Spiritual care models of patients living with cancer in Taiwan.

BACKGROUND: Psychological, social and spiritual needs are often unmet during the care of patients with cancer in Taiwan. AIM: The purpose of this study was to confirm the spiritual care models including the spiritual distress symptoms (SDS), spiritual distress symptoms interventions (SDSI), and spiritual distress outcomes criteria (SDOC) of patients with cancer in the initial, relapse and terminal stages. METHOD: This cross-sectional survey collected data from 150 professional nurses about their perceptions of the SDS, SDSI and SDOC for patients with cancer. RESULTS: The significant total effects of SDS on SDOC by SDSI of the patients with cancer in the initial, relapse and terminal stages were found. Additionally, the direct effects of SDS on SDOC by SDSI of the patients with cancer from the initial, relapse to terminal stage were gradually enhanced. CONCLUSIONS: The relationship between spiritual distress symptoms, interventions and outcomes was significantly higher from the initial to relapse state until at the end of life, based on the perceptions of 150 professional nurses.

Delirium Care by Intensive Care Unit Nurses: Focus Group Studies in a Medical Center of Southern Taiwan.

OBJECTIVES: Studies have identified many nursing interventions that can prevent delirium and fall accidents in clinical patients, detect and treat delirium early to prevent functional decline in the patient, shorten hospitalization duration, and lower the death rate. This study aimed to explore delirium care by intensive care unit (ICU) nurses in a medical center of southern Taiwan. METHODS: This study conducted 3 semistructured focus group interviews, each for a single medical ICU, involving groups of 6 to 8 nurses each. The nurses were recruited through purposive sampling. This research was approved by an institutional review board in the medical center of southern Taiwan from March 31, 2020, to January 30, 2021. The co-principal investigator described the purpose and process of this study to the participants before they provided their written informed consents. The interviews were conducted in the meeting room and were audiotape recorded. The recordings were transcribed and subject to content analysis to identify the themes of delirium care. RESULTS: For nursing interventions of delirium, satisfying the patient's physical needs: comfort care, massages, and early rehabilitation; and psychological care: being presence, communication, and ensuring familial support were included. In terms of environmental interventions for delirium, providing reorientation, music, light, belongings with sentimental value, and audiovisual equipment were included. However, according to the recruited medical ICU nurses, these nonpharmacological interventions, although effective, do not have long-lasting effects. Finally, nurses reported themselves as having been attacked by patients with delirium. Thus, they all agreed that restraining patients with delirium may be necessary, but restraining is a double-edged sword for ICU delirium patients. CONCLUSIONS: Research team suggests for future studies to extend their evidence-based findings of physical, psychological, and environmental care for ICU delirium patients toward integrating the efforts of various health care professionals.

Spiritual distress of patients living with cancer in Northern Vietnam.

BACKGROUND: Literature on the spirituality of cancer patients has been mainly focused on the experiences of western patients. Few studies explore the experience of Asian cancer patients, while no spiritual study on cancer patients has been conducted in Vietnam. PURPOSE: The purpose of this study was to survey the spiritual distress of cancer patients at two general hospitals in northern Vietnam. METHODS: This was a quantitative survey with a cross-sectional design. This study used purposive sampling with a fitting the inclusion criteria, alongside the Spiritual Distress Scale-Vietnam version (SDS-V). The data was collected by an investigator in two general hospitals in northern Vietnam. The study received approval from two research councils. RESULTS: The results demonstrated that the demographics of cancer patients in the study reflected the national data of Vietnam. Regarding the four exploratory dimensions, more than 50% of cancer patients expressed feeling hardship and sorrow, most did not feel loneliness, most patients reported a good relationship with others and God, while the majority of were afraid to discuss death. CONCLUSIONS: Due to impact of aging and poverty on the sample patients, further studies into the interconnectivity between economics and the spiritual health status of patients is recommended. Additionally, since the 132 Vietnamese cancer patients reported a positive relationship with others and God, healthcare professionals should study effective strategies to apply the above strengths in easing hardships for future cancer patients.

