Browsing by Author "Chang, Pei-Shiun"

Now showing 1 - 7 of 7
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    Daily Engagement in Meaningful Activity for Home Care Patients with Subjective Cognitive Decline and Caregivers
    (Oxford University Press, 2023-12-21) Lu, Yvonne; Ellis, Jennifer; Perkins, Susan; Hickman, Susan; Chang, Pei-Shiun; Haase, Joan; Otis, Laurie; Winton, Rebecca; School of Nursing
    Patients with subject cognitive decline (SCD) often lose sense of control, disengage from meaningful activities, and have less confidence in their ability to manage daily challenges. The objectives of pragmatic pilot phase study were to evaluate the feasibility and benefits of a Daily Engagement in Meaningful Activity Professional (DEMA-Pro) for patients with SCD; and explore nurses’ experience of DEMA-Pro implementation. Forty-nine patients at four home healthcare sites received six weekly DEMA-Pro telephone sessions. The Outcome and Assessment Information Set-D were collected at starting date (pre-intervention) and discharge date (post-intervention). Quantitative surveys and qualitative focus group methods were used to explore the DEMA-Pro nurses (n = 3) experiences. The consent rate was 67.1%, the completed intervention rate 36.7%, and the partial completed intervention rate 25.5%. For 36 subjects with discharge data available, both IADLs and self-care scores improved (d = 3.11 and d = 2.66, respectively). Specifically, those that completed all DEMA-Pro sessions (n=14), partial completers (n=12), and non-completers (n=10), had improved scores on IADLs (d = 4.0, 4.2, and 2.5, respectively) and Self-Care (d = 3.7, 3.1 and 2.0, respectively). Completers had greater improvement than non-Completers for both outcomes and greater improvement on IADLs than partial completers (all p-values < 0.03). Nurses reported high satisfaction with their training, and high confidence that the implementation of the intervention met patient and caregiver needs. The DEMA-Pro has shown benefits and feasibility that will need further testing in a large pragmatic trial in homecare settings.
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    Effects of Qigong Exercise on Physical and Psychological Health among African Americans
    (Sage, 2021-06) Chang, Pei-Shiun; Lu, Yvonne; Nguyen, Chi Mai; Suh, Youngnok; Luciani, Mary; Ofner, Susan; Powell, Savannah; School of Nursing
    Interventions are needed to address physical and psychological health in middle-aged and older African Americans (AAs). The purpose of this pilot study was to evaluate the feasibility and potential benefits of an eight-week Qigong exercise on physical ability and function, balance, frailty, depression and anxiety, and spiritual well-being in AAs using a single-group design. Fifteen AAs with a mean age of 64 years received Qigong exercise over 16 semi-weekly, one-hour sessions. The majority were female (93.3%) and college-level educated (53.3%). Repeat chair stands, physical function, and spiritual well-being improved significantly (p < .05) with effect sizes ranging from .45 to .87. Over 52% of participants showed improved depression scores, fast gait speed, and standing balance. Nearly 42% demonstrated some frailty improvement over baseline. No adverse events were reported. Qigong exercise potentially improves the physical ability and function, and spiritual well-being of AAs and needs further testing in a randomized clinical trial.
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    Feasibility and Acceptability of Qigong Exercise in Community-Dwelling Older Adults in the United States
    (Liebert, 2018-01) Chang, Pei-Shiun; Knobf, M. Tish; Funk, Marjorie; Oh, Byeongsang; School of Nursing
    Objectives:Qigong exercise has been shown to improve physical and psychological well-being in adults with chronic conditions, but little is known about the feasibility and acceptability of engaging in a qigong exercise program in community-dwelling older adults in the United States. The purpose of this study was to explore the feasibility, acceptance, and adherence to an 8-week qigong exercise intervention in community-dwelling American older adults. Design: An exploratory study design. Setting: Two senior centers in southern Connecticut. Subjects: Forty-five community-dwelling older adults aged 65 to 85 years enrolled. Intervention: A supervised 1-h health qigong exercise session twice weekly for 8 weeks. Outcome measures: An investigator-designed questionnaire with seven items that were rated on a 1 to 6 scale, with higher scores indicating better results, and nine open-ended questions were used to obtain data on feasibility and acceptability. Adherence was calculated as the proportion of the 16 planned sessions attended. Results: Of the 45 older adults enrolled, 6 never started and 6 withdrew, with 33 evaluable at the end of the intervention. The mean age of the sample was 74.8 years; the majority were female (84.4%) and white (91.1%). Mean scores on aspects of difficulty, acceptability, suitability, or effectiveness of qigong exercise were all ≥5. Participants identified benefits of qigong exercise, such as calming and relaxing feelings, inner peace, better balance, and flexibility. Attendance rate was 78.8%, with 94% performing qigong exercise at least once weekly outside the class. All participants indicated that they would recommend qigong exercise to others. No adverse events occurred. Conclusion: An 8-week qigong exercise program was feasible, acceptable, and safe for American older adults. Future robust randomized controlled trials are needed to confirm these findings.
