Abstract: Content analysis is a methodology for objectively and systematically studying the content of communication in various formats. Content analysis in nursing research and nursing education is called qualitative content analysis. Qualitative content analysis is frequently applied to nursing research, as it allows researchers to determine categories inductively and deductively. This article examines qualitative content analysis in nursing research from theoretical and practical perspectives. We first describe how content analysis concepts such as unit of analysis, meaning unit, code, category, and theme are used. Next, we describe the basic steps involved in using content analysis, including data preparation, data familiarization, analysis unit identification, creating tentative coding categories, category refinement, and establishing category integrity. Finally, this paper introduces the concept of content analysis rigor, including dependability, confirmability, credibility, and transferability. This article elucidates the content analysis method in order to help professionals conduct systematic research that generates data that are informative and useful in practical application.

Abstract: Taiwan's increasingly aging population has increased demand for elderly and long-term care dramatically. Professional competency based on the latest information and best-practice techniques is essential for nurses to provide high-quality care. As of 2012, the Protection Act for the Rights and Interests of Disabled Citizens requires that healthcare providers evaluate level of disability according to the WHO's International Classification of Functioning, Disability and Health (ICF). Professional nurses thus must fully understand the ICF. This article introduces ICF concepts as well as its development, coding system, core sets, and application. We also introduce a case situation to illustrate ICF coding methodology. This article is intended to raise awareness of the ICF evaluation approach and facilitate its quick and proper application in clinical work and guidance on best-practice nursing interventions.

Abstract: BACKGROUND People living with HIV (human immunodeficiency virus) are at a high risk of depressive symptoms attributed to disease progression and HIV-related stress While depressive symptoms are difficult to detect, in HIV patients they may negatively impact upon quality of life, decrease adherence to antiretroviral therapies, and further exacerbate disease progression PURPOSE Study purposes were to: (1) explore relationships among immune function indicators, perceived stress, social stigma and depressive symptoms and (2) identify depressive symptom indicators in HIV patients METHODS Researchers recruited a total of 160 participants from infectious disease outpatient clinics at a university hospital in southern Taiwan Chart reviews and four self-administered questionnaires (Beck Depression Inventory-II (BDI-II), Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and Social Impact Scale) were used to collect data RESULTS Symptoms of depression (BDI >= 14) were observed in 68 (425%) patients and symptoms of major depression (BDI >= 29) in 25 (156%) We found immune function indicators negatively associated with depressive symptoms (p < 05) and perceived stress and social stigma positively associated with depressive symptoms (p < 01) Stepwise multiple regression analysis indicated that perceived stress and social stigma accounted for 444% of depressive symptom variance CONCLUSION Findings suggest that reducing perceived stress and social stigma may positively affect perceived depressive symptoms in this population and may be referenced in future development of related interventions

Abstract: BACKGROUND Properly educating myocardial infarction (MI) patients in the extremely busy cardiac care unit (CCU) work environment is difficult for CCU nurses. PURPOSE This study examined the effectiveness of multimedia nursing education in reducing illness-related anxiety and uncertainty in MI patients following percutaneous coronary intervention (PCI). METHODS A quasi-experimental study with judgment sampling was designed and performed at a medical center in South Taiwan. The control group (n = 36) received written nursing education material and the experimental group (n = 40) received multimedia nursing education. Participant illness-related anxiety and uncertainty was measured at four specific periods, namely (1) at admission to the CCU, (2) immediately after completing the nursing education interventions, (3) upon transfer to the general ward, and 4) at discharge. Measurement tools included Mishel's uncertainty in illness scale (MUIS), the state-trait anxiety inventory (STAI), and noninvasive physiological monitoring instruments. RESULTS Results showed that both interventions lowered anxiety ÷ uncertainty in participants with moderate to severe levels (experimental group - anxiety: t₃₉ = -6.615, p < .001 and uncertainty: t₃₉ = -8.317, p < .001; control group - anxiety: t₃₅ = -4.767, p < .001 and uncertainty: t₃₅ = -9.739, p < .001). The experimental group achieved significantly greater reductions than the control group in terms of anxiety and uncertainty in each of the four measurement periods. CONCLUSIONS / IMPLICATIONS FOR PRACTICE Based on the evidence, both nursing education formats are valid for patient education and may be chosen based on CCU clinical conditions.

