Browsing by Author "Tang, Siew Tzuh"

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Revisiting the concept of malnutrition in older people
(2007-11-01)
Chen, Cheryl Chia-Hui
;
Bai, Ya-Ying
;
Huang, Guan-Hua
;
Tang, Siew Tzuh
;
統計學研究所
Aim. The aim of this study is to revisit the concept of malnutrition in older people, trace the new development and test the use of refined framework with empirical data. Background. Malnutrition in older people is a common and significant problem worldwide. Continuing Chen's earlier work in 2001, a refinement was conducted and a prospective study was designed to test the use of this refined framework. Design. A cohort study of 114 hospitalized older patients in Northern Taiwan. Methods. The sample consists of 114 older patients aged 65 years and older, who were admitted for the cardiac and orthopaedic services at a tertiary 2300-bed hospital. From March to August 2004, assessed by one trained nurse, participants completed a structured face-to-face interview evaluating their age, visual/hearing impairments, oral health, cognitive status, comorbidities, medication use, social economic status, functional status, social support, depressive symptoms and nutritional status within 48 hours of admission. Participants who stayed > 5 days were reassessed before discharge (n = 70). The data from admission were the main focus of this report. Results. Regression analysis revealed that that more medication taken, female gender, lower functional status ( beta 0.34, P < 0 001) and higher depressive symptoms were independent predictors of poor nutritional status, with the full model accounting for 48 2% of the variance. The result is in- line with the original theoretical underpinnings and it suggests that this refined framework detailing sub- concepts and measurable indices appears to fit the empirical data and suitable for clinical use. similar to 2007 The Authors. Journal compilation similar to 2007 Blackwell Publishing Ltd 2015 doi: 10.1111/ j. 1365- 2702.2006.01867. xRegression analysis revealed that that more medication taken, female gender, lower functional status (beta = 0.34, P < 0.001) and higher depressive symptoms were independent predictors of poor nutritional status, with the full model accounting for 48.2% of the variance. The result is in-line with the original theoretical underpinnings and it suggests that this refined framework detailing sub-concepts and measurable indices appears to fit the empirical data and suitable for clinical use. Conclusion. The findings lend support to the use of this framework in managing malnutrition in older people. Relevance to clinical practice. Nurses have an essential role in providing care for older people a framework like this would provide a road map guiding the intervention efforts.
Trajectories of caregiver depressive symptoms while providing end-of-life care
(2013-12-01)
Tang, Siew Tzuh
;
Huang, Guan-Hua
;
Wei, Yu-Chung
;
Chang, Wen-Cheng
;
Chen, Jen-Shi
ObjectiveThe course of caregivers' depressive symptoms may not be homogenous. This study identified trajectories of depressive symptoms among caregivers providing end-of-life care to cancer patients and profiled the unique characteristics of caregivers within each trajectory. MethodsTrajectories of depressive symptoms were explored in 447 caregivers who completed the Center for Epidemiological Studies Depression Scale over four periods close to the patient's death (1-30, 31-90, 91-180, and >180days). Distinct trajectories were identified by latent class analysis. ResultsFour trajectories were identified as endurance, resilience, moderately symptomatic, and chronically distressed and contained 32.0%, 11.4%, 36.9%, and 19.7% of the sample, respectively. Caregivers in the endurance trajectory were relatively well-adjusted individuals with less education, adequate financial support, and ample psychological resources but provided care to older patients with greater symptom distress. They perceived less subjective caregiving burden than caregivers with moderate or chronic depressive symptoms. Caregivers in the resilience trajectory were in a more vulnerable position than those in other trajectories when they first transitioned into the caregiving role because they were more likely to be the patient's spouse, have greater educational attainment and insufficient finances, provide higher intensity assistance to a younger relative, and have weaker psychological resources. However, they were older, reported greater confidence in caregiving, and perceived less caregiving burden than caregivers in other trajectories. The moderately symptomatic and chronically distressed trajectories were differentiated only by the strength of psychological resources. ConclusionsCaregivers of terminally ill cancer patients follow distinct depressive-symptom trajectories while providing end-of-life care. Copyright (c) 2013 John Wiley & Sons, Ltd.