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The care of patients with obsessive-compulsive disorder (OCD) has raised quality of life (QOL) issues. The purpose of this study was to compare the level of QOL between patients with and without OCD, and to examine the associations between QOL and sociodemographic data, course of illness, psychopathology, perceived social support, and treatment characteristics. The QOL levels measured with the Taiwan version of the Short Form of the World Health Organization Questionnaire on Quality of Life were compared between 57 subjects with OCD and 106 subjects without OCD. The correlates of QOL were examined among subjects with OCD. The analysis revealed that QOL scores for the general, physical, psychological and social relationship domains were lower in the OCD group than in the control group; however, no difference in the environmental domain was found. Multiple factors were associated with poor QOL in subjects with OCD, including comorbid depression, severe obsession symptoms, perceived low social support, severe adverse effects of medication, combined use of mood stabilizers, and low social status. Different domains of QOL are differently affected by OCD. The QOL of subjects with OCD was correlated to multiple factors that were specific to individual subjects and influenced by interactions with treatment and the social environment.

Aim: The purpose of the present study was to investigate the burden of the primary family caregivers of schizophrenia patients and the factors that affect caregiver burden. Methods: A total of 126 pairs of patients and their primary family caregivers were recruited from the day care and acute wards of two teaching general hospitals. Demographic information was collected. All patients went through an interview with a senior psychiatrist using the Brief Psychiatric Rating Scale (BPRS). The Caregiver Burden Inventory–Brief Version and the Chinese Health Questionnaire (CHQ) were used to assess the caregiver burden and the caregivers' health condition. One-way analysis of variance and Pearson correlation were used to analyze the relationship between demographic factors and caregiver burden. Multiple regression was used to analyze predictors of burden of caregivers. Statistical significance in this study was defined as P ≤ 0.05. Results: The caregiver burden scores (25.9 ± 10.7; range, 3–61) indicated a moderate burden level. Among the five dimensions of burden, caregiver anxiety (2.13 ± 0.86) was the highest, followed by dependency of the patient (1.85 ± 1.02), feeling shame and guilt (1.56 ± 1.02), and family interference (1.43 ± 0.83). The burden level of stigmata (1.32 ± 1.24) was the lowest. The first three rankings of burden were ‘I worry about his/her safety when he/she is alone’ (2.26 ± 1.15), ‘I worry that she/he will become sick at any time’ (2.23 ± 1.10), and ‘I feel he/she depends on me very much’ (2.02 ± 1.29). Patient satisfaction with medical staff support (P = 0.00), CHQ scores of the caregivers (P = 0.00), and the BPRS scores of the patients (P = 0.01) were significantly associated with the caregiver burden scores. Conclusions: The physical and mental health condition of the primary family caregiver of schizophrenia patients was the most important factor determining the caregiver burden level. Comprehensive multidisciplinary care of chronic schizophrenia patients is needed, care that supports the needs and improves the psychiatric symptoms of the patients, helps to decrease the caregiver burden level, and facilitates family participation in treatment.

This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people.

According to current surveys conducted between September and December 2011, the accuracy of primary caregiver-administered Home Total Parenteral Nutrition Care (HTPNC) was 62.0%. Further, nursing staffs provide instruction on HTPNC to only 22.2% of caregivers responsible for administering HTPNC. Main related causes were: (1) difficult to comprehend health education tools; (2) inconsistent nursing guidelines; (3) a lack of relevant standard operating procedures; and (4) poor caregiver adoption of TPN skills.This project was developed to (1) increase the accuracy of primary caregiver-administered HTPNC to 90% and (2) increase the percentage of nurse-administered HTPNC to 90%.We developed appropriate nursing guidelines, created a health education CD-ROM with input from a cross-disciplinary team and total parenteral nutrition focus group, designed reusable teaching model aids for repetitive practice, and held regular group health education sessions.The nursing staff HTPNC instruction rate increased to 100%. Caregiver HTPNC implementation accuracy increased to 100% prior to patient discharge.This approach was successful in achieving its stated goals. Further, using reusable teaching model aids may reduce caregiver anxiety and increase caregiver confidence. The greatest benefit of this project was its extension of teaching model aids to relevant units, allowing for routine monitoring by the department of nursing quality management.提升主要照顧者執行居家全靜脈營養照護之正確率調查本科2011年9月至12月出院前主要照顧者執行居家全靜脈營養照護正確率偏低僅62.0%，護理人員執行護理指導執行率僅22.2%；經現況分析發現主要問題為：缺乏標準作業流程、護理指導不一致、衛教工具不易瞭解及主要照顧者無法有效學習成效所致。(1)提升主要照顧者執行居家TPN（total parenteral nutrition）照護正確率達90%；(2)提升護理人員執行居家TPN護理臨床指導之執行率達90%。經問題確立及參考文獻後，設立改善策略，包括(1)制定護理臨床指導路徑；(2)跨團隊與TPN小組共同製作衛教光碟；(3)設計回覆示教模型包提供反覆練習；(4)定期舉辦團體衛教。主要照顧者於出院前執行居家全靜脈營養照護正確率可達100%，且護理人員指導執行居家全靜脈營養照護之執行率達100%。藉由制定護理臨床指導路徑，透過回覆示教模型包操作，可提升主要照顧者執行居家全靜脈營養照護正確率，增加其自信心。本專案最大的效益是已由護理部TPN小組，於院內平行推展至相關單位執行，並落實於日常管理。