Abstract: Background There have been major changes to the medical care system and heightened standards for quality in the nursing profession in recent decades. Multifunctional capabilities are closely related to individual working attitudes, and work satisfaction directly affects group performance. Hospital administrators increasingly expect to utilize nursing staffs flexibly in terms of working hours and shift rotation assignments. This study addresses the need to provide appropriate educational training to nurses and effectively delegate and utilize human resources in order to help nurses adapt to the rapidly changing medical environment. Purpose This study on nursing staff in Tainan area explored the relationships between job rotation, work performance and satisfaction. Methods We used a questionnaire sampling method to survey nurses working in the Tainan area of southern Taiwan. Subjects were volunteers and a total 228 valid questionnaires (99.13%) were returned out of a total 230 sent. Results Both job satisfaction and performance correlated positively with job rotation perception and intention; Job satisfaction and job performance were positively related; Job satisfaction was found to affect work performance via job rotation perception and intention. Conclusions This study found the hospital nursing staff rotation plan to be an effective management method that facilitates social evolution to increase positive perceptions of work rotation. Nursing staffs thus become more accepting of new positions that may enhance job satisfaction.

Abstract: Background New nurses undergo a stressful and challenging transition process in the nursing workplace. Lack of patient care knowledge and skills and work adaption difficulties lead to a high turnover rate that drains essential new talent away from the nursing profession and further exacerbates professional staffing shortages in the healthcare sector. The "last mile" program is a program developed jointly by a nursing school and hospital as a mechanism to bridge classroom learning to clinical practice and smooth the transition of nursing students into nursing professionals. Purpose The purpose of this study was to understand the effect of the "last mile" program on job performance and occupational burnout among new nurses. Methods We conducted a quasi-experimental study in 2009 on a convenience sample of new nurses in a medical center. Participants were assigned into two groups, namely those enrolled in the last mile program (n = 29) and those not enrolled in the program (n = 94). Research team members and several collaborative universities developed the last mile program used in this study; Seven experts established content validity; The last mile program included 84 hours of lecture courses and 160 hours of clinical practice. Data was collected using the nursing job performance scale developed in 2007 by Greenslade and Jimmieson and translated ÷ back translated into an equivalent Chinese version. Exploratory factor analysis showed all items aggraded into 8 factors, which could be divided into task performance and contextual performance concept categories. Task performance concepts included: social support, information, coordination of care, and technical care; Contextual performance concepts included: interpersonal support, job-task support, volunteering for additional duties and compliance. The Cronbach's α for the 8 factors were .70-.95. The occupational burnout inventory included the 4 subscales of personal burnout, work-related burnout, client-related burnout, and over-commitment, with associated Cronbach's α ranging from .84-.90. Data was collected at one, three, and six months after employment. Repeated measures ANOVA and an independent t-test were used to analyze data. Results The average age of the 123 participants surveyed was 23 years, with no differences identified between last-mile and non-last-mile groups in terms of education level, work unit, or other demographic variables. New nurses who participated in the last mile program achieved significantly higher performance scores for job-task support, volunteering for additional duties, and overall task and contextual performance than those who did not. Last-mile-program group participants also had significantly lower client-related burnout than their non-last-mile-program peers. Conclusions / implications for practice The last mile program facilitates new nurses' contextual performance and reduces incidence of care burnout. The cooperative education model linking universities and hospitals can be a positive component in a new nurse retention strategy for hospital administrators and educators.

