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      • Factors Predicting Nurse Intent and Status Regarding Pap Smear Examination in Taiwan: a Cross-sectional Survey

        Chen, Shu-Ling,Tsai, Shu-Fang,Hsieh, Mei-Mei,Lee, Lin-Lin,Tzeng, Ya-Ling Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1

        Background: Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. Materials and Methods: Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. Results: Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. Conclusions: Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.

      • SCIESCOPUSKCI등재
      • KCI등재

        Overexpression of Ornithine Decarboxylase Suppresses Thapsigargin-Induced Apoptosis

        Hsieh, Wei-Chung,Hsu, Pei-Chen,Liao, Ya-Fan,Young, Shu-Ting,Wang, Zeng-Wei,Lin, Chih-Li,Tsay, Gregory J.,Lee, Huei,Hung, Hui-Chih,Liu, Guang-Yaw Korean Society for Molecular and Cellular Biology 2010 Molecules and cells Vol.30 No.4

        Ornithine decarboxylase (ODC), the key enzyme of polyamine biosynthesis, has paradoxical roles in apoptosis. Our published papers show overexpression of ODC prevents the apoptosis induced by many cytotoxic drugs. Thapsigargin (TG) is an inhibitor of the sarcoplasmic/endoplasmic reticulum (ER) $Ca^{2+}$ ATPase (SERCA) pumps and causes ER stress-induced apoptosis. We used ODC overexpressing cell lines to examine whether overexpression of ODC inhibits TG-induced apoptosis. Our results indicated overexpression of ODC attenuated TG-induced apoptosis. Overexpression of ODC blocked procaspse-4 cleavage and phosphorylation of protein kinase-like ER-resident kinase (PERK), triggered by TG. It also attenuated the increase in CAAT/enhancer binding protein homologous protein (CHOP). Cells with overexpressed ODC had greater Bcl-2 expression. Overexpression of ODC preserved the expression of Bcl-2, inhibited the increase in Bak and stabilized mitochondrial membrane potential without the influences of TG. Cytochrome c release and downstream caspase activation were blocked. That is, overexpression of ODC inhibits the mitochondria-mediated apoptotic pathway, induced by TG. Finally, overexpression of ODC maintains the protein and mRNA expression of SERCA. In conclusion, overexpression of ODC suppresses TG-induced apoptosis by blocking caspase-4 activation and PERK phosphorylation, attenuating CHOP expression and inhibiting the mitochondria-mediated apoptotic pathway.

      • KCI등재

        Self-Management Programs on eGFR, Depression, and Quality of Life among Patients with Chronic Kidney Disease: A Meta-Analysis

        Mei-Chen Lee,Shu-Fang Vivienne Wu,Nan-Chen Hsieh,Juin-Ming Tsai 한국간호과학회 2016 Asian Nursing Research Vol.10 No.4

        Purpose: Chronic kidney disease (CKD) is a condition characterized by the gradual loss of kidney function over time. Self-management programs have been widely applied to chronic disease education programs, which are designed to delay deteriorating kidney functions, preclude depression, and improve quality of life. This study aims to analyze effectiveness of self-management programs in bettering CKD patients' eGFR, mitigating depression symptoms and improving quality of life in randomized control or clinical trials. Methods: Using key terms, a search was conducted in English-language, peer-reviewed journals on CKD that were published between 2002 and 2014 on databases including CINAHL, Cochrane Library, MEDLINE. The measurable variables included CKD patients' eGFR, depression, and quality of life. Random and fixed effects meta analysis were applied with standard error and correlation based measure of effect size. Results: Eight studies met the inclusion criteria. A self-management program significantly impacted CKD patients' depression and mental quality-of-life dimensions, with an effect size of .29 [95% confidence interval (CI) (0.07, 0.53)] and .42 [95% CI ( 0.75, 0.10)]. However, the intervention of a selfmanagement program had no significant effect on patients' eGFR as well as physical quality-of-life dimensions, with effect sizes of .06 [95% CI ( 0.69, 0.81)] and .16 [95% CI ( 0.81, 0.50)]. Conclusions: Self-management programs of patients with chronic kidney disease can improve the depression and mental quality of life. Aside from providing more objective evidence-based results, this study provides a reference for clinical health care personnel who tend to patients with CKD.

