Identification and fungicides sensitivity evaluation of the causal agent of cobweb disease on Lyophyllum decastes in China.

BACKGROUND: Cobweb disease is a fungal disease that commonly affects the cultivation and production of edible mushrooms, leading to serious yield and economic losses. It is considered a major fungal disease in the realm of edible mushrooms. The symptoms of cobweb disease were found during the cultivation of Lyophyllum decastes. This study aimed to identify the causative pathogen of cobweb disease and evaluate effective fungicides, providing valuable insights for field control and management of L. decastes cobweb disease. RESULTS: The causal agent of cobweb disease was isolated from samples infected and identified as Cladobotryum mycophilum based on morphological and cultural characteristics, as well as multi-locus phylogeny analysis (ITS, RPB1, RPB2, and TEF1-α). Pathogenicity tests further confirmed C. mycophilum as the responsible pathogen for this condition. Among the selected fungicides, Prochloraz-manganese chloride complex, Trifloxystrobin, tebuconazole, and Difenoconazole exhibited significant inhibitory effects on the pathogen's mycelium, with EC50 values of 0.076 µg/mL, 0.173 µg/mL, and 0.364 µg/mL, respectively. These fungicides can serve as references for future field control of cobweb disease in L. decastes. CONCLUSION: This study is the first report of C. mycophilum as the causing agent of cobweb disease in L. decastes in China. Notably, Prochloraz-manganese chloride complex demonstrated the strongest inhibitory efficacy against C. mycophilum.

High-Activity and High-Selectivity Air-Stable Nickel and Copper Complexes for Copolymerization of Epoxides with Anhydrides.

Ring-opening copolymerization (ROCOP) of epoxides with anhydrides presents a highly promising pathway for the synthesis of diverse polyester copolymers. This process involves the simultaneous opening of the epoxide ring and the anhydride ring, resulting in the formation of copolymer chains with alternating repeating units. Here, we synthesized a series of nickel and copper complexes coordinated by amine-bis(benzotriazole phenolate) ligands (C1NNBiBTP-H2). Different acid-base conditions can result in the synthesis of diverse coordination structures. The six-coordinated mononuclear Ni catalyst synthesized in this study exhibited competitive turnover frequencies (TOF = 450 h-1) compared to previous studies involving copolymerization of epoxides with anhydrides. This indicates the catalyst's high activity in facilitating the copolymerization reaction. The results indicate that the catalyst exhibited a high molecular weight control ability and high polymer selectivity for the ROCOP of epoxides and anhydrides. Thus, this air-stable catalyst has the potential for use in industries.

Cordierite@MOFs with Easy Recovery in CO2 Cycloaddition.

The objective of this research is to create monolithic heterogeneous catalysts (cordierite@MOFs) through the application of metal-organic framework (MOF) materials onto honeycomb cordierite for CO2 cycloaddition. By employing monolithic catalysts instead of powdered catalysts, the recycling and reusability of catalysts during postreaction treatment can be significantly improved.

Well-Defined and Highly Effective Nickel Catalysts Coordinated on Tridentate SNO Schiff-Base Derivatives for Alternating Copolymerization of Epoxides and Anhydrides.