Abstract: Background & problems We observed in our institute a 13.6% incidence of prolonged surgery (>4 hours) induced facial pressure ulcers that required prone positioning. Causes identified included: (1) customized silicon face pillows used were not suited for every patient; (2) our institute lacked a standard operating procedure for prone positioning; (3) our institute lacked a postoperative evaluation and audit procedure for facial pressure ulcers. Purpose We designed a strategy to reduce post-prolonged surgery facial pressure ulcer incidence requiring prone positioning by 50% (i.e., from 13.6% to 6.8%). Resolutions We implemented the following: (1) Created a new water pillow to relieve facial pressure; (2) Implemented continuing education pressure ulcer prevention and evaluation; (3) Established protocols on standard care for prone-position patients and proper facial pressure ulcer identification; (4) Established a face pressure ulcers accident reporting mechanism; and (5) Established an audit mechanism facial pressure ulcer cases. Results After implementing the resolution measures, 116 patients underwent prolonged surgery in a prone position (mean operating time: 298 mins). None suffered from facial pressure ulcers. The measures effectively reduced the incidence of facial pressure ulcers from 13.6% to 0.0%. Conclusions The project used a water pillow to relieve facial pressure and educated staff to recognize and evaluate pressure ulcers. These measures were demonstrated effective in reducing the incidence of facial pressure ulcers caused by prolonged prone positioning.

Abstract: BACKGROUND The professional nursing clinical ladder program can effectively enhance the professional morale of nursing staff and help retain the best senior nurses in clinical settings. Hence, it is important to explore factors that influence nurse staff intentions to participate in the clinical ladder. PURPOSE This study examined factors that affect nurse staff intention to participate in the N3 nurse clinical ladder program. METHODS We used a cross sectional study design and a structured questionnaire survey. We employed purposive sampling to recruit 389 nurse staffs qualified for promotion to the N3 level from a medical center in southern Taiwan. RESULTS Findings showed: (1) Nearly two-thirds (233, 59.9%) of participants intended to participate in clinical ladder; (2) The factors of age, years of nursing experience, years in current position, project/research experience, promotion experience, and intention all significantly affected intent to participate in the ladder; (3) A significant difference between willingness to participate in the ladder program and each of the following variables--motivation, satisfaction, professional capacity, and sense of achievement; (4) Logistic regression analysis identified only motivation as a valid predictor of willingness to participate the ladder program (95% CI: 1.21-3.78). CONCLUSION/IMPLICATIONS FOR PRACTICE Results provide a useful reference to nursing administrators for planning on-the-job training and increasing nurse staff participation in the ladder. The authors hope results can help promote better human resource management and achievements.

Abstract: BACKGROUND Quality of life (QOL) is a critical issue in mental health care. The associations between quality of life and schizophrenia patients' stigma perception and stigma coping behavior are not well understood. PURPOSE This study investigated quality of life in schizophrenia patients. METHODS We used a cross-sectional, correlational research design; enrolled 119 individuals diagnosed with schizophrenia as participants; and used instruments including a demographics datasheet, perceived stigma scale, stigma coping behavior scale, and the World Health Organization quality of life scale, brief version to collect data. Data were analyzed using SPSS 12.0 for Windows software. RESULT (1) Participants had an average QOL index score of 62.40, indicating moderate quality of life; (2) Long working hours, holding rehabilitation-related employment, and receiving social welfare support correlated with lower QOL; (3) Marital issues had the greatest impact on quality of life, with participants who chose secrecy ÷ concealment reporting generally better QOL; (4) Social welfare support, number of working hours, stigma perception, stigma coping, level of job satisfaction, and level of salary satisfaction together accounted for 48.8% of total QOL variance. CONCLUSIONS Findings increase our understanding of the influence of socio-demographics, stigma perception, and stigma coping behavior on quality of life in individuals with schizophrenia. Greater community involvement in schizophrenia treatment programs can enhance patient satisfaction with their jobs and lives.

Abstract: Background & problem Our pediatric medical ward administers an average of 80 intravenous injections to preschool children. We found that 91.1% exhibit behavior indicative of fear and anxiety. Over three-quarters (77.8%) of this number suffer severe fear and actively resist receiving injections. Such behavior places a greater than normal burden on human and material resources and often gives family members negative impressions that lower their trust in the healthcare service while raising nurse-patient tensions. Using observation and interviews, we found primary factors in injection fear to be: Past negative experiences, lack of adequate prior communication, measures taken to preemptively control child resistance, and default cognitive behavioral strategies from nursing staff. Purposes This project worked to develop a strategy to reduce cases of severe injection fear in preschool children from 77.8% to 38.9% and achieve a capacity improvement target for members of 50%. Resolutions Our team identified several potential strategy solutions from research papers and books between August 1st, 2009 and April 30th, 2010. Our proposed method included therapeutic games, self-selection of injection position, and cognitive behavioral strategies to divert attention. Other measures were also specified as standard operating procedures for administering pediatric intravenous injections. Result We applied the strategy on 45 preschool children and identified a post-injection "severe fear" level of 37.8%. Conclusions This project was designed to reduce fear in children to make them more accepting of vaccinations and to enhance children's positive treatment experience in order to raise nursing care quality.

