[The long road home: a discussion of the autonomy of schizophrenia patients after their discharge from the hospital].

Every adult has the right to self-determination and to have his or her autonomy respected. While schizophrenia patients have the right to be discharged from the hospital, their needs subject their caregivers to high care loadings. This situation presents a dilemma for the medical team. The authors justify the patient's autonomy to request and to be granted a discharge. Then, present the decision-making process related to discharge for the reference of medical teams. Capacity is necessary to autonomy. There is currently no standard for assessing the capacity of patients that clearly defines their competence. A sliding scale approach to decision making distinguishes between decisions involving significant potential risk and, therefore, involving higher level of capacity requirements and decisions on minimal potential risk. In order to protect the interests of patients, the sliding scale approach takes into account different decisions. Cases in which schizophrenia patients choose to self-discharge involve a high-level of risk. Poor preparations for follow-up care lead to poor-quality patient care and may cause harm to the patients. In a share decision model, the medical team plays the role of negotiator between the patient and the family and respects the autonomy of the patient while supporting the family through the hospital discharge process. Medical team must have a discharge planning for the patient and family, follow-up care system, and support network. During hospitalization, the discharge plan aims to facilitate the life adaptation and disease recovery for patients with the goal of restoring their normal home life.

[The parenting practices of transnational marriage mothers in Taiwan].

Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.

[Testing the reliability and validity of a parenting scale for Indonesia mothers in transnational marriages].

BACKGROUND: In Taiwan, transnational-marriage families face more challenges to childrearing success than their domestic marriage counterparts. The parenting approaches and behaviors of transnational-marriage mothers have yet to be adequately studied, and few quantitative studies have been done. PURPOSE: The present study verifies the reliability and validity of the Modified Child Rearing Practice Report (M-CRPR) parenting scale for Indonesian mothers in transnational-marriage families in Taiwan. METHODS: Purposive sampling was used to recruit Indonesian mothers in the Kaohsiung and Pingtung. Women who were the primary caregiver of one or more children aged between 3 and 12 years were asked to participate. In-depth interviews were first conducted to determine whether participant experiences fit the M-CRPR concept. A total of 201 qualified women agreed to participate and were asked to respond to the Indonesian-version M-CRPR, produced using a double-translation approach. M-CRPR reliability and validity were subsequently evaluated. RESULTS: Factor analysis identified three factor clusters: nurturance (15 items), restrictiveness (14 items), and protection (5 items). The factor loading of each item was between 0.32 and 0.69 and these 3 factors explained 28.13% of total variance. The internal consistency of the Indonesia-version M-CRPR was 0.84 and the ICC was 0.88. CONCLUSIONS: The reliability and validity of the Indonesian M-CRPR were both acceptable. This instrument may be used to investigate parenting issues faced by Indonesia mothers in transnational-marriage.

[Nursing staff communication during nursing shift changes].

Nursing shift reports (NSRs) are crucial to the maintenance of patient safety and continuity of care. Relevant literature note that NSRs serve four main functions, including (a) communicate patient information, (b) provide a framework for emotional support between colleagues, (c) establish tacit understanding for group development, and (d) facilitate professional care practices. However, lack of self-confidence and lack of influence over the NSR format have been concerns voiced by some nurses. This paper discusses through a review of the literature the purposes and significance of NSRs and common NSR practices. Strategies for improving shift reports are also recommended.

The mothering experience: perspectives of women from Indonesia married and living in Taiwan.

The purpose of this study was to explore the mothering experiences of Indonesian women married to Taiwanese and living in Taiwan. Women with children aged from three to twelve years old were qualified to participate and we used snowballing to recruit participants. A total of 21 mothers agreed to participate in semi-structured interviews, the contents of which were recorded and immediately transcribed following each session. All 21 mothers completed their interviews, in which two common themes appeared. These were: (1) reflection: searching for self-worth through the mothering role and (2) projection: spending all of the "self" for their children. The results of this study provide valuable information necessary to understand the experience of Indonesian mothers in Taiwan.

Staring at My Body: The Experience of Body Reconstruction in Breast Cancer Long-term Survivors.

BACKGROUND: Breast cancer takes time for its survivors after a mastectomy to adjust to their changed bodies. There are limited studies about the process of how those survivors accept the changes of their bodies and how they reestablish their new selves. OBJECTIVE: The aim of this study was to understand the perception of body from women diagnosed with breast cancer more than 5 years previously and whose treatment included a mastectomy. METHODS: A phenomenological method was applied to this study. Women who received a mastectomy at least 5 years previously were invited to participate. Eight participants were recruited from southern Taiwan. RESULTS: Twenty transcripts were obtained and analyzed using Colaizzi's method. Three themes were obtained from the data analysis: "restoration of the body image," "abandonment of objectification," and "redefinition of self." Subthemes were also identified and described. CONCLUSION: The results indicate that women with breast cancer have embodied the recovering experience to a new self and have adapted to identify their new bodies. They overcome being a female body with an absent breast(s) by discovering the value of their existence and being free from self-objectification. IMPLICATIONS FOR PRACTICE: This study contributes to the understanding of the perception of body in long-term breast cancer survivors, which reflects the process of adjusting to the loss of a breast/breasts to reconstructing a new body experience. Health professionals could help and encourage women undergoing a mastectomy to engage in self-recovery by searching for and affirming self-value.

Correlates of attitudes toward homosexuality and intention to care for homosexual people among psychiatric nurses in southern Taiwan.

This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people.