lui chang - Academia.edu (original) (raw)

Papers by lui chang

Research paper thumbnail of Prevalence and impact on quality of life of lower urinary tract symptoms among a sample of employed women in Taipei: A questionnaire survey

Background: Previous studies about the prevalence and impact of lower urinary tract symptoms (LUT... more Background: Previous studies about the prevalence and impact of lower urinary tract symptoms (LUTS) were focused on urinary incontinence or overactive bladder in the general population. Little research has been focused on the role that the workplace has in employed women's experiences with LUTS or the impact of LUTS on their health-related quality of life (HRQL). Objectives: To estimate the prevalence of LUTS among employed female nurses in Taipei and to compare the HRQL for nurses with and without LUTS. Design: This study was a cross-sectional, questionnaire survey. Settings: Three medical centers and five regional hospitals in Taipei were selected randomly. Participants: In the selected hospitals, 1065 female nurses were selected randomly. Data analyses were based on 907 usable surveys. All participants were native Taiwanese; most of the female nurses were 26-35 years of age (mean = 31.02, SD = 6.32), had normal body mass index, and had never given birth. Most nurses' bladder habits were poor or very poor and their personal habits of fluid consumption at work were inadequate. Methods: Data were collected using the Taiwan Nurse Bladder Survey and the Short Form 36 Taiwan version. Chi-square tests were used to compare the prevalence rates of different LUTS for nurses in different age groups. Student's t-tests were conducted to compare the mean scores of HRQL for nurses with and without LUTS. Results: Based on 907 usable surveys, 590 (65.0%) experienced at least one type of LUTS. The prevalence for different LUTS ranged from 8.0% to 46.5%. Nurses who reported LUTS also reported lower HRQL, more so on physical health than mental health, than nurses who did not report LUTS. Conclusions: Although most of the nurses in this study were young (235 years) and nulliparous, LUTS were common among this group. The high prevalence rate of LUTS leads to concerns about nurses' possible dysfunctional voiding patterns and possible effects of working environment and poor bladder and personal habits on LUTS. Study results showed

Research paper thumbnail of Psychometric evaluation of the Taiwanese version of the Kiddo-KINDL® generic children’s health-related quality of life instrument

Quality of Life Research, 2008

Background Health-related quality of life measures are increasingly being used in evaluating heal... more Background Health-related quality of life measures are increasingly being used in evaluating health care outcome around the world. There is a demand for the development of quality of life measures to be used cross-culturally. The aim of this study is to evaluate the psychometric properties of the Taiwanese version of Kiddo-KINDL Ò , a healthrelated quality of life questionnaire. Methods The original German-version of Kiddo-KINDL Ò was translated into Chinese (Taiwanese) via the forward/backward translation process. Psychometric testing was performed with a national sample of 1,985 healthy students between the ages of 12 and 16. Data were analyzed based on 1,675 usable questionnaires. Results The reliability coefficients were a = 0.81 (overall) and-0.31 to 0.84 for six subscales. The subscales with low Cronbach's a were ''school'' and ''friends.'' Test-retest reliability was 0.77. Convergent validity was examined with the broadly used Taiwanese version of the Adolescent Depressive Mood Self-Detecting Scale. The result was satisfactory. Construct validity was further examined with exploratory factor analysis. The six-factor solution explained 45.2% of the variance. The construct of Kiddo-KINDL Ò (Taiwanese version) appeared to be appropriate for measuring health-related quality of life in healthy adolescents. Conclusions Kiddo-KINDL Ò (Taiwanese version) is a relatively reliable and valid questionnaire of adolescents' health-related quality of life. However, items in the ''school'' and ''friends'' subscales need to be further modified to be more culturally appropriate.

