RESUMEN
This pilot study evaluated effects of a video-guided T'ai Chi group intervention on center of balance (COB) and falls efficacy, using a one arm, pre/post design. Thirty-two participants began the study, 17 completed pre- and post-testing and 15 were lost to follow-up. Outcomes were compared for the 17 participants who completed pre- and post-testing and subgroups based on session attendance. Irrespective of session attendance, participant COB scores improved. There was a significant negative correlation between number of sessions attended and pre and post scores on the fall efficacy (fear of falling) measure, indicating those with higher fear of falling were less likely to complete the study. Older participants were also less likely to continue participation. Findings indicate potential benefits of T'ai Chi in improving COB (a fall risk factor) among community-dwelling older adults. However, those with greater potential benefit (higher fear scores, older participants) were less likely to continue participation.
Asunto(s)
Accidentes por Caídas/prevención & control , Evaluación Geriátrica/métodos , Equilibrio Postural/fisiología , Taichi Chuan/organización & administración , Grabación en Video , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Vida Independiente , Masculino , Análisis Multivariante , Cooperación del Paciente/estadística & datos numéricos , Proyectos Piloto , Evaluación de Programas y Proyectos de SaludRESUMEN
This two-group pretest and posttest quasi-experimental study aimed to evaluate the effects of a Tai Chi exercise programme on exercise behaviour and blood pressure (BP) in outpatients with hypertension. The experimental group (n = 27) received the Yang-style Tai Chi exercise programme three times a week for 8 weeks. The control group (n = 31) received routine care with no Tai Chi exercise. Exercise behaviour and exercise time using Routine Health Care Behaviour scale and BP were assessed at baseline and 8 weeks. The experimental group had a significant improvement on exercise behaviour (t = 2.11, P < 0.001) and exercise time (t = 1.44, P = 0.003), and a significant reduction in systolic BP (t = 2.57, P < 0.001) and diastolic BPs (t = 2.86, P < 0.001) compared with those of the control group. Tai Chi is an inexpensive and viable exercise and can improve exercise behaviour and BP control in outpatients with hypertension. Tai Chi exercise might offer outpatients with hypertension additional options, such as an adjunct to formal cardiac rehabilitation or as an exercise alternative in their management of hypertension. Nursing staff can easily learn and incorporate this exercise in patient education or care planning in the care of patients with hypertension in outpatient settings.
Asunto(s)
Presión Sanguínea/fisiología , Ejercicio Físico/fisiología , Conductas Relacionadas con la Salud , Hipertensión/prevención & control , Taichi Chuan , Adulto , Atención Ambulatoria , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Taichi Chuan/organización & administraciónRESUMEN
BACKGROUND: Cardiac rehabilitation improves physical, cognitive and psychosocial functioning, yet services are greatly underutilized with increasing patterns of attrition over time. Tai Chi has been suggested as a possible adjunct to cardiac rehabilitation exercise training. AIM: To describe differences in physical, cognitive and psychosocial functioning among adults ≥ 45 years old attending phase III cardiac rehabilitation, who have or have not self-selected Tai Chi exercise as an adjunct physical activity. METHODS: A cross-sectional design compared subjects attending group-based Wu style Tai Chi classes plus cardiac rehabilitation, with cardiac rehabilitation only. Subjects had a battery of physical and cognitive functioning tests administered to examine aerobic endurance, balance, strength, and flexibility, verbal retrieval/recall, attention, concentration and tracking. Subjects completed a health survey to ascertain cardiac event information, medical history, and psychosocial functioning (i.e. health-related quality of life, stress, depressive symptoms, social support, and Tai Chi self-efficacy). RESULTS: A total of 51 subjects (75% married, 84% college-educated, 96% White/European-American) participated. Subjects were on average 70 (± 8) years old and had attended cardiac rehabilitation for 45 (± 37) months. Approximately 45% (n = 23) attended Tai Chi classes plus cardiac rehabilitation, while 55% (n = 28) attended cardiac rehabilitation only. Subjects attending Tai Chi plus cardiac rehabilitation had better balance, perceived physical health, and Tai Chi self-efficacy compared to those attending cardiac rehabilitation only (p ≤ 0.03). CONCLUSION: Tai Chi can be easily implemented in any community/cardiac rehabilitation facility, and may offer adults additional options after a cardiac event.
