude that more effective improvements in all aspects of QOL for patients suffering from depression could be achieved by the provision of comprehensive intervention programs aimed at reducing stigma, as well as placing greater emphasis on a reduction in the patients' depressive symptoms, and enhancements to their social support and mastery.

Health-related quality of life is an important outcome indicator of mental health. We assessed the perception of health-related quality of life of persons with schizophrenia in Hong Kong and Taipei. In-person survey interviews were conducted using the Chinese World Health Organization Quality of Life Scale--Brief Version. A convenience sample was recruited from psychiatric outpatient departments: 176 from Hong Kong and 80 from Taipei. We found that both groups were significantly less satisfied with their psychological and social relationship domains compared to other domains. Poor mental health predicted poor perception of health-related quality of life. Schizophrenia has an impact on many aspects of a person's functioning. A rehabilitation model that takes into account symptoms, financial situation, family support, and social functioning is required.

BackgroundStudies of outpatient clinical training in AIDS care have shown positive effects on residents' knowledge, attitudes and intentions. In this study, residents' knowledge, attitudes and intentions regarding the care of HIV-infected patients were used as outcome measures to evaluate the effectiveness of a 1-month residency training in an AIDS inpatient unit.MethodsFrom April 2000 through April 2001, 33 internal medicine residents completed pretest-posttest questionnaires evaluating changes in their knowledge, attitudes and intention to care for HIV-infected patients. Of these 33 residents, 25 participated in a posttest interview, reflecting on their learning experience during the 1-month clinical rotation.ResultsAt the posttest, residents were significantly more accurate in assessing HIV-associated risk (p < 0.001), and were significantly more knowledgeable about the necessary protective equipment to prevent HIV transmission (p < 0.01). Residents were significantly less concerned about the risk of infection (p < 0.01) and interpersonal concerns (p < 0.05). Residents' reluctance to care for HIV-infected patients was significantly lower (p < 0.05), as was their tendency to avoid invasive procedures or treatment of HIV-infected patients (p < 0.001). Residents designated after their training were more likely to practice universal precautions and less likely to be afraid and to stereotype HIV-infected patients. They also reported gaining insight into HIV diseases and patients' multifaceted needs, and appreciating the importance of teamwork in AIDS care.ConclusionA 1-month AIDS residency training can effectively enhance residents' HIV-related knowledge, attitudes and intention to care for patients infected with HIV.

The potential for risky sexual behaviors and adolescent unplanned pregnancy has become a main concern in the health care system for aborigines in eastern Taiwan. Using aboriginal nurses to provide information on sexual behaviors may have potential as a means of promoting healthy sexual practices among aborigines. This study explored aboriginal nurses’ perceptions of facilitators and barriers for taking a sexual history. Several health centers in eastern Taiwan were randomly selected to recruit subjects in 2000. A self-report questionnaire was administered to 206 female nurses (age = 28.4 SD = 7.4) who worked in various clinical units. These aboriginal nurses perceive the major facilitators in taking a sexual history to be having attended a communication training course and experiencing a needle stick accident; they want to prevent themselves or colleagues from becoming infected. The major perceived barriers to taking sexual history result from patients’ feeling embarrassed and not knowing how to answer the questions and patients’ purposely concealing information. Decreasing these barriers and reinforcing facilitators about taking a sexual history is an important task for nursing education and nurses can play an important role in promoting aborigines’ sexual health and decreasing the prevalence of sexually transmitted diseases in this population. (authors)

The purpose of this study was to explore HIV/AIDS patients' symptom experiences and self-care symptom management strategies using a semi-structured questionnaire. Concurrently, the investigators gathered information about patients' symptom management strategies from healthcare providers. A total of 134 HIV-infected persons and 31 healthcare providers voluntarily participated in this study. Nausea, pain, anxiety, vomiting, diarrhea, fear and lack of appetite were described frequently by HIV-infected participants. Nausea, anxiety, diarrhea, fever, fear, pain and vomiting were observed frequently by healthcare providers. The management strategies used by these patients are presented and the differences in findings between Taiwan and Western cultures are discussed. In general, the results indicated that healthcare providers hold limited knowledge about self-care symptom management of HIV/AIDS. Filling this knowledge gap is an essential task for all healthcare providers in Taiwan.

Introduction and aims Previous studies showed that persons with mental illness had poorer quality of life than persons with the other medical conditions. We developed a manualized treatment - Quality of Life Enhancement Program (QOLEP) based on literature review and clinical experiences. The contents of the program include 4 sessions of ‘occupational life scheduling’ and 4 sessions of ‘coping skills’ provided by an occupational therapist during a 4-week period (2 times/week) which each session lasts for one to two hours. Methods Twenty-one subjects were recruited from community mental health rehabilitation centers in northern Taiwan. They were randomly assigned to either treatment group (N=11) or control group (N=10). The subjects in the control group received general supportive therapy over the phone twice a week for 4 weeks. Both groups were evaluated at baseline and posttreatment. The mixed-effects linear model was applied to analyze the efficacy of the treatment. Results The results showed that the subjects who participated in the QOLEP had significantly better physical QOL than that of control group (-9.66+4.24, p Discussion With the program developed based on concept of occupational engagement, we were able to demonstrate the efficacy of specific treatment on quality of life and used it as evidence to support future development in mental health area.

