Physical activity patterns, sleep quality, and stress levels among rotating-shift nurses during the COVID-19 pandemic.

AIM: To examine the associations between physical activity patterns, sleep quality, and stress levels among rotating-shift nurses during the COVID-19 pandemic. BACKGROUND: Stress adversely impacts hospital nurses, particularly those on rotating shifts. The effects of physical activity patterns and sleep quality on the stress levels of these nurses during the COVID-19 pandemic warrant investigation. METHODS: A multicenter cross-sectional study was conducted with 550 eligible registered hospital nurses, randomly selected from four hospitals during the COVID-19 pandemic in Taiwan. The work schedule type of these nurses was categorized into rotating shifts (working at least two shifts in a month, involving day, evening, and night shifts) or fixed-day shifts (working only the day shift). Data were collected on sociodemographic characteristics, physical activity patterns (sedentary or active), sleep quality (poor or adequate), and stress levels for analysis. RESULTS: Rotating-shift nurses with active physical activity patterns exhibited lower stress levels compared with those with sedentary patterns. Nurses who experienced adequate sleep quality had lower stress levels compared with those with poor sleep quality among rotating and fixed-day shift nurses. CONCLUSIONS: Active physical activity patterns and adequate sleep quality were associated with lower stress levels among rotating-shift nurses during the pandemic. Promoting active physical activity and enhancing sleep quality are essential strategies for reducing stress in these nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Strategies aimed at promoting physical activity and improving sleep quality should be integral components of health promotion programs and policymaking efforts directed at nursing leaders, to foster a healthy and supportive work environment and enhance the welfare of rotating-shift hospital nurses. REPORTING METHOD: The study is reported using the statement of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Effectiveness of eAsthmaCare on Symptoms, Childhood Asthma Control Test, and Lung Function among Asthmatic Children.

A web-based self-health management system-eAsthmaCare, was developed as an intervention for asthmatic children. A randomized controlled trial was performed. Consent was obtained for 98 children with asthma to participate in the study and the pre- and post-test data collection process. The experimental group was given access to eAsthmaCare online management, the control group was subjected to general asthma management. The experimental and control groups' asthma symptoms, Childhood Asthma Control Test (C-ACT) scores, and lung function were evaluated, and their pre- and 3-month post-test results were compared. The following records were maintained: (1) medication record (2) daily asthma symptoms log (3) monthly C-ACT and lung function records. The C-ACT results indicated a p-value of < .01 for: overall improvements to childhood asthma symptoms, time effect, group and time interaction effects, and group and time interaction effects in relation to sleeping condition on the previous day; cough symptom time effect, and group and time interaction effects; the two groups' time effect in relation to cough symptoms; the two groups' time effect in relation to monthly activity restrictions (number of days); and the two groups' time effect in relation to nasal symptoms; the two groups' time effect; and group and time interaction effects (p < .01). In terms of the predictive values for lung function (FVC, FEV1, PEFR), the improvements in both groups were not statistically significant. The implementation of the eAsthmaCare intervention might have a positive impact on pediatric patients, making it an effective management tool for monitoring asthmatic children's physical function and discomfort.

Applicability of modified SWAT model (SWAT-Twn) on simulation of watershed sediment yields under different land use/cover scenarios in Taiwan.

Climate change leads to increasing intensity and frequency of extreme rainfalls, especially in Taiwan with steep slopes and rapid currents. Heavy rainfalls trigger serious erosion and landslides on hillslopes, which increase sand concentration in rivers, and thus affect the water quality of reservoirs and the ecohydrological functions of rivers. We take the Zhuoshui River basin as an example and applied the modified Soil Water Assessment Tool (SWAT) model, SWAT-Twn, to simulate sediment in the basin. In SWAT-Twn, estimation of sediment yield is carried out by integrating the Taiwan Universal Soil Loss Equation (TUSLE) and the landslide simulation. Results of daily streamflow simulation showed that the model performances were above the satisfactory level, while simulations of daily sediment loads showed that the SWAT-Twn model performed better than the official SWAT (SWAT664), in terms of PBIAS of - 46.6 to 16.0% (SWAT-Twn) and - 1.2 to - 107.0% (SWAT664). Two scenarios of land use/cover, scenario 1 with fixed land use/cover and scenario 2 with updated land use/cover in each year, were applied to simulate annual sediment in the river basin for investigating the effects of landslide area variation on sediments. Results of sediment simulation under the two scenarios showed that although updating landslide area may facilitate sediment yield simulation at the subbasin level, the sediment transport equation, Bagnold equation, does not reflect the variation in sediment loads in the watershed. With further modifications, SWAT-Twn is expected to be an effective tool for simulating the impacts of landslide on sediment loads in the watersheds with rainfall-induced landslide.

