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Background: The purpose of this study was to develop and test the psychometric properties of a questionnaire that assesses preschool teachers' self-efficacy in providing asthma care. Methods: A total of 407 teachers from 54 preschools in Taiwan participated in the study by completing the asthma management self-efficacy scale. We assessed validity of the scale through expert opinion, exploratory factor analysis, and confirmatory factor analysis. The reliability of the scale was assessed using Cronbach's alpha. Results: A 10-items questionnaire was developed to assess self-efficacy concerning asthma treatment. On the basis of explorative factor analysis, 2 major factors emerged from the 10 self-efficacy items that together explained 61.68% of the total variance in teachers' self-efficacy with regard to asthma care. We named these factors "prevention of an asthma episode" and "the treatment of an asthma exacerbation." Confirmatory factor analysis revealed that the 2-factor model provided the best goodness-of-fit. Conclusions: This scale could provide health professionals with useful information concerning preschool teachers' self-efficacy with respect to the management of asthma in the preschool setting.

Background: In recent decades, 95% of children with congenital heart disease (CHD) can survive to adolescence and adulthood. However, adolescents with CHD are prone to poorer health-related quality of life (HRQoL). It is imperative to develop a reliable and valid instrument for health professionals to monitor the HRQoL. This study aims to: (1) evaluate the psychometric properties of the traditional Chinese version of Pediatric Quality of Life™ 3.0 Cardiac Module (PedsQL-CM) and measurement invariance across adolescents with CHD and their parents; and (2) investigate the adolescent-parent agreement in HRQoL. Methods: A total of 162 adolescents and 162 parents were recruited. Internal consistency was examined using Cronbach's alpha and McDonald's Omega. The criterion-related validity was evaluated with intercorrelations between the PedsQL-CM and PedsQL™ 4.0 Generic Core (PedsQL-GC) Scale. The construct validity was examined by second-order confirmatory factor analysis (CFA). Measurement invariance was evaluated using the multi-group CFA. The adolescent-parent agreement was analyzed with the intraclass correlation (ICC), paired t-tests, and Bland–Altman plots. Results: PedsQL-CM showed acceptable internal consistency (self-reports 0.88, proxy-reports 0.91). The intercorrelations were medium to large effect size (self-reports 0.34–0.77, proxy-reports 0.46–0.68). The CFA supported the construct validity (CFI = 0.967, TLI = 0.963, RMSEA = 0.036, 90% CI = 0.026–0.046, SRMR = 0.065). The multi-group CFA proved scalar invariance between self and parent proxy-reports. Parents significantly underestimated their adolescents' HRQoL in cognitive problems (Cohen's d = 0.21) and communication (Cohen's d = 0.23) subscales, while there was a negligible difference in total HRQoL (Cohen's d = 0.16). ICCs were poor to moderate effect size with the highest and lowest agreement in heart problems and treatment subscale (ICC = 0.70) and communication subscale (ICC = 0.27), respectively. The Bland–Altman plots showed lesser variability in the heart problem and treatment subscale and the total scale. Conclusion: The traditional Chinese version of PedsQL-CM has acceptable psychometric properties to measure disease-specific HRQoL in adolescents with CHD. Parents may be proxies for adolescents with CHD to rate total HRQoL. When the patient-reported score is the primary outcome, the proxy-reported score could serve as a secondary outcome for research and clinical evaluation. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effect of sensory impairment on quality of life in older adults and to assess the role of physical function as a mediator of the effect of the sensory impairment on quality of life. Design: A cross‐sectional study. Methods: Older adults aged ≥65 years (N = 600) were recruited from January 2019 to May 2020. Hearing and visual function were measured with pure‐tone audiometry and Snellen visual acuity tests, respectively. Quality of life (World Health Organization Quality of Life Scale Brief Version), physical function (Multidimensional Functional Assessment Questionnaire) and sociodemographic characteristics were reported by participants using interviewer‐administered questionnaires. Propensity score weighting analysis was conducted based on generalized propensity scores via multinominal logistic regression for age, gender, education, income, and comorbidities. The difference in the quality of life was tested by applying a one‐way analysis of variance. Multiple mediation analysis was conducted to explore the direct, indirect, and total effects of sensory impairment on quality of life through physical function. Results: After propensity score weighting adjustment, when compared with participants with no sensory impairment, participants with dual sensory impairment had the worst quality of life, followed by visual impairment and then hearing impairment. Physical function statistically significantly mediated the effect of hearing impairment, visual impairment and dual sensory impairment on quality of life in older adults. Conclusion: Our findings demonstrated that the negative effect of the sensory impairment on quality of life in older adults was mediated through physical function. Impact The convergence of an increasing ageing population and the prevalence of sensory impairment presents a significant global health burden. This study demonstrated that physical function was a mediator of quality of life in older adults. Designing appropriate physical activity interventions for older adults with sensory impairment could serve to enhance physio‐psychological health and improve quality of life. [ABSTRACT FROM AUTHOR]

