Standardized patients' experiences of portraying characters in difficult communication scenarios: Narrative inquiry.

BACKGROUND: There are limited studies that explored the preparation and challenges faced by standardized patients (SPs) in portraying characters in difficult communication scenarios, and the strategies used to overcome these challenges. The purpose of this study was to understand the experience of SPs in interpreting difficult communication situations and the learning needs of performing similar scenarios. And it allows the researchers to explore the meaning, beliefs, values, and aspiration associated with their role as SPs. The findings could shade light on the significance of their experiences and provide valuable insights for the development of future SP training programs. METHODS: The design of this study is framed by a narrative inquiry, using semi-structured guidelines to conduct in-depth interviews with 11 SPs who have participated in the performances of difficult communication situations. Research data were analyzed by Polkinghorne narrative analysis, and Riessman's four criteria were used to establish rigor. RESULTS: Analysis revealed the following five themes: scenarios to real life connections, process of preparing for a performance, methods to detach from character, obtaining unexpected rewards, and needs for performance training. There are two to three subthemes that are subsumed under each theme. CONCLUSIONS: To strengthen training in difficult communication for healthcare professionals, the use of SPs to interpret challenging difficult communication scenarios will continue to increase. Educators need to ensure that SPs are fully prepared physically and emotionally before, during and after their performance. Offering of continuing education and training in feedback techniques are crucial to extend the tenure of SPs, reduce their frustration, prevent attrition, and ultimately, reduce training costs. In the future, SP training should also include detachment and feedback techniques to alleviate SPs' stress.

Effectiveness of a multicomponent activity and horticultural intervention for the hospitalized older adults: A randomized controlled trial: Effectiveness of Intervention for the Hospitalized Older Adults.

This study evaluated the effectiveness of different intervention programs in improving function among hospitalized older individuals using the Comprehensive Geriatric Assessment (CGA). A randomized controlled trial consisted of three groups: routine care, horticulture, and multicomponent activities (n = 32 each). Horticultural and multicomponent activity interventions showed beneficial effects on the CGA in hospitalized older individuals, particularly regarding cognitive function and quality-of-life. Additionally, horticultural activities significantly contributed to the perception of older adults' health status. We recommend to select older patients in geriatric wards with long-term hospitalization and adjust the frequency of activities or choose a single intervention program to provide long-term and effective intervention effects.

[Embracing the Era of Artificial Intelligence: Innovation and Preparation in Nursing Education].

Rapid recent advances in information technology have opened the door for artificial intelligence (AI)-related technologies to be applied extensively across many industries. The Ministry of Education has emphasized the importance of cultivating advanced-level professionals in diverse fields, particularly in smart machinery, the Asia-Silicon Valley sector, green energy technology, biotechnology, national defense, new agricultural, and circular economy industries, to enhance innovation and promote industrial competitiveness (Kuo, 2019). While interdisciplinary talent in AI and digital innovation is being actively developed elsewhere, nursing education remains in the exploratory phase of AI and digital technology talent cultivation. Although AI is now a well-known term, the competencies required for its application in nursing remain unclear. Moreover, most nursing professionals are unfamiliar with how to best integrate AI into nursing expertise or practice settings. With the application of AI in the healthcare industry now unstoppable, it is vital to consider how to help nursing students adapt to healthcare's new technology landscape (Huang et al., 2021). AI facilitates the digital simulation of human thought patterns, logic, and behaviors with the goal of assisting human users solve problems, especially those that are time-consuming and require repetitive processing. The development of AI requires interdisciplinary collaboration among domain experts, data scientists, software engineers, robotics experts, and computer programmers. Such collaboration is essential to developing products able to meet the demands of the times and to help students become competent future nursing professionals (Murray, 2018). Nurses spend the most time interacting with patients and are thus best able to understand the perceptions and challenges of patients and their families. Collaborating with professionals from interdisciplinary fields is the best strategy for achieving optimal healthcare outcomes. However, nursing schools have yet to provide a clear response to the impact of AI on nursing education. Nursing educational institutions must enable nursing students to comprehend the concepts and principles of AI and equip them with AI literacy to allow them to unleash their potential, continuously innovate, and stay abreast with the times (Ng et al., 2021). In this issue, experts and scholars currently engaged in AI-related research in the nursing discipline share their research findings in the realms of machine learning, deep learning, emotional recognition, and natural language application. These articles offer insights into the implications of AI, suggest how nursing education may best respond to emerging AI trends, and provide the authors' perspectives on nursing education reform. The editor hopes readers will be inspired to explore new concepts, gain a deeper understanding of the application and significance of AI, and apply AI to address clinical and educational challenges to foster competent nursing professionals for tomorrow.

