The association of sociodemographic factors and needs of haemodialysis patients according to Maslow's hierarchy of needs.

AIM: To explore the association between the sociodemographic factors and the needs of patients undergoing haemodialysis in Taiwan. BACKGROUND: Concomitant discomfort, including physical and mental aspects, affects the patients' quality of life and their willingness to undergo haemodialysis. Maslow's hierarchy of needs is a well-known tool to assess different levels of human needs. METHOD: We conducted a small-scale cross-sectional observational study using a structured needs assessment questionnaire on 159 patients from the Taipei Veterans General Hospital haemodialysis unit. RESULTS: The overall mean scores of physical, mental, spiritual, other needs and needs in relation to medical staff care were 4.0 ± 0.8, 3.2 ± 0.8, 2.7 ± 1.0, 3.1 ± 0.9 and 4.1 ± 0.7, respectively. The results showed that the patients' highest need was in relation to medical staff care, followed by physical needs. Further analysis showed that patients who are still employed during the treatment process have higher mental, spiritual and other needs. Patient who is financially supported by their family has higher physical needs. Patients taken care of by paid caregivers have lower spiritual needs and other needs. This is also the same with patients who are religious as opposed to those who are nonreligious. Patients who have attained tertiary education have higher other needs compared with patients who have only achieved up to primary or secondary education. CONCLUSION: The study is the first in Taiwan to identify and quantify the needs of patients undergoing haemodialysis. When the needs of the patients are identified in relation to their sociodemographic factors, the medical staff can give the appropriate treatment in order to meet the needs and improve the patients' well-being. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should not only focus on the patients' physiological needs, but should determine and address their other needs in various aspects in order to improve the quality and efficacy of the dialysis care process.

Nurse characteristics, leadership, safety climate, emotional labour and intention to stay for nurses: a structural equation modelling approach.

AIM: The aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses. BACKGROUND: Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses' intention to stay; more comprehensive theoretical foundations for examining nurses' intention to stay and its related factors are lacking. DESIGN: Cross-sectional. METHODS: A purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013-June 2014. Structural equation modelling was employed to test the theoretical models of the relationships among the constructs. RESULTS: Our data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate. CONCLUSION: Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses' intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses' intent to stay. Transformational leadership did not directly influence nurses' intention to stay; however, it reduced emotional labour, thereby increasing intention to stay.

Nurses' attitudes and perceived barriers to the reporting of medication administration errors.

AIMS: (1) To explore the attitudes and perceived barriers to reporting medication administration errors and (2) to understand the characteristics of - and nurses' feelings - about error reports. BACKGROUND: Under-reporting of medication administration errors is a global concern related to the safety of patient care. Understanding nurses' attitudes and perceived barriers to error reporting is the initial step to increasing the reporting rate. METHODS: A cross-sectional, descriptive survey with a self-administered questionnaire was completed by the nurses of a medical centre hospital in Taiwan. RESULTS: A total of 306 nurses participated in the study. Nurses' attitudes towards medication administration error reporting were inclined towards positive. The major perceived barrier was fear of the consequences after reporting. The results demonstrated that 88.9% of medication administration errors were reported orally, whereas 19.0% were reported through the hospital internet system. Self-recrimination was the common feeling of nurses after the commission of an medication administration error. CONCLUSIONS: Even if hospital management encourages errors to be reported without recrimination, nurses' attitudes toward medication administration error reporting are not very positive and fear is the most prominent barrier contributing to underreporting. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should establish anonymous reporting systems and counselling classes to create a secure atmosphere to reduce nurses' fear and provide incentives to encourage reporting.

Inactive nurses in Taiwan: human capital, intention to return to hospital nursing, and incentives for returning.

AIMS: To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. BACKGROUND: Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. METHOD: Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. RESULTS: Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. CONCLUSIONS: Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. IMPLICATIONS FOR NURSING MANAGEMENT: The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing.

Nurse administrators' intentions and considerations in recruiting inactive nurses.