      • KCI등재

        Overexpression of Ornithine Decarboxylase Suppresses Thapsigargin-Induced Apoptosis

        Wei-Chung Hsieh,Pei-Chen Hsu,Ya-Fan Liao,Shu-Ting Young,Zeng-Wei Wang,Chih-Li Lin,Gregory J. Tsay,Huei Lee,Hui-Chih Hung,Guang-Yaw Liu 한국분자세포생물학회 2010 Molecules and cells Vol.30 No.4

        Ornithine decarboxylase (ODC), the key enzyme of poly-amine biosynthesis, has paradoxical roles in apoptosis. Our published papers show overexpression of ODC pre-vents the apoptosis induced by many cytotoxic drugs. Thapsigargin (TG) is an inhibitor of the sarcoplasmic/en-doplasmic reticulum (ER) Ca2+ ATPase (SERCA) pumps and causes ER stress-induced apoptosis. We used ODC overexpressing cell lines to examine whether overexpres-sion of ODC inhibits TG-induced apoptosis. Our results indicated overexpression of ODC attenuated TG-induced apoptosis. Overexpression of ODC blocked procaspse-4 cleavage and phosphorylation of protein kinase-like ER-resident kinase (PERK), triggered by TG. It also attenuated the increase in CAAT/enhancer binding protein homolo-gous protein (CHOP). Cells with overexpressed ODC had greater Bcl-2 expression. Overexpression of ODC pre-served the expression of Bcl-2, inhibited the increase in Bak and stabilized mitochondrial membrane potential without the influences of TG. Cytochrome c release and downstream caspase activation were blocked. That is, overexpression of ODC inhibits the mitochondria-medi-ated apoptotic pathway, induced by TG. Finally, overex-pression of ODC maintains the protein and mRNA expres-sion of SERCA. In conclusion, overexpression of ODC suppresses TG-induced apoptosis by blocking caspase-4 activation and PERK phosphorylation, attenuating CHOP expression and inhibiting the mitochondria-mediated apoptotic pathway.

      • KCI등재

        Survival benefit of patients with early-stage ovarian carcinoma treated with paclitaxel chemotherapeutic regimens

        Chien-An Chen,Chun-Ju Chiang,Yun-Yuan Chen,San-Lin You,Shu-Feng Hsieh,Chao-Hsiun Tang,Wen-Fang Cheng 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.1

        Objective: Adjuvant chemotherapy was introduced in patients with early-stage ovarian cancer (OC). The benefit of standard chemotherapeutic regimens including taxane has not been established. Methods: Patients with early-stage OC from the National Health Insurance Research database of Taiwan who received platinum plus cyclophosphamide (CP) or platinum plus paclitaxel (PT) for 3–6 cycles were recruited, and the disease-free survival (DFS) and overall survival (OS) were determined. Results: A total of 1,510 early-stage OC patients, including 841 who received CP regimen and 699 who received PT regimen, were included. The 2 groups had a similar estimated probability of 5-year DFS (PT vs. CP, 79.0% vs. 77.6%; p=0.410) and OS (84.6% vs. 84.3%; p=0.691). Patients >50 years of age who received the CP regimen had a lower 5-year DFS than the patients ≤50 years of age who received the CP (p<0.001) or PT regimens (p=0.001). Additionally, patients >50 years of age who received the CP regimen had a worse 5-year OS compared with the other 3 groups (p=0.019) (p=0.179 for patients >50 years of age in the PT group; p=0.002 for patients ≤50 years of age in the CP group; and p=0.061 for patients ≤50 years of age in the PT group). Patients with the CP or PT regimen for 3–5 cycles had a similar 5-year DFS and OS compared to 6 cycles (p>0.050). Conclusion: Chemotherapeutic regimens with taxane could be recommended for early-stage OC patients >50 years of age.