Active Physical Activity Patterns Are Associated With Improved Quality of Life and Depression Status in Taiwanese Women With Metabolic Syndrome.

BACKGROUND: Metabolic syndrome (MetS), health-related quality of life (HRQL), and depression status are independently associated with cardiac health. Therefore, understanding the associations between MetS, HRQL, and depression status and determining factors related to improved HRQL and depression status in people with MetS may help in cardiovascular disease prevention. OBJECTIVE: The aim of this study was to examine whether there are differences in HRQL and depression status between Taiwanese women with and without MetS and whether physical activity patterns are associated with HRQL and depression status in this population. METHODS: A cross-sectional study of 326 Taiwanese middle-aged and older women (≥40 years) was conducted. Metabolic syndrome was determined based on the National Cholesterol Education Program Adult Treatment Panel III definition. Health-related quality of life and depression status were collected using the Short Form 36 Health Survey and Beck Depression Inventory. Univariate and multivariate linear regression analyses were conducted. RESULTS: Women with MetS had lower HRQL (P < .001) and higher depression status (P = .002) than those without MetS. Participants with active physical activity patterns had higher HRQL (P < .001) and lower depression status (P = .046) than those with sedentary patterns. Among women with MetS, those with active physical activity patterns had higher HRQL (P = .001) and lower depression status (P = .007) than those with sedentary patterns. CONCLUSIONS: Metabolic syndrome is related to lower HRQL and higher depression status in women 40 years and older. Active physical activity patterns are associated with better HRQL and reduced depression status in middle-aged and older women (≥40 years) with MetS.

Motivational Counseling to Reduce Sedentary Behaviors and Depressive Symptoms and Improve Health-Related Quality of Life Among Women With Metabolic Syndrome.

BACKGROUND: Motivational interviewing, as a counseling approach, could promote not only behavioral changes but also individuals' psychological adaptation. Previous studies provide evidence that motivational interviewing focused on increasing physical activity decreases the risk of metabolic syndrome in women. Its effects on sedentary behaviors, depressive symptoms, and health-related quality of life (HRQL) remain unknown. OBJECTIVES: The aim of this study was to evaluate whether a 12-week motivational counseling program reduces sedentary behaviors and depressive symptoms and improves HRQL in Taiwanese women. METHODS: A randomized controlled study was conducted. Participants (n = 115) were randomly assigned into 3 groups: experimental group (received a brochure on lifestyle modification combined with 12 weeks of motivational counseling), comparison group (received a lifestyle modification brochure), and usual care group (UCG). Outcome variables were measured at baseline and at 12 weeks post intervention by the International Physical Activity Questionnaire, Beck Depression Inventory, and Medical Outcomes Short Form-36 Health Survey. Generalized estimating equations were applied to analyze the intervention effects of groups by interaction of group and time. RESULTS: Women in the experimental group not only reduced (P < .001) weekly sitting time by 374 minutes but also decreased (P < .05) depressive symptoms, as well as had greater overall HRQL including 8 subscales as compared with the UCG. As compared with the UCG, the women in the comparison group had no change in sedentary behaviors, but they had reduced depressive symptoms and improvement on some HRQL subscales. CONCLUSIONS: Motivational counseling that incorporates behavioral change principles is effective in reducing sedentary behaviors and depressive symptoms and improving HRQL for women with metabolic syndrome.

Influence of Socioeconomic Status and Perceived Barriers on Physical Activity Among Taiwanese Middle-Aged and Older Women.

BACKGROUND: Physical activity (PA) is associated with cardiovascular health in general populations, particularly in women. Middle-aged and older women are at high risk of less engagement in PA for unknown and complicated reasons. OBJECTIVES: The aim of this study was to investigate whether PA was positively associated with socioeconomic status and psychosocial correlates of PA (self-efficacy and perceived benefits) but inversely correlated with perceived barriers in women (age >40 years). METHODS: A cross-sectional survey of 326 community-dwelling women was conducted. Data on socioeconomic status, PA, and its psychosocial correlates (ie, perceived benefits/barriers and self-efficacy) were collected using self-report questionnaires. Analyses were performed by multiple linear regressions. RESULTS: Monthly income (ß = .35, P = .015), employment status (ß = .32, P < .001), and perceived barriers to PA (ß = -.19, P = .008) were significantly associated with PA. More highly educated women participated in more (ß = .13, P = .033) vigorous PA, women with fewer perceived barriers participated in more (ß = -.14, P = .047) moderate-intensity PA, and employed women participated in more (ß = .35, P < .001) walking. Significantly higher scores of perceived barriers, including "no trainer," "feeling exhausted," "lack of motivation," and "lack of guidance," were identified in women with low PA compared with those with moderate PA. CONCLUSION: Socioeconomic status and perceived barriers are associated with PA and its intensity level. Some specific barriers provide insights into the key factors that contribute to low PA in middle-aged and older women. These findings can be considered in future interventions to design PA promotion programs for this population to protect against cardiovascular diseases.

