Changes in Body Weight and Serum Albumin Levels in Patients Requiring Home Long-term Oxygen Therapy

Purpose: To investigate the long-term changes in body weight and serum albumin levels in patients with respiratory failure, and those with chronic heart failure, who were treated with home long-term oxygen therapy (LTOT) to understand the current status and contribute to future measures. Methods: Patients with chronic obstructive pulmonary disease (COPD), those with interstitial pneumonia (IP), and those with chronic heart failure (CHF) undergoing home LTOT for 6 months or more between January 2011 and January 2019 were included in the study. Body weight and serum albumin levels were assessed at the start of home LTOT and at the end of the observation period, a minimum of 6 months after commencing home LTOT. Results: Sixty-two patients (29 COPDs, 23 IPs, and 10 CHFs) were included. In COPD patients and IP patients, body weight decreased (P = 0.0017, P = 0.0018, respectively, Wilcoxon signed-rank test). Serum albumin levels decreased in IP patients (P = 0.0185) but not in COPD patients. There was neither significant decrease in body weight nor serum albumin levels in patients with CHF. Conclusion: Chronic respiratory failure patients who have home LTOT were likely to have a decreased nutritional status. In order to provide prolonged home LTOT, medical staff need to pay close attention to the nutritional status of patients receiving home LTOT.

Home Visit Based Mindfulness Intervention for Vietnamese American Dementia Family Caregivers: A Pilot Feasibility Study

Background: Healthcare disparities continue to exist among the Vietnamese American (VA) community and many factors (e.g., fear of social stigma) deter family caregivers of persons with dementia (PWD) from seeking assistance. Purpose: To pilot-test a language-specific and culturally appropriate mindfulness intervention to improve dementia VA family caregiver well-being. Methods: Bilingual, trained research assistants administered a mindfulness exercise (i.e., deep breathing) to family caregivers and provided continuous support and care resources through weekly home visits for a month. Weekly surveys measured changes in emotion, feelings of connectedness to the PWD, and mood (i.e., happiness) before and after the intervention. Results: A total of nine VA family caregivers of PWD participated in this pilot study. Positive affect showed an increasing trend (Mpre = 16.0 (SD = 3.48), Mpost = 17.1 (SD = 3.06)) and negative affect showed a decreasing trend (Mpre = 6.44 (SD = 3.31), Mpost = 5.22 (SD = 0.359)). Happiness showed an increasing trend (Mpre = 4.30 (SD = 0.767), Mpost = 4.44 (SD = 0.873)). Conclusions: These findings suggest that a home-based dementia family caregiver intervention with mindfulness exercises may potentially increase positive affect and decrease negative affect in Vietnamese American family caregivers of PWD. Similar interventions may help reduce caregiver burden in dementia family caregivers of other cultures.

Deconstructing Racialized Experiences in Healthcare: What a Missed Opportunity for Healing Looks Like and Healthcare Resources for Children and Their Families

Some patients and families of color, including Asian Americans, face significant adverse stressors due to living within a White-dominant society. Xenophobia and racism can impact health. Research evidence points to early exposure to adverse childhood experiences such as racial discrimination as being detrimental and having significant short-term and long-term impact on physical and mental health. The purpose of this commentary article is to illuminate the need of patients and their families who may seek health care providers (HCPs) to express their concerns and fears when issues of xenophobia and racism arise. Patients and families need space in a healthcare setting to feel heard and understood. Anti-Asian xenophobia and racism among medically underserved Asian Americans persists and has been heightened during the COVID-19 pandemic. We describe tenets of Critical Race Theory and AsianCrit, and use this lens to understand an example actual scenario, a counter-story, of a Vietnamese mother, and her Vietnamese-Chinese American family’s experience with xenophobia and racism at a community recreation center and the subsequent communication of this experience with a HCP. We describe the impacts of these experiences of seeking healing including discontinuity of a HCP-patient-family relationship. It takes bravery for patients and families to tell their story of xenophobia and racism to a HCP. There are Asian Americans who are afraid to seek healthcare because of anti-Asian xenophobia and concerns about White fragility. Following, we highlight research evidence on implicit bias, also known as unconscious bias, as context about its persistent and widespread existence among healthcare professionals in general and the need to address this in healthcare. Implicit bias can influence care provided to a patient-family and the interactions between a HCP-patient-family. We include additional resources such as those from the National Association of Pediatric Nurse Practitioners, American Psychological Association Office on Children Youth and Families, the Office of Ethnic Minority Affairs, the Office on Socioeconomic Status, and American Academy of Pediatrics to consider in support of equity in healthcare practice of children and their families.

Associations Between Food Insecurity and Depression among Diverse Asian Americans

Background: Proper nutrition is an essential component to both physical and emotional health. Food insecurity (FI) is a potentially critical public health problem. The link between FI and elevated risk for depression has been well documented. Yet, it is largely unknown how diverse older adult populations experience FI differently. Therefore, the aims of this study were to examine how gender, race/ethnicity, and nativity may impact the magnitude of the association between FI and depression. Methods: We used a nationally representative sample of the Asian American population from the National Latino and Asian American Study (NLAAS). We built logistic regression models with major depression in the past 12 months as the dependent variable, and FI as the independent variable. Several demographic and socioeconomic characteristics were added to the models to control for potential biases. All statistical estimates were weighted, using the recommended NLAAS sampling weight, to ensure representativeness of the US population. Results: About 35% (weighted adjusted 95% CI: 29.49–39.00) of Asian Americans experienced some level of FI at the time of survey. Experiencing FI over the past 12 months increased the likelihood of having clinical depression (weighted adjusted odds ratio: 1.44, weight adjusted confidence interval: 0.79–2.10). The magnitude of associations between FI and depression varied by race/ethnicity (F (7, 47) = 6.53, p (3, 41) = 10.56, p (3, 41) = 9.85). Conclusions: Food insecurity significantly increases the likelihood of clinical depression among Asian Americans. Greater attention is needed towards food-insecure Asian Americans and their mental health.