Abstract: Comfort is an important concept and core value of nursing. The defining attributes, antecedents and consequences of comfort need further analysis and exploration, even though the concept of comfort has been addressed previously in nursing literature. We employed the strategies of concept analysis as described by WalkerA 2) family and meaningful relationships; 3) maintaining functionality; 4) self-characteristics; 5) physical symptom relief, states, and interventions; 6) psychological, spiritual activities and states; and 7) a sense of safety and security. Antecedents consist of discomfort, distress and suffering. Consequences consist of (1) met/satisfied needs; (2) increased sense of control; (3) sense of inner peace; (4) a pleasant experience; (5) feeling cared for; (6) relief of symptoms; (7) reduced suffering; (8) decreased disequilibrium; and (9) absence of discomfort. We also outline the construction of cases, empirical references and comfort measurement tools. Analysis found comfort to have multiple dimensions and confirmed it as a clinical issue that should receive greater emphasis and valuation. Findings are hoped to increase nurse understanding of the concept of comfort and enable nurses to evaluate level of comfort and follow up on variations in such using empirical tools. Concept analysis can guide further comfort related interventions and research to benefit patients.

Abstract: BACKGROUND Breast cancer is currently the type of cancer with the highest annual incidence among women in Taiwan, resulting in a median age of death of 57 years. Nevertheless, the proportion of Taiwanese women with a history of mammographic screening is relatively low. The international literature associates participation in mammographic screening with factors such as age, education level, ethnicity, and previous cancer history. Few such studies in Taiwan have addressed a cross-section sample that is representative of the overall population. PURPOSE The present study investigated factors associated with non-utilization of mammographic screening in women aged between 50 to 69 years in Taiwan. METHODS This study used secondary data analysis to investigate data obtained from the 2005 National Health Interview Survey in Taiwan. Researchers used logistic regression analysis to evaluate factors associated with mammographic screening in Taiwanese women based on the Andersen behavioral model of health services use. RESULTS Only 24.3% of the survey population had received mammographic screening. Results of multiple logistic regression analysis indicated non-utilization of mammographic screening is associated with a relatively low education level, being currently employed, a relatively low average monthly salary, having no additional insurance coverage outside the National Health Insurance, having no physical examination history, and having no history of menopausal hormone replacement therapy use. CONCLUSIONS Hospitals and health units may use findings from the present study to plan mammographic screening programs. Mammography promotional material should consider the needs of women with lower education levels; screening schedules should be coordinated with employers and made convenient for working women; and promotional materials should target women who have never previously received a physical examination. Enhancing the willingness of women to obtain mammography may reduce the threat of breast cancer to the lives of Taiwanese women.

Abstract: BACKGROUND The elderly (> = 65 years of age) accounted for 10.4% of Taiwan's population in 2008. Hip-fracture-related hospitalizations cost the National Health Insurance Bureau around NT$1.3 billion annually. Hip fractures currently account for one-fifth of all fractures, and this proportion has been rising by 2.8 % annually. Hip fracture-associated mortality has been reported as 8.4-36% during the first post-fracture year. Hip fractures in the elderly is an issue that deserves further elucidation and study. PURPOSE We investigated whether variables including gender, age, body mass index, lifestyle, and medical history were risk factors for elderly hip fractures. METHODS We used a case control study and collected data via retrospective chart review and telephone questionnaires. Hip fracture risk factor data collected included demographic, lifestyle, and medical history data. RESULTS Results showed average age in the hip fracture group as significantly higher than the non-hip fracture group and body mass index as significantly lower in the hip fracture than the non-hip fracture group (p < .05). Gender, history of alcoholism, exercise habits, history of stroke, diabetes mellitus, hypertension, depression, and past fractures were identified as significant hip fracture risk factors. CONCLUSIONS / IMPLICATIONS FOR PRACTICE This study identified critical hip fracture risk factors in the elderly. Results provide a reference for prevention and health education. Reducing hip fractures, in addition to improving daily life quality for elderly individuals, can significantly reduce medical and social expenses.

