Two empirical studies were conducted to test the facilitating effect of need-supportive parenting (NSP) on Taiwanese adolescents' individuating autonomy (IA) and relating autonomy (RA) as well as to ...investigate the mediating effect of IA and RA on the relationship between NSP and adaptation. Study 1 adopted a cross-sectional design and found that (1) NSP was positively related to adolescents' IA and RA capacity; and (2) the positive effects of NSP on intrapersonal adaptation (i.e., self-esteem and happiness) and interpersonal adaptation (i.e., empathy and reciprocal filial piety) were superiorly mediated by IA and RA, respectively. Study 2 used a longitudinal design and added negative criteria (i.e., anxiety and depression for intrapersonal maladaptation, and hostility and delinquent behavior for interpersonal maladaptation). Hierarchical linear modeling analyses indicated that (1) NSP not only positively contributed to Taiwanese adolescents' IA and RA, but also facilitated the change rate of IA and RA; (2) the changes in IA and RA within individuals over time were related to the changes in intrapersonal and interpersonal criteria, respectively; and (3) IA primarily mediated the effects of NSP on both intrapersonal adaptation and maladaptation, while RA mediated the effects of NSP on both interpersonal adaptation and maladaptation. Limitations and future directions are discussed.
Bottom-up and governance paradigms are becoming more prevalent in rural community planning in East Asia. Rural communities must enhance their institutional capacities, which are the baseline for ...planning future changes. However, few studies have analyzed the relationship between institutional capacity and rural community planning. Using a quantitative method of event history analysis, we compared the hazards of establishing conferences and plan approval from the Sato-dzukuri of Kobe City, Japan. We examined the effect of institutional capacity on rural community planning for the conference establishment and plan approval. We found that knowledge resources and relational resources are related to the proxy mobilization capacity for conference establishment. These resources are related to plan approval, although no relationship exists between conference establishment and plan approval. Conferences can be planned more rapidly than plans for approval can be, although both require substantial time. Communities with rural contexts present more rapid conference establishment than do suburban areas, whereas there are no significant differences in plan approval. This suggests that rural communities require more effort for the plan approval process. Rural community planning should judiciously address issues of institutional capacity regarding restrained knowledge resources and progress management, and should maintain vigilance regarding administration to achieve local governance.
Background: Dyspnea is the most common and distressing symptom of heart failure (HF). Evidence from empirical studies has shown that multiple factors apart from pathophysiological changes may ...influence this symptom. Purpose: This study explored the moderating effect of psychosocial factors between clinical characteristics and dyspnea in patients with HF. To assess the potential effects of cultural background, this study also compared differences in psychosocial factor moderating effects between HF patients in Taiwan and the United States. Methods: We recruited patients with HF from outpatient clinics in Taiwan and the United States. Data were collected at clinics and research centers. Dyspnea was measured using the modified pulmonary function status and dyspnea questionnaire. Psychosocial factors considered were depression, anxiety, perceived control, and perceived social support. These factors were measured using the Brief Symptom Inventory, Revised Control Attitudes Scale, and Multidimensional Scale of Social Support Scale, respectively. Multiple regressions with interaction effect analysis tested the moderator effects across these two groups. Results: Ninety-seven Taiwanese (mean age = 66.2 ± 12.1 years; 76%male; 28% NYHA New York Heart Association III/IV) and 96 American (mean age = 61.6 ± 11.7 years; 74% male; 42% NYHA III/IV) patients participated. In Taiwanese patients, only perceived social support (B = .08, p = .034) moderated the relationship between clinical variables and dyspnea. In American patients, depression (B = .75, p = .028) and anxiety (B = .85, p = .041) were moderators of the relationship between clinical status and dyspnea severity. Conclusions/Implications for Practice: Depression, anxiety, and perceived social support moderated the relationship of clinical characteristics with dyspnea in Taiwanese and American HF patients, respectively. Attention to these psychosocial factors may improve dyspnea status in HF patients. Symptom management should include a focus on patients' psychological distress and social perspectives.
Breast cancer is a major threat to Taiwanese women's health. Despite the controversy surrounding the effectiveness of breast self-examination (BSE) in reducing mortality, BSE is still advocated by ...some health departments. The aim of the study is to provide information about how women decide to practice BSE and their experiences through the training process. Sixty-six women aged 27-50 were recruited.