Asunto(s)
Terapia por Ejercicio/métodos , Enfermería Geriátrica/métodos , Cardiopatías/rehabilitación , Enfermería en Rehabilitación/métodos , Taichi Chuan/métodos , Anciano , Anciano de 80 o más Años , Cognición , Centros Comunitarios de Salud/organización & administración , Estudios Transversales , Terapia por Ejercicio/enfermería , Terapia por Ejercicio/organización & administración , Femenino , Enfermería Geriátrica/organización & administración , Encuestas Epidemiológicas , Cardiopatías/enfermería , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Psicometría , Calidad de Vida , Enfermería en Rehabilitación/organización & administración , Taichi Chuan/enfermería , Taichi Chuan/organización & administraciónRESUMEN
PURPOSE/OBJECTIVES: To determine the feasibility of conducting a study of a tai chi self-help education program in Korean adults with gastric cancer and to describe the effects of a six-month tai chi self-help education program on depression, health-related quality of life (HRQOL), and immune markers. DESIGN: One-group, pre- and post-test design. SETTING: Outpatient clinics of two large hospitals in the Republic of Korea. SAMPLE: Convenience sample of 33 Korean adults with gastric cancer diagnoses after gastrectomy. METHODS: The Korean gastric cancer survivors participated in a 24-week tai chi self-help education program. The participants completed the Center for Epidemiologic Studies-Depression (Korean version) and the Functional Assessment of Cancer Therapy-General (Korean version) for HRQOL and provided blood samples for immune markers. All measurements were conducted at baseline and at one week following the 24-week intervention. MAIN RESEARCH VARIABLES: Feasibility was determined as the percentage of participants completing the 24-week protocol. Preliminary data on depression, HRQOL, and immune markers were obtained. FINDINGS: The dropout rate was 36.4%; 21 of 33 survivors participated in the tai chi self-help education program for 24 weeks. No complications or injuries occurred to the participants during the program. No significant differences were noted in depression, HRQOL, and immune markers before and after the intervention. CONCLUSIONS: Tai chi exercise, in combination with a self-help program, can be safe and feasible for Korean gastric cancer survivors. This feasibility study did not show that the tai chi self-help education program improves depression, HRQOL, and immune markers in Korean gastric cancer survivors. IMPLICATIONS FOR NURSING: Additional studies are needed to determine the long-term impact relative to usual care.
Asunto(s)
Educación del Paciente como Asunto/organización & administración , Autocuidado , Neoplasias Gástricas/rehabilitación , Sobrevivientes , Taichi Chuan , Biomarcadores/sangre , Antígenos CD4/sangre , Relación CD4-CD8 , Antígenos CD8/sangre , Depresión/diagnóstico , Depresión/prevención & control , Depresión/psicología , Estudios de Factibilidad , Gastrectomía/psicología , Gastrectomía/rehabilitación , Humanos , Interleucina-6/sangre , Células Asesinas Naturales/metabolismo , Corea (Geográfico) , Investigación en Evaluación de Enfermería , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Calidad de Vida/psicología , Autocuidado/métodos , Autocuidado/psicología , Neoplasias Gástricas/sangre , Neoplasias Gástricas/inmunología , Neoplasias Gástricas/psicología , Sobrevivientes/psicología , Taichi Chuan/organización & administración , Taichi Chuan/psicología , Factor de Necrosis Tumoral alfa/sangreRESUMEN
In this, the first of 2 companion papers, we present a framework for viewing t'ai chi as a complex, multicomponent intervention that integrates numerous physical, cognitive, and ritualistic components. We discuss how the richness and complexity of t'ai chi poses challenges related to the traditional distinction between specific versus nonspecific effects, the development and interpretation of valid sham controls, and more generally, to the reductionist causal approach of attributing observed outcomes to single, independent component factors. We also discuss parallels between t'ai chi research and the emerging field of whole systems research, and how t'ai chi research may benefit from the use of an ecologic framework. In a second, companion paper, we discuss additional challenges inherent in defining the t'ai chi intervention itself, and more comprehensively outline the benefits and limitations of commonly used clinical research designs to evaluate the efficacy and safety of t'ai chi.
Asunto(s)
Medicina Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/organización & administración , Proyectos de Investigación/normas , Taichi Chuan/organización & administración , Humanos , Satisfacción del Paciente , Aptitud Física , Resultado del TratamientoAsunto(s)
Anciano de 80 o más Años/psicología , Actitud Frente a la Salud/etnología , Casas de Salud , Calidad de Vida/psicología , Autoimagen , Taichi Chuan , Actividades Cotidianas/psicología , Distribución de Chi-Cuadrado , China , Factores de Confusión Epidemiológicos , Femenino , Estado de Salud , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Salud Mental , Análisis Multivariante , Evaluación de Resultado en la Atención de Salud , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Taichi Chuan/organización & administración , Taichi Chuan/psicologíaRESUMEN
BACKGROUND: To counter pervasive disparities in healthcare and guide public health prevention programs, culturally sensitive recruitment and retention strategies for Chinese immigrants participating in health-related research studies are needed. OBJECTIVES: The aim of this study was to develop and implement recruitment and retention strategies with Chinese immigrants in a Tai Chi exercise study. METHODS: After substantial project planning and incorporating community-based research principles, a multidimensional approach was used to ensure minimal loss to follow-up. Recruitment strategies included partnering with a community-based agency, distributing study information using a multimedia approach, communicating in the native language, and demonstrating cultural sensitivity. Retention strategies included establishing a tracking method during recruitment, providing personalized feedback, maintaining the same location for all aspects of the study, eliminating potential linguistic barriers, providing personal attention and encouragement, monitoring attendance, utilizing a charismatic Tai Chi instructor, respecting Chinese culture, providing appropriate incentives, and maintaining good communication. RESULTS: Sixty persons showed interest in the study, 52 persons were screened, and 39 persons were enrolled. Recruitment was completed within 3 weeks. An advertisement in the Chinese newspaper was the most fruitful recruitment source, yielding approximately 60% of the study participants. Retention in the study was also very high (97%, n = 38). DISCUSSION: The successful recruitment and retention of Chinese immigrants in this Tai Chi exercise study are due to a variety of factors on many levels, including the participants, study investigator, and community-based agency.