Abstract: Appropriate management of cancer symptoms positively influences quality of life Inappropriate symptom management, disease recurrence, co-morbidity and death result from lack of medication adherence Factors influencing adherence are multidimensional and include personal attributes, knowledge and beliefs regarding the disease and medication, self-efficacy and social support The patient-physician relationship is a significant factor of influence in patient medication adherence and ultimate positive outcomes If patients are satisfied with the relationship, they are highly likely to comply with health provider advice Improving patient-physician relationships can effectively promote patient medication adherence In cancer pain management and adjuvant hormone therapy for breast cancer, regular follow-up examinations have a positive impact The physician-patient relationship with regard to cancer patient satisfaction is a relatively new topic of discussion, and many implications are scarcely understood However, the physician-patient relationship should not be ignored as a factor in cancer symptoms management, especially with regard to promoting compliance behavior

Abstract: This research applied the Ecological System Theory of Dr. Bronfenbrenner (1979) to evaluate and analyze the impact of a school-age asthmatic child's ecological environment on the child's development. This project ran from March 16th to April 16th, 2010. A full range of data was collected during clinical care, outpatient follow-up services, telephone interviews, home visits, and school visits and then identified and analyzed. Results indicated that the family, household environment, campus, teachers, classmates, physical education program, and medical staffs comprised the most immediate microsystem and that parents, school nurses, teachers, and classmates formed the child's mesosystem. Researchers found a lack of understanding and appreciation in the mesosystem regarding asthmatic patient care needs. Hidden factors in the environment induced asthma, which eventually caused the child to be unable to obtain necessary medical care assistance. The exosystem reflected adequacy of the family social economy. The father's flexible working hours allowed him to allocate more time to childcare responsibilities. The government Asthma Medical Payment program also facilitated effective care. The macrosystem demonstrated parental cognition related to asthma treatment and caring to be deeply influenced by local customs. Thus, rather than using advanced medical treatments, parents preferred to follow traditional Chinese medicinal practices. Evaluation using the Ecological of Human Development Theory showed the subject's ecology environment relationships as based upon a foundation of family and school. Therefore, active family and school support for an asthma management plan appropriate to the subject's needs was critical. Asthma symptoms were better controlled after the child and his parents invested greater effort in mastering asthma management protocols.

Abstract: Background: Schizophrenia-related violent behavior is a social stigma borne by schizophrenic patients and a highly painful burden faced by caregivers. Purpose: This study focused on how primary caregivers deal with schizophrenic patient violent behavior and factors that affect this burden. Methods: Researchers recruited a purposive sample from the acute wards of a psychiatric hospital in Taipei city. This cross-sectional study studied 100 primary caregivers of schizophrenic patients with a history of violent behavior. Socio-demographic data were collected using structured questionnaires on coping methods and caregiver burden. Results: Results found an average primary caregiver burden score of 30.8 points, indicating a moderate degree of burden. Factors contributing to the total care burden were: patient occupation, caregiver level of education, emotional coping method, negative cognitive coping method and violent behavior type. After multiple regression analysis, the two significant factors affecting caregiver burden were identified as: Emotional coping method and violent behavior type. Conclusions / Implications for Practice: This study highlighted a higher burden in violent schizophrenic patient caregivers who use emotional coping methods. Researchers recommended that clinical staff voluntarily assess caregiver burdens and methods of coping with patients' violent behavior in order to help caregivers develop specific and efficient coping strategies to reduce care burden. Language: zh

Abstract: Resilience as a social culture adaptation skill is a concept created by a combination of culture-based protection and risk factors influenced by individual, family and society variables. When encountering life event stresses, elder resilience helps the elderly achieve positive adaptation processes and results using personal character and support systems. This study used concept analysis strategies (Walker & Avant, 2005) to define the concept of elder resilience and typical, borderline and contradictory models to define the attributes of self-efficacy, hope and expectation, flexibility, sense of humor, and positive relationships / social support. We identified antecedent and consequence factors of elder resilience and evaluated three empirical measurement tools. Concept analysis results are hoped to benefit clinical practice and further research. Healthcare provider should further develop a positive healthcare philosophy and intervention approaches in order to assist the elderly with successful aging and positive adaptation.