Research paper thumbnail of Perceptions of Exercise in Obese School-Aged Children

Journal of Nursing Research, 2009

Although the prevalence of obesity continues to increase worldwide, information related to obese ... more Although the prevalence of obesity continues to increase worldwide, information related to obese school-aged children's perceptions of exercise remains limited. This study aimed to explore perceptions of exercise held by obese school-aged children. This study used a qualitative research design. Using purposive sampling, 11 obese students who were 11 to 13 years old, currently enrolled at two primary schools, and in the precontemplation stage were recruited from a total population of 1,714 to participate in the study. An interview guide with five open-ended questions was used to guide focus group discussions. Data were analyzed using content analysis to identify significant themes. Six themes emerged from collected data, including (a) positive impressions about doing exercise, (b) recognition of negative effects associated with not doing exercise, (c) feelings of discomfort after exercise, (d) self-ambivalence, (e) false beliefs about exercise, and (f) making excuses for not doing exercise. Study findings provided information giving a better understanding of exercise perceptions among obese children. Such may be used to assist obese children to increase exercise levels as part of efforts to improve health in this vulnerable population.

Research paper thumbnail of Support groups for caregivers of intellectually disabled family members: effects on physical-psychological health and social support

Journal of Clinical Nursing, 2012

Research paper thumbnail of The Effects of a Support Group on Dementia Caregivers’ Burden and Depression

Journal of Aging and Health, 2010

Objective: The aim of the study is to investigate the effects of a support group on depression le... more Objective: The aim of the study is to investigate the effects of a support group on depression levels and burden among dementia caregivers in Taiwan. Method: An experimental, pre-intervention postintervention control group design was used in this study. The experimental group received intervention consisting of a 12-week support group for dementia caregivers. A total of 85 subjects were evaluated before intervention, after intervention, and at 1-month follow-up. Results: (a) The depression level of participants in the experimental group was significantly decreased after the intervention and at 1-month follow-up. (b) There was no significant difference in caregiver’s burden after the support group intervention and 1-month follow-up. Discussion: The improvement in dementia caregivers’ depression levels shows that the support group was effective for reducing caregivers’ depression although not effective for relieving their burden of care.

Research paper thumbnail of The development and psychometric testing of East Asian Acculturation Scale among Asian immigrant women in Taiwan

Ethnicity & Health, 2013

This is a report of development and psychometric testing of the East Asian Acculturation Measure-... more This is a report of development and psychometric testing of the East Asian Acculturation Measure-Chinese version (EAAM-C) scale. An instrument validation design with a cross-sectional survey was conducted. The process was carried in two phases. In Phase 1, Barry's East Asian Acculturation Measure was translated and back translated to evaluate its content, face validity, and feasibility validity. In Phase 2, the 16-item EAAM-C was pilot-tested among 485 female immigrants for test-retest reliability, internal consistency, theoretically-supported construct validity and concurrent validity. The pilot work and the survey results indicated the tools possessed adequate content and face validity. The Cronbach's Alphas for the EAAM-C was 0.72, and 0.76-0.79 for its subscales, and the correlation of test-retest reliability (at 3 weeks) was 0.75. After dropping one item, four theoretically-supported factors which explained 61.82% of the variance were abstracted using exploratory factor analysis: assimilation, integration, separation, and marginalization. Based on the underlying four-factor theoretical structures of the EAAM, the confirmatory factor analysis of the EAAM-C was further examined. The analysis revealed that the four-factor model was an acceptable fit for the data which demonstrated adequate finding in its construct validity. These factors were inter-correlated, and showed statistically significant correlation with the Chinese Health Questionnaire, indicating adequate concurrent validity. The scale shows acceptable validity and consistency, and suggests that immigrant acculturation is a complex construct. This quick evaluation instrument can be applied to assess clients' acculturation and in further developing certain interventions to improve their health.