Background: This study aims to examine whether coping strategies employed by caregivers are related to distinct symptoms of patients with dementia and to investigate the associations between burden and coping among caregivers of patients with dementia. Methods: A cross-sectional study design was used. A total of 57 caregivers of patients with dementia were enrolled. Coping strategies were assessed using the Ways of Coping Checklist, and burden was assessed using the Chinese version of Caregiver Burden Inventory. Correlations between coping and patients’ behavior or memory problems were examined. Severities of behavior and memory problems were adjusted to examine the correlations between caregiver burden and coping strategies. Results: The patients’ disruptive behavior problems were associated with avoidance, and depression problems were associated with avoidance and wishful thinking. After adjusting for severity of behavior problems, coping strategies using avoidance were positively correlated with caregiver burden. Conclusions: Emotion-focused coping strategies are a marker of caregiver burden.

Caregivers of patients with late-life major depressive disorder experience a significant level of general caregiver burden. Disability in patients is possibly one of the origins of caregiver burden. Frontal lobe dysfunction might be the source of disability. This study investigated if frontal lobe dysfunction (body level) of patients with late-life major depressive disorder was associated with their disability (individual level), and if it led to a high level of caregiver burden (societal level). Thirty-four unselected pairs of caregivers and their family members with late-life major depressive disorder were recruited. Frontal Assessment Battery and Timed Instrumental Activities of Daily Living (TIADL) were used to assess patients' frontal function and disability, and Caregiver Burden Inventory was used to measure caregiver burden. Frontal Assessment Battery correlated with TIADL (r= −0.47; p

This paper reports on a nurse's experience helping alleviate psychosomatic symptoms in a psychiatric outpatient suffering from depression. It was found that the OPD patient had been suffering from depression as well as long-time tension and pain. Between April 10th and July 24th, 2008, the author employed holistic nursing assessment and collected data through both observation and interview. Three major care problems were identified, including ineffective individual coping, chronic pain, and sleep disturbance. Focusing nursing care on relaxation techniques and biofeedback, the author discussed the problems with the patient and then implemented relaxation training and biofeedback training sessions as well as nursing care plans, which averaged 45~60 minutes per time for 8 times. Sessions included interviews, relaxation techniques (e.g., progressive muscular relaxation, meditative relaxation, meditation, music and abdominal breathing) and visual feedback measured by a biofeedback device with a thermistor sensor. During sessions, the patient was clearly motivated to change and participated actively. Furthermore, the patient not only became gradually aware of both the inner feeling of relaxation and etiology of psychosomatic symptoms, but also learned relaxation strategies for coping with life stressors. After therapy, the patient's self-control over relaxation had improved considerably and care problems were resolved satisfactorily. Also, the patient could increasingly incorporate relaxation into daily life routines.