Abstract: Nursing is a clinical profession influenced by social and environmental change. Facing the continuing evolution of the medical practice environment, nursing educators should take into account both current issues and future trends. As nursing clinical education undergoes radical reform, it must address both current and future healthcare demands. Relevant articles in the literature indicate that students continue to face significant difficulties applying classroom knowledge to clinical practice. This article describes the meanings, purposes, elements and models of nursing clinical education as well as relevant factors of influence. We also offer suggestions for meeting future societal demands.

Abstract: Longer average life expectancies and an ageing society have made long-term care an urgent and important issue in Taiwan. Although the implementation of Long-Term Care Ten-year Project four years ago has begun showing success in terms of assessing Taiwan's needs in terms of long-term care services and resources, there has been little forward progress in terms of training, recruiting and maintaining more competent professionals in the long-term care sector. This paper explores the current state of long-term care competency in Taiwan and educational strategies in place to improve the competency of long-term care professionals. Results indicate that the term geriatric competency embraces sub-competencies in direct care, communication, assessment, teamwork, cultural sensitivities and career care competencies. The term long-term care competency embraces the sub-competencies of supervision, management, information technology, resource management, and organizational skill. As a main contributor to effective long-term care, the nursing profession must employ effective strategies to develop competency-based education. Also, the profession must have an adequate supply of competent manpower to effectively respond to Taiwan's aging society.

Abstract: Good self-care behaviors can control diabetes and its complications effectively. Today, it is estimated that less than 20% of diabetes patients adhere to the self-care behavior regimens suggested by their healthcare providers. The World Health Organization advocates incorporating empowerment strategies into diabetes education to enhance patient abilities to control their disease and improve overall care efficacy. This article reviews the literature to develop the MAGIC strategy empowerment approach. MAGIC is an acronym for: Motivating patient self-awareness (M); assessing the causes of the problem (A); goal setting (G); individual self-care plan development (I) and Checking whether goals or plans have been achieved (C). The MAGIC empowerment process, involving interaction between healthcare professionals and patients, has the potential to work like "magic" to help patients implement effective self-care behavior. Guidelines and practice are necessary to shift professionals from the traditional education model to the empowerment approach. This article is a useful reference for clinical practice.

Abstract: Background Compared to their non-diabetic peers, diabetic patients who undergo coronary artery bypass surgery (CABG) face greater complications and poorer outcomes Identifying related risk factors is essential to improving post-CABG outcomes in this vulnerable population Improving self-efficacy and compliance can further improve patient outcomes over the long term Purpose This study compared differences in self-efficacy predictors and compliance between diabetic and non-diabetic patients who received coronary artery bypass surgery Method We used a cross-sectional design with convenience sampling A total of 350 patients were recruited from two medical centers and one teaching hospital Instruments used included a demographics questionnaire, chronic disease self-efficacy questionnaire and compliance scale SPSS 170 for Windows was used to analyze data Results Results found self-efficacy positively associated with compliance in both groups The non-diabetic group had higher self-efficacy and lower compliance than the diabetic group In the diabetic group, gender, compliance, education, employment status and marital status were all predictors of self-efficacy, with self-efficacy the single predictor of compliance In the non-diabetic group, compliance, primary care provider, education, time since surgery, gender and exercise were predictors of self-efficacy Self-efficacy, primary care provider, employee status prior surgery were all predictors of compliance Conclusions Results provide valuable information regarding the impact of diabetes on CABG patient outcomes and differences in predictors of self-efficacy and compliance between diabetic and non-diabetic patients Healthcare providers can promote healthy behavior and enhance quality of life by providing patient support tailored to their characteristics and considering the factors associated with better self-efficacy vs compliance

Abstract: Nursing aesthetics belong to the broader school of aesthetics, a branch of philosophy, as well as the nursing arts, an element of professional nursing. The philosophy of aesthetics recognizes the connection between an author and appreciators and identifies both substantive and abstract aesthetic experiences in interpersonal communication through the fine arts. Nursing aesthetics values the meaningful moments of patients, is sensitive to the influences of different circumstances and situations, and appreciates the unique qualities of humanness. Nursing aesthetics is emancipatory knowledge and involves empirical, ethical and personal knowing. The article is based on a search of OvidSP and Chinese Electronic Periodical Services (CEPS) database references using key words including aesthetic, aesthetics, art of nursing, or nursing aesthetics as well as a review of books related to aesthetics, knowledge construction, and nursing aesthetics. Authors determined definitions as defined by nursing experts and the applications thereof in clinical practice. This article aimed to illustrate that the ultimate concern of philosophy is "goodness" and that the foundation of caring behaviors is "love". In practice, nursing aesthetics is expressed through empathy, appreciation, inspiration and the therapeutic use of the self. Through aesthetic knowing and enhanced perceptual sensibility and reflection, nurses can transform intuitive knowing into art-acts and ultimately enhance nursing care quality.

Abstract: The shortage of nursing manpower has recently attracted significant attention from Taiwan society. Government efforts to improve the nursing practice environment have challenged the quality of current domestic nursing education. This article provides an overview of Taiwan nursing education in terms of its development under current nursing shortage conditions and in light of Taiwan's low birthrate, ageing society. A few suggestions for nursing education are listed at the end of the article.

Abstract: Asthma is a common chronic disease among children in Taiwan. Acute asthma exacerbation is a cause of strong concern for children and parents and represents a challenge for pediatric healthcare providers. This review summarizes the most up-to-date information on assessing and managing acute asthma exacerbations in children. The latest guidelines (National Asthma Education and Prevention Program, Expert Panel Report 3, 2007 and the Global Initiative for Asthma, 2010) recommend using sensitive instruments to assess asthma exacerbation severity and administering early treatment in order to avoid emergency outpatient visits and hospitalizations. SABA (short acting β-agonist) in combination with systematic cortisone is the most widely prescribed pharmaceutical intervention for acute asthma management. Other pediatric asthma medications are still in the trial stage. Educating parents on self-management techniques, especially with regard to the correct application of asthma medication on children, is crucial to reducing relapse incidents and visits to the emergency ward. Nursing studies addressing the issue of asthma exacerbation in children and parents are currently at the initial, qualitative stage. More evidence-based studies are necessary to explore and understand the independent role and function of nurses in acute pediatric asthma care.

Abstract: Catheter-related bloodstream infections are associated with significantly increased morbidity, mortality, and expenditures. Such infections are a serious threat to patient safety in the intensive care unit. This review describes the latest protocols related to preventing and treating central venous catheter-associated bloodstream infections in critically ill patients. According to 2011 Center for Disease Control (CDC) guidelines and central line care bundles by the institute for healthcare improvement (IHI), prevention measures for catheter-related bloodstream infections include the following: hand hygiene, maximal barrier precautions insertion, chlorhexidine skin antisepsis, optimal catheter site selection, proper catheter maintenance, insertion site care, and daily review of line necessity, with prompt removal of unnecessary lines. These are important and effective infection prevention measures. Guidelines and care bundles also recommend organizing care modules based on unit characteristics; integrating resources and empirical measures; education and training to promote comprehensive implementation; and auditing and monitoring to ensure staff continue to follow procedures. Effectively preventing central venous catheter-related bloodstream infections can enhance care quality and move healthcare closer to achieving the goal of zero tolerance.

Abstract: Background: The 2008 Sichuan Earthquake caused great damage to the environment and property. In the aftermath, many citizens were relocated to live in newly constructed prefabricated (prefab) communities. Purpose: This paper explored the current quality of life (QOL) of elderly residents living in prefabricated communities in areas damaged by the Sichuan earthquake and identified factors of influence on QOL values. The ultimate objective was to provide evidence-based guidance for heath improvement measures. Methods: The authors used the short form WHOQOL-BREF to assess the quality of life of 191 elderly residents of prefabricated communities in the Sichuan Province 2008 earthquake zone. A Student's t-test, variance analysis, and stepwise multivariate regression methods were used to test the impact of various factors on QOL. Results: Results indicate the self-assessed QOL of participants as good, although scores in the physical (average 56.2) and psychological (average 45.7) domains were significantly lower than the norm in China. Marital status, capital loss in the earthquake, number of children, level of perceived stress, income, interest, and family harmony each correlated with at least one of the short form WHOQOL-BREF domains in t-test and one-way analyses. After excluding for factor interaction effects using multivariate regression, we found interest, family harmony, monthly income and stress to be significant predictors of physical domain QOL, explaining 13.8% of total variance. Family harmony and interest explained 15.3% of total variance for psychological domain QOL; stress, marital status, family harmony, capital loss in the earthquake, number of children and interest explained 19.5% of total variance for social domain QOL; and stress, family harmony and interest explained 16.5% of total variance for environmental domain QOL. Family harmony and interest were significant factors across all domains, while others influenced a smaller proportion. Conclusions: Quality of life for elderly living in prefab communities should be improved. The authors hope study findings will increase awareness among healthcare providers regarding the quality of life of this vulnerable population. Study results suggest that key steps to promoting QOL in this population include improving family harmony, helping to cultivate well-rounded interests, alleviating economic stresses, providing necessary medical and psychological counseling services, and affording more social support. Language: zh

Abstract: Intra-aortic balloon pump (IABP) is one of the most important treatment strategies for patients with heart failure in the intensive care unit (ICU). To ensure quality of treatment, clinical preceptors must employ effective teaching strategies to acquaint nurses with the proper use of IABPs. Many nurses are hesitant to use IABPs due to lack of knowledge regarding their use. Classroom lectures and instruction manual-style materials are often ineffective strategies for teaching novice nurses to use IABPs properly and have resulted in unsatisfactory patient treatment quality. This study developed a creative, pithy rhyme to help nurses remember the key elements of IABP support as part of their IABP learning process. This innovative tool uses rhymes and mental images to instill critical information related to IABP use and help nurses become fluent IABP users.

Abstract: Background Taiwan's Department of Health (DOH) promotes a standardized 2-year training program to raise the competence of newly certified nurses in the realms of patient care, nursing professionalism and communication skills as well as to ensure professional nurse training program quality. Purpose This study evaluated training program participants' self-perception of nursing competency. Method We used a cross-sectional approach and structured questionnaire to evaluate the nursing competency of 128 nurse trainees at a medical center. Questionnaires were filled out independently by participants and thus reflect participant self-assessments of questionnaire items. Descriptive and correlation analyses further explored data. Result Results showed: mean scores were 3.80 ± .60 for clinical technique; 3.78 ± .67 for administrative skill; and 3.21 ± .88 for educational and research skills . Nursing ability correlated significantly with age, seniority, nursing grade, and courses taken. The relationship between participant total score and program completion ratio formed a "V"-shaped distribution. Conclusions / implications for practice The DOH training program was has a positive effect on nursing competency in nurse trainees. Results also provide valuable information and suggestions for revising the DOH's nurse training program in the future.

Abstract: Advanced information technologies and increasingly convenient transportation links have drawn countries forward into the current era of globalization, while growing transnational migration has encouraged multicultural trends. The difficulties new immigrants have in adapting to their adopted culture is an issue to which healthcare must be sensitive and responsive. Information on approaches to cross-cultural healthcare is sparse in the Taiwan literature. In this paper, the author reviews relevant domestic and overseas articles to assess historical and government policy trends as well as cross-cultural care competency development. As different ethnic populations increase, each should be provided with proper health education supported by medical volunteers from their own ethnicities. In terms of policy, healthcare personnel should understand their own culture and develop sensitivity to the needs and concerns of others. As part of their training, healthcare staff should gain a second language competency in order to enhance cultural literacy and enhance cross-cultural sensitivity and overall sensitivity within the healthcare system to the needs of the global community.