AIMS: To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. BACKGROUND: Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. METHODS: A census survey collected data from 392 nurse administrators via a mailing method. RESULTS: Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. CONCLUSIONS: Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence.

The Smoking Outcome Expectation Scale and Anti-Smoking Self-Efficacy Scale for Early Adolescents: Instrument Development and Validation.

Smoking-related outcome expectation and self-efficacy have been found to be associated with adolescent smoking initiation. There is, however, a lack of appropriate instruments to investigate early adolescents' smoking outcome expectations and antismoking self-efficacy. The purpose of this study was to develop and validate the Smoking Outcome Expectation Scale (SOES) and Anti-Smoking Self-Efficacy Scale (ASSES). A total of 232 fifth and sixth graders from four elementary schools in Taiwan participated in the study. Both scales had good content validity, internal consistency, and test-retest reliability. On the basis of exploratory factor analysis, the 6-item SOES with two factors accounted for 54.72% of total variance and the 15-item ASSES with three factors accounted for 56.49% of total variance. The SOES had convergent and discriminant validity and ASSES had convergent validity. The two scales could help school nurses to understand early adolescents' smoking outcome expectation and antismoking self-efficacy and to develop more appropriate antismoking curricula.

Evaluating nurses' knowledge of chemotherapy.

BACKGROUND: The characteristics of the drugs that are used in chemotherapy have given rise to many issues, one of which is whether nurses are competent when working with chemotherapy. METHODS: Nurses' knowledge of chemotherapy was evaluated with a questionnaire that included 20 true-or-false questions. The questionnaire was developed from literature and expert input and validated by subject experts (content validity). A pilot study (contrasted-groups approach) was also conducted. RESULTS: A total of 203 nurses participated in the study and achieved an average overall correct answer rate of 60.9%. Most of the respondents, 63.5% (129 of 203), had a score of less than 70, and 77.3% (157 of 203) hoped to undergo more training on chemotherapy. Their knowledge of chemotherapy came mainly from consultation with colleagues (4.0 ± 0.8) and in-hospital continuing education (3.9 ± 0.8). CONCLUSION: The evidence-based results suggested that nurses have insufficient knowledge about chemotherapy. More fundamentally, however, nurses need more education about chemotherapy in nursing school and through in-hospital continuing education.

[Medication errors in emergency rooms, intensive care units and pediatric wards].

Medication safety is a major concern worldwide that directly relates to patient care quality and safety. Reducing medication error incidents is a critical medication safety issue. This literature review article summarizes medication error issues related specifically to three hospital units, namely emergency rooms (ERs), intensive care units (ICUs), and pediatric wards. Time constrains, lack of patient history details and the frequent need to use rapid response life-saving medications are key factors behind high ER medication error rates. Patient hypo-responsiveness, complex medication administration and frequent need to use high-alert medications are key factors behind high ICU medication error rates. Medication error in pediatric wards are often linked to errors made by nurses in calculating dosage based on patient body weight. This article summarizes the major types of medication errors reported by these three units in order to increase nurse awareness of medication errors and further encourage nurses to apply proper standard operational procedures to medication administration.

Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies.

Evaluation of Nurse Practitioners' Professional Competence and Comparison of Assessments Using Multiple Methods: Self-Assessment, Peer Assessment, and Supervisor Assessment.

PURPOSE: Nurse practitioners (NPs) are increasingly important in healthcare as they play a key role in leading advanced nursing practices. Assessing their professional competence is essential. The aim of this study was to evaluate NPs' professional competencies based on at a collaborative model around NP self and compare different methods of assessment. METHODS: This is a cross-sectional study, and a purposive sample of 211 participants in the teaching hospital was used. Methods used were self-assessment (nurse practitioners), peer assessment (physicians and nurses) and supervisor assessment (head nurses). RESULTS: The competence of nurse practitioners was rated as moderate (mean score = 3.45 of a possible 5; SD = 0.59). However, each method resulted in differences in competence for total scores and dimensions. The highest competence was in direct patient care (mean = 3.55, SD = 0.53), and the lowest score was in monitoring the quality of patient care (mean = 3.30, SD = 0.82). post hoc analysis shown that supervisor assessment rated professional competence significantly lower than the method of self-assessment and peer assessment (F = 10.07, p < .001). CONCLUSION: NPs require an increased effort to continuous learning for enhancing professional competencies. Moreover, using multiple methods for assessment to obtain a more comprehensive and accurate evaluation of NPs' professional competence.