Research paper thumbnail of The Relationship Between Light Exposure and Sleep, Fatigue, and Depression in Cancer Outpatients

Cancer Nursing, 2013

Light is an important cue for the entrainment of circadian rhythms, which can be related to sleep... more Light is an important cue for the entrainment of circadian rhythms, which can be related to sleep quality, fatigue, and depression in cancer patients. The purpose of this study was to determine the effects of light exposure on sleep quality, fatigue, and depression in cancer patients, to test whether the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. This was a cross-sectional study for which we recruited 163 cancer outpatients. For 3 consecutive days, they wore an Actiwatch to measure light exposure. Instruments included the Pittsburgh Sleep Quality Index-Taiwan form, the Brief Fatigue Inventory-Taiwan form, and the Beck Depression Inventory II-Taiwan version. The results indicated that the Pittsburgh Sleep Quality Index-Taiwan form score was significantly and negatively correlated with minutes of light exposure (MLE) of 1000 lux or greater (r = -0.61, P < .001) and the intensity of light exposure under activity (r = -0.59, P < .001). Fatigue was negatively correlated with MLE (r = -0.18, P = .03). Depression was also negatively correlated with MLE and intensity of light exposure (both r = -0.18, P = .02). Most important, the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. Light exposure appeared to be a shared factor for the co-occurrence of fatigue, sleep disturbances, and depression. Light exposure has great potential for improving sleep quality as well as ameliorating fatigue and depression in cancer outpatients.

Research paper thumbnail of Family Influence on Self-Care, Quality of Life, and Metabolic Control in School-Age Children and Adolescents with Type 1 Diabetes

Journal of Pediatric Nursing, 2007

This study explored the influence of family behaviors on self-care, quality of life (QoL), and me... more This study explored the influence of family behaviors on self-care, quality of life (QoL), and metabolic control in school-age children and adolescents with type 1 diabetes. Ninety-nine participants were recruited in the midsouth from a health science center and an affiliated diabetes camp. Warm and caring family behaviors predicted self-care behaviors and aspects of QoL for the participants. African American school-age children and adolescents had more worries related to diabetes and had poorer metabolic control than Caucasians. Nursing implications included emphasizing open family communication and providing emotional support for diabetes management to promote developmentally appropriate levels of self-care and QoL.

Research paper thumbnail of Prevalence and impact on quality of life of lower urinary tract symptoms among a sample of employed women in Taipei: A questionnaire survey

Background: Previous studies about the prevalence and impact of lower urinary tract symptoms (LUT... more Background: Previous studies about the prevalence and impact of lower urinary tract symptoms (LUTS) were focused on urinary incontinence or overactive bladder in the general population. Little research has been focused on the role that the workplace has in employed women's experiences with LUTS or the impact of LUTS on their health-related quality of life (HRQL). Objectives: To estimate the prevalence of LUTS among employed female nurses in Taipei and to compare the HRQL for nurses with and without LUTS. Design: This study was a cross-sectional, questionnaire survey. Settings: Three medical centers and five regional hospitals in Taipei were selected randomly. Participants: In the selected hospitals, 1065 female nurses were selected randomly. Data analyses were based on 907 usable surveys. All participants were native Taiwanese; most of the female nurses were 26-35 years of age (mean = 31.02, SD = 6.32), had normal body mass index, and had never given birth. Most nurses' bladder habits were poor or very poor and their personal habits of fluid consumption at work were inadequate. Methods: Data were collected using the Taiwan Nurse Bladder Survey and the Short Form 36 Taiwan version. Chi-square tests were used to compare the prevalence rates of different LUTS for nurses in different age groups. Student's t-tests were conducted to compare the mean scores of HRQL for nurses with and without LUTS. Results: Based on 907 usable surveys, 590 (65.0%) experienced at least one type of LUTS. The prevalence for different LUTS ranged from 8.0% to 46.5%. Nurses who reported LUTS also reported lower HRQL, more so on physical health than mental health, than nurses who did not report LUTS. Conclusions: Although most of the nurses in this study were young (235 years) and nulliparous, LUTS were common among this group. The high prevalence rate of LUTS leads to concerns about nurses' possible dysfunctional voiding patterns and possible effects of working environment and poor bladder and personal habits on LUTS. Study results showed