A descriptive study was conducted using small group and individual in-depth interviews to collect data, and using thematic analysis and constant comparison techniques for data analysis.
It was found that a sense of self-security became an important motivator for entering BSE training. The satisfaction in obtaining a sense of self-security emerged as the central theme. Furthermore, a ladder motivation model was developed to explain the participants' motivations for entering BSE training. The patterns of motivation include opportunity taking, clarifying confusion, maintaining health, and illness monitoring, which were connected with the risk perception for breast cancer.
We recognize that the way women decide to attend BSE training is influenced by personal and social factors. Understanding the different risk assessments women rely on in making their health decisions is essential. This study will assist researchers and health professionals to gain a better understanding of alternative ways to deal with breast health, and not to be limited by the recommendations of the health authorities.
Background/Purpose Early detection and intervention of psychosis is clinically important. This study aimed to test the applicability of the Chinese version of the Prodromal Questionnaire (CPQ) for ...identifying prodromal states of psychosis. Methods This is a two-group cross-sectional comparative study. The Prodromal Questionnaire (PQ) was translated into traditional Chinese based on Brislin's Revised Model. Like the PQ, the CPQ provides results on four subscales: (1) positive symptoms, (2) negative symptoms, (3) disorganized symptoms, and (4) general symptoms. An expert panel of five senior psychiatrists established the content validity of the CPQ. The experimental group was a sample of 100 first-visit patients to a psychiatric outpatient department (FVPOD). The comparison group comprised 98 nursing students without any history of psychiatric disturbances. Both the CPQ and the Chinese Health Questionnaire-12 were administered to all 198 subjects. Clinical psychosis was assessed using the Chinese version of the Diagnostic Interview for Genetic Studies, and 30 of the 100 FVPOD subjects were thus identified as psychotic patients and the remaining 70 were non-psychotic. Results Content validity of the CPQ was confirmed by an expert panel of five senior psychiatrists, achieving an overall reliability in the range of 0.86-0.93. The FVPOD group and comparison group had significantly different mean scores on all four subscales of the CPQ. In identifying psychotic cases, the 35-item positive symptom subscale had high sensitivity (97%) and low specificity (30%) with a cutoff value of 8. Due to the low specificity, patients identified as potential psychotic cases were referred for further clinical evaluation. Conclusion Applicability of the CPQ was demonstrated by its high reliability and good ability to discriminate between clinical patients and a comparison group. The 35-item positive symptom subscale can be useful alone in general mental health settings for screening psychotic cases.
Abstract Objective This study explored (1) physicians’ perceptions of pelvic examination (PE) procedures and (2) the discrepancy between physicians’ perceptions and their practices as observed by ...their attending nurses. Method Data were collected from 20 physician-completed questionnaires on the perceived importance of 23 PE procedures. Each physician’s practice of the same 23 PE procedures was assessed by 4–6 attending nurses (100 nurse observations). Physicians and nurses were sampled by convenience from the obstetrics/gynecology outpatient departments of 3 teaching hospitals in central Taiwan. Discrepancies between physicians’ perceptions and their practices as assessed by attending nurses were examined by the Mann–Whitney U test. Results Physicians’ mean scores ranged from 3.15 to 4.00, indicating that PE procedures were generally perceived as important. The procedures were rank ordered according to the mean scores from highest to lowest. Physicians’ 5 top-ranking procedures were wearing gloves during the PE, asking agreement for the examination, paying attention to privacy during the PE, protecting the woman’s personal information, and protecting the woman’s medical records. Physicians’ 5 lowest ranking procedures were telling the woman before inserting the speculum that she will feel some pressure, explaining the procedure before the PE, proactively providing information, asking the woman how she feels during the PE, asking a woman’s permission to examine prior to commencing the PE, and describing observations to the woman during the PE (the last two procedures were tied for 5th rank). For 15 of the 23 PE procedures, physicians’ perceptions did not differ significantly from their practices as assessed by attending nurses. The remaining 8 procedures were statistically significant between physicians’ perception and their practices, and were rated higher by physicians (perception) than by attending nurses (practice). Conclusion The 5 top-ranking PE procedures in terms of perceived importance were related to procedural behaviors, whereas the 5 lowest ranking procedures were verbal statements with explicit affective content. During nurse-observed PEs, Taiwanese physicians consistently practiced the procedural aspects of PEs they perceived as important (e.g., communication and consultation, protection and skilled technique, and confidentiality). However, physicians’ practices were less consistent in affective aspects (e.g., explanation and consent, information and instruction, and sensitivity). Practice implications Our results suggest that physicians should concentrate not only on procedural behaviors, but also on affective behaviors. These findings could be incorporated in medical education, particularly for medical students training to become obstetric and gynecological physicians.
