Christian Ethical Foundations of Modern Nursing in China.

ABSTRACT: The influence of Western Christian missionary nurses has been recorded in the history and development of nursing in China. The purpose of this study was to investigate the influence of Christianity on Chinese nursing ethics. This documentary research used content analysis to investigate Christian value trends over 13 years (1920-1932) as reflected in a major bilingual Chinese nursing journal.

[The Application of Grief Theories to Bereaved Family Members].

Loss is an inevitable experience for humans for which grief is a natural response. Nurses must have an adequate understanding of grief and bereavement in order to be more sensitive to these painful emotions and to provide appropriate care to families who have lost someone they love deeply. This article introduces four important grief theories: Freud's grief theory, Bowlby's attachment theory, Stroebe and Schuts' dual process model, and Neiyemer's meaning reconstruction model. Freud's grief theory holds that the process of grief adaptation involves a bereaved family adopting alternative ways to connect with the death of a loved one and to restore their self-ego. Attachment theory holds that individuals who undergo grieving that is caused by separation from significant others and that triggers the process of grief adaptation will fail to adapt if they resist change. The dual process model holds that bereaved families undergo grief adaptation not only as a way to face their loss but also to restore normality in their lives. Finally, the meaning reconstruction model holds that the grief-adaptation strength of bereaved families comes from their meaning reconstruction in response to encountered events. It is hoped that these theories offer nurses different perspectives on the grieving process and provide a practical framework for grief assessment and interventions. Additionally, specific interventions that are based on these four grief theories are recommended. Furthermore, theories of grief may help nurses gain insight into their own practice-related reactions and healing processes, which is an important part of caring for the grieving. Although the grieving process is time consuming, nurses who better understand grief will be better able to help family members prepare in advance for the death of a loved one and, in doing so, help facilitate their healing, with a view to the future and to finally returning to normal daily life.

[The nursing history research journey: experience sharing].

This paper introduces the authors' journeys into nursing history research and shares their experience with international nursing history academic exchanges. The first section of this paper summarizes a literature review and analysis of nursing history in Taiwan; the second section shares the authors' experiences participating in international nursing history academic exchanges, organizing the International Perspectives of Nursing History Conference along with relevant observations and comments. The authors hope that more scholars will engage in nursing history research in order to enrich the knowledge base and facilitate the further development of nursing history research in Taiwan.

[A study of work values, professional commitment, turnover intention and related factors among clinical nurses].

BACKGROUND: The high rate of turnover in nursing positions is a global problem. There have been few studies done addressing the relationship between work values and nurse turnover intention. PURPOSE: The purpose of this study was to explore the relationship between work values, professional commitment and turnover intention among clinical nurses. METHOD: A cross-sectional survey was conducted between February 1st to March 10th, 2008 on a convenience sample of nurses, all of whom had at least a half year of work experience at one of four teaching hospitals in Taiwan. RESULTS: A total of 289 valid responses were received, with a response rate of 96.3%. Major findings included: (1) Nurses who were older, had more years of school, had worked more years, held specific job duties, earned a higher salary, held Buddhist beliefs, or were married with two or more children presented higher work values and professional commitment and lower turnover intention; (2) As a group, total work values and professional commitment scores corresponded negatively with turnover intention scores; (3) Significant factors affecting turnover intent in clinical nurses included professional commitment, institution characteristics, Buddhist beliefs and salary. These four variables accounted for 52.2% of the variation in turnover intention. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study indicated that nurses with higher work values and professional commitment tend to exhibit less turnover intention. It is highly recommended to develop strategies to bolster the teaching of altruistic values and professional commitment in nursing education in order to reduce turnover intent. Also, further studies on the influence of religious beliefs and organizational attributes on nurse turnover intentions are also suggested.

[The life experiences of nurses receiving cross-training].