Asunto(s)
Asiático/etnología , Emigración e Inmigración , Investigación en Evaluación de Enfermería/organización & administración , Aceptación de la Atención de Salud/etnología , Selección de Paciente , Taichi Chuan/organización & administración , China/etnología , Barreras de Comunicación , Centros Comunitarios de Salud/organización & administración , Participación de la Comunidad , Conducta Cooperativa , Características Culturales , Estudios de Seguimiento , Humanos , Motivación , Multimedia , Evaluación de Necesidades , Pacientes Desistentes del Tratamiento/psicología , Evaluación de Programas y Proyectos de Salud , San Francisco , Taichi Chuan/psicologíaRESUMEN
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among older adults worldwide, including Europe, Asia, and North America. In the United States (US), CVD is also the leading cause of death among Asian-Americans. Physical activity has been shown to reduce CVD risk factors. Reduction in blood pressure (BP) in response to Tai Chi (TC) exercise in persons with CVD risk factors have been reported, though not in ethnic Chinese living in the US. AIM: Hemodynamic responses to a 12-week community-based TC exercise intervention among ethnic Chinese with CVD risk factors were examined. METHODS: Quasi-experimental design. Ethnic Chinese > 45 years old with at least 1 major CVD risk factor, living in the San Francisco Bay Area, attended a TC intervention three times a week for 12 weeks. A 2-min step-in-place test assessed aerobic endurance. BP and heart rate were measured at rest, and within 1-min after the step-test. Data were collected at baseline, 6 and 12 weeks. RESULTS: A total of 39 subjects (69% women), 66 +/- 8.3 years old, with hypertension (92%), hypercholesteremia (49%), and/or diabetes (21%), and 1 current smoker participated. Adherence to the intervention was high (87%). Subjects were sedentary at baseline, though had a statistically significant improvement in aerobic endurance over-time (eta2 = 0.39). At baseline, the average BP at rest was 150/86, while BP in response to the step-test was 178/99. Clinically and statistically significant reductions in BP at rest (131/77), and in response to the step-test (164/82) were found over 12 weeks of TC (p < 0.01). No significant change in heart rate was observed. CONCLUSIONS: This innovative, culturally relevant, community-based 12-week TC exercise intervention, appealed to Chinese adults with CVD risk factors, with significant reductions in BP and improvement in aerobic endurance. Given the number of persons estimated to have HTN and other CVD risk factors, the identification of new approaches to improve health, combined with risk factor reduction is needed. This is particularly important, given the rise in HTN among adults in the US and the associated public health burden of HTN. TC has the potential to reduce expenditures associated with CVD by facilitating a lifestyle that promotes physical activity, while remaining a low-tech, low-cost alternative to exercise.
Asunto(s)
Asiático , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/prevención & control , Hemodinámica , Conducta de Reducción del Riesgo , Taichi Chuan/organización & administración , Adulto , Asiático/etnología , Asiático/estadística & datos numéricos , Presión Sanguínea , Enfermedades Cardiovasculares/etiología , China/etnología , Centros Comunitarios de Salud , Diabetes Mellitus/prevención & control , Estudios de Factibilidad , Femenino , Frecuencia Cardíaca , Humanos , Hipercolesterolemia/complicaciones , Hipercolesterolemia/prevención & control , Hipertensión/complicaciones , Hipertensión/prevención & control , Masculino , Resistencia Física , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , San Francisco , Fumar/efectos adversos , Prevención del Hábito de FumarRESUMEN
This article provides a description of a clinical project that used combined Tai Chi and mindfulness-based stress reduction as an educational program. The 5-week program demonstrated that sustained interest in this material in middle school-aged boys and girls is possible. Statements the boys and girls made in the process suggested that they experienced well-being, calmness, relaxation, improved sleep, less reactivity, increased self-care, self-awareness, and a sense of interconnection or interdependence with nature. The curriculum is described in detail for nurses, teachers, and counselors who want to replicate this type of instruction for adolescent children. This project infers that Tai Chi and mindfulness-based stress reduction may be transformational tools that can be used in educational programs appropriate for middle school-aged children. Recommendations are made for further study in schools and other pediatric settings.