[Excelling in the AI Era: Cultivating AI Literacy].

In light of the rapid advancements in artificial intelligence (AI), the future of the nursing profession is expected to be closely intertwined with AI applications. In response to this challenge, nursing educators must cultivate AI literacy in students to ensure their ability to communicate and collaborate effectively with their interdisciplinary peers. Nursing educators should comprehend the essence of AI literacy, integrate AI literacy into their curriculum designs, and regularly assess the effectiveness of AI literacy cultivation efforts among their students to ensure nursing graduates are able to effectively fulfill their roles in nursing and healthcare. The purpose of this paper is to explain the essence of AI literacy, approaches for cultivating AI literacy in students, and methods for assessing AI literacy with the aim of educating nursing students to become competent nurses for tomorrow.

Excessive gestational weight gain and emotional eating are positively associated with postpartum depressive symptoms among taiwanese women.

BACKGROUND: Excessive gestational weight gain and emotional eating may be associated with postpartum depression symptoms. This study was designed to identify how gestational weight gain and eating behaviors are related to postpartum depression (PPD) symptoms among women in Taiwan. METHODS: A cross-sectional study was conducted from March 2022 to October 2022 with 318 postpartum women recruited in Taipei, Taiwan. Gestational weight gain (GWG) for the total pregnancy period was recorded as inadequate, adequate, or excessive, based on the 2009 Institute of Medicine recommendations (IOM), accounting for pre-pregnancy body mass index category. Eating behavior at one month postpartum was measured on a 16-item 5-point Likert scale with three subscales: uncontrolled, restrained, and emotional. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale with a cutoff score of 13. RESULTS: The prevalence of postpartum depression symptoms (Edinburgh Postnatal Depression Scale ≥ 13) was 23.9% at one month postpartum. Logistic regression analysis revealed that excessive gestational weight gain and emotional eating were positively associated with postpartum depression symptoms at that time. CONCLUSION: Evidence presented here suggests that emotional eating and excessive GWG are associated with PPD symptoms in a Taiwanese population. In addition, it should be a public health priority to ensure a particular focus on mental health during the postpartum period. Healthcare providers should discourage pregnant women from unhealthy eating habits by targeting appropriate GWG and focusing on demand eating to reduce PPD in the postpartum period.

[Development and Validation of the Outpatient Nurses Communication Behavior Inventory].

BACKGROUND: Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings. PURPOSE: The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity. METHODS: During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated. RESULTS: The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.

[The Mediating Role of Novice Nurse Practitioner Professional Commitment on Workplace Stress and Teaching Behaviors].

BACKGROUND: Teaching is a vital competency for nurse practitioners (NP). Correlations among teaching behaviors, workplace stress, and professional commitment in novice NPs have been identified in previous research. However, the mediating effect of professional commitment on workplace stress and teaching behaviors is an issue that has been investigated in only a few studies. PURPOSE: To explore the relationships among workplace stress, teaching behaviors, and professional commitment in novice NPs and to identify the predictors and mediators of teaching behaviors. METHODS: This cross-sectional study used a sample of 79 novice NPs. The research instruments used were the Nurse Workplace Stress Scale, Nurse Professional Commitment Questionnaire, and Clinical Teaching Behavior Inventory. RESULTS: Negative correlations were found between workplace stress and professional commitment (r = -.37, p < .01) and between workplace stress and teaching behavior (r = -.27, p < .05). A positive correlation was found between professional commitment and teaching behaviors (r = .61, p < .001). Professional commitment was identified as a predictor of teaching behaviors (ß = .59, R² = .38, p < .001) and as a mediator of workplace stress and teaching behaviors (Z = -3.11, p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings verified professional commitment in novice NPs to be a moderator of workplace stress and teaching behaviors. The results of this study may be used to facilitate growth in professional commitment in healthcare practice settings.

Mechanisms and Effects of Health Coaching in Patients With Early-Stage Chronic Kidney Disease: A Randomized Controlled Trial.