A series of Ni complexes supported by SNO Schiff-base derivatives were synthesized in this study. Complex synthesis and characterization data are reported herein. Treatment of the pro-ligands [L1-H = 2-(((2-(methylthio)ethyl)imino)methyl)phenol, L2-H = 2,4-di-tert-butyl-6-(((2-(methylthio)ethyl)imino)methyl)phenol, L3-H = 2-(((2-(methylthio)ethyl)imino)methyl)-4,6-bis(2-phenylpropan-2-yl)phenol, L4-H = 4-bromo-2-(((2-(methylthio)ethyl)imino)methyl)phenol, and L5-H = 4-chloro-2-(((2-(methylthio)ethyl)imino)methyl)phenol] with Ni(OAc)2·4H2O in refluxing ethanol afforded six-coordinate mono-Ni(II) complexes [L2nNi] (n = 1-5). Noteworthy, a heptanuclear nickel(II) octacarboxylate species complex 6 and dinuclear nickel complex 6a resulted from treatment of L6-H [4-fluoro-2-(((2-(methylthio)ethyl)imino)methyl)phenol] with different metal precursors [Ni(OAc)2·4H2O for 6; NiBr2 for 6a] giving a quantitative yield. The reaction of nickel acetate tetrahydrate and L7-H to L9-H [L7-H = 2-methoxy-6-(((2-(methylthio)ethyl)imino)methyl)phenol, L8-H = 5-methoxy-2-(((2-(methylthio)ethyl)imino)methyl)phenol, and L9-H = 4-methoxy-2-(((2-(methylthio)ethyl)imino)methyl)phenol] produced the four-coordinate complexes [L2nNi] (n = 7-9). The highest performing catalyst was complex 3, which was highly efficient for the ring-opening copolymerization of phthalic anhydride (PA) and cyclohexene oxide (CHO) in the presence of a cocatalyst (4-dimethylaminopyridine). In addition, the same copolymerization conditions produced narrowly dispersed polyesters, with high selectivity and polymerization control. In addition to PA-CHO copolymerization, efficient diglycolic anhydride-PA and PA-propene oxide copolymerization was achieved under the same conditions. These catalysts are straightforward to produce and extend the scope of potential substrates.

[Nursing Experience Using Motivational Interviewing to Increase Medication Adherence in a Patient With Schizoaffective Disorder].

This article describes an experience providing care for non-adherence to medication in a patient with schizoaffective disorder. The patient, a long-term resident of a rehabilitation home, was experiencing auditory hallucination symptoms related to his non-adherence to medication. After being hospitalized, he refused to take oral medications, and had limited ability to effectively deal with the command auditory hallucinations, leading to his self-harm behavior. The nursing period was from April 7th to May 3rd, 2021. Data were collected using observation, in-depth interviews, and a medical history review. The nursing assessment was conducted using the five dimensions of nursing assessment. The authors used empathy, listening, and caring attitudes to establish a trusting and therapeutic interpersonal relationship with the patient. A motivational interview approach was employed to strengthen motivation to take medication, guide and link the value of personal life, and jointly draw up a patient-centered plan to establish rules to which the patient would be able to adhere. Subsequently, the patient achieved reduced interference from auditory hallucinations and close adherence to his medication protocol and attended follow-up appointments regularly in the outpatient department after discharge.

Acceptability Evaluation of the Use of Virtual Reality Games in Smoking-Prevention Education for High School Students: Prospective Observational Study.

BACKGROUND: Alternative forms of cigarettes, such as electronic cigarettes (e-cigarettes), are becoming increasingly common among adolescents. Many high schools now provide smoking-prevention education in an attempt to minimize the potential negative health effects and illness burdens e-cigarettes may induce in adolescents. However, it is often difficult to motivate young students to engage with traditional education regarding the harmful effects of tobacco; thus, the development of alternative approaches may be required. OBJECTIVE: In this study, we aimed to conduct an acceptability evaluation of educational virtual reality games designed to support smoking-prevention measures. We based the acceptability evaluation on the following two experience types: game-playing and content-learning experiences. The paths by which these experience types affect the intention to abstain from smoking were also examined. METHODS: We applied a prospective observational study design. We developed educational games based on three-dimensional virtual reality technology, in which participants operated joysticks to complete challenge tasks. To increase the possibility of the games fostering motivation to abstain from smoking, the ARCS motivational model (comprising attention, relevance, confidence, and satisfaction) was used as a framework during the games' design. We measured the participants' game-playing experiences by inquiring about the strength of the ARCS elements; content-learning experiences were measured using overall knowledge improvement and the perceived persuasiveness of the content. A total of 130 students participated in the program. Study hypotheses for this evaluation were derived from a literature review. We used partial least squares structural equation modeling to examine the proposed hypotheses. RESULTS: Based on the responses of the students to questionnaire items concerning attention, relevance, confidence, and satisfaction in the context of the games, most students agreed or strongly agreed that the educational games were motivational, and that their game-playing experiences were positive. Regarding content-learning experiences, there was a significant improvement in knowledge (t129=25.67, P<.001), and most students perceived themselves as being persuaded to abstain from smoking. Attention, relevance, and satisfaction significantly influenced perceived persuasiveness (t=3.19, P<.001; t=4.28, P<.001; and t=3.49, P<.001, respectively); however, confidence did not (t=0.42, P=.67). Perceived persuasiveness, relevance, and satisfaction significantly influenced the intention to abstain from smoking (t=3.57, P<.001). In addition to directly affecting the intention to abstain from smoking, indirect effects were observed from both relevance and satisfaction to intention via perceived persuasiveness (t=2.87, P=.004 and t=2.11, P=.04, respectively). However, intention was not significantly influenced by knowledge improvement. CONCLUSIONS: Our findings revealed that the educational games were positively accepted by the participating students. This indicates that the integration of the ARCS framework and persuasive strategies is applicable for smoking-prevention education. We recommend that the games be included as teaching materials for smoking-prevention education.