Nurses' knowledge of high-alert medications: instrument development and validation.

AIM: This paper is a report of the development and validation of an instrument to measure nurses' knowledge of high-alert medications and to analyse known administration errors. BACKGROUND: Insufficient knowledge is a factor in nurses' drug administration errors. Most errors do not harm patients, but incorrect administration of high-alert medications can result in serious consequences. Sufficient knowledge about high-alert medications is vital. METHOD: A cross-sectional study was conducted in 2006 in Taiwan using a questionnaire developed from literature review and expert input, and validated by subject experts and two pilot studies. Section 1 of the questionnaire (20 true-false questions) evaluated nurses' knowledge of high-alert medications and section 2 was designed to analyse known administration errors. Snowball sampling and descriptive statistics were used. FINDINGS: A total of 305 nurses participated, giving a 79.2% response rate (305/385). The correct answer rate for section 1 was 56.5%, and nurses' working experience contributed to scores. Only 3.6% of nurses considered themselves to have sufficient knowledge about high-alert medications, 84.6% hoped to gain more training, and the leading obstacle reported was insufficient knowledge (75.4%). A total of 184 known administration errors were identified, including wrong drug (33.7%) and wrong dose (32.6%); 4.9% (nine cases; 9/184) resulted in serious consequences. CONCLUSION: The questionnaire was valid and reliable. Evidence-based results strongly suggest that nurses have insufficient knowledge about high-alert medications and could benefit from additional education, particularly associated with intravenous bolus administration of high-alert medications. Further research to validate the instrument is needed.

Wound Care Knowledge, Attitudes, and Practices and Mobile Health Technology Use in the Home Environment: Cross-Sectional Survey of Social Network Users.

BACKGROUND: Injury causing wounds is a frequent event. Inadequate or inappropriate treatment of injuries can threaten individual health. However, little is known about wound care knowledge, attitudes, and practices and mobile health (mHealth) use in the home environment in Taiwan. OBJECTIVE: This study aimed to evaluate wound care knowledge, attitudes, and practices and mHealth technology use among social network users. METHODS: A cross-sectional survey on social media platforms was conducted on adults aged 20 years and older. Data were collected from social network users in the home environment. RESULTS: A total of 361 participants were enrolled. The mHealth technology use of participants was positively correlated with wound care knowledge (r=.132, P=.01), attitudes (r=.239, P<.001), and practices (r=.132, P=.01). Participants did not have adequate knowledge (correct rate 69.1%) and were unfamiliar with the guidelines of proper wound care (correct rate 74.5%). Most participants had positive attitudes toward wound care and mHealth technology use. A total of 95.6% (345/361) of participants perceived that the use of mHealth technology can improve wound care outcomes, and 93.9% (339/361) perceived that wound care products should be optimized to be used with a mobile device. However, 93.6% (338/361) of participants had no experience using mHealth technology for wound care. CONCLUSIONS: Our study shows the potential of mHealth technology to enhance wound care knowledge among social network users. Thus, government agencies and medical institutions in Taiwan should provide easy-to-use information products that enhance wound care knowledge, promote adequate behavior toward wound care, and prevent unpredictable or undesirable outcomes.

Using snowball sampling method with nurses to understand medication administration errors.

