Development and Validation of the Interprofessional Collaboration Practice Competency Scale (IPCPCS) for Clinical Nurses.

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.

Development and validation of a Chinese version of the Sleep Apnea Quality of Life Index.

OBJECTIVE: A Chinese version of the Sleep Apnea Quality of Life Index (SAQLI) for patients with obstructive sleep apnea (OSA) undergoing treatment with continuous positive airway pressure (CPAP) was developed and validated. No Chinese versions of the SAQLI have been previously validated. METHODS: A convenience sample of 78 patients with OSA who received CPAP therapy at a Taiwanese teaching hospital was enrolled. The SAQLI is organized into four domains: daily functioning, social interactions, emotional functioning, and symptoms. This study evaluated the equivalence (forward translation and back translation), validity, and reliability of a Chinese version of the SAQLI. RESULTS: The content validity index (CVI) values of the daily functioning, social interactions, emotional functioning, and symptom domains were .93, .93, .96, and 1.00, respectively. Construct validity of one factor was generated by exploratory factor analysis, and the factor explained the following: (A) daily functioning 54%, (B) social interactions 59%, (C) emotional functioning 64%, and (D) symptoms 75% of total explained variance. The Cronbach's α internal consistency values for the daily functioning, social interactions, emotional functioning, and symptom domains were 0.68, 0.94, 0.93, and 0.92, respectively. The repeatability of the SAQLI at 7 days and 30 days after the first administration showed reliability coefficients of .94 and .93 (p = 0.001), respectively. CONCLUSIONS: The results indicate that the Chinese version of the SAQLI has good reliability and validity, as well as refined indicators for assessing the tool's accuracy. Clinicians may thus use the scale to examine the quality of life in Chinese-speaking patients with OSA undergoing CPAP therapy.

The effects of integrated nursing education on quality of life and health-related outcomes among obstructive sleep apnea patients receiving continuous positive airway pressure therapy.

PURPOSE: This study sought to examine the effects of a nursing education program on quality of life and sleep disturbance among obstructive sleep apnea (OSA) patients receiving continuous positive airway pressure (CPAP) therapy. METHODS: This study was a randomized controlled trial with an intervention group consisting of a nursing education program. The intervention group received the instruction of the CPAP nursing education program, and the control group received routine care. Data was collected for both groups before the intervention (pre-test), on the 7th day measurement after the intervention, and on the 30th day measurement after the intervention. RESULTS: The results showed, first, that the intervention group reported a significantly reduced level of disturbance from wearing CPAP compared with that of the control group after the intervention (ß = -1.83, p = .040). Second, the Calgary sleep apnea quality of life index (SAQLI) total scores significantly improved after the intervention (ß = 1.669, p = 0.014). Also, symptoms of the SAQLI sub-items were improved and significantly different (ß = 5.69, p = 0.007) after the intervention in the intervention group. CONCLUSIONS: According to the results of the study, the disturbance from wearing CPAP, the total score of the SAQLI and the symptoms of the SAQLI were significantly improved after the nursing education intervention. Therefore, an adequate nursing education program is recommended for the initial period of CPAP use among OSA patients.

Life experiences among obstructive sleep apnoea patients receiving continuous positive airway pressure therapy.

AIMS AND OBJECTIVES: To generate a descriptive theoretical framework for experiences among obstructive sleep apnoea (OSA) patients undergoing continuous positive airway pressure (CPAP) therapy. BACKGROUND: Insufficient information is available about subjective experiences among OSA patients undergoing CPAP therapy. This study aims to address that lack of insight into patients' feelings. DESIGN: A qualitative study using the grounded theory method to establish a descriptive theory. METHODS: Twenty-two Taiwanese OSA patients undergoing CPAP therapy participated in comprehensive interviews. RESULTS: The patients, aged 37-68 years, participated in wide-ranging interviews. 'Living with CPAP' was the core theme describing the life experiences of OSA patients undergoing CPAP. Health warnings were identified as the antecedent condition, with subcategories including the following: severe snoring, choking and feelings of a terrible death during sleep, day and night sleepiness, easy tiredness, decreased memory, poor sleep, dry mouth, dry throat, headache, high blood pressure, poor blood sugar level control and falling asleep while driving. Analyses indicated seven subcategories of OSA patients with CPAP: (1) seeking medical information, (2) difficulties with CPAP, (3) trial and error for the 'right' CPAP, (4) long scheduled waiting times, (5) wondering, (6) high expectations, and (7) getting back good health. CONCLUSIONS: The results will assist healthcare providers with references for OSA health care based on patients' subjective perspectives. RELEVANCE TO CLINICAL PRACTICE: After interpreting and analysing results, suggestions include the following: (1) provide medical resource education for outpatients and inpatients to access self-care knowledge regarding OSA; (2) institute professional personnel for providing OSA health education in sleep clinics or sleep centres; (3) develop hospital standards for sleep examination processes to shorten waiting times; (4) establish case management for pursuing OSA patients receiving CPAP; (5) arrange regular forums for patients to share their experiences; and (6) provide community health education to promote awareness of snoring issues.

Relieving my discomforts safely: the experiences of discontinuing HRT among menopausal women.

AIM AND OBJECTIVES: To generate a descriptive theoretical framework about the experiences of women who discontinued hormone replacement therapy. BACKGROUND: Some menopausal women would depend on hormone replacement therapy for relieving their menopausal symptoms. However, most of them feared of hormone replacement therapy's side effects and tried to discontinue hormone replacement therapy immediately. How did these women self-manage their discomforts without using dependent medicine--hormone replacement therapy? There are few studies conducted on this issue. DESIGN: A grounded theory research was applied. METHODS: Nineteen Taiwanese women discontinuing hormone replacement therapy for three months, aged 45 to 67 years, participated in face-to-face audio-taped interviews. Data collection, and coding of interviews, and data analysis occurred simultaneously. All conversations were audio-recorded and then transcribed as verbatim text. The constant comparative method was used to analyse the interview data. RESULTS: 'Relieving my discomforts safely' was the core theme for describing and guiding the process of discontinuing hormone replacement therapy. 'Immediately discontinuing hormone replacement therapy--it would hurt my body' was identified as the antecedent condition. Analyses showed five dimensions to the women's relieving my discomforts safely: (1) symptoms bothered me again, (2) negative emotions, (3) learning to let it go, (4) trying to use nonhormone replacement therapy or products and (5) choosing safely therapies as first priority. Finally, some women would choose their suitable nonhormone replacement therapy way, and some women would reuse hormone replacement therapy cautiously. CONCLUSIONS: 'Relieving my discomforts safely' was the first-priority consideration for the menopausal women discontinuing hormone replacement therapy. It is the challenge to establish the health programme or management for helping these women felt safety and security to relieve their menopausal symptoms by using hormone replacement therapy or nonhormone replacement therapy. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers need to empower women the rights of decision-making of using hormone replacement therapy and assist them in monitoring their health status to reduce their fear and uncertainty.