Research paper thumbnail of Psychometric evaluation of the Taiwanese version of the Kiddo-KINDL® generic children’s health-related quality of life instrument

Quality of Life Research, 2008

Background Health-related quality of life measures are increasingly being used in evaluating heal... more Background Health-related quality of life measures are increasingly being used in evaluating health care outcome around the world. There is a demand for the development of quality of life measures to be used cross-culturally. The aim of this study is to evaluate the psychometric properties of the Taiwanese version of Kiddo-KINDL Ò , a healthrelated quality of life questionnaire. Methods The original German-version of Kiddo-KINDL Ò was translated into Chinese (Taiwanese) via the forward/backward translation process. Psychometric testing was performed with a national sample of 1,985 healthy students between the ages of 12 and 16. Data were analyzed based on 1,675 usable questionnaires. Results The reliability coefficients were a = 0.81 (overall) and-0.31 to 0.84 for six subscales. The subscales with low Cronbach's a were ''school'' and ''friends.'' Test-retest reliability was 0.77. Convergent validity was examined with the broadly used Taiwanese version of the Adolescent Depressive Mood Self-Detecting Scale. The result was satisfactory. Construct validity was further examined with exploratory factor analysis. The six-factor solution explained 45.2% of the variance. The construct of Kiddo-KINDL Ò (Taiwanese version) appeared to be appropriate for measuring health-related quality of life in healthy adolescents. Conclusions Kiddo-KINDL Ò (Taiwanese version) is a relatively reliable and valid questionnaire of adolescents' health-related quality of life. However, items in the ''school'' and ''friends'' subscales need to be further modified to be more culturally appropriate.

Research paper thumbnail of Perceptions of Exercise in Obese School-Aged Children

Journal of Nursing Research, 2009

Although the prevalence of obesity continues to increase worldwide, information related to obese ... more Although the prevalence of obesity continues to increase worldwide, information related to obese school-aged children's perceptions of exercise remains limited. This study aimed to explore perceptions of exercise held by obese school-aged children. This study used a qualitative research design. Using purposive sampling, 11 obese students who were 11 to 13 years old, currently enrolled at two primary schools, and in the precontemplation stage were recruited from a total population of 1,714 to participate in the study. An interview guide with five open-ended questions was used to guide focus group discussions. Data were analyzed using content analysis to identify significant themes. Six themes emerged from collected data, including (a) positive impressions about doing exercise, (b) recognition of negative effects associated with not doing exercise, (c) feelings of discomfort after exercise, (d) self-ambivalence, (e) false beliefs about exercise, and (f) making excuses for not doing exercise. Study findings provided information giving a better understanding of exercise perceptions among obese children. Such may be used to assist obese children to increase exercise levels as part of efforts to improve health in this vulnerable population.

Research paper thumbnail of Support groups for caregivers of intellectually disabled family members: effects on physical-psychological health and social support

Journal of Clinical Nursing, 2012

Research paper thumbnail of The Effects of a Support Group on Dementia Caregivers’ Burden and Depression

Journal of Aging and Health, 2010

Objective: The aim of the study is to investigate the effects of a support group on depression le... more Objective: The aim of the study is to investigate the effects of a support group on depression levels and burden among dementia caregivers in Taiwan. Method: An experimental, pre-intervention postintervention control group design was used in this study. The experimental group received intervention consisting of a 12-week support group for dementia caregivers. A total of 85 subjects were evaluated before intervention, after intervention, and at 1-month follow-up. Results: (a) The depression level of participants in the experimental group was significantly decreased after the intervention and at 1-month follow-up. (b) There was no significant difference in caregiver’s burden after the support group intervention and 1-month follow-up. Discussion: The improvement in dementia caregivers’ depression levels shows that the support group was effective for reducing caregivers’ depression although not effective for relieving their burden of care.