Dyspnea is a distressing and functionally limiting symptom that patients with heart failure commonly experience. A valid instrument to quantify dyspnea for comparison of groups and for illness ...management is important.
To validate the Chinese version of the Modified Pulmonary Functional Status and Dyspnea Questionnaire.
The Chinese version was developed by using translation and back translation and was tested in Taiwan in 88 patients who had heart failure but no pulmonary disease or comorbid conditions limiting physical function. Data on a Taiwanese subsample (n=30) were compared with data on 30 patients in the United States matched by sex, age, and severity of disease to determine the equivalence of the Chinese and English versions. Construct validity was assessed by testing the hypothesis that health-related quality of life measured by using the Minnesota Living With Heart Failure Questionnaire is associated with the score on the dyspnea questionnaire. Reliability was assessed by using the Cronbach alpha and item-total correlations.
Equivalence between the US and Taiwanese samples was high, from 0.67 to 0.91 for each item of the questionnaire and for the total score. Satisfactory correlations between the Chinese dyspnea and the Minnesota questionnaires, especially in the physical dimension (r=0.71, P<.001), provided support for the construct validity of the Chinese questionnaire. Reliability of the Chinese questionnaire was adequate (alpha=0.94).
The Chinese Modified Pulmonary Functional Status and Dyspnea Questionnaire is a reliable and valid measure for dyspnea that can be used in Taiwanese patients with heart failure.
This paper explores the trend of educational opportunity competition at different educational levels over different birth cohorts, examines the effect of cohort size on the competition for ...educational opportunity at different, educational level, and tests whether the effect of cohort size on competition for educational opportunity differs by educational reform stages. With data from Education Statistics of the Republic of China, 1958-2010, a multilevel growth curve analysis is employed to analyze the relationships between birth cohort size and competition for educational opportunity at different educational levels, and to assess whether its relationship changes across educational reform stages. The results reveal that birth cohort size has a negative effect on the competition for educational opportunity at the junior high school level, no significant effect at the senior high school level, and a positive effect at the college level when holding the effect of educational reform constant. Moreover, the effect o
The aim of this study is to examine the geographic patterning of suicide rates across townships and the temporal evolution from 1980 to 2000 in Taiwan and to shed light on the appropriateness of ...spatial clustering mechanisms of local suicide rates in Taiwan, including both Durkheim's structural hypothesis and Tarde's imitation hypothesis. A spatial analysis of data from a mortality database and population and housing census data of Taiwan from 1980 to 2000 was conducted. The results of exploratory spatial data analysis show that township-level suicide rates exhibit significant spatial dependence in Taiwan. Clusters of high suicide rates are found in aboriginal areas and east townships, whereas those of low rates are detected in the metropolitan areas. The degree of spatial dependence of local suicide rates in Taiwan has weakened from 1980 to 2000. Controlling for effects of social fragmentation and resource deprivation, local suicide rates still manifest persistent spatial clustering patterns. The Lagrange Mu
Objectives: The aim of this study was to explore the spatial patterns of suicide by jumping in Taiwan and to examine the effects of the availability of high-rise buildings on suicide completers' ...propensity to jump from heights. Methods: Data on all completed suicides during the period 1994-2007 (n=50,705) were derived from the cause of death database provided by the Department of Health, Executive Yuan, Taiwan. The proportion of high-rise building at the township-level (n=358) came from the 2000 census of population and housing. Exploratory spatial data analysis methods were used to investigate the spatial patterns of proportions of suicide by jumping and high-rise buildings. Multilevel logistic regressions were employed to assess the association between the township-level availability of high-rise buildings and the individual's choice of suicide methods. Results: The proportion of suicide by jumping showed a significant spatial dependence (Moran's I=0.551, p＜0.001). Hot spots were detected in Keelung-Taipei-
PDF
