Correlates of fatigue phenomenon in palliative care patients with advance cancers in Taiwan.

Background: Fatigue is a multidimensional phenomenon that has different meanings according to different societal and cultural settings. This study aims to decipher fatigue in Taiwanese patients with cancer.

Methods: We recruited 440 patients with advanced cancer admitted consecutively to the palliative care unit of a major medical center in Taiwan.

Multi-source evaluation of interpersonal and communication skills of family medicine residents.

There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and teaching staffs and to compare the ratings with the objective structured clinical examination (OSCE). Our results revealed instruments used by staffs, peers, nurses, and self-evaluation have good internal consistency reliability (α > 0.

Can a good death and quality of life be achieved for patients with terminal cancer in a palliative care unit?

Background: Lack of evidence supporting the claim that palliative care can improve quality of life and promote good death in patients with terminal cancer.

Objectives: This study was designed to evaluate the change of quality of life and quality of death over time and between patients of long and short survival in a palliative care unit.

Methods: Patient demography, cancer sites, Eastern Cooperative Oncology Group (ECOG) status were collected at admission.

A quick dementia screening tool for primary care physicians.

The accuracy and consuming-time of screening methods are important factors in the early diagnosis of dementia. In this study, we aimed to know whether the eight-item test (including three-item recall, attention and calculation, subtracted from the mini-mental state examination (MMSE), clock drawing test (CDT), and instrumental activities of daily living (IADL) impairment or any combination of the above tests can be used as a quick and effective dementia screening tool. A total of 188 seniors aged over 60 years were enrolled at a geriatric clinic.

Assessment of behavioral and psychological symptoms of dementia by family caregivers.

This study was designed to test the performance and related factors of a self-administered instrument in assessing behavioral and psychological symptoms of dementia (BPSD) by family caregivers. We recruited 173 patients with dementia and major caregivers from two neurological clinics. Information about clinical diagnosis, the Mini Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), the Dementia Behavior Disturbance Inventory (DBDI), and global caregivers' strain were collected from interview and chart review.

What do laypersons consider as a good death.

Goals: This study was designed to understand laypersons' attitude of good death.

Materials And Methods: A 53-item Good-Death Questionnaire (GDQ) was generated by applying "good-death principles" and past research on good death in Chinese people.

Main Results: A total of 184 adults completed the questionnaire.

Validation of the Tutotest in a hybrid problem-based learning curriculum.

The Tutotest is one of the few structured instruments developed for the assessment of students' learning skills in a problem-based learning (PBL) curriculum. This study was designed to validate the Tutotest in a hybrid PBL curriculum. Forty-four tutors completed 370 evaluations on second to fourth year medical students at the end of the first semester in 2004 using the Chinese version of the Tutotest.

Acute pancreatitis and amiodarone: a case report.

Amiodarone, a class III antiarrhythmic drug, is one of the most effective drugs used in the treatment of ventricular and paroxysmal supraventricular tachyarrhythmia. Adverse effects of amiodarone including pulmonary toxicity, hepatotoxicity, aggravation of arrhythmia, and thyroid diseases are well understood. A 66-year old woman with acute pancreatitis was admitted to our hospital with the complaint of epigastralgia radiating to both flanks for two months.

Social support and family functioning on psychological symptoms in elderly Chinese.

The purpose of this study was to extend our knowledge about how social support and family functioning affect mental health, and to examine the buffering effects of support in the presence of health stressors. A random cluster sample of 507 elderly community people were surveyed with a structured questionnaire, which included the depression and anxiety subscale of the Chinese version of Symptom Checklist 90-R (SCL-90-R), Social Support Rating Scale (SSRS), Family Emotional Involvement and Criticism Scale (FEICS), Short Portable Mental Status Questionnaire (SPMSQ), and the Katz Activities of Daily Living Scale (KADL). Results revealed that women had more anxiety symptoms than men (mean=3.

Factors affecting students' evaluation in a community service-learning program.

A community service-learning curriculum was established to give students opportunities to understand the interrelationship between family and community health, the differences between community and hospital medicine, and to be able to identify and solve community health problems. Students were divided into small groups to participate in community health works such as home visits etc. under supervision.

Anatomy instruction in medical schools: connecting the past and the future.

Anatomy curriculum has changed dramatically around the world since the 1960s. These changes include the reduction of course hours, the abandonment of cadaver dissection, the use of problem-based learning, application of other teaching modalities such as prosected specimens, models, radiographic images, computer simulations, and the introduction of humanity and death education. This article discusses the controversies in anatomy curriculum in Western countries, including the rationale for those changes, and the opinions of the objections.

The influence of awareness of terminal condition on spiritual well-being in terminal cancer patients.

We developed a Spirituality Transcendence Measure (STM) and studied whether awareness of terminal illness affects spiritual well-being in terminal cancer patients. Three sources of spiritual transcendence--the situational, the moral and biographical, and the religious aspect--were assessed in the STM. Cronbach's alpha of the STM was 0.

Students' evaluation on a two-stage anatomy curriculum.

This study evaluated students' perspectives of the two-stage anatomy course, which is designed to retain the time-honored tradition of cadaver dissection and to include innovative components into anatomy education. A total of 94 sixth-year medical students completed a questionnaire survey at the end of the second stage anatomy course. The results showed that more than half of the students were satisfied with the two-stage anatomy course.

The development and validation of a dementia behavior disturbance inventory.

Objective: To develop an instrument that measures observable problematic behaviors in patients with dementia.

Methodology: We used focus group interviews to identify the problematic behaviors of patients with dementia. Eighty-two behaviors grouped into 12 domains were generated from the data collected from five different focus groups.

The use of focus groups in evaluating quality of life components among elderly Chinese people.

In Taiwan, to measure the quality of life (QOL) of elderly Chinese, one must rely on instruments developed in other Chinese or Western populations and not specifically for the elderly. The purpose of this study is to understand the components of QOL for elderly Chinese from Taiwan living in residential homes or in their communities. Forty-four elderly men and women divided into six focus groups were interviewed on video tape and the resultant recording was analyzed qualitatively by six independent researchers.

Development of a teaching style inventory for tutor evaluation in problem-based learning.

Objective: To develop and validate a self-rating instrument to assess teaching styles among tutors in problem-based learning (PBL).

Methods: The development of the teaching style inventory (TSI) was based theoretically on four types of teaching behaviours: the assertive, suggestive, collaborative and facilitative styles, as proposed by Bibace et al. A 35-item questionnaire was generated and evaluated for content validity by a group of experienced tutors.