PURPOSE: To examine the effects of health coaching on self-management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self-efficacy and patient activation mediate the effect of health coaching on self-management and QOL. DESIGN AND METHODS: A single-center, parallel-group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health-coaching intervention group or a usual care control group. Participants' QOL (World Health Organization Quality of Life Scale), self-management (CKD Self-Management instrument), patient activation (Patient Activation Measure), and self-efficacy (CKD Self-Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention. FINDINGS: Health coaching improved QOL, self-management, patient activation, and self-efficacy at postintervention and at 12 weeks' follow-up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self-management through improvements in self-efficacy and patient activation. CONCLUSIONS: The findings demonstrated that health coaching can effectively improve QOL and self-management. A health-coaching intervention can raise self-efficacy and activation levels through which self-management and QOL further improve. CLINICAL RELEVANCE: Health-coaching strategies can be used to assist patients with early-stage CKD in reaching their health goals and becoming activated in self-management of their diseases.

Empowering the public during the COVID pandemic through interactive social media platform.

During the COVID-19 pandemic, healthcare professionals and academic facilities are called to provide leadership in disseminating accurate and timely information through approaches that meet the needs of the public. Graduate students from a university in Taiwan collaborated with experts to provide interactive live broadcasting sessions on the COVID-related topics to the public through the Facebook platform. The broadcasting sessions also trained the students to communicate COVID-related information through succinct and interactive presentations. Twelve broadcasting sessions were conducted twice a week for three weeks in May 2020. Upon completion of the broadcasting sessions, students demonstrated growth in professional confidence, assessment of the public's knowledge gaps and needs, and preparation and delivery of professional live broadcasts. We recommend creating a live broadcast training application through an artificial intelligence (AI) expert system. Multidisciplinary academic-practice collaboration in preparing for the broadcasting and engaging in dialogues with the public is recommended.

[Transformation in Nursing Education: Development and Implementation of Diverse Innovative Teaching].

Nursing education in Taiwan has evolved from the hospital-based nursing programs of the prewar era to today`s school-based education (Yeh, 2014), while the pedagogy utilized in nursing education has similarly transitioned from traditional apprenticeships to school-based education. Nursing faculty engage in knowledge transformation and skills demonstrations in hopes of producing practice-ready graduates who meet the needs of their time. However, new graduates often experience difficulties in transitioning into practice settings. They tend to engage in passive learning and are inadequately prepared on competencies such as problem-solving and critical thinking. Thus, they are not fully equipped to manage diverse clinical situations. In 2006, the Taiwan Ministry of Education established the Taiwan Nursing Accreditation Council, which subsequently proposed eight core competencies of nursing education as a guide for cultivating excellent professional nurses. While traditional approaches remain the mainstream pedagogy, clinical scenarios have been integrated into the nursing curriculum. Clinical simulation in conjunction with objectively structured clinical examinations has been implemented in all nursing programs and even been used to determine eligibility for graduation. Problem-based learning, experiential learning, game-based learning, the flipped classroom approach, and technology integration (such as virtual reality and augmented reality) are developing trends in innovative teaching approaches and educational reform strategies. Specifically, authentic technology-integrated education is the current direction for nursing education. Furthermore, resolving nursing clinical dilemmas with design thinking and the creation of new products are also guiding the development of the nursing profession. Applications of these innovative teaching approaches are intended to reduce the gap between practice and theory. Because of the rapid advancement of information technology, big data and artificial intelligence have become unstoppable. Examples include clinical implementations of Line chatbot and the constant development of knowledge through artificial intelligence. The impact of these technological advancements on the nursing profession cannot be ignored. Nursing education is progressing away from traditional teaching approaches and focusing increasingly on the cultivation of professional nurses. Nevertheless, as nurse educators, we need to reflect whether our educational approaches remain overly limited by the traditional framework and, if so, whether we are preparing our future nurses for the past? It is our professional responsibility to prepare the nursing workforce for the present and the future (Murray, 2018). The knowledge required for developing artificial intelligence and relevant technologies is distinctly different from the knowledge required for the nursing profession. Nurse educators must contemplate strategies for leading the new generation of nursing students to be in line with current trends and reflect constantly on the essence and goals of nursing education. We must relentlessly learn new knowledge, align ourselves with the pulse of the times, develop innovative educational strategies, and engage in interprofessional collaboration to produce effective and wise nursing professionals.