Reasons for family involvement in elective surgical decision-making in Taiwan: a qualitative study.

AIMS AND OBJECTIVES: To inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. BACKGROUND: Making a patient the centre of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking. DESIGN: A qualitative study. METHOD: In order to record and examine reasons for family involvement in adult patients' surgical decision-making, 12 different family members of 12 elective surgery patients were interviewed for collecting and analysing data. RESULTS: Three major reasons for family involvement emerged from the data analyses: (1) to share responsibility; (2) to ensure the correctness of medical information; and (3) to safeguard the patient's well-being. These findings also reveal that culture is not the only reason for family involvement. CONCLUSIONS: Making decision to undergo a surgery is a tough and stressful process for a patient. Family may provide the patient with timely psychological support to assist the patient to communicate with his or her physician(s) and other medical personnel to ensure their rights. It is also found that due to the imbalanced doctor-patient power relationship, a patient may be unable, unwilling to, or even dare not, tell the whole truth about his or her illness or feelings to the medical personnel. Thus, a patient would expect his or her family to undertake such a mission during the informed consent and decision-making processes. RELEVANCE TO CLINICAL PRACTICE: The results of this study may provide medical professionals with relevant insights into family involvement in adult patients' surgical decision-making.

[Percutaneous Edge-to-Edge Mitral Valve Repair: New Transcatheter Approach and Nursing Experience in Patients With Severe Mitral Regurgitation and Prohibitive Surgical Risk].

Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications. Since 2016, MitraClip has been available for clinical use in Taiwan. The aim of this report is to introduce this new treatment with a focus on nursing care in order to provide a reference for clinical care.

Chinese adolescents' attitudes toward sexual relationships and premarital sex: implications for promoting sexual health.

This study was designed to explore Taiwanese school students' attitudes toward sexual relationships and premarital sex. This was an exploratory descriptive, qualitative study. Focus groups (N = 8) were conducted with 47 adolescents from three high schools in Taiwan. Transcripts were transcribed and thematically analyzed using Atlas V 5.0. Adolescent attitudes toward sexual relationships and premarital sexual behavior comprise the following three dimensions: (1) external incentives, (2) the developmental process, and (3) internal control. External incentives include the normalization of sexual behavior between peers, the desire to feel included in a group, parental influence, and media influence. The developmental process includes imagining the sexual experience and onset of sexual activity. Internal control includes the fear of pregnancy, the fear of parental rejection, and the fear of being judged. These findings can provide a reference for designing future sex education curricula and counseling programs for adolescents.

[Nursing experience with a schizophrenic breast cancer patient after mastectomy].