Breast cancer is recognized as one of the most common cancers in women. The prevalence rate of breast cancer in Taiwan is 53/100,000 in 2007. Although the survival rate for the breast cancer was enhanced in recent years, the consequences of the illness, including its impact on the quality of life are in need of attention and treatment. The purpose of the study is to investigate factors related to the quality of life for persons with breast cancer from longitudinal view. The model of the study includes predictors from categories of illness related, psychosocial, contextual and activity participation. The outcome variables are 26 items of the World Health Organization Quality of Life Brief Taiwan version (WHOQOL-BREFTW). The study was approved by the IRB board. One hundred subjects diagnosed as breast cancer were recruited to participate in the study. They were from an outpatient treatment center in a teaching hospital in northern Taiwan. Seventy-six subjects were followed up after three months. The mean age of the subjects was 49.6 (SD=8.6); 77% of them were married; 55% of them had college degree; the average onset duration was 254.7 days (SD=337.7). Seventy percent of the subjects were receiving chemotherapy; 30% of the subjects were receiving targeted therapy. Sixty percent of the subjects were diagnosed as 2nd stage cancer. The study was longitudinal in nature. The average follow up duration was 104 days (SD=15.9 days). The independent variables of the model included: disease stage; number of comorbidity; medication side effect; sense of mastery; sense of competence; level of depression and anxiety; social support; satisfaction with daily occupation; time spent in certain activity and role perofrmance etc. The linear mixed effect model was used to analyze the dataset which offers benefits to overcome missing data, repeated measurement and small sample size. The results of the study showed that overall QOL was predicted by the number of comorbidity, satisfaction with daily occupations, time spent at leisure activity, time at rest and number of roles. Overall health was predicted by side effects, level of depression, level of social support and time spent at leisure activity. Satisfaction with daily occupations was the most important factor to predict QOL, followed by sense of competence, level of depression, level of anxiety, and educational level. “The meaningfulness of life” was predicted only by social support; “Enjoying life” was predicted by educational level, stage of cancer and time spent at leisure activity. “The satisfaction with sex life” was predicted only by “social support”. The results support the importance of participation in daily occupation as a way to improve the QOL of persons with breast cancer. Furthermore, levels of depression, level of anxiety as well as sense of competence are significant factors to be addressed. Finally, social support provides essential buffering effect on the aspect of QOL. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4442. doi:1538-7445.AM2012-4442

Depression is a common mental disorder that substantially impairs a client's functioning. The aim of this study is to examine the predictive factors of quality of life (QOL) for depression from longitudinal perspectives. 237 outpatients with depression were recruited in the study. They were from a psychiatric outpatient clinic in northern Taiwan. All subjects were tested on the baseline and followed up twice during 3-year period. The average age of subjects was 47.1 years. Most subjects were female, married and lived with their spouses.Seventy subjects participated in both follow ups (T2 and T3). There were no significant differences on the demographic characteristics at T1 between the respondents (N = 70) and non-respondents (N = 167) except for gender. The subjects were tested on the WHOQOL-BREF-Taiwan version, occupational self assessment, mastery, social support and Center of Epidemiology Study-Depression Scale (CESD). The data were analyzed by mixed effect model using SAS computer program.The severity of depression could predict overall QOL, overall health and 13 items of QOL. The type of antidepressants had significant impact on the subjects’ QOL in 10 items. The occupational competence and sense of mastery predicted 13 items (50%) and 14 items (53.8%), respectively.In order to advance the treatment outcomes, the professionals should pay more attention on the enhancement of the sense of competence and mastery. We suggested that treatments should target at improving adaptive skills, lifestyle, and occupational competence.

Objective/Background The Kinetic-House-Tree-Person (KHTP) drawing test is widely used by psychiatric occupational therapists in Taiwan; however, very little support has been provided through studies examining its psychometric properties. The aim of the study is to validate a scoring system for the KHTP on a group of people with psychiatric disorders. Methods A total of 66 individuals with psychiatric disorders were recruited for this study along with 53 college students as a comparative group. Each participant completed the KHTP test. Half of the individuals with psychiatric disorders (33 people) completed the KHTP again following a 2-week period. The KHTP scoring system contains 54 items representing drawing characteristics. Two independent raters determined the score of the drawings, with the validity and reliability of the KHTP scoring system being subsequently examined by the Rasch and traditional analysis. Results The results reveal both validity and unidimensionality of the KHTP scoring system, demonstrating acceptable test—retest reliability. The intraclass correlation coefficient of the scoring system's inter-rater reliability was .76, with significant statistical differences found between the KHTP scores of college students and individuals with psychiatric disorders. Conclusion The KHTP scoring system has acceptable construct validity, inter-rater reliability, and test—retest reliability. Because drawing tests have the advantage of expressing nonverbal characteristics, the scoring system should prove to be very useful for those who are unwilling or unable to communicate verbally. This study therefore provides valuable information for clinical application, particularly for the psychiatric rehabilitation professions.