The purpose of this phenomenological study was to explore the life experiences of nurses who received cross-training. Snowball sampling was used to recruit nurses over a 4-month period (01/2006 to 04/2006) at a medical center located in southern Taiwan. Data were compiled from the audio transcripts of 12 participants who completed in-depth interviews in hospitals. Analysis was performed using Colaizzi's (1978) methodology. Results emerged along four themes, including: "conflict between resistance and acceptance," "when in Rome, do as the Romans do," "endure complaints alone," and "awareness." Firstly, nurses felt themselves starting to resolve bottlenecks, but remained anxious about future uncertainties. Next, they maintained a low profile and tried to maintain superficially amenable situations, and then took advantage of chances to learn. Finally, the need for nurses to face peer critiques created significant anxiety. Once they had gone through these three steps, nurses returned to their 'normal' selves, although with broadened perspectives that led them to re-think and re-plan their professional career. In summary, nurses participating in cross-training underwent a process of cultural adaptation. This process was full of opportunities for exploration, growth and self-awareness. To design future cross-training programs, the input of these nurses should be taken into consideration by nursing educators and administrators.

[Promoting good health: the role and influence of nursing on Taiwan competitiveness].

Nurses understand that protecting the health of the general public represents one of their core responsibilities. In recent years, health promotion policies and strategies have been treated as critical components in overall efforts to enhance the holistic health of the nation. This study investigated the roles and influences of nurses in health promotion. Our paper introduces the history of health promotion, studies on improvements in healthy behavior attributable to evidence-based health promotion activities, and the roles and influences of nurses in health promotion. The authors hope this study can help confirm the critical role played by nurses in making health promotion activities effective in improving the overall health of the nation. Also, study results can help nurses self-check themselves to confirm whether they are maximizing their own potential as role models for healthy behavior. Does a healthy image exist for nursing professionals in Taiwan? Let us remind each other of this important objective and work together to "do what we say and say what we do" in health promotion.

[Humanity education in nursing].

Nurses play a pivotal role in caring for people. Since every person is unique, providing holistic care is central to the nursing profession. Rapidly advancing technology and the rise of cost-oriented healthcare management have, nevertheless, changed the nurse-patient dynamic and, created new challenges for the nursing profession. It is believed that cultivating humanism in nursing education can sustain nurses' adherence to patient-centered care amidst rapid changes in the health care system. Humanity education can further help nurses develop deeper insights into their own values and life experiences and, in turn, assist them to deal with life and work-related frustrations more effectively. Through a review of the literature, the authors tried to identify content and strategies central to successful humanity education for nursing students. At the end of this article, some suggestions are proposed for the future development of humanity education within Taiwan's nursing community.

The grief reactions of nursing students related to the sudden death of a classmate.

More than one-thousand adolescents are killed in accidents in Taiwan every year. Developmental factors shape young people's various reactions and responses to the death of their peers. While counseling research has been conducted in a few studies to address this issue of general bereavement, there remains a need for more knowledge on the grieving process and the needs of undergraduate nurse students who experience the loss of a classmate. The purpose of this study was to explore nursing student fears of death and their grief reactions in such a situation. The phenomenological method was used to uncover the meanings of eleven 19-year-old female nursing students' feelings and narratives about their grieving process in relation to the loss of a classmate, who died in a car accident. All interviews were tape recorded and then transcribed. Descriptions were analyzed using Colaizzi's phenomenological methodology (Colaizzi, 1978). The following core themes emerged from the data: morbid anxiety, helplessness after death, fear of disappearance, and thinking of one's own future. The study also found that, while nursing students could cope with their grief, they rarely shared their feeling with others. Young nursing students require careful step-by-step caring to pass successfully through the grieving process. In view of this gap, this study aspires to serve as a useful reference in understanding the sense of loss felt by grieving young people and providing effective and individualized bereavement counseling to nursing students.

[Parental stress in mothers of children with asthma].

Cases of asthma are increasing dramatically. Asthma is the most common chronic disease among children. Children's health and education can be affected by uncontrolled disease. Families play an important role in childhood asthma management. The main purpose of this study was to understand the parental stress and associated coping behaviors of mothers of children with asthma. The study adopted the survey design with the purposive sampling method. Data collection took place between December, 2003 and February, 2004. Sixty-eight mothers participated in the research. Data were collected with structured questionnaires, incorporating the Parental Distress Rating Scale, the Parental Coping Behavior Rating Scale, the Seriousness of Asthma Symptom Rating Scale and Demographic Data Sheet. Data analysis was conducted using SPSS/10.0 software. The results showed that factors affecting the mother's stress, included her age and the seriousness of the child's disease. Factors affecting the mother's coping behaviors included the mother's educational level, the child's age, the seriousness of the child's disease, the mother's age, the number of asthmatic children in the family, and the mother's system of belief. Using multiple regression analysis, the number of asthmatic children in the family, and the mother's coping behavior were found to be significant in explaining 47% of the variance in parental stress. We hope that these data will help clinical health care providers in fostering more effective strategies of health care in asthma of children and mother.