Building Spiritual Care in Nursing: An Overview of Ku's Spiritual Studies in Taiwan.

This paper describes the overview of Ku's spiritual literature on nursing through five stages in Taiwan: the development of a spiritual framework, a scale of spiritual distress, a spiritual care model, a spiritual nursing course, and a spiritual care book in nursing. The article demonstrates the process of building spiritual care in nursing from constructing theoretical frameworks, measurements, and applying to education. The integrative overview of Ku's spiritual studies developed in this article could be an example in clinical and education fields for nurse administrators to develop spiritual capabilities.

[The application of creative thinking teaching in nursing education].

Nursing education is increasingly expected to cultivate nursing student creative abilities in line with general Ministry of Education promotion of greater creativity within education and the greater leeway for creativity won domestically for nurses by professional nursing organizations. Creative thinking has been named by education experts in the United States as the third most important goal of nursing education. However, nursing students in Taiwan have been shown to test lower in terms of creativity than students enrolled in business management. Leaders in nursing education should consider methods by which to improve the creative thinking capabilities of nursing students. Articles in the literature indicate that courses in creative studies are concentrated in the field of education, with few designed specifically for nursing. The teaching of constructing creative thinking is particularly weak in the nursing field. The purpose of this article was to review literature on education and nursing in order to explore current definitions, teaching strategies, and evaluation approaches related to creativity, and to develop a foundation for teaching creativity in nursing. The authors hope that an appropriate creative thinking course for nursing students may be constructed by referencing guidance provided in this in order to further cultivate creative thinking abilities in nursing students that will facilitate their application of creative thinking in their future clinical practicum.

Establishing the validity of a spiritual distress scale for cancer patients hospitalized in southern Taiwan.

The present study was conducted to establish the validity of the spiritual distress scale (SDS), a scale developed as part of a qualitative study in which 20 cancer patients were interviewed about spiritual needs in 2003-2004. The SDS has four domains: relationship with self, relationship with others, relationship with God, and attitude towards death A measurement study was conducted whereby 85 patients completed the SDS during their hospitalization in the oncology unit of a medical centre in southern Taiwan. The SDS, including four domains of sub-scales, was broader than other spiritual scales in the literature that only contained one or two domains and focused on the health area. The SDS has established the adequate content and construct validity. Further training of nurses for assessing spiritual distress of cancer patients using the SDS would be recommended for future study. The established content and construct validity of the SDS could be applied in oncology for nurses to assess spiritual distress of cancer patients.

[Exploration of life experiences of an aged woman in a military housing community through reminiscing on photos].

Reminiscence therapy helps elders recall memories of old times through activities designed to achieve self-healing. The qualitative case in this research was a 70 year-old woman who had lived in a military village for 40 years. Semi-structured questionnaires were used for the interview and data was recorded and transcribed word for word. Analytical methods used the three major patterns of reminiscing over objects, vertical and horizontal life. In reminiscing over objects, the author performed interconnected analysis using selected objects that were beloved and/or had special meaning to the subject. In the perspective of vertical life, the author explored the subject's life experiences through each life stage (childhood, adolescence, middle age, and aged). Themes examined included the Confucian ethical code and patriarch, marriage, economic life, and living alone with loneliness. In the perspective of horizontal life, the author described and analyzed special events in the subject's life, including themes of illness and death, serving in the KMT (Kuomintang) political party and women's organizations, and the contribution of medical treatment. Life experience stories from the subject's four decades living in a military housing community was shared through personal photos. Such a process was targeted to help integrate the life experience of an aged woman in a military housing community and confirm the meaning, value, and contribution of her own life.

Efficacy of integrating information literacy education into a women's health course on information literacy for RN-BSN students.