This case study used cognitive therapy to improve the life quality of a 46-year-old woman with chronic schizophrenia who had undergone a mastectomy for breast cancer. This case had suffered from schizophrenia for over 24 years and was hospitalized in the chronic ward of our hospital. Breast cancer was revealed during an annual comprehensive physical checkup. In May 2012, this case received a right mastectomy at a local hospital. After the surgery, she was readmitted to the psychiatric acute ward for further care from May 30th to August 28th, 2012. A holistic nursing assessment was conducted that addressed five major aspects. The major nursing problems found during hospitalization were: acute pain, body image disturbance, and low self-esteem. A decline in pain score from 10 to 4 was achieved by developing rapport with the patient, empathizing with her distress, and providing active care to the wound. Her body image changed because of loosing her breast. Her acceptance of the loss improved through helping her to explore her feelings of change. To improve her self-esteem, we offered cognitive therapy to change her negative thinking process. She became more sanguine and cheerful. Moreover, her dependence in terms of activities of daily living decreased. This individualized intervention contributed to the recovery of a post-mastectomy, schizophrenic patient from low self-esteem.

Mobile Apps for Patients with Peritoneal Dialysis: Systematic App Search and Evaluation.

BACKGROUND: Peritoneal dialysis (PD) is one type of renal replacement therapy. If patients have problems during the dialysis process, healthcare providers may not be able assist the patients immediately. mHealth can provide patients with information and help them to solve problems in real-time, potentially increasing their willingness to choose PD. OBJECTIVE: The objectives of this study were to conduct a comprehensive review of free mobile applications for patients with PD on the Internet and to recommend suitable mobile applications to facilitate patient self-management and health. METHODS: We conducted a systematic search for PD mobile applications on Google Play and the Apple iTunes Store from 3 to 16 June 2023. RESULTS: A total of 828 identifiable mobile applications were initially identified, and ultimately, 21 met the inclusion criteria. The Mobile App Rating Scale (MARS) assessment of the applications revealed the highest score in the functionality domain, followed by the aesthetics, information, app-specific, subjective quality, and engagement domains, respectively. In the comprehensive self-management of PD, the highest percentage was related to disease-related information. CONCLUSION: The findings of this study suggest that some applications, with the highest quality, can be recommended to patients for use in English or traditional Chinese.

Family as a whole: elective surgery patients' perception of the meaning of family involvement in decision making.

AIMS AND OBJECTIVES: This study aimed to explore patient perception of the meaning of family involvement in elective surgery decision making in Taiwan. BACKGROUND: Informed consent is based on respecting patient autonomy. However in cultures where family plays a key role in medical decision making, a patient's perspective of family involvement has not been fully investigated. DESIGN AND METHODS: Based on a phenomenological approach, this study conducted semistructured interviews to elicit the experiences of 10 elective surgery patients in southern Taiwan who had family present during their surgery decision making. An adapted version of Colaizzi's (1978) method was used to analyse narratives. RESULTS: Three themes emerged from the elective surgery patients' perception of the meaning of family involvement in their surgery decision-making process: (1) Primacy of family well-being, (2) family as information broker, and (3) family as patient advocate. Patients articulated reciprocal relationships amongst family members, and they expressed overall family well-being as their ultimate concern when making their treatment decision. The essence of the elective surgery patients' perception of the meaning of family involvement in decision making was 'family as a whole'. CONCLUSIONS: Patients' concern for overall family well-being and their perspective that family plays a supportive role in transmitting information and acting as patient advocate during the decision-making process may both enhance and restrict individual patient autonomy. In cultures where family is central in decision making, appropriately involving the family in medical decisions should not be overlooked. RELEVANCE TO CLINICAL PRACTICE: Understanding and acknowledging the important roles of family in medical decision making from the patients' perspective can enable health professionals to more effectively communicate with patients and their family. Then, health professionals can empower the individual who is making the medical decision based on his or her own needs.

Exploring ethical aspects of elective surgery patients' decision-making experiences.

The practice of respecting patients' autonomy is rooted in the healthcare professionals' empathy for patients' situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients' experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi's method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes emerged from the analyses: (a) a voluntary yet necessary alternative--to undergo a surgery and (b) alternatives compelled by the unalterable decision--the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel.

The Relationship of Parent Support and Child Emotional Regulation to School Readiness.