The purpose of the present study was to investigate the burden of the primary family caregivers of schizophrenia patients and the factors that affect caregiver burden.A total of 126 pairs of patients and their primary family caregivers were recruited from the day care and acute wards of two teaching general hospitals. Demographic information was collected. All patients went through an interview with a senior psychiatrist using the Brief Psychiatric Rating Scale (BPRS). The Caregiver Burden Inventory-Brief Version and the Chinese Health Questionnaire (CHQ) were used to assess the caregiver burden and the caregivers' health condition. One-way analysis of variance and Pearson correlation were used to analyze the relationship between demographic factors and caregiver burden. Multiple regression was used to analyze predictors of burden of caregivers. Statistical significance in this study was defined as Por= 0.05.The caregiver burden scores (25.9 +/- 10.7; range, 3-61) indicated a moderate burden level. Among the five dimensions of burden, caregiver anxiety (2.13 +/- 0.86) was the highest, followed by dependency of the patient (1.85 +/- 1.02), feeling shame and guilt (1.56 +/- 1.02), and family interference (1.43 +/- 0.83). The burden level of stigmata (1.32 +/- 1.24) was the lowest. The first three rankings of burden were 'I worry about his/her safety when he/she is alone' (2.26 +/- 1.15), 'I worry that she/he will become sick at any time' (2.23 +/- 1.10), and 'I feel he/she depends on me very much' (2.02 +/- 1.29). Patient satisfaction with medical staff support (P = 0.00), CHQ scores of the caregivers (P = 0.00), and the BPRS scores of the patients (P = 0.01) were significantly associated with the caregiver burden scores.The physical and mental health condition of the primary family caregiver of schizophrenia patients was the most important factor determining the caregiver burden level. Comprehensive multidisciplinary care of chronic schizophrenia patients is needed, care that supports the needs and improves the psychiatric symptoms of the patients, helps to decrease the caregiver burden level, and facilitates family participation in treatment.

The objective of this project was to increase the rate of participation in relevant educational programs of immediate relatives of individuals currently undergoing psychiatric treatment. According to statistics, the average participation rate in such educational programs averages only 23.4%; a ratio considered unacceptably low. After analysis, major problems identified included: (1) relatives were not informed in advance of meeting schedules; (2) there was no standard manner by which hospitals communicated with relatives; (3) interaction between patients and their families was, in general, poor; (4) program staff were unable to ensure that relatives knew correct meeting times; and (5) relatives generally lacked interest in health education topics. A special project group was organized and charged to improve the rate of participation of psychiatric patient relatives in health education groups. Three proposals made by this group included: (1) create an annual patient relative attendance planning schedule; (2) implement a patient "life passport" for use as a standardized tool in day hospital care; and (3) arrange time after education activities for patient-parent interaction. After measures were implemented, patient relative participation in education programs rose to 64.8% from 23.4%. Results demonstrate method feasibility and validity. As the proposed method does not require nurses to send out notifications or conduct follow-ups over the phone, it indirectly cuts down costs and manpower and improves patient-family relations, ultimately raising the quality of nursing care.

Summary Objectives: The aims of this study were to explore different dimensions of the attitudes toward gay men and lesbians among nurses in southern Taiwan and to examine the association between attitudes and intention to provide care to homosexual individuals. The factors related to attitudes towards gay men and lesbians by nurses were also examined. Methods: In total, 1824 nurses from a medical centre and two regional teaching hospitals in southern Taiwan were recruited into this study. We used the Attitudes Toward Homosexuality Questionnaire (ATHQ) to examine four-dimensional concepts toward homosexuality among nurses. The association of attitudes with the intention of taking care of homosexual patients was examined. Correlations of attitudes toward homosexuality with demographic and occupational data, sexual orientation, knowledge about homosexuality, and experiences of having contact with gay men and lesbians were examined using a stepwise multiple linear regression. Results: Participants had the most negative attitude toward homosexuality in the ‘contact' and ‘stereotypes' dimensions, followed by the ‘morality' dimension and then the ‘condemnation/tolerance' dimension. Nurses with more negative attitudes toward homosexuality had lower intentions of taking care of patients with a homosexual orientation. Nurses who had friends or relatives with a homosexual orientation, had a higher educational degree, and had provided care to homosexual patients were more likely to have positive attitudes toward homosexuality. In contrast, nurses who had worked for a longer period, labelled themselves as being absolutely heterosexual, and were religious were more likely to have negative attitudes toward homosexuality. Conclusions: The factors related to attitudes toward homosexuality identified in this study have to be taken into consideration when intervening for nurses' attitudes toward gay men and lesbians.

The experiences during nine meetings with a psychotherapy outpatient suffering from low self-esteem between 1/1/02 to 4/10/02. Using comprehensive nursing assessment practices for guidance, two conclusions were arrived at regarding the patient's mental health: a) an imbalance in individual response ability, and b) long-term problems with low self-esteem. This assessment was used to help the authors practice appropriate nursing skills associated with assertiveness training and cognitive therapy and to establish a trusting, caring, and accepting relationship with the client. The treatment plan included attempts to increase personal confidence and to promote suitable skills for improving living functions, enhancing relationships, and practicing social behavior.