Information literacy, essential to evidences-based nursing, can promote nurses' capability for life-long learning. Nursing education should strive to employ information literacy education in nursing curricula to improve information literacy abilities among nursing students. This study explored the effectiveness of information literacy education by comparing information literacy skills among a group of RN-BSN (Registered Nurse to Bachelors of Science in Nursing) students who received information literacy education with a group that did not. This quasi-experimental study was conducted during a women's health issues course taught between March and June 2004. Content was presented to the 32 RN-BSN students enrolled in this course, which also taught skills on searching and screening, integrating, analyzing, applying, and presenting information. At the beginning and end of the program, 75 RN-BSN student self-evaluated on a 10 point Likert scale their attained skills in searching and screening, integrating, analyzing, applying, and presenting information. Results identified no significant differences between the experimental (n = 32) and control groups (n = 43) in terms of age, marital status, job title, work unit, years of work experience, and information literacy skills as measured at the beginning of the semester. At the end of the semester during which content was taught, the information literacy of the experimental group in all categories, with the exception of information presentation, was significantly improved as compared to that of the control group. Results were especially significant in terms of integrating, analyzing, and applying skill categories. It is hoped that in the future nursing students will apply enhanced information literacy to address and resolve patients' health problems in clinical settings.

Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students.

A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

The effectiveness of teaching strategies for creativity in a nursing concepts teaching protocol on the creative thinking of two-year RN-BSN students.

Because of changes in the medical environment, nurses must maintain the ability of divergent thinking to solve the health problems of patients. However, many nurses whose work in clinical practice has become routine have lost the ability of creativity. To cultivate nurses creativity should be a goal of nursing education. The purpose of this study is to evaluate a nursing concepts teaching protocol by utilizing teaching strategies directed toward creativity to promote creativity in two-year RN-BSN students. This study design is a time series and one group experiment utilizing multiple instances of treatment. Teaching strategies for creativity were applied to a teaching unit and 52 two-year RN-BSN students were tested for creativity before the end of each semester. This study was conducted from March, 1999 to May, 2000, but only 30 students completed all tests and reached a 58% return rate. Torrance s (1974) definitions of creativity includ fluency, flexibility, and uniqueness were followed and the instrument, a questionnaire on Creativity in the application of the Nursing Process Tool (CNPT), was designed based on Emerson (1988). The content validity of Chinese-version CNPT was.79. The inter-coder reliability between two researchers was.84 following a coding guide that ten nursing education experts had established. The results indicated that 30 two-year RN-BSN students had improved fluency and flexibility. The improvements reached a significant level after the third semester. Only uniqueness declined. It is suggested that nursing faculty apply teaching strategies uniqueness more often in a teaching protocol of nursing concepts. By utilizing teaching strategies of creativity in a teaching protocol of nursing concepts, it is expected that two-year RN-BSN students can acquire characteristics of creativity for problem-solving skills in clinical settings.

The efficacy of problem solving strategies utilized in professional nursing concepts course to improve problem solving abilities in students enrolled in a two-year baccalaureate nursing program.

Using problem solving strategies in professional nursing concepts course (PS-PNC) was a newly developed core course in a two-year baccalaureate nursing program in an institute of technology. The purpose of this study was to evaluate the efficacy of problem solving strategies used in this new course to improve students clinical problem solving abilities. Prior to the PS-PNC, 12 faculty who participated in the teaching received complete training, and then continued to receive supervision and to conduct group discussions during the whole period of the PS-PNC implementation. A one- group posttest design with repeated measures was used. In total 49 nursing students from one class agreed to be recruited as the study subjects. The PS-PNC was performed separately in three semesters. After each class learning, students would start their clinical practice, were advised by the same faculty group who participated in the PS-PNC, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. A coding strategy was developed by the investigators. Then, data were collected and analyzed by four selected faculty who had been involved in the PS- PNC. The overall score of problem solving indicated that the three post-tests significantly increased, meaning those students clinical problem solving ability improved. However, data on the sub-concepts of problem solving on nursing assessment, nursing diagnosis, nursing intervention, and nursing evaluation showed no constant improvement. It is inferred that teaching of professional nursing concepts utilizing problem-solving strategies may be useful for future nursing students but dignified control should be strengthened.