Exploring Meaning of Life in Women With Breast Cancer in Taiwan: A Phenomenological Study.

BACKGROUND: Globally, breast cancer is the most common cancer type in terms of incidence for women. Women with breast cancer endure higher levels of psychological distress than other types of cancer because many lose their identity as a woman, which is an additional characteristic of their psychological distress. Research using phenomenology to explore "the meaning of life" is rare among women with breast cancer. PURPOSE: The purpose of this study was to explore the perspectives of women with breast cancer on "the meaning of life." METHODS: A phenomenological approach was used. Twenty-six women living with breast cancer drawn from a cancer treatment hospital in Taiwan participated in this study. A semistructured interview was utilized to collect the data, and Colaizzi's seven steps were used to analyze the data. RESULTS: Four themes emerged: (a) value of overcoming suffering, (b) value of reciprocal love, (c) value of self-transcendence, and (d) value of spiritual comfort. This means that the participants defined "the meaning of life" through the lens of suffering from cancer, reciprocal love from their families and friends, uncovering and discovering creative pathways that transformed their pain while searching for the value of their existence, and seeking spiritual guidance from religion. CONCLUSIONS: The participants identified the most pivotal aspect of healing as transforming their pain and accepting value for their suffering. They acknowledged they could not change the fact that they had cancer, but they could learn to accept it as part of their lived experience. Healthcare professionals may use these four themes at a clinically appropriate time on women's journeys toward healing to inspire women with breast cancer to process their own unique "meaning of life."

Exploring the meaning of life from the perspective of patients with depression: A phenomenological study.

This study explored the perceptions of meaning of life for patients with depression. A qualitative phenomenology approach was used. Patients with depression (n = 20) were recruited until data saturation occurred. Findings revealed four themes all related to their value of: (1) accepting depression; (2) appreciating work (paid and non-paid); (3) embodying love and taking on responsibilities; (4) receiving spiritual comfort. Healthcare professionals could facilitate patients with depression to explore their meaning of life while enduring and transforming the emotional pain that accompanies depression, hence, perhaps, decreasing their suicidal ideations.

Modeling Body-Mind-Spirit Well-Being and the Possibility of Relapse Intention in Adults Who Have a History of Substance Use in Taiwan.

BACKGROUND: Substance use is a global mental health issue. There has been limited research exploring the relationships among body, mind, and spirit well-being and the possibility of relapse across different categories of substance users. AIMS: The purpose of the current path analysis was to examine the relationship between body-mind-spirit well-being and the possibility of relapse intention as well as other relevant predictors in people who had a history of substance use. METHODS: A cross-sectional survey was used. Participants were recruited in Southern Taiwan between December 2015 and June 2016. Data were collected from 467 participants who had a history of using controlled substances. RESULTS: Path analysis results revealed that body-mind-spirit well-being was negatively predictive of the possibility of relapse intention. Out of several predictors, stress influence and duration of substance use had direct effects on body-mind-spirit well-being and the possibility of relapse intention, respectively. Stress influence and duration of substance use were associated with decreased body-mind-spirit well-being and increased relapse intention scores. In addition, no history of health problems and male gender were associated with increased body-mind-spirit well-being. CONCLUSIONS: Stress management and the duration of substance use play an important role in body-mind-spirit well-being and relapse intention in people with a history of substance use. Health care professionals could teach substance users coping strategies to address their stress and problems, which may improve their health and reduce the possibility of relapse intention.

Rationale underpinning postgraduate student nurses' choice of research methods used for their masters' theses.

Many nurses in Taiwan use quantitative research for their master's thesis. However, qualitative research explores humankind in depth providing a more holistic approach relating to nursing. The purpose of this study was to explore the rationale postgraduate students used to choose the research methods for their masters' theses in Taiwan. A descriptive qualitative research design was used. Data were collected through semi-structured interviews of sixteen nursing students studying a master's from seven different Universities in Taiwan in 2016. Data were analyzed using thematic analysis. Finding revealed three themes (1) Students' personal and professional backgrounds; (2) Myths about quantitative research; (3) Misperceptions about qualitative research. Nurse educators could use these findings as a reference to design post-graduate nursing courses. It is essential to provide a balanced educative experience between delivering qualitative and quantitative modules to enhance respect of research method, knowledge and skills. Further, this could facilitate students' choice in research methods when designing their master's theses.

Development and psychometric testing the Health of Body, Mind and Spirit Scale for assessing individuals who have drug abuse histories.