Considering the factors of gender and body weight in the promotion of healthy behavior among adolescents.

Obesity among adolescents is increasing in both developed and developing countries. However, previous studies have paid little attention to the roles that gender and body weight variables play in health-related behavior. This article examines the effects of these two variables on health-related behavior in Taiwanese adolescents. A cross-sectional descriptive design was used with three body weight categories (underweight, average and overweight) and two gender categories (female and male). Data were analyzed using descriptive statistics, Student's t test, and one-way ANOVA with Scheffe's post hoc test. The results showed that average weight adolescents scored significantly higher than their overweight peers in the three dimensions of social support, health responsibility, and exercise behavior. Average weight adolescents also scored higher than the underweight group in the dimension of health responsibility. Girls scored significantly better than boys in five out of the total six health-related behavior - scoring lower only in the exercise dimension. These findings should sound an alarm for all public health professionals to take heed to what is happening to our youth. School and family health promotion counseling should be encouraged for overweight adolescents to improve their exercise and lifestyle habits. Based on the findings, school health promotion programs should focus on gender differences. Girls, in particular, need encouragement to improve their exercise habits.

The experiences of overweight female adolescents after health promotion counseling.

The experiences of female overweight adolescents undergoing weight reduction are rarely reported. There is a paucity of studies using qualitative methodology to evaluate weight-reduction experiences. The aim of this study was to understand the main themes of the experiences of overweight female adolescents undergoing weight reduction after receiving school based health promotion counseling. Qualitative design was adopted and seven focus group discussions were conducted. On the basis of the qualitative method, the data were subjected to content analysis by means of the constant comparison method. A total of 30 female participants studying in a junior college of nursing were recruited in this study. All of them had been overweight or obese throughout the past four years. The findings revealed four themes of weight reduction experiences: living with changes; aspire vs. retreat; sense of alienation; support is a motivator. The outcomes of this study support the value of health promotion counseling conducted at school-based settings. It also provides references for health professionals promoting healthy ways of life.

[A primary exploration of nursing practicum during epidemics of major contagious diseases].

The purpose of this article was to investigate the issues related to nursing students' clinical practicum when severe contagious diseases occur. Based on the concept that patient-benefit must come first, the authors suggested that nursing students should remain on duty even if there were an outbreak of a severe contagious disease. The authors also discussed relevant issues in terms of professional roles and the safety of the learning environment. The problems identified and the proposed strategies for solving them are outlined in this article. There is no single strategy applicable to all conditions, however. Finally, the authors urge schools and hospitals to develop effective communications and close cooperation and to remain well informed about severe contagious diseases.

Preceptor-guided clinical practica and the learning experiences of nursing students.

BACKGROUND: In Taiwan, nearly one third of newly graduated nurses quit their first nursing job within 3 months and many never return to nursing. Because traditional clinical practice designs do not offer adequate opportunities for students to work independently, many senior nursing students lack self-confidence in their nursing skills and are not familiar with the day-to-day realities of nursing even after completing all their required clinical practica. A model for a preceptor-guided clinical practicum was designed to address this concern. PURPOSE: The aim of this study was to explore the learning experiences of senior nursing students who worked with preceptors during their clinical practica. METHODS: Thirteen female nursing students were interviewed to discover their perceptions of their preceptor-guided clinical practicum. All interviews were tape recorded and transcribed. Descriptions were analyzed using Colaizzi's phenomenological methodology. RESULTS: Four themes emerged from the data that described the preceptorship experience in the clinical practicum: (1) information and new experience overload, (2) feelings of loneliness and stress, (3) questioning whether strict preceptors achieve the best results, and (4) beginning to feel like a nurse. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings suggest that it is important for nurse educators to be clear and precise about the expectations of the preceptorship experience. Orientation for both preceptors and students is essential. Support and encouragement throughout the entire practicum experience for preceptors and students is necessary to ensure program success.