Using data from the longitudinal Early Head Start Research and Evaluation Project that were obtained when children were 14 through 60 months old, this study aims to explore the transactional effects between parent supportiveness and child emotion regulations skills. An autoregressive model with cross-lagged paths was utilized to examine the developmental trajectories of parent supportiveness and child emotion regulation, the directions of transactional relationships between them, and the transactional effects on the prediction of child cognitive school readiness. Significant autoregressive effects were found in both parent supportiveness and child emotion regulation trajectories. Significant concurrent and longitudinal transactional effects between these two processes were documented. The effects of child emotion regulation, parent supportiveness, and their transactional effects significantly predicted cognitive school readiness. This study exemplifies the use of archival longitudinal data to move beyond current unidirectional empirical understandings of child early psychosocial development toward more integrated perspectives. Equally important, the results provide critical insights for the timing of interventions as well as the involvement of parents in early intervention programs that early childhood educators and family services providers can benefit from.

Psychiatric Nurses' Knowledge and Practice Barriers to Administering Long-Acting Injectable (LAI) Antipsychotics in Taiwan: A Mixed-Methods Study.

Long-acting antipsychotic injections require that psychiatric nurses choose the proper injection site and technique to avoid harming patients. This research conducted a mixed-method study to examine the long-acting injectable antipsychotic (LAI) knowledge, practice, and administrative barriers in a sample of 269 psychiatric nurses from 3 public psychiatric hospitals in Taiwan. Self-report questionnaires showed female nurses exhibiting higher scores and older nurses demonstrating more knowledge. The dorsogluteal (DG) site was the most widely used for injections, with 57.6% of nurses using the Z-track method. Qualitative data analysis was performed on 20 psychiatric nurses who chose the DG site as their preferred injection site. There were two key themes. The first was a gap between the nurses' knowledge of LAI administration and their actual practice. The second needed more confidence and training in using the ventrogluteal injection site. These results highlight the need for continued education and training to improve LAI practice among psychiatric nurses.

Validity, reliability, and cross-validation of a new questionnaire developed using the Theory of Planned Behavior: The Dating Violence Bystander Help-giving Intention Questionnaire (DVBHIQ).

The present study aimed to develop and psychometrically test a scale by using the Theory of Planned Behavior (TPB) comprising two types of measurement (direct and belief-based [indirect]) to assess bystander help-giving intention to victims of dating violence among youth. A two-phase, mixed-method design was adopted. The primary source of the samples was five universities, each in the northern, central, southern, eastern, and outer islands regions of Taiwan. Phase I involved developing an instrument based on the TPB (n = 10) and pilot testing (n = 220). Phase II conducted the psychometric evaluation (n = 622). The study used item analysis, explanatory factor analysis, confirmatory factor analysis, internal consistency, and cross-validation to examine the psychometric properties of the Dating Violence Bystander Help-giving Intention Questionnaire (DVBHIQ) with two types of measure (direct and belief-based). Explanatory factor analysis resulted in a four-factor solution (attitude/behavioral beliefs, subjective norms/normative beliefs, perceived behavioral control/control belief, and intention) of the direct and belief-based measures of the DVBHIQ, accounting for 72.67% and 76.62% of total variance respectively. Confirmatory factor analysis and cross-validation confirmed the proposed four-factor model and demonstrated good internal consistency reliability. The two types of DVBHIQ had good validity, reliability, and measurement invariance which may help address the core cognitive determinants for bystander help-giving intention. Healthcare providers (e.g., school nurses) could use the DVBHIQ to evaluate how bystander education programs affect youth and conduct related research in the future.

Pubescent male students' attitudes towards menstruation in Taiwan: implications for reproductive health education and school nursing practice.

AIM: To explore male students' attitudes towards menstruation. BACKGROUND: Menstruation is a biological event that is often surrounded by secrecy and social stigma that causes anxiety amongst many young girls. A key element of this is the attitudes of young males towards this reproductive health issue. However, the literature around what young males think and feel about menstruation is limited. DESIGN: Qualitative. METHODS: A sample of 27 male students aged between 10-12 years participated in five focus groups. Data were then subject to a thematic analysis. RESULTS: Five themes emerged from the data analysis that reflected the boys' feelings, experiences and attitudes towards menstruation: 'A silent topic', 'An unimportant issue', 'Errant information about menstruation'. In addition, according to their experience, participants gradually came to see menstruation from the 'menstrual stereotype' viewpoint. In their social life, they made choices that resulted in gradually regulating their behaviour that affected their 'relationships with girls'. CONCLUSION: Young boys have misguided knowledge about menstruation and this helps to perpetuate the stigma surrounding this element of reproductive health. Boys also express a desire to learn more but are often restricted in this by home and school. School nurses are the best placed professionals to address this issue. RELEVANCE TO CLINICAL PRACTICE: Menstrual education with boys should take a greater prominence than it often does in sexual health education in schools. Such inclusion will provide boys with a balanced and accurate knowledge base and therefore help towards reducing the social stigma around menstruation that is often experienced by young girls.