AIMS AND OBJECTIVES: To develop the Health of Body, Mind and Spirit Scale (HBMSS), which was designed to assess drug abusers' health condition. BACKGROUND: Helping drug abusers to become healthy is important to healthcare professionals. However, no instrument exists to assess drug abusers' state of health. DESIGN: A cross-sectional questionnaire survey was implemented to examine the validity of the HBMSS. METHODS: Data were collected from 2015-2016 at one drug abuse prevention centre in Taiwan. Participants (N = 320) who had abused drugs were invited to complete a preliminary 64-item version of the HBMSS. An item analysis, criterion-related validity analysis (using the Relapse Prediction Scale [RPS] score), split-half reliability testing and confirmatory factor analysis (CFA) were conducted to examine the psychometric properties of the HBMSS. RESULTS: The final version of the HBMSS contained 15 items that were divided into three subscales: the health of the body, mind and spirit. Cronbach's α and split-half reliability coefficients were all above .85. The factor loading of each item was between .74-.95. The HBMSS had satisfactory criterion-related validity with the RPS score (r = -.50, p < .001). A second-order CFA was conducted on the HBMSS. The fit indexes were good, χ2  = 184.060, df = 94, χ2 /df = 1.958 (p = .000). CONCLUSIONS: The entire HBMSS and the subscales had satisfactory reliability and validity. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals could use the HBMSS to evaluate the condition of the health of individuals with a drug abuse history.

The Effects of Muscle Relaxation and Therapeutic Walking on Depression, Suicidal Ideation, and Quality of Life in Breast Cancer Patients Receiving Chemotherapy.

BACKGROUND: The suicide rate of cancer patients is high in Taiwan. Breast cancer has a high incidence rate and is the leading cause of cancer in women. There is a lack of research examining breast cancer-related depression, suicidal ideation, and quality of life. OBJECTIVES: This study evaluated the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy. METHODS: An experimental approach was adopted. A group of 87 breast cancer patients receiving chemotherapy were randomly assigned into an experimental group (n = 44) or a control group (n = 43). The subjects in the experimental group received 2 interventions for 3 months. This study used 3 instruments, including (1) the Center for Epidemiological Studies Depression Scale, (2) the Beck Scale for Suicidal Ideation, and (3) the World Health Organization Questionnaire on Quality of Life. RESULTS: The results showed no significant difference in any outcome variable in the pretest. The results of the posttest indicated that the 2 groups scored significantly differently only on the Center for Epidemiological Studies Depression Scale (U = 638.00, P < .05). The breast cancer patients who participated in the 3 month muscle relaxation and therapeutic walking interventions had a lower level of depression (RE¯ = 37.00) than those who did not (RC¯ = 51.16). CONCLUSION: The muscle relaxation and therapeutic walking program was effective in the reduction of breast cancer patients' depression. IMPLICATIONS FOR PRACTICE: Nursing staff could teach muscle relaxation and therapeutic walking to breast cancer patients to reduce their depression.

The healing process following a suicide attempt: context and intervening conditions.

The purpose of this study was to explore the context and the intervening conditions that impacted on individuals' healing from a suicide attempt. Patients who had survived a suicide attempt (n=14) and their caregivers (n=6) were interviewed in this study. Findings revealed that the suicidal individuals who lived in a sheltered, friendly environment, and had support systems helped their suicidal healing process. Conversely, suicidal individuals who experienced negative aspects of self, family predicaments, environmental difficulties, and the re-emergence of stressors impeded their suicidal healing process. Consequently, health professionals need to promote healthy internal and external environments for suicidal individuals.

A theory for the nursing care of patients at risk of suicide.

AIM: This paper presents a nursing care theory developed to guide the care given to people with suicidal ideas and those with a previous suicide attempt. BACKGROUND: Suicide is a major public health problem. According to the World Health Organization, international suicide rates range from highs of more than 20 per 100,000 people in Hungary (1997 figures), to fewer than 10 per 100,000 in the United Kingdom (2002 figures). In 2002, the number of completed suicides in Taiwan increased by nearly 10% over the previous year, and the Taiwanese Government has set targets to reduce this rate. Psychiatric nurses play a vital role in helping reduce the suicide rate through prevention, education and by providing care that promotes the healing of patients who attempt suicide. METHODS: A grounded theory approach was used. Fifteen patients who had either suicidal ideas or had attempted suicide and 15 psychiatric nurses working on acute wards were interviewed and observed using an observer-as-participant strategy. Data were collected through field notes and by tape-recorded interviews during 2003, and analysed using open, axial and selective coding and the qualitative software program QRS NUD*IST. FINDINGS: The core category that emerged from the data collected was the provision of 'safe and compassionate care via the channel of the therapeutic relationship'. Other key categories linked to and embraced within this core category were: providing holistic assessments; providing protection; providing basic care; and promoting healing through advanced care. CONCLUSION: The theory generated from the findings could be used by nurses as a guide as they initiate and maintain therapeutic relationships with patients who are at risk of suicide. The theory could advance the quality of care provided by nurses. In addition, it holds potential for instilling hope in patients who have lost their ability to cope with life events and perhaps life itself.