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    The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review
    (Oxford Academic, 2022-10) Liu, Chiung-ju; Chang, Pei-Shiun; Griffith, Cheryl F; Hanley, Stephanie I; Lu, Yvonne; School of Nursing
    BACKGROUND AND OBJECTIVES: The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS: Two reviewers independently screened 1,410 studies identified from 5 electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS: The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing - specific. DISCUSSION AND IMPLICATIONS: Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
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    Physical and Psychological Effects of Qigong Exercise in Community-Dwelling Older Adults: An Exploratory Study
    (Elsevier, 2018-01) Chang, Pei-Shiun; Knobf, M. Tish; Oh, Byeonsang; Funk, Marjorie; School of Nursing
    Older adults need exercise programs that correspond to age-related changes. The purpose of this study was to explore preliminary effects of an 8-week Qigong exercise intervention on the physical ability, functional and psychological health, and spiritual well-being of community-dwelling older adults. Forty-five community-dwelling adults with the mean age of 74.8 years participated a 1-h Health Qigong exercise session twice weekly for 8 weeks. The majority were female (84%) and white (91%), and lived with their spouse (49%). Physical ability (p < 0.001), functional health (p = 0.001), balance (p < 0.001), functional reach (p < 0.001), depression (p = 0.005), and spiritual well-being (p = 0.004) improved significantly after the 8-week intervention. Most participants perceived physical ability, mental health, and spiritual well-being benefits. No adverse events were reported. A twice weekly Qigong exercise program over 8 weeks is feasible and has potential to improve physical ability, functional health, balance, psychological health, and spiritual well-being in older adults.
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    Physical and Psychological Health Outcomes of Qigong Exercise in Older Adults: A Systematic Review and Meta-Analysis
    (World Scientific, 2019) Chang, Pei-Shiun; Knobf, Tish; Oh, Byeongsang; Funk, Marjorie; School of Nursing
    Physical limitations, depression and anxiety are prevalent among older adults. Mild to moderate exercise can promote physical and psychological health and reduce the risk of chronic diseases. Qigong, a type of Chinese traditional medicine exercise, has demonstrated beneficial effects on physical ability and mental health in adults with chronic conditions. The purpose of this review was to systematically assess the effects of Qigong exercise on physical and psychological health outcomes in older adults. A total of 1282 older adults aged 62 to 83 years with depressive symptoms, frailty or chronic medical illnesses were included in this review. The meta-analysis showed that Qigong exercise resulted in significantly improved physical ability compared with active control or usual care (standardized mean difference [SMD] = 1.00 and 1.20, respectively). The pooled effects of studies with thrice weekly Qigong sessions had the greatest effect (SMD=1.65) on physical ability in older adults. Lower quality studies demonstrated larger effect sizes than those of higher quality. Although Qigong exercise showed favorable effects on depression, balance and functioning, the overall effects did not reach statistical significance. No significant adverse events were reported. The findings suggest that the Qigong exercise may be an option for older adults to improve physical ability, functional ability, balance and to lessen depression and anxiety. However, the number of RCTs that enroll older adults is limited. More methodologically sound RCTs are needed to confirm the efficacy of Qigong exercise on physical and psychological health in older adults with chronic illnesses.
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    Risk factors for inpatient facility admission among home health care patients with diabetes
    (Elsevier, 2023) Webster-Dekker, Katelyn E.; Hacker, Eileen; Perkins, Susan M.; Chang, Pei-Shiun; Ellis, Jennifer; Winton, Rebecca; Otis, Laurie; Gates, Maria; Lu, Yvonne; School of Nursing
    Background: Home health care (HHC) patients with diabetes are at high risk for inpatient admissions. Purpose: To identify variables associated with inpatient admissions among adults age ≥50 with diabetes receiving HHC in the community and in assisted living (AL). Methods: Retrospective HHC data (collected October 2021 to March 2022 in the Southern United States) from the Outcome and Assessment Information Set D were analyzed with logistic regression (n = 5,308 patients). Discussion: The inpatient admission rate was 29.5%. For community-dwelling patients, multiple hospitalizations, depression, limited cognitive function, decreased activities of daily living (ADL) performance, and unhealed pressure ulcer or injury ≥stage 2 were significantly associated with inpatient admission. For those in AL, multiple prior hospitalizations and decreased ability to perform ADLs were associated with inpatient admission. Conclusion: Understanding risk factors for inpatient admissions among patients with diabetes can support the identification of at-risk patients and inform interventions.