[A Reflection on Nursing Education: Assuring the Readiness of the Nursing Profession for the Age of Artificial Intelligence].

With the rapid advancement of information technology, artificial intelligence (AI) is being progressively utilized in various fields. The application of AI in healthcare practice is more advanced than in healthcare education. The advancement of AI is unstoppable. Nursing educators need to have a good understanding of AI to equip nursing students with the requisite knowledge to meet the needs of the AI age. The purpose of this article is to briefly describe the history of AI in education, relevant AI concepts, current applications of AI in healthcare education, dilemmas, and recommendations for the future. AI is not invincible, and it is critical to prudently evaluate and consider the related data biases and ethical issues. Nursing educators should reflect on whether we are preparing students for yesterday`s job or for the future workforce. Nursing educators need to engage in curriculum reform and gain an understanding of critical AI concepts and applications to equip nursing students with the requisite information-technology capacities to meet the needs of the AI age.

Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial.

AIM AND OBJECTIVES: To determine whether the virtual reality as a distracting intervention could reduce pain and fear in school-age children receiving intravenous injections at an emergency department. BACKGROUND: An intravenous injection is the most common invasive procedure that paediatric patients encounter in emergency department. School-age children seldom show their fear or discomfort during the procedure which may be ignored. DESIGN: A randomised controlled trial was conducted from December 2017-May 2018 and performed according to the CONSORT guidelines. METHODS: One hundred and thirty-six children aged 7-12 years were randomly allocated to receive either a routine intravenous injection procedure or one with an immersive virtual reality experience. Children were asked to rate their pain and fear along with their caregivers and nurses on the Wong-Baker FACES Pain Rating Scale and Children's Fear Scale, respectively. The time required for successful intravenous insertion was also assessed in the emergency department. Clinical trial registration was done (ClinicalTrials.gov.: NCT04081935). RESULTS: Pain and fear scores were significantly lower in the virtual reality group, as were the children's ratings as perceived by their caregivers and nurses. The children's ratings of pain and fear were positively correlated with the caregivers' ratings and the nurses' ratings as well. The time required for successful intravenous insertion was significantly lower in the virtual reality group. CONCLUSION: Visual reality intervention can effectively reduce the pain and fear during intravenous procedure in school-age children in emergency department. RELEVANCE TO CLINICAL PRACTICE: The results of this study indicate the feasible clinical value of virtual reality interventions during the administration of intravenous injections in school-age children in emergency departments.

Development of an 18-item abbreviated Chinese version of Berger's HIV Stigma Scale.

AIM: Human immunodeficiency virus (HIV) stigma in people living with HIV is associated with depression and poor treatment adherence. The current literature lacks a Chinese instrument to measure HIV stigma in Taiwan. Thus, the purpose of this study was to develop an abbreviated Chinese translation version of Berger's HIV Stigma Scale. METHODS: The instrument development process was guided by Brislin's Translation Model of establishment of construct validity and convergent validity and verification of reliability. RESULTS: This study recruited 540 HIV-infected adults (January-November 2015). Data analysis using confirmatory factor analysis resulted in an 18-item abbreviated Chinese version of Berger's HIV Stigma Scale, consisting with four factors: personalized stigma (seven items), disclosure concerns (three items), negative self-image (four items), and concerns with public attitudes toward people with HIV (four items). The final model demonstrated a good fit. A positive correlation between HIV stigma and depression was found. The Cronbach α for internal consistency was 0.92. CONCLUSION: The 18-item abbreviated Chinese version of Berger's HIV Stigma Scale demonstrated adequate reliability and validity to assess HIV stigma among Chinese people living with HIV. It is a feasible tool that allows for rapid assessment of HIV-related stigma.

[The Long-Term Care Experiences and Care Needs of Parents Caring for Children With Adrenoleukodystrophy].