Research paper thumbnail of The development and psychometric testing of East Asian Acculturation Scale among Asian immigrant women in Taiwan

Ethnicity & Health, 2013

This is a report of development and psychometric testing of the East Asian Acculturation Measure-... more This is a report of development and psychometric testing of the East Asian Acculturation Measure-Chinese version (EAAM-C) scale. An instrument validation design with a cross-sectional survey was conducted. The process was carried in two phases. In Phase 1, Barry's East Asian Acculturation Measure was translated and back translated to evaluate its content, face validity, and feasibility validity. In Phase 2, the 16-item EAAM-C was pilot-tested among 485 female immigrants for test-retest reliability, internal consistency, theoretically-supported construct validity and concurrent validity. The pilot work and the survey results indicated the tools possessed adequate content and face validity. The Cronbach's Alphas for the EAAM-C was 0.72, and 0.76-0.79 for its subscales, and the correlation of test-retest reliability (at 3 weeks) was 0.75. After dropping one item, four theoretically-supported factors which explained 61.82% of the variance were abstracted using exploratory factor analysis: assimilation, integration, separation, and marginalization. Based on the underlying four-factor theoretical structures of the EAAM, the confirmatory factor analysis of the EAAM-C was further examined. The analysis revealed that the four-factor model was an acceptable fit for the data which demonstrated adequate finding in its construct validity. These factors were inter-correlated, and showed statistically significant correlation with the Chinese Health Questionnaire, indicating adequate concurrent validity. The scale shows acceptable validity and consistency, and suggests that immigrant acculturation is a complex construct. This quick evaluation instrument can be applied to assess clients' acculturation and in further developing certain interventions to improve their health.

Research paper thumbnail of The Relationship Between Light Exposure and Sleep, Fatigue, and Depression in Cancer Outpatients

Cancer Nursing, 2013

Light is an important cue for the entrainment of circadian rhythms, which can be related to sleep... more Light is an important cue for the entrainment of circadian rhythms, which can be related to sleep quality, fatigue, and depression in cancer patients. The purpose of this study was to determine the effects of light exposure on sleep quality, fatigue, and depression in cancer patients, to test whether the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. This was a cross-sectional study for which we recruited 163 cancer outpatients. For 3 consecutive days, they wore an Actiwatch to measure light exposure. Instruments included the Pittsburgh Sleep Quality Index-Taiwan form, the Brief Fatigue Inventory-Taiwan form, and the Beck Depression Inventory II-Taiwan version. The results indicated that the Pittsburgh Sleep Quality Index-Taiwan form score was significantly and negatively correlated with minutes of light exposure (MLE) of 1000 lux or greater (r = -0.61, P < .001) and the intensity of light exposure under activity (r = -0.59, P < .001). Fatigue was negatively correlated with MLE (r = -0.18, P = .03). Depression was also negatively correlated with MLE and intensity of light exposure (both r = -0.18, P = .02). Most important, the effect of light exposure on sleep quality, fatigue, and depression was mediated by the other 2 symptoms. Light exposure appeared to be a shared factor for the co-occurrence of fatigue, sleep disturbances, and depression. Light exposure has great potential for improving sleep quality as well as ameliorating fatigue and depression in cancer outpatients.

Research paper thumbnail of Family Influence on Self-Care, Quality of Life, and Metabolic Control in School-Age Children and Adolescents with Type 1 Diabetes

Journal of Pediatric Nursing, 2007

This study explored the influence of family behaviors on self-care, quality of life (QoL), and me... more This study explored the influence of family behaviors on self-care, quality of life (QoL), and metabolic control in school-age children and adolescents with type 1 diabetes. Ninety-nine participants were recruited in the midsouth from a health science center and an affiliated diabetes camp. Warm and caring family behaviors predicted self-care behaviors and aspects of QoL for the participants. African American school-age children and adolescents had more worries related to diabetes and had poorer metabolic control than Caucasians. Nursing implications included emphasizing open family communication and providing emotional support for diabetes management to promote developmentally appropriate levels of self-care and QoL.