AIMS AND OBJECTIVES: We aimed to encourage nurses to release information about drug administration errors to increase understanding of error-related circumstances and to identify high-alert situations. BACKGROUND: Drug administration errors represent the majority of medication errors, but errors are underreported. Effective ways are lacking to encourage nurses to actively report errors. METHODS: Snowball sampling was conducted to recruit participants. A semi-structured questionnaire was used to record types of error, hospital and nurse backgrounds, patient consequences, error discovery mechanisms and reporting rates. RESULTS: Eighty-five nurses participated, reporting 328 administration errors (259 actual, 69 near misses). Most errors occurred in medical surgical wards of teaching hospitals, during day shifts, committed by nurses working fewer than two years. Leading errors were wrong drugs and doses, each accounting for about one-third of total errors. Among 259 actual errors, 83.8% resulted in no adverse effects; among remaining 16.2%, 6.6% had mild consequences and 9.6% had serious consequences (severe reaction, coma, death). Actual errors and near misses were discovered mainly through double-check procedures by colleagues and nurses responsible for errors; reporting rates were 62.5% (162/259) vs. 50.7% (35/69) and only 3.5% (9/259) vs. 0% (0/69) were disclosed to patients and families. High-alert situations included administration of 15% KCl, insulin and Pitocin; using intravenous pumps; and implementation of cardiopulmonary resuscitation (CPR). CONCLUSIONS: Snowball sampling proved to be an effective way to encourage nurses to release details concerning medication errors. Using empirical data, we identified high-alert situations. Strategies for reducing drug administration errors by nurses are suggested. RELEVANCE TO CLINICAL PRACTICE: Survey results suggest that nurses should double check medication administration in known high-alert situations. Nursing management can use snowball sampling to gather error details from nurses in a non-reprimanding atmosphere, helping to establish standard operational procedures for known high-alert situations.

Applying the technology acceptance model to explore public health nurses' intentions towards web-based learning: a cross-sectional questionnaire survey.

BACKGROUND: In the era of the knowledge economy, public health nurses (PHNs) need to update their knowledge to ensure quality of care. In pre-implementation stage, policy makers and educators should understand PHNs' behavioural intentions (BI) toward web-based learning because it is the most important determinant of actual behaviour. OBJECTIVES: To understand PHNs' BI toward web-based learning and further to identify the factors influencing PHNs' BI based on the technology acceptance model (TAM) in pre-implementation stage. DESIGN: A nationwide-based cross-sectional research design was used in this study. SETTING: Three hundred and sixty-nine health centres in Taiwan. PARTICIPANTS: A randomly selected sample, 202 PHNs participated in this study. METHODS: Data were collected by mailing in a questionnaire. RESULTS: The majority of PHNs (91.6%, n=185) showed an affirmative BI toward web-based learning. PHNs rated moderate values of perceived usefulness (U), perceived ease of use (EOU) and attitude toward web-based learning (A). Multiple regression analyses indicated that only U revealed a significantly direct influence on BI. U and EOU had significantly direct relationships with A; however, no significant relationship existed between A and BI. Additionally, EOU and an individual's computer competence revealed significant relationships with U; Internet access at the workplace revealed a significant relationship with EOU. CONCLUSION: In the pre-implementation stage, PHNs perceived a high likelihood of adopting web-based learning as their way of continuing education. In pre-implementation stage, perceived usefulness is the most important factor for BI instead of the attitude. Perceived EOU, an individual's computer competency, and Internet access at workplaces revealed indirect effects on BI. Therefore, increasing U, EOU, computer competence, and Internet access at workplace will be helpful in increasing PHNs' BI. Moreover, we suggest that future studies should focus on clarifying problems in different stages of implementation to build a more complete understanding of implementing web-based learning.

Development and validation of a Quality of Life Scale for elementary school students.