BACKGROUND: Children suffering from adrenoleukodystrophy (ALD) requires life-long care. Little is known about the care needs of parents of ALD children at different stages of their disease. PURPOSE: The purpose of this study was to understand the long-term care experiences and care needs of parents caring for their ALD children. METHODS: A descriptive qualitative study with 7 in-depth interviews was conducted with parents. RESULTS: The results of these care experiences were distinguished into three phases: "pathogenesis to diagnosis", "rapid deterioration of physiological functions", and "bedridden until the death". The long-term care experiences revealed five themes, including "chaos and helplessness to seek medical attention then being forced to accept", "self-accusation and guilt", "strengthening parents' toughness", "seizing the moment and facing the future", and "accompanying children through life without pain". Within the three phases, the care needs comprised the three themes of "integrating resources and providing immediate care", "obtaining information and support regarding ALD rapidly", and "establishing individualized long-term care". CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study revealed the long-term care experiences and care needs of the parents of ALD children. Providing individualized care, nursing instruction, and telephone consultation as well as connecting case managers with the hospice-care team will help facilitate and meet the care needs of these parents.

Women's perception of support and control during childbirth in The Gambia, a quantitative study on dignified facility-based intrapartum care.

BACKGROUND: In The Gambia, a woman faces 1 in 24-lifetime risk of maternal death due to pregnancy and childbirth, yet, only 57% of deliveries are conducted by skilled birth attendants. However, poor provider attitude has been identified as one of the contributing factors hampering the efforts of the government in improving access to skilled care during childbirth. This study, therefore, explored women's perception of support and control during childbirth in The Gambia. METHODS: A descriptive cross-sectional study was employed. A convenience sampling method was used to select participants in two regions in The Gambia. A sample size of 200 women who met the eligibility criteria was recruited after informed consent. The demographic-obstetric information sheet and the Support and Control in Birth scale (SCIB) were used to collect data. Data analysis was done using SPSS software version 23.0. RESULTS: Women's perceptions of support and control were low. External control 1.85 (SD ± 0.43) recorded the least perception compared to internal control 2.41 (SD ± 0.65) and perception of support 2.52 (SD ± 0.61). Participants reported the lowest perceptions in pain control, involvement in decision making, information sharing and the utilization of different position during birth. Women's age (p < .001) and mode of delivery (p = .01), significantly predicted women's perception of internal control. Educational status (p = .02), mode of delivery (p = .04), place of delivery (p < .001) and perception of support (p < .001) significantly predicted women's perception of external control, whilst birth plan (p = .001), mode of delivery (p = .04), and perception of external control (p < .001) significantly predicted women's perception of support. CONCLUSION: This study concluded that an environment that promotes women feeling a sense of control and support during childbirth should be created in order to ensure a dignified intrapartum care in The Gambia. This can be achieved through effective training of skilled birth attendants on non-pharmacological pain management, effective communication with clients and promoting women's participation in decision-making regarding their care throughout the process of childbirth.

[Application of Creative Teaching].

The 21st century is an era of information, technology, knowledge application, innovation, and globalization. The purpose of education is not only to provide knowledge but also to extend knowledge across many disciplines and national and ethnic boundaries. Education requires teachers to guide students to expand the depth and breadth of their learning and to make global connections. The Executive Yuan's 2017 white paper on vocational education stresses that people in the technical and vocational education fields must adopt innovative thinking, be innovative in practice, and be prepared to engage in interdisciplinary collaboration. Creativity is the ability to present and/or do something in a unique and unconventional manner that ends up improving or enhancing that activity in some way. Therefore, creative teaching is the teaching of normal content differently (such as flipping classroom teaching, creative thinking teaching methods) in combination with information technology media such as the Kahoot app or through participating in international competitions. Today's university students are members of the so-called Z generation, a generation that is very comfortable with using technology products such as the Internet, smartphones, and computers as learning tools. Thus, teachers should make full use of these products to connect with their students, and creative teaching should promote knowledge transfer by using learning styles that Z-generation students prefer and by guiding students to extend their learned knowledge. Education quality is a key indicator of national competitiveness. One way to improve competitiveness is to begin by understanding the experience of others. This column invites nursing educators to share their experiences in creative teaching and international competition, with articles hopefully inspiring readers to explore and develop their own innovative thinking.

[Application of Flipped Classroom Teaching Strategy in Nursing Education].