[Transformative Care Rooted in Evidence-Based Nursing].

As clinical scientists on the interdisciplinary healthcare team, nurses use the art and science of current nursing knowledge to provide evidence-based healthcare to each patient and his/her family. Nurses not only comprise the largest contingent of medical personnel and provide 24-hour patient care but are also professional scientists that develop unique nursing knowledge through reflective practice. Five strategies for expanding the body of current evidence-based nursing scientific knowledge include: (1) reflecting empirically on the practice-service domain, (2) developing nursing knowledge using rigorous methodology, (3) emancipating nursing knowledge using innovative transformation, (4) using collaborative interdisciplinary healthcare that is based in patient-centered care, and (5) initiating innovative transformation in nursing education. Nurses are critical healthcare providers that make important contributions to today's healthcare system. Nursing scientists provide frontline, evidence-based transforming care that deserves to be respected and valued on an equal basis with the care and services that are provided by other medical personnel.

[Development and Testing of the Taiwanese Hospital Nurses' Job Satisfaction Scale].

BACKGROUND: In the context of professional nursing, the concept of job satisfaction includes the degree to which a nurse is satisfied with the nursing profession, his/her personal adaptation to this profession, and his/her current working environment. No validated scale that addresses the job satisfaction of nurses working in hospitals currently exists in Taiwan. PURPOSE: To develop a reliable and validated scale for measuring the job satisfaction of hospital nurses in Taiwan. METHODS: A three-phase, cross-sectional study design was used. First, a literature review and expert focus group discussion were conducted to develop the initial scale items. Second, experts were invited to validate the content of the draft scale. Finally, convenience sampling was used to recruit 427 hospital nurses from 6 hospitals. These nurses completed the scale and the results were analyzed using item analysis, factor analysis, and internal consistency analysis. RESULTS: The 31-item Taiwanese hospital nurse job satisfaction scale developed in the present study addresses 5 factors, including supportive working environment, professional autonomy and growth, interpersonal interaction and collaboration, leadership style, and nursing workload. The overall Cronbach's α was .96. The results indicate that the developed scale provides good reliability and validity. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study confirms the validity and reliability of the developed scale. It may be used to measure the job satisfaction of nurses working in hospitals.

[Precision Nursing: Individual-Based Knowledge Translation].

U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine. Nursing science should follow and keep pace with this trend in order to develop empirical knowledge and expertise in the area of personalized nursing care. Nursing scientists must encourage, examine, and put into practice innovative research on precision nursing in order to provide evidence-based guidance to clinical practice. The applications in personalized precision nursing care include: explanations of personalized information such as the results of genetic testing; patient advocacy and support; anticipation of results and treatment; ongoing chronic monitoring; and support for shared decision-making throughout the disease trajectory. Further, attention must focus on the family and the ethical implications of taking a personalized approach to care. Nurses will need to embrace the paradigm shift to precision nursing and work collaboratively across disciplines to provide the optimal personalized care to patients. If realized, the full potential of precision nursing will provide the best chance for good health for all.

Evaluation of uraemic pruritus in long-term dialysis patients using a modified Chinese scale.

AIM: To examine the reliability and validity of a modified Chinese version of the uraemic pruritus scale for measurement of different degrees of itching, as well as to identify the predictors for the severity of uraemic pruritus among long-term dialysis patients. METHODS: Long-term dialysis patients (n = 110) were recruited for a cross-sectional study from a medical centre in Taiwan. A modified Chinese version of the uraemic pruritus scale was used to evaluate sleep disturbance and the severity, frequency and distribution of itching. Reliability was evaluated using item-total correlations, Cronbach's α, and intra-class correlation. Validity was evaluated by the content validity index, predictive and discriminative validity. Multiple linear regression was used on the predictors for the severity of uraemic pruritus. RESULTS: After optimization for reliability, the scale retained seven items. The Cronbach's α was 0.86, and the results showed that the scale had predictive and discriminative validity. High intact-parathyroid hormone and creatinine clearance rate were important predictors for the severity of uraemic pruritus. The severity of uraemic pruritus was the important predictor for the sleeping disturbance. CONCLUSION: The modified uraemic pruritus scale can discriminate between patients with a total pruritus score of ≥11 and those with a score of 0 points. The modified Chinese scale is a useful tool for clinically assessing the various degrees of itching among long-term dialysis patients. Our study validates that it could apply to clinical practice in assessment of uraemic pruritus.