Emotional well-being affects the school performance of elementary school children. Quality of life (QoL) measurements are indicative of emotional well-being; however, the development of assessment tools suitable for measuring the QoL of elementary school children has received little attention and, therefore, the creation of reliable assessment tools for measuring QoL among this population is required. Method: We employed qualitative and quantitative research methods to develop and validate a QoL scale for elementary school children in Taiwan. We used cluster random sampling to recruit 711 fifth and sixth grade students, aged 10-12 years, from 14 elementary schools. Results: The scale comprised six factors (School function, Family function, Environmental life, Vitality for life, Learning ability, and Peer relationships) that explained 44% of the variance. The developed 21-item elementary school QoL (ESQoL) instrument had high internal consistency and satisfactory reliability and validity. Conclusions: The ESQoL instrument can facilitate the evaluation of factors associated with students' emotional well-being. Additional studies using the ESQoL instrument are required to assess its applicability for evaluating relationships between QoL and school performance and other areas of student life.

ANTECEDENTES/OBJETIVO: El bienestar emocional afecta el rendimiento escolar de los niños de Educación Primaria. Las mediciones de la calidad de vida (QoL) son indicativas del bienestar emocional. Sin embargo, el desarrollo de herramientas de evaluación adecuadas para medir la calidad de vida de niños de Educación Primaria ha recibido escasa atención y, por lo tanto, se requiere la creación de herramientas de evaluación confiables para medir la calidad de vida en esta población. Método: Se empleraron métodos de investigación cualitativa y cuantitativa para desarrollar y validar una escala de QoL para niños de Primaria en Taiwán. Se utilizó un muestreo aleatorio por grupos para reclutar a 711 estudiantes de Quinto y Sexto Grado, de 10 a 12 años, de 14 escuelas primarias. Resultados: La escala agrupa seis factores (Función escolar, Función familiar, Vida ambiental, Vitalidad para la vida, Capacidad de aprendizaje y Relaciones entre compañeros) que explican el 44% de la varianza. El instrumento de QoL (ESQoL) de 21 ítems tiene alta fiabilidad de consistencia interna y validez satisfactoria. Conclusiones: El instrumento ESQoL puede facilitar la evaluación de factores asociados con el bienestar emocional de los escolares. Se requieren estudios adicionales utilizando el instrumento ESQoL para evaluar su aplicabilidad en el análisis de las relaciones entre QoL y rendimiento escolar, y otras áreas del ámbito escolar.

Study of hepatotoxicity of naltrexone in the treatment of alcoholism.

Since a black box warning was issued by the Food and Drug Administration regarding the use of the opiate antagonist naltrexone (NTX), many clinicians have been concerned about current labeling of the potential hepatotoxicity risk of NTX in the treatment of opiate dependence and alcoholism. Despite many reports that demonstrated that the use of NTX did not cause elevation of liver enzymes, controversy concerning whether NTX is hepatotoxic continues. The current study monitored 74 alcoholic patients who received 25mg of NTX daily in the first week and then 50mg of NTX daily for the rest of the 12-week period. After the 12-week treatment, levels of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) did not show any elevation, except in one subject, and the results strongly support that NTX did not induce abnormalities in liver function tests or elevate the liver enzymes. Instead, a statistical significance of decreasing levels of ALT and AST in the liver was shown throughout the study. These findings provide further support that NTX is not hepatotoxic at the recommended daily dose and may be beneficial for patients with elevated liver enzymes.

Taiwanese Version of the Work-Related Quality of Life Scale for Nurses: Translation and Validation.