The ultimate purpose of education is to provide students with the skills and motivation necessary for lifelong learning. Students with lifelong learning abilities are better able to continue improving their professional core competencies, especially in terms of problem solving and clinical reasoning. Prior to enhancing lifelong learning abilities, students must learn self-directed learning. Studies have shown that flipped classroom learning has the potential to improve self-directed learning. Flipped classroom teaching requires prerecorded lectures, strengthened teacher-student interaction, and assisting students to learn in-depth. The authors developed a four-phase dynamic case-based learning (4D CBL) innovative teaching strategy and then assimilated this strategy into flipped classroom teaching. This innovative teaching strategy may be used in various academic nursing programs to reinforce self-directed learning and clinical reasoning abilities. After introducing the concepts of flipped classroom teaching and 4-D CBL, how to merge 4D CBL with the flipped classroom model and the effectiveness of this innovative teaching strategy are demonstrated. Nurse educators may use the flipped classroom teaching strategy with 4D CBL in their future practice.

[HIV Stigma and Spiritual Care in People Living With HIV].

HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

Work stress, occupational burnout and depression levels: a clinical study of paediatric intensive care unit nurses in Taiwan.

AIMS AND OBJECTIVES: This study aimed to examine the relationship between work stress and depression; and investigate the mediating effect of occupational burnout among nurses in paediatric intensive care units. BACKGROUND: The relationships among work stress, occupational burnout and depression level have been explored, neither regarding occupational burnout as the mediating role that causes work stress to induce depression nor considering the paediatric intensive care unit context. DESIGN: A cross-sectional correlational design was conducted. METHODS: One hundred and forty-four female paediatric intensive care unit nurses from seven teaching hospitals in southern Taiwan were recruited as the participants. Data were collected by structured questionnaires including individual demographics, the Nurse Stress Checklist, the Occupational Burnout Inventory and the Taiwan Depression Questionnaire. RESULTS: The results indicated that after controlling for individual demographic variables, the correlations of work stress with occupational burnout, as well as work stress and occupational burnout with depression level were all positive. Furthermore, occupational burnout may exert a partial mediating effect on the relationship between work stress and depression level. CONCLUSION: This study provides information about work stress, occupational burnout and depression level, and their correlations, as well as the mediating role of occupational burnout among paediatric intensive care unit nurses. RELEVANCE TO CLINICAL PRACTICE: It suggests government departments and hospital administrators when formulating interventions to prevent work stress and occupational burnout. These interventions can subsequently prevent episodes of depression in paediatric intensive care unit nurses, thereby providing patients with a safe and high-quality nursing environment.

Concurrent validity of self-rating scale of self-directed learning and self-directed learning instrument among Italian nursing students.

BACKGROUND: Self-Directed Learning develops when students take the initiative for their learning, recognising needs, formulating goals, identifying resources, implementing appropriate strategies and evaluating learning outcomes. This should be seen as a collaborative process between the nurse educator and the learner. At the international level, various instruments have been used to measure Self-Directed Learning abilities (SDL), both in original and in culturally-adapted versions. However, few instruments have been subjected to full validation, and no gold standard reference has been established to date. In addition, few researchers have adopted the established tools to assess the concurrent validity of the emerging new tools. Therefore, the aim of this study was to measure the concurrent validity between the Self-Rating Scale of Self-Directed Learning (SRSSDL_Ita) - Italian version and the Self-Directed Learning Instruments (SDLI) in undergraduate nursing students. METHODS: A concurrent validity study design was conducted in a Bachelor level nursing degree programme located in Italy. All nursing students attending the first, second or third year (n = 428) were the target sample. The SRSSDL_Ita, and the SDLI were used. The Pearson correlation was used to determine the concurrent validity between the instruments; the confidence of intervals (CI 95 %) bias-corrected and accelerated bootstrap (BCa), were also calculated. RESULTS: The majority of participants were students attending their first year (47.9 %), and were predominately female (78.5 %). Their average age was 22.5 ± 4.1. The SDL abilities scores, as measured with the SRSSDL_Ita (min 40, max 200), were, on average, 160.79 (95 % CI 159.10-162.57; median 160); while with the SDLI (min 20, max 100), they were on average 82.57 (95 % CI 81.79-83.38; median 83). The Pearson correlation between the SRSSDL_Ita and SDLI instruments was 0.815 (CI BCa 95 % 0.774-0.848), (p = 0.000). CONCLUSIONS: The findings confirm the concurrent validity of the SRSSDL_Ita with the SDLI. The SRSSDL_Ita instrument can be useful in the process of identifying Self-Directed Learning abilities, which are essential for students to achieve the expected learning goals and become lifelong learners.