Moderate physical activity level as a protective factor against metabolic syndrome in middle-aged and older women.

AIMS AND OBJECTIVES: To investigate whether physical activity is a protective factor against metabolic syndrome in middle-aged and older women. BACKGROUND: Socio-demographic and lifestyle behaviour factors contribute to metabolic syndrome. To minimise the risk of metabolic syndrome, several global guidelines recommend increasing physical activity level. However, only limited research has investigated the relationship between physical activity levels and metabolic syndrome in middle-aged and older women after adjusting for socio-demographic and lifestyle behaviour factors. DESIGN: Cross-sectional design. METHODS: A convenience sample of 326 middle-aged and older women was recruited. Metabolic syndrome was confirmed according to the National Cholesterol Education Program, Adult Treatment Panel III guidelines, and physical activity levels were measured by the International Physical Activity Questionnaire. RESULTS: The sample had a mean age of 60·9 years, and the prevalence of metabolic syndrome was 43·3%. Postmenopausal women and women with low socioeconomic status (low-education background, without personal income and currently unemployed) had a significantly higher risk of developing metabolic syndrome. After adjusting for significant socio-demographic and lifestyle behaviour factors, the women with moderate or high physical activity levels had a significantly lower (OR = 0·10; OR = 0·11, p < 0·001) risk of metabolic syndrome and a lower risk for each specific component of metabolic syndrome, including elevated fasting plasma glucose (OR = 0·29; OR = 0·26, p = 0·009), elevated blood pressure (OR = 0·18; OR = 0·32, p = 0·029), elevated triglycerides (OR = 0·41; OR = 0·15, p = 0·001), reduced high-density lipoprotein (OR = 0·28; OR = 0·27, p = 0·004) and central obesity (OR = 0·31; OR = 0·22, p = 0·027). CONCLUSIONS: After adjusting for socio-demographic and lifestyle behaviour factors, physical activity level was a significant protective factor against metabolic syndrome in middle-aged and older women. Higher physical activity levels (moderate or high physical activity level) reduced the risk of metabolic syndrome in middle-aged and older women. RELEVANCE TO CLINICAL PRACTICE: Appropriate strategies should be developed to encourage middle-aged and older women across different socio-demographic backgrounds to engage in moderate or high levels of physical activity to reduce the risk of metabolic syndrome.

Using CV-GLUE procedure in analysis of wetland model predictive uncertainty.

This study develops a procedure that is related to Generalized Likelihood Uncertainty Estimation (GLUE), called the CV-GLUE procedure, for assessing the predictive uncertainty that is associated with different model structures with varying degrees of complexity. The proposed procedure comprises model calibration, validation, and predictive uncertainty estimation in terms of a characteristic coefficient of variation (characteristic CV). The procedure first performed two-stage Monte-Carlo simulations to ensure predictive accuracy by obtaining behavior parameter sets, and then the estimation of CV-values of the model outcomes, which represent the predictive uncertainties for a model structure of interest with its associated behavior parameter sets. Three commonly used wetland models (the first-order K-C model, the plug flow with dispersion model, and the Wetland Water Quality Model; WWQM) were compared based on data that were collected from a free water surface constructed wetland with paddy cultivation in Taipei, Taiwan. The results show that the first-order K-C model, which is simpler than the other two models, has greater predictive uncertainty. This finding shows that predictive uncertainty does not necessarily increase with the complexity of the model structure because in this case, the more simplistic representation (first-order K-C model) of reality results in a higher uncertainty in the prediction made by the model. The CV-GLUE procedure is suggested to be a useful tool not only for designing constructed wetlands but also for other aspects of environmental management.

[A new vision of nursing: the evolution and development of evidence-based nursing].