      • The Effect of a Scenario-Based Spiritual Care Course on Spiritual Care Competence among Clinical Nurses

        Suh-Ing Hsieh,Li-Ling Hsu,Hui-Ling Lin,Chen-Yi Kao,Yi-Ping Tseng,Li-Yun Szu,Ching-Yun Lee,Lun-Hui Ho,Shu-Ling Yeh,Shu-Hua Kao,Yen-Fang Chou,Tzu-Hsin Huang 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8

        Aim(s): Clinical nurses are facing patients’ biopsychosocial and spiritual problems at diverse clinical settings, but they are lack of knowledge, skills, and confidence on providing spiritual care. However, no studies adopted simulated educational program and objective structure clinical examination (OSCE) to educate nurses and to assess the outcomes. Therefore, this study was to validate the effect of a scenario-based spiritual care course on spiritual care competence in clinical nurses. Methods: This non-equivalent quasi-experimental study with a pre-test and two post-tests (end of the intervention and three months later) was conducted between August 2019 and February 2021 (11 sessions). The recruitment posters with a QR code were distributed to different units at three branches of a large medical institute for recruiting clinical nurses, who provided direct patient care. The attendees of one-day scenario-based spiritual care course are the experimental group (n=53) and the control group (n=85) was matched with the experimental group (1:1-3 ratio) by similar units, ages, working experience, and clinical ladder. Instruments include basic information, self-evaluated and head nurses evaluated spiritual care competence scale (SCCS), spiritual perspective scale (SPS), and spiritual care perspective scale-revised (SCPSR) for both groups and reflective log, course satisfaction scale, OSCE checklist, and standardized patient feedback scale for the experimental group. The data were analyzed using descriptive statistics, repeated measures ANOVA, linear regression, and paired t test. Results: After controlling for pre-test scores and interest in attending spirituality/spiritual care, the experimental group showed significant higher SPS (p=0.012) and self-evaluated SCCS (p=0.002) and lower SCPSR (p=0.015) than the control group at the 2nd post-test. Repeated measure ANOVA also showed significant within-subject effects across three time points of the experimental group on SPS (p<0.001), SCPSR (p<0.001), and self-evaluated SCCS (p<0.001), but paired t test showed non-significant differences on SPS, SCPSR, and self-evaluated SCCS between pre-test and post-test with an exception of head nurse evaluated SCCS (p=0.035). The mean overall course satisfaction of the experimental group was 4.34±0.62. The mean global performance of OSCE was 3.40±0.91 and the majority of experimental group was pass (43.4%) and good (35.8%). 64.5% and 26.1% of standardized patients were partial and strongly agreed with examinees’ performance in spiritual care assessment respectively. Conclusions: The scenario-based spiritual care course is effectively to enhance clinical nurses’ spiritual care competence. It may cultivate clinical preceptors with better spiritual care pedagogy through simulation and OSCE for bedside teaching of nurse post-graduate year.

      • Order Imbalances in Options and Volatility Risk Premium on Equity Index

        Chin-Ho Chen,Huimin Chung,Wen-Liang G. Hsieh,Shu-Fang Yuan 한국재무학회 2011 한국재무학회 학술대회 Vol.2011 No.09

        This study explores the impact of aggregate daily order imbalances in options on volatility risk premium on its underlying index. Two types of volatility risk premium, ex-post and ex-ante volatility risk premiums, are included to address this issue. Based on Taiwan stock index and options (TXO) data over the period from January 1, 2005 to December 31, 2009, several interesting results emerge. First, order imbalances in near-month options, especially for call options’, have a predominant influence on ex-post and ex-ante volatility risk premiums. Next, order imbalances of near-month options in either direction, excess buy orders or excess sell order, have distinct effect on volatility risk premium. Overall, the increased level of excess buy orders drives ex-post and ex-ante volatility risk premiums upward, but downward only for excess sell orders in call options. Finally, ex-post and ex-ante volatility risk premiums are positively related to order imbalances of near-month options in respond to continuous price variations. Nonetheless, there is no significant relation for index price jumps.

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