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1.
Healthcare (Basel) ; 12(7)2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38610228

RESUMO

Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach's α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.

2.
Psychol Sci ; : 9567976241239915, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38648277

RESUMO

This study investigated how relocation patterns affect disaster survivors' psychological stress on the diverse durations and spaces of relocation. It analyzed a 10-year data set of 1,236 families affected by 2009's Typhoon Morakot in Taiwan, identifying six relocation patterns through dynamic time warping (DTW). A hierarchical linear model was utilized, revealing the discernible impacts of environmental factors, sociocultural factors, and family-level socioeconomic factors on psychological stress. The study revealed that survivors who quickly found stable residences after the disaster initially experienced lower stress levels, but in the long term, their stress increased. Conversely, those with unstable residences experienced higher initial stress but lower long-term stress. Comparing similar patterns, we found that survivors who had more time for preparation and who sought opportunities, coped, or adapted to secondary stressors before long-distance relocation faced lower stress levels. These findings suggest that relocation patterns have a greater impact on the psychosocial stress of disaster survivors than time or relocation distance.

4.
Front Oncol ; 13: 1132972, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37736552

RESUMO

Background: Malnutrition is common in patients undergoing surgery for cancers and is a risk factor for postoperative outcomes. Body composition provides information for precise nutrition intervention in perioperative period for improving patients' postoperative outcomes. Objection: The aim was to determine changes in parameters of body composition and nutritional status of cancer patients during perioperative period. Methods: A total of 92 patients diagnosed with cancer were divided into gastrointestinal and non-gastrointestinal cancer group according to different cancer types. The patients body composition assessed by bioelectrical impedance vector analysis (BIVA) on the day before surgery, postoperative day 1 and 1 day before discharge. The changes between two groups were compared and the correlation between body composition and preoperative serum nutritional indexes was analyzed. Results: The nutritional status of all patients become worse after surgery, and phase angle (PA) continued to decrease in the perioperative period. Fat-free mass (FFM), fat-free mass index (FFMI), skeletal muscle mass (SMM), extracellular water (ECW), total body water (TBW), hydration, and body cell mass (BCM) rise slightly and then fall in the postoperative period in patients with gastrointestinal cancer, and had a sustained increase in non-gastrointestinal patients, respectively (P<0.05). Postoperative body composition changes in patients with gastrointestinal cancer are related to preoperative albumin, pre-albumin, hemoglobin, and C-reactive protein (P<0.05), whereas postoperative body composition changes in patients with non-gastrointestinal cancer are related to age (P<0.05). Conclusions: Significant changes in body composition both in patients with gastrointestinal cancer and non-gastrointestinal cancer during perioperative period are observed. Changes in body composition for the cancer patients who undergoing surgery are related to age and preoperative serum nutrition index.

5.
Clin Transl Radiat Oncol ; 43: 100671, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37692995

RESUMO

Purpose: To investigate the effect of reduced margin pelvic radiotherapy on gastrointestinal toxicity and outcomes in gynecological cancer. Materials and methods: This retrospective study analyzed data of 590 patients who underwent hysterectomy and adjuvant pelvic radiotherapy between 2010 and 2020 at two tertiary centers. The pelvic nodal region was delineated based on a reduced margin definition or the Radiation Therapy Oncology Group (RTOG) guidelines. All patients were treated with intensity-modulated radiotherapy with imaging guidance. Gastrointestinal toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) and the Patient-Reported Outcome version (PRO-CTCAE). Results: Overall, 352 (59.7%) and 238 (40.3%) patients underwent RTOG and reduced margin pelvic radiotherapy, respectively. Median follow-up was 6.4 years (IQR: 3.7-9.6). Reduced margin pelvic radiotherapy significantly lowered the radiation dose to the small bowel. For CTCAE grade ≥ 2 or 3, acute gastrointestinal toxicity was lower in the reduced margin group than in the RTOG group (16.4% vs. 33.5%, p < 0.001; 2.9% vs. 8.5%, p < 0.001). The reduced margin group reported less severe acute gastrointestinal toxicity (PRO-CTCAE score ≥ 3) than the RTOG group (12.5% vs. 28.7%, p < 0.001). Late grade 3 gastrointestinal toxicity was lower in the reduced margin group than in the RTOG group (0.8% vs. 4.8%, p = 0.006). The 5-year pelvic recurrence-free survival and disease-free survival in the RTOG and reduced margin pelvic radiotherapy groups were 97.4% and 97.9% (p = 0.55) and 80.7% and 83.5% (p = 0.18), respectively. Conclusion: Reduced margin pelvic radiotherapy decreased acute and late gastrointestinal toxicity and achieved favorable outcomes.

6.
Curr Psychol ; : 1-13, 2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37359570

RESUMO

The COVID-19 pandemic has induced traumatic and fear responses globally. Time attitudes, which refer to one's feelings toward the past, present and future, may have certain effects on psychological adaptations during this crisis period. This study employed a person-centered approach and a two-wave prospective design to investigate how people with different time attitude profiles change differently in their PTSD symptoms and COVID-19-related fears from a low-risk stage to the first big COVID-19 outbreak in Taiwan. Participants were 354 adults with a mean age of 27.79 years. The result provided support for the theoretical six-factor structure of the traditional Chinese Adolescent and Adult Time Inventory-Time Attitudes Scale (AATI-TA). Four clusters of time attitude profiles were identified (Positives, Negatives, Past Negatives and Pessimists). At both waves, Positives had lower levels of PTSD severity and COVID-19-related fears than most of the other groups, and the reverse was noted for Negatives. As for time effects, people across all profiles were significantly affected during the outbreak, but Negatives showed a greater increase in PTSD severity than other groups. In conclusion, mental health services should put efforts into early identification of those with highly negative time attitudes and implement interventions that nudge people toward a more balanced or positive attitude in each temporal frame, especially during adversity such as the COVID-19 pandemic.

7.
Nurs Open ; 10(2): 1144-1150, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36109827

RESUMO

AIM: This paper explored the differences in perspectives on the core competencies of nurse preceptors among postgraduate-year nurses, clinical nursing preceptors and head nurses. DESIGN: Cross-sectional design with nominal group technique (NGT). METHOD: The sample consisted of 32 postgraduate-year nurses, 42 preceptors and 27 head nurses. Two rounds of NGT were used to collect the group opinions. RESULTS: While the rank/level of importance varied, three groups all agreed that teaching traits, clinical nursing profession, communication and collaboration, teaching pedagogy, reaction of contingency and consultation of academic writing were important core competencies for nurse preceptors. The three groups disagreed on critical thinking and reflection, as well as lifelong learning. This study clarifies cognitive differences and expectations among three groups and can assist medical institutes in designing preceptor training courses.


Assuntos
Preceptoria , Visitas de Preceptoria , Humanos , Estudos Transversais , Preceptoria/métodos , Enfermagem , Educação Continuada
8.
J Trauma Stress ; 35(3): 813-826, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35182441

RESUMO

The widely used Centrality of Event Scale (CES) measures the extent that a traumatic event serves as a central component of self-identity, a reference point, and a turning point in an individual's life story. The present study aimed to develop a Chinese version of the CES and assess its reliability, criterion validity, and factor structure. Data were collected from three samples of trauma-exposed Taiwanese individuals (N = 939), including 420 earthquake survivors, 300 trauma-exposed community adults, and 219 trauma-exposed undergraduate students. We conducted an exploratory factor analysis and confirmatory factor analysis and compared the resulting models with a one-factor model and the originally proposed model. The results indicated that a new three-factor model, S-Bχ2 (167, N = 519) = 687.01, p < .001, CFI = .95, IFI = .95, NNFI = .94, RMSEA = .078, SRMR = .047, might better represent the construct compared to the one-factor or originally proposed model. Furthermore, the Chinese CES demonstrated excellent internal consistency, Cronbach's αs = .89-.94; adequate 1-month reliability, rs = .54-.64, and 6-month temporal stability, rs = .52-.67; and good concurrent and predictive validity. The findings indicate that the Chinese version of the CES demonstrates good psychometric properties with a three-factor structure, and it could be used to assess event centrality among nonclinical trauma-exposed Taiwanese adults.


Assuntos
Traumatismo Múltiplo , Transtornos de Estresse Pós-Traumáticos , Adulto , China , Análise Fatorial , Humanos , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
World J Surg ; 46(3): 497-503, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35013777

RESUMO

BACKGROUND: Acute care surgery is an important component of health care in the developed nations. However, in Malaysia, acute care surgery is yet to be recognized as a specific subspecialty service. Due to high demands of limited ICU beds, some patients have to be ventilated in the wards. This study aims to describe the outcomes of acute surgical patients that required mechanical ventilation. METHODS: This is a retrospective review of all mechanically ventilated surgical patients in the wards, in a tertiary hospital, in 2020. Sixty-two patients out of 116 patients ventilated in surgical wards fulfilled the inclusion criteria. Demography, surgical diagnosis and procedures and physiologic, biochemical and survival data were analyzed to explore the outcomes and predictors of mortality. RESULTS: Twenty-two out of 62 patients eventually gained ICU admission. Mean time from intubation to ICU entry and mean length of ICU stay were 48 h (0 to 312) and 10 days (1 to 33), respectively. Survival for patients admitted to ICU compared to ventilation in the acute surgery wards was 54.5% (12/22) vs 17.5% (7/40). Thirty-four patients underwent surgery, and the majority were bowel-related emergency operations. SAPS2 score validation revealed AUC of 0.701. More than half of patients with mortality risk < 50% eventually were not admitted to ICU. CONCLUSIONS: ICU care for critically ill surgical patients provides better survival. There is a need to improve triaging for intensive care, especially for low-mortality-risk patients using risk scores which are locally validated.


Assuntos
Unidades de Terapia Intensiva , Respiração Artificial , Cuidados Críticos , Estado Terminal , Mortalidade Hospitalar , Humanos , Tempo de Internação , Estudos Retrospectivos
10.
Vet Pathol ; 59(1): 143-151, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34794345

RESUMO

Xanthogranulomatosis is an inflammatory lesion characterized by lipid-containing macrophages, extracellular lipid, hemorrhage, and necrosis. We describe disseminated intracoelomic xanthogranulomatosis in 5 eclectus parrots (Eclectus roratus) and 2 budgerigars (Melopsittacus undulatus). Postmortem, clinicopathologic, and historical case material was reviewed. Ages ranged from 3 to 24 years; there were 5 males and 2 females. Table food was included in the diet of 3/5 cases, and animal products were included in 2/3 cases. Common clinicopathologic abnormalities included leukocytosis (4/5 cases) and elevated concentrations of bile acids (3/4 cases) and cholesterol within 6 months prior to death (2/4 cases). At postmortem examination, all 7 birds had grossly visible, irregular, soft, tan to yellow, amorphous plaques distributed on the surfaces of the viscera and body wall. Histologic evaluation and oil red O stain revealed xanthogranulomatous inflammation with phagocytized and extracellular lipid, necrosis, cholesterol clefts, fibrosis, and mineralization. Infectious agents were not identified with special stains in all cases. Concurrent hepatobiliary disease was present in 6/7 cases, and 6/7 had lipid accumulation within the parenchyma of various visceral organs. Five cases had atherosclerosis of great vessels. We describe a unique form of disseminated coelomic xanthogranulomatosis in 2 psittacine species. This condition should be recognized as a differential diagnosis in cases of disseminated coelomic mass formation and coelomic distension in psittacine birds, particularly in eclectus parrots and budgerigars.


Assuntos
Doenças das Aves , Melopsittacus , Papagaios , Animais , Doenças das Aves/diagnóstico , Diagnóstico Diferencial , Feminino , Masculino
11.
Omega (Westport) ; : 302228211060596, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34920680

RESUMO

Suicidal risk has been a significant mental health problem. However, the predictive ability for repeated self-harm (SH) has not improved over the past decades. This study thus aimed to explore a potential tool with theoretical accommodation and clinical application by employing traditional logistic regression (LR) and newly developed machine learning, random forest algorithm (RF). Starting with 89 items from six commonly used scales (i.e., proximal suicide risk factors) as preliminary predictors, both LR and RF resulted in a better solution with much fewer items in two phases of item selections and analyses, with prediction accuracy 88.6% and 79.8%, respectively. A combination with 12 selected items, named LR-12, well predicted repeated self-harm in 6-month follow-up with satisfactory performance (AUC = 0.84, 95% CI: 0.76-0.92; cut-off point by 1/2 with sensitivity 81.1% and specificity 74.0%). The psychometrically appealing LR-12 could be used as a screening scale for suicide risk assessment.

12.
Sensors (Basel) ; 21(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502736

RESUMO

Mental health is as crucial as physical health, but it is underappreciated by mainstream biomedical research and the public. Compared to the use of AI or robots in physical healthcare, the use of AI or robots in mental healthcare is much more limited in number and scope. To date, psychological resilience-the ability to cope with a crisis and quickly return to the pre-crisis state-has been identified as an important predictor of psychological well-being but has not been commonly considered by AI systems (e.g., smart wearable devices) or social robots to personalize services such as emotion coaching. To address the dearth of investigations, the present study explores the possibility of estimating personal resilience using physiological and speech signals measured during human-robot conversations. Specifically, the physiological and speech signals of 32 research participants were recorded while the participants answered a humanoid social robot's questions about their positive and negative memories about three periods of their lives. The results from machine learning models showed that heart rate variability and paralinguistic features were the overall best predictors of personal resilience. Such predictability of personal resilience can be leveraged by AI and social robots to improve user understanding and has great potential for various mental healthcare applications in the future.


Assuntos
Robótica , Comunicação , Frequência Cardíaca , Humanos , Interação Social , Fala
13.
Nurse Educ Pract ; 56: 103200, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34555785

RESUMO

AIM: The aim of this study was to explore core competencies of nurse preceptors based on the perspectives of postgraduate-year nurses, nurse preceptors and head nurses. BACKGROUND: Perspectives of core competencies of nurse preceptors are varied among postgraduate-year nurses, nurse preceptors and head nurses, which makes it difficult to establish preceptor training programs and develop evaluation instruments. DESIGN: A nominal group technique study. METHODS: A nominal group technique procedure was applied to small-group and large-group discussion. The participants were recruited from the inpatient units at five nonprofit hospitals, each having over 1000 patient beds, in Taiwan. A total of 101 participants were involved in this study: 32 postgraduate-year nurses, 42 nurse preceptors and 27 head nurses, who were respectively sorted into five, six and four small groups with six to eight members in each group. After applying nominal group technique procedure, the core competencies were scored and ranked. Based on the final scores and ranking, the core competencies that the participants felt to be most important for nurse preceptors were identified. The expert panel then integrated these core competencies and derived a consensus. RESULTS: Seven core competencies of nurse preceptors were derived, in order of declining importance: teaching traits, clinical nursing profession, communication and collaboration, teaching pedagogy, reaction of contingency, critical thinking and reflection and consultation on academic writing. All participants perceived that teaching traits (198 points) and clinical nursing profession (161 points) were the most important. Consultation of academic writing is unique, which may be due to the clinical ladder system still being implemented in Taiwan. CONCLUSIONS: The nominal group technique is an efficient and proper method to conduct a consensus for specific issues or values among individuals and groups. The results of this study can facilitate the development of evaluation indicators or instruments as well as provide a direction of continuing education program for preceptor training.


Assuntos
Enfermagem , Preceptoria , Competência Clínica , Humanos , Taiwan
14.
J Zoo Wildl Med ; 52(2): 704-709, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34130414

RESUMO

Spotted turtles (Clemmys guttata) are an endangered species and are commonly encountered in the pet trade and in many zoological collections across the United States, yet peer-reviewed published reference intervals (RI) for common clinicopathologic tests are unavailable for this species. The objectives of this study were to calculate partial RI for routine hematology, biochemistry, and electrophoretic analyses, as well as to perform an initial comparison of capillary zone electrophoresis (CZE) and agarose gel electrophoresis (AGE) in this species. A single blood sample was obtained from a single collection of 32 apparently healthy captive spotted turtles weighing at least 100 g and was submitted for standard hematologic and biochemistry analyses, as well as electrophoresis via CZE and AGE methods. Partial RI were calculated for corresponding analytes for each type of testing. While CZE and AGE protein fractions were found to have good correlation, some significant differences were observed, reinforcing that RI should be reported with the specific method used for their determination. The spotted turtle electrophoretograms were distinctly different from those previously reported from turtles in the same taxonomic family, including differences in the number and relative prominence of protein fractions.


Assuntos
Proteínas Sanguíneas/química , Eletroforese em Gel de Ágar/veterinária , Eletroforese Capilar/veterinária , Tartarugas/sangue , Animais , Animais de Zoológico , Contagem de Eritrócitos , Feminino , Hematologia , Contagem de Leucócitos/veterinária , Masculino , Minerais/sangue , Valores de Referência
15.
BMC Nurs ; 20(1): 91, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098937

RESUMO

BACKGROUND: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners' clinical competency, work stress, professional confidence, and career satisfaction. METHODS: A Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale). RESULTS: Among the novice nursing practitioners, 41 of them (74.5 %) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7 %) and the intensive care unit-emergency department (77.8 %) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE. CONCLUSIONS: We found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. An appropriate OSCE program is vital for novice nursing practitioners, educators, and administrators. The effective application of OSCEs can help novice nursing practitioners gain confidence in their clinical skills.

16.
Am J Manag Care ; 27(4): e130-e134, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33877780

RESUMO

OBJECTIVES: This report aimed to determine whether transitional care management (TCM) services, provided by Inspira Care Connect, LLC (ICC), a Track 1 Medicare Shared Savings Program accountable care organization, were effective in reducing 30-day readmission rates, observation stay days, and emergency department visits, along with mortality rates, total costs, and frequency of primary care physician (PCP) visits among Medicare beneficiaries served by ICC. STUDY DESIGN: In accordance with TCM programming, ICC contacted the majority of patients telephonically within 48 business hours after discharge from an inpatient setting and scheduled a face-to-face visit with the patient's PCP within 1 to 14 days after discharge from an inpatient setting. The patients were provided with non-face-to-face services as needed throughout the 30-day period. METHODS: The effectiveness of the TCM model was measured using a retrospective propensity score matching design, which allowed for an accurate comparison between those who received TCM and similar ICC Medicare beneficiaries who did not. The analysis utilized Medicare parts A and B claims from January 1, 2016, to December 31, 2017. RESULTS: Patients who received TCM had lower 30-day readmission rates than those who did not (P < .05). CONCLUSIONS: The services provided to ICC Medicare patients through the TCM model may have enhanced the ability to identify problems at an earlier stage, resulting in the prevention of complications and unnecessary utilization of costly health care services.


Assuntos
Cuidado Transicional , Idoso , Humanos , Medicare , Alta do Paciente , Readmissão do Paciente , Estudos Retrospectivos , Estados Unidos
17.
Psychooncology ; 30(5): 765-772, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33427382

RESUMO

OBJECTIVE: Advanced practice nurses (APNs) can best support physicians in improving the quality of truth-telling. However, the effectiveness of communication skill training (CST), based on the Japanese SHARE model exclusive to APNs, has not been tested from APNs' and recipients' viewpoints, motivating the author to conduct the present study. METHODS: A two-group before-after model design was adopted, and 61 APNs from two hospitals were randomly assigned to either an experimental group (EG; N = 28) or an control group (CG; N = 33). APNs in the EG received 6 h of CST under the guidance of qualified facilitators and simulated patients. This study used APNs' subjective assessment (N = 61) (self-confidence and perceptions on truth-telling) and recipients' opinions (N = 480) (cancer patients' and their caregivers' satisfaction with truth-telling and emotional status) to assess the effectiveness of the SHARE CST. Data were collected before CST (baseline, T0), immediately after (T1), and 2 weeks after (T2). RESULTS: APNs in the EG had more confidence (p < 0.05) and better perceptions of cancer truth-telling (p < 0.01) than APNs in the CG at both T1 and T2. No group differences were found in patients' or their caregivers' satisfaction with truth-telling, emotional distress, and anxiety (p > 0.05). In addition, patients in the EG had higher depression than patients in the CG (ß = 1.65, p = 0.01). CONCLUSIONS: SHARE CST can improve APNs' confidence and perceptions of cancer truth-telling. However, more rigorous studies are required to test the effectiveness of CST from recipients' viewpoint.


Assuntos
Neoplasias , Enfermeiras e Enfermeiros , Comunicação , Humanos , Projetos Piloto , Taiwan , Revelação da Verdade
18.
J Anxiety Disord ; 74: 102261, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32580119

RESUMO

The Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) is an updated DSM-5 version of the PDS, a widely used measure for PTSD. The PDS-5 has recently been shown to possess sound psychometric properties and awaits cross-cultural validation. The present study aimed first, to evaluate the psychometric properties of the Chinese version of the PDS-5; second, to evaluate alternative factor models of DSM-5 PTSD symptoms with multiple trauma samples. Data were collected from five samples of Taiwanese trauma-exposed individuals (total N = 903): 138 burn injury survivors, 403 earthquake survivors, 181 trauma-exposed young adults, 91 trauma-exposed undergraduates, and 90 female domestic violence survivors. The Chinese PDS-5 possessed excellent internal consistency (α s = .94-.95) and satisfactory five-week (r = .80) and one-year temporal stability (r = 0.76). Convergent, concurrent, and discriminant validity were also established. Consistent with recent studies, confirmatory factor analyses demonstrated the best fit of a seven-factor Hybrid model, followed by a six-factor Anhedonia model across multiple trauma samples.


Assuntos
Povo Asiático , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Traduções , Adolescente , Adulto , Idoso , Anedonia , Queimaduras/psicologia , Violência Doméstica/psicologia , Terremotos , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/psicologia , Psicometria , Reprodutibilidade dos Testes , Estudantes/psicologia , Sobreviventes/psicologia , Taiwan , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-32517289

RESUMO

The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum.


Assuntos
Currículo , Enfermagem Baseada em Evidências , Prática Clínica Baseada em Evidências , Serviços de Enfermagem Escolar , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aprendizagem , Serviços de Enfermagem Escolar/educação , Autoeficácia , Inquéritos e Questionários , Taiwan
20.
Vet Radiol Ultrasound ; 61(4): 409-416, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32436257

RESUMO

Xanthogranulomatous disease is a rare condition, which can be caused by infection, inflammation, hemorrhage, immunologic disease, or inherited lysosomal disorders. It is characterized by non-intracellular lipid and cholesterol deposits among an inflammatory infiltrate of vacuolated macrophages and giant cells. The diagnosis of xanthogranulomatous disease is challenging, with nonspecific imaging findings often misinterpreted as aggressive neoplastic processes in humans. In this retrospective case series study, we describe the diagnostic imaging characteristics of a disseminated xanthogranulomatous condition identified in five eclectus parrots (Eclectus roratus). Decreased serosal detail and celomic distension were present in all three birds radiographed, with multifocal variably sized celomic mineralization (3/3 birds), and extracelomic mineralized masses (1/3 birds). Celomic effusion with foci of celomic mineralization and hepatomegaly were identified in all birds (3/3) imaged with ultrasound. Finally, a mineralized mural ventricular mass was present in one of three patients imaged with CT, multifocal celomic mineralization with moderate to severe celomic effusion in two of three patients, diffuse severe proventricular and intestinal dilation in all three patients, and atherosclerosis of the major arterial trunks in all three patients. Veterinary radiologists should be aware of this inflammatory condition in birds, especially in eclectus parrots, and should be able to recognize the imaging features of xanthogranulomatous inflammation.


Assuntos
Doenças das Aves/diagnóstico por imagem , Granuloma/veterinária , Papagaios , Xantomatose/veterinária , Animais , Feminino , Granuloma/diagnóstico por imagem , Inflamação/veterinária , Estudos Retrospectivos , Xantomatose/diagnóstico por imagem
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