The concept and principles of evidence-based medicine (EBM), first introduced in 1996 in the UK and Canada, have greatly impacted healthcare worldwide. Evidence-based care is a new approach to healthcare that works to reduce the gap between evidence and practice in order to further the scientific credentials and practices of the nursing profession. The revolution in healthcare has perhaps most noticeably impacted the nursing sciences. Today, new methodologies are increasingly synthesizing knowledge, while expanded access to publication resources is creating a new era in evidence-based nursing. Therefore, we expect to see in Taiwan the increased sharing of innovative implementations of evidence-based nursing practice and promotion campaigns and the exploration of a new evidence-based nursing paradigm for incorporating evidence-based concepts into the policymaking process, nursing practice, and nursing education. All scientists in clinical care, education, and research are responsible to establish scientific nursing knowledge in support of the evidence-based nursing practice.

[Improving care for transitional-stage clients in the emergency department: a family-centered approach].

The focus of emergency departments on resolving immediate threats to patient survival and wellbeing distinguishes their services from those provided by all other hospital departments. The high-pressure environment in the emergency department is a source of significant stress for patients and their families, with some experiencing serious physical and mental impacts that result in high tension, acute stress, anxiety, and other mental and physical reactions. The concepts of family-centered care and transition theory have been shown to help promote a sense of wellbeing and adjustment to unfamiliar experiences. Therefore, these concepts may be applied to help facilitate the successful transition of patients and their families to the emergency department and thus help maintain normal family functions during the transition from the emergency department to other departments.

Systematic review of impact of lifestyle-modification programs on metabolic risks and patient-reported outcomes in adults with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is primarily attributed to an unhealthy lifestyle, which is a modifiable risk factor. Researchers have been exploring various strategies, including lifestyle-modification programs (LMPs), to prevent the progression of MetS. However, the effectiveness of LMPs on metabolic risks and patient-reported outcomes (PROs) among adults with MetS remains inconclusive. AIM: To evaluate the effectiveness of LMPs on the metabolic risks and PROs among adults with MetS. METHODS: A systematic review of randomized controlled trials published from January 1985 to June 2014 was conducted. The review extracted LMP interventions that included outcomes on the metabolic risks and PROs (quality of life and any other psychological health indicators). The quality of the included studies was assessed using the Cochrane Collaboration criteria. RESULTS: Among the five trials included, the most commonly applied intervention components were diet plans, supervised exercise, health education, individual counseling, behavioral modification, and motivational interviewing. Three fifths of the studies were nurse-led, and only one of the selected trials was theory-guided. LMPs can effectively reduce triglyceride levels, waist circumference, and systolic blood pressure. However, few trials consistently confirmed the benefits of metabolic risks, and none revealed a significant effect on high-density lipoprotein, fasting blood glucose, or any PRO, except quality of life. The duration of LMPs in the included trials ranged from 4 to 24 weeks, and durations of at least 12 weeks significantly improved quality of life. LINKING EVIDENCE TO ACTION: LMPs had positive effects on some metabolic risks and on quality of life, whereas longer-duration LMPs may have highly beneficial effects on quality of life. The essential elements of LMPs need to be evaluated more thoroughly to determine their effectiveness. Larger and more rigorous randomized controlled trials are required to assess the effectiveness of LMPs on metabolic risks and PROs among adults with MetS.

[The new era of evidence-based nursing: comprehensive mobilization and development of the nursing sciences].

Science is subject to inevitable evolutionary change. Philosopher of science Thomas Kuhn defined a scientific revolution as a period in time during which a particular field of scientific knowledge is set to transition to a new paradigm that will propel it toward a new milestone. Because person-centered care embraces the universal values of trans-disciplinary healthcare teams, evidence-based healthcare represents a paradigm shift toward evidence-based nursing. The rapid development of evidence-based practice is an evolutionary process of revolutionary importance to science. The resulting era of evidence-based nursing will help fully realize the development potential of the nursing sciences. This article introduces the process of knowledge construction in evidence-based nursing, reviews the literature to identify the general model used to promote evidence-based nursing internationally, and proposes practical strategies to promote evidence-based nursing in Taiwan. We hope this article will help further promote the clinical application of evidence-based nursing and the development of nursing science.

[The family transition experience: family-centered hospitalization care of bipolar disorder patients].