Effects of an Interdisciplinary Communication Partner Training Program on Student Learning.

BACKGROUND: Communication partner training (CPT) involves educating conversation partners to implement communication strategies that facilitate improved interactions with people with aphasia (PWA). This study aimed to investigate (1) whether a CPT program increased the knowledge and confidence of students with and without a communication disorders background and (2) the differential effects of this training on students from different allied health disciplines. METHODS: Quasi-experimental design study with 6 adult volunteers with aphasia and 36 students (18 speech-language pathology [SLP] students and 18 physical therapy/occupational therapy [PT/OT] students). The CPT program was provided twice (in 2015 and 2016) as a single seminar at an American university. RESULTS: All students reported increased confidence in communicating with PWA and were able to identify a greater number of appropriate communication strategies after the CPT than they could identify before the training. The SLP students demonstrated greater aphasia knowledge than the PT/OT students prior to training; only the PT/OT students reported increased knowledge about aphasia after training. DISCUSSION: Involvement of PWA in CPT programs may be particularly important in enabling students to develop confidence in communicating with PWA. Practice opportunities with PWA can be provided as early as the beginning of didactic coursework through an interdisciplinary CPT program.

Mental Health Nurses' Tacit Knowledge of Strategies for Improving Medication Adherence for Schizophrenia: A Qualitative Study.

Non-adherence to medication among patients with schizophrenia is an important clinical issue with very complex reasons. Since medication administration is an essential nursing responsibility, improving strategies for patient medication compliance must be fully understood. This study aimed to explore the strategies mental health nurses (MHNs) implement in clinically improving patients with schizophrenia and to describe the nurses' tacit knowledge of application strategies. A qualitative study with purposeful sampling was used. Twenty-five experienced MHNs in a psychiatric hospital in central Taiwan were given an in-depth interview. The texts were content-analyzed using NVivo 12 Pro software. MHNs promote medication adherence among patients with schizophrenia using the following strategies: establishing a conversational relationship, overall assessment of non-adherence to medication, understanding the disease and adjusting the concept of medication, incorporating interpersonal connection feedback, and building supportive resources. This study explored the strategies of MHNs that incorporated knowledge in managing treatment adherence in patients with schizophrenia. The findings add knowledge to clinical nursing practice about medication adherence among patients with schizophrenia.

Effects of Rehabilitation Models on Self-Stigma among Persons with Mental Illness.

Social stigma is inevitable for mentally ill patients, but how patients treat themselves is a priority for rehabilitation and an important buffer mechanism. This study thus aimed to measure the effectiveness of rehabilitation models for improving self-stigma. This quasi-experimental research design applied purposeful sampling. The participants (n = 250) were persons with mental illness who received rehabilitation treatment in central Taiwan. They were divided into community- (n = 170) and institution-based (n = 80) rehabilitation groups. The Internalized Stigma of Mental Illness Scale was evaluated at the time of recruitment, and a follow-up was conducted after 1 and 3 months. A generalized estimation equation was used in data analysis to measure whether self-stigma improved with the rehabilitation model and time, and to test the effect of different rehabilitation models on participants' self-stigma improvement. The study found that the self-stigma of patients receiving CBR improved more than that of those receiving IBR when behavioral problems, education, OT level, sex, and first-time self-stigma were controlled. Returning to the community is the goal of rehabilitation for patients with mental illness, but IBR still dominates the rehabilitation model in Taiwan. Thus, it is necessary to continue promoting CBR plans for future mental health policies.