Development and validation of the oral presentation evaluation scale (OPES) for nursing students.

BACKGROUND: Oral presentations are an important educational component for nursing students and nursing educators need to provide students with an assessment of presentations as feedback for improving this skill. However, there are no reliable validated tools available for objective evaluations of presentations. We aimed to develop and validate an oral presentation evaluation scale (OPES) for nursing students when learning effective oral presentations skills and could be used by students to self-rate their own performance, and potentially in the future for educators to assess student presentations. METHODS: The self-report OPES was developed using 28 items generated from a review of the literature about oral presentations and with qualitative face-to-face interviews with university oral presentation tutors and nursing students. Evidence for the internal structure of the 28-item scale was conducted with exploratory and confirmatory factor analysis (EFA and CFA, respectively), and internal consistency. Relationships with Personal Report of Communication Apprehension and Self-Perceived Communication Competence to conduct the relationships with other variables evidence. RESULTS: Nursing students' (n = 325) responses to the scale provided the data for the EFA, which resulted in three factors: accuracy of content, effective communication, and clarity of speech. These factors explained 64.75% of the total variance. Eight items were dropped from the original item pool. The Cronbach's α value was .94 for the total scale and ranged from .84 to .93 for the three factors. The internal structure evidence was examined with CFA using data from a second group of 325 students, and an additional five items were deleted. Except for the adjusted goodness of fit, fit indices of the model were acceptable, which was below the minimum criteria. The final 15-item OPES was significantly correlated with the students' scores for the Personal Report of Communication Apprehension scale (r = -.51, p < .001) and Self-Perceived Communication Competence Scale (r = .45, p < .001), indicating excellent evidence of the relationships to other variables with other self-report assessments of communication. CONCLUSIONS: The OPES could be adopted as a self-assessment instrument for nursing students when learning oral presentation skills. Further studies are needed to determine if the OPES is a valid instrument for nursing educators' objective evaluations of student presentations across nursing programs.

Factors associated with spiritual care competencies in Taiwan's clinical nurses: A descriptive correlational study.

AIMS AND OBJECTIVES: To determine factors associated with nurses' spiritual care competencies. BACKGROUND: Holistic nursing care includes biopsychosocial and spiritual care. However, nurses are limited by a lack of knowledge, time constraints and apprehension of assessing spiritual issues, which leaves them unable to assess and meet patients' spiritual needs. Thus, when patients experience spiritual distress, clinical nurses lose the opportunity to support spiritual growth and self-actualisation. In Taiwan, spiritual care, religion and culture are unique compared to those in other countries. Overall, factors associated with Taiwanese nurses' spiritual care competencies lack comprehensive exploration. METHODS: This study adopted a descriptive correlational design using cross-sectional survey (see Appendix S1). Cluster sampling was used to select clinical nurses from fourteen units of a medical centre and a regional hospital. Data were collected from January-June 2018 with a 97.03% response rate. Clinical nurses completed a background questionnaire, spiritual