BACKGROUND: Differences in cognition and attitudes between bipolar disorder patients and their families frequently result in differences between the two in terms of opinions and perceptions on appropriate medical treatments and prognoses. Transforming patient-centered-care psychotherapy into an intervention that provides family-focused nursing, promotes interaction among family members, and changes communication styles may assist families to adapt and focus on pursuing the soundest medical treatment. PURPOSE: This qualitative study explores the healing process of family transition in terms of family-centered care for bipolar disorder patients and nursing strategy intervention. METHODS: A psychiatric nurse with clinical experience used four 60-90 minute semi-structured, in-depth interviews to collect data from 8 families. The process was recorded and transcribed verbatim. Content analysis was used to analyze and categorize the major themes. RESULTS: Results were generalized into three themes that addressed the interaction-in-transition between patients and their families. These themes were: "All of the blame comes from the disease", "There is love in the family", and "Agreement to start over". Nurses increased their positive interaction with the family by facilitating cognitive, emotional, and behavioral change in the family. The 3 nursing strategy interventions used in this study to promote family adaptation in this study were: (1) guiding family experiences of the disease situation; (2) inspiring the potential strength in the families; (3) mobilizing the internal and external resources of families. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Nurses may help family healing by identifying family strengths and resources, looking for solutions to problems, transforming effective communicating style, and making family contracts.

[Spontaneous fracture: a potential clinical concern].

Spontaneous fracture is an issue of increasing concern in clinical care. However, this topic has received only limited attention in nursing research. Gaps in understanding related to spontaneous fractures may increase medical-legal risks faced by frontline care nurses, exacerbate nursing pressures, and serve as a disincentive to remain in the already understaffed nursing profession. This article reviews previous research on spontaneous fractures to determine the epidemiological causes of clinical spontaneous fracture and identify effective prevention strategies. We hope this paper may increase clinical practitioner and expert awareness of spontaneous fractures; help establish a screening mechanism to identify high risk spontaneous fracture patients; and help nurses develop and implement proactive prevention / treatment strategies to strengthen awareness of this topic among patients and their families.

Perception of the factors contributing to family happiness among caregivers of stroke survivors in a suburban community in Thailand: A qualitative study.

Introduction: Caring for stroke survivors in primary care settings substantially impacts family life and health. Caregivers of stroke survivors have different challenging experiences in providing care in relation to family happiness. This study aimed to explore family happiness and its contributing factors among family members caring for stroke survivors in suburban Thailand. Method: Qualitative semi-structured interviews and observations were conducted among 54 family caregivers in suburban Thailand communities from January to July 2020. Interviews and focus group discussions were digitally recorded, independently transcribed and analysed using ATLAS.ti 8.0. Qualitative data analysis method was used. Results: Family happiness was found to help a family function and be satisfied with caring. The analysis revealed three themes for achieving family happiness: 1) ideal caregiver characteristics: virtue, love and gratitude, experience in caring, good health and self-care ability, good management of emotions and freedom to manage problems and obstacles; 2) family function: family structure, roles and duties, relationships and management of family problems; and 3) resource support: financial, health and environmental supports. Conclusion: The findings demonstrate how life adaptations can improve family happiness within families of stroke survivors. Understanding caregivers' perceptions of their experiences in caring for stroke survivors is a challenge for healthcare providers; overcoming this could transform an unpleasant life into caregiving happiness. Appropriate and practical support from healthcare authorities could empower families of stroke survivors to succeed in caregiving and achieve family happiness.

Determinants of nurses' readiness for disaster response: A cross-sectional study.

Reducing the impacts of disasters is imperative in these times when disasters continually threaten people's lives. Given that the readiness for disaster response of nurses are essential in mitigating damage, however, studies on the determinants of nurses' readiness for disaster response remain inconclusive and require further research, especially with various populations. This study therefore aimed to investigate factors associated with readiness for disaster response among Taiwanese hospital nurses. A cross-sectional study was conducted on 365 eligible and registered nurses at a medical centre in northern Taiwan. The Readiness for Disaster Responses Scale including four subscales: personal preparedness, self-protection, emergency response, and clinical management were used for assessment. Analyses were performed using multiple linear regression models. Our study results showed that the length of nursing work was positively associated with nurses' readiness for disaster responses (ß = 0.28, p < .001). Nurses with a master's degree and working in intensive care units or emergency rooms had higher readiness for disaster responses (ß = 0.13, p = .032; ß = 0.14, p = .024) than those with a bachelor's degree and working in other units/specialties (i.e., outpatient department, operating rooms, etc.). Furthermore, nurses with previous disaster training were associated with greater readiness for disaster responses (ß = 0.24, p < .001). This study findings indicate that the identified determinants of hospital nurses' readiness for disaster responses can be taken into consideration in the future recruiting of nurses for deployment to disaster response assistance and the designing of disaster training programmes specifically for nurses.