Abstract Background The use of complementary and alternative medicine (CAM) continues to increase in Taiwan. This study examined the use of CAM and beliefs about CAM as expressed by patients with traumatic brain injury (TBI) in Taiwan. Methods TBI patients and their accompanying relatives were interviewed by using a structured questionnaire at an outpatient clinic in a medical center in northern Taiwan. Results A total of 101 patients with TBI participated in the study. Sixty-four (63%) patients had used at least one form of CAM after sustaining TBI. CAM users had used an average of 2.72 forms of CAM after sustaining TBI. The most frequently used CAM category was traditional Chinese medicine (37; 57.8%), followed by folk and religious therapies (30; 46.9%), and dietary supplements (30; 46.9%). The majority of the patients (45; 70.3%) did not report CAM use because they felt it was unnecessary to do so. Patients who used CAM had a significantly stronger positive belief in CAM than those who did not (t = −2.72; P = .008). After using CAM, most of the patients (54; 85%) perceived moderate satisfaction (2.89 ± 0.44), according to a 4-point Likert scale. Conclusion Although the use of CAM is common for TBI patients receiving conventional medical health care in Taiwan, most patients did not inform health care personnel about their CAM use. TBI patients perceive combined use of CAM and conventional medicine as beneficial for their overall health.

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This article applied a family strengths-oriented therapeutic conversations approach to explore the advanced practice nursing experience of a female adolescent with Leigh Syndrome and her family. During the nursing care period from September 20 to November 19, 2022, the author collected data through direct care, observation, interview, telecare, home visits, and medical record reviews and confirmed the nursing problems to be the inadequate coping capability of the family. The author leveraged her advanced nurse practitioner role and used family strength-oriented therapeutic conversations to enable the parents of the patient to reflect on their experiences with this disease and to improve their quality of life and satisfaction with healthcare services. Three modes of care, including accessibility, coordination, and comprehensiveness, were offered to the female adolescent patient and her family to achieve the goal of family-centered, community-based, and medical-system-centered care. It is suggested that before making healthcare decisions, patients and their families should be given the opportunity to participate in the healthcare process and reach consensus on healthcare decisions based on existing evidence and their values and preferences. The medical decisions made by patients and their families after carefully considering their current situation and needs should be supported and assisted.

The major objective of this study was to examine the association between Methylenetetrahydrofolate Reductase (MTHFR) polymorphisms and the risk of various types of leukemias across the lifespans of children and adults by using the meta-predictive techniques. The secondary objective was to examine the interactions among epigenetic risk factors (including air pollution), MTHFR polymorphisms, and the risks of developing leukemia. We completed a comprehensive search of 6 databases to find 54 studies (10,033 leukemia cases and 15,835 controls) for MTHFR 677, and 43 studies (8,868 cases and 14,301 controls) for MTHFR 1298, published from 1999 to 2014. The results revealed that, in European populations; childhood populations; children from Europe, East Asia, and America; and children with acute lymphocytic leukemia (ALL), MTHFR 677 polymorphisms (both TT and CT types together and individually) are protective, while CC wildtype was leukemogenic. In addition, MTHFR 1298 polymorphisms were protective against ALL and acute myeloid leukemia in European children, and in chronic myeloid leukemia in all adults worldwide and American adults. Air pollution played a role in the increased polymorphisms of MTHFR 677 genotypes in childhood leukemia.

Phagocyte, the first inflammatory response of the immune system, is an important component of the wound healing process. For children with low immunity who suffer from phagocyte deficiency, even a small wound will result in a rapid response to systemic infection, poor wound healing, and hospitalization for treatment. Such treatments often bring enormous pressure to bear on the child, with serious impacts on his or her psychological well-being as well as on that of the family. This paper applies the concept of preschool-age child development and "TIME" criteria proposed by Dr. Schultz to assess pathological changes in poor healing wounds in order to promote wound healing and shorten necessary hospitalization times. Teaching the primary caregiver (oftentimes the patient's mother) adequate at-home wound dressing skills to reduce re-admission rates is also a main focus of nursing care. This article integrates related articles in the literature with a case analysis by reporting on an individualized nursing intervention for a child with cellulites induced by phagocyte deficiency. It is hoped that recommendations provide a valuable clinical reference for nursing colleagues to care for children suffering from phagocyte deficiency.

The purpose of this article is to describe the process of designing an Infection Control Health Education Program (ICP) for adolescents with cancer, to describe the content of that program, and to evaluate its validity. The program consisted of an audiovisual "Infection Control Health Education Program in Video Compact Disc (VCD)" and "Self-Care Daily Checklist (SCDC)". The VCD was developed from systematic literature reviews and consultations with experts in pediatric oncology care. It addresses the main issues of infection control among adolescents. The content of the SCDC was designed to enhance adolescents' self-care capabilities by means of twice daily self-recording. The response format for content validity of the VCD and SCDC was a 5-point Likert scale. The mean score for content validity was 4.72 for the VCD and 4.82 for the SCDC. The percentage of expert agreement was 99% for the VCD and 98% for the SCDC. In summary, the VCD was effective in improving adolescents' capacity for self-care and the extensive reinforcement SCDC was also shown to be useful. In a subsequent pilot study, the authors used this program to increase adolescent cancer patients' self-care knowledge and behavior for, and decrease their levels of secondary infection.

Asthma is the most prevalent and costly chronic childhood disease worldwide, unexpected flare-ups and exacerbation of which threaten the safety and quality of life of children and their families. As the capacity for self-management among children is limited by their developmental level, much of the weight of asthma management falls on the shoulders of caregivers. This article outlines the impact of asthma, and guidelines for diagnosis and management of asthma, and symptom self-monitoring and management in children. It is aimed at facilitating self-monitoring to improve assessments of the severity of the condition in order to prevent deterioration and improve the quality of life of children and their families.

Background and Purpose: Mothers who are separated from their infants due to the necessity of surgical treatment for congenital heart disease (CHD) may develop lack of confidence in their ability to care for their infant. This research developed a systematic discharge nursing plan (SDNP) for mothers to care for their infants with CHD and evaluated the effects of this plan on maternal knowledge and confidence in caring for their infant with CHD at home., Methods: A quasi-experimental design was adopted for the study. Subjects were recruited by purposive sampling from mothers who had a hospitalized infant with CHD aged from 0 to 6 months. There were 20 mothers in the control group and 15 mothers in the intervention group. Control group subjects received current nursing instruction and were followed at the outpatient department after discharge of the infant from the hospital whereas the intervention group completed the SDNP in addition to current nursing instruction. Evaluations of these 2 groups based on the mother's knowledge of infant care and confidence to provide adequate care were conducted twice, at 1 week and 1 month after the infant's discharge from the hospital., Results: The intervention group had better confidence than the control group at 1 week and 1 month after the infants' discharge (p < 0.05). There was no significant difference of improvement in knowledge of infant care score between the 2 groups. No significant relation was found between knowledge of infant care and maternal confidence., Conclusions: This research showed that an SDNP improved maternal confidence in caring for an infant with CHD. Thus, an SDNP may be a valuable part of standard clinical practice in caring for infants with CHD.