BACKGROUND: The shortage of professional nurses is a global issue of critical importance. Improving the retention and recruitment of nurses is necessary to reduce this shortage. The ability to measure the quality of work life (QWL) of nurses is important to understand the current QWL status among nurses and to develop appropriate improvement strategies. The two instruments that are currently used in Taiwan both require excessive amounts of time to complete. Furthermore, the results that these two instruments generate are not easily interdisciplinary and international comparisons. PURPOSE: The aims of this study were to translate into Chinese the English version of the Work-Related Quality of Life Scale (WRQoL) that was developed by Van Laar, Edwards, and Easton (2007) and then to determine the reliability and validity of this Chinese-version scale in terms of measuring the QWL of nurses in Taiwan. METHODS: The WRQoL was translated from English into Chinese using forward-translation with group discussions, back-translation, and verification of conceptual equivalence. Concurrent validity, test-retest reliability, and internal consistency reliability were determined in two samples of nurses (n = 30 and n = 213 for Phases 1 and 2, respectively) from a medical center in Taiwan during September 2009. RESULTS: The 23-item Taiwanese version of the WRQoL showed satisfactory concurrent validity with a Taiwanese QWL scale (correlation = .75). The 3-week test-retest reliability was .89, and the Cronbach's alpha was .88, indicating high internal consistency reliability. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Taiwanese version of the WRQoL is acceptable for measuring the QWL of nurses in Taiwan. Larger scale studies are recommended for confirmatory factor analysis. This tool may be used for human resources management and policy-making applications, providing the potential to help retain and recruit nurses in Taiwan. Furthermore, the Taiwanese-version scale may be used to compare work-related quality of life between Taiwanese nurses and their counterparts overseas.

Students' perceptions of effective and ineffective clinical instructors.

Clinical nursing faculty possess four categories of important qualities: professional competence, interpersonal relationship, personality characteristics, and teaching ability. The main purpose of this study was to understand of these four categories of qualities, which, taken together, was the main contributor to effectiveness differences among clinical nursing faculty. A total of 214 students from two nursing schools completed the questionnaire, using a 5-point Likert-type scale. The results showed that effective teachers possessed significantly high scores (> 4) in all of these four qualities. While the scores of ineffective teacher were lower (< 3) in all categories, except professional competence. Larger differences in scores between effective and ineffective teachers were found in the interpersonal relationship category, followed by the category of personality characteristics. Smaller differences in scores between effective and ineffective teachers were in the professional competence category, followed by the teaching ability category. From these results, we suggest that teachers' attitudes toward students, rather than their professional abilities, are the crucial difference between effective and ineffective teachers. This research also indicates that students from different nursing schools have similar opinions regarding this concern. Based on these findings, we highly recommend that teachers strive to improve their attitudes toward students as the best way to achieve the goals of clinical teaching.

Faculty's perceptions of humanistic teaching in nursing baccalaureate programs.

In an attempt to investigate faculty's perceptions of humanistic teaching in nursing baccalaureate programs, a qualitative study was conducted by interviewing 10 faculty members (including one dean, and five associate deans) who all had experience in teaching nursing baccalaureate students. The participants were from five universities located in the southwestern, southeastern, and southern parts of the USA. The data were collected from 6/28-7/12, 2002. All the interviews were audio-taped and transcribed verbatim. Data analysis was inductive, seeking understanding of individuals' perceptions. When a number of coded contexts were considered to have common elements, they were merged to form categories and presented as results. The findings showed that there are five essential elements in faculty's perceptions of humanistic teaching in nursing baccalaureate programs: availability, caring, authenticity, empowerment, and a transformative curriculum.

A preliminary psychosocial study of Parkinson's patients after fetal tissue transplantation.

A novel and promising approach currently available is the grafting of fetal nigra tissues into the brain of a Parkinson's patient. However, the degree of success for such treatment has mainly been evaluated by histological, radiological and physical assessments, with little or no attention paid to its effects on the patient's psychosocial status. In order to provide a more comprehensive profile, a survey was conducted using questionnaires and interviews to examine the physio-psycho-social progress of six Parkinson's patients who underwent fetal tissue grafting in Taiwan. Results indicated that the physiological effects varied among patients. Noticeably an improvement in walking was the most gratifying, but progress in dressing and writing ability seemed disappointing. From the psychological point of view, depression was commonly felt by patients. Other feelings included fear, ambivalence, and change in body image. In addition, all six patients found that their relationship with spouse became worse; they also reduced social interaction to the minimum. From the findings, we also noticed that inadequate knowledge contributed to part of the results. Therefore, some nursing suggestions especially educating the patients and family about the facts and outcome of fetal tissue transplantation are highly recommended. These may help Parkinson's patients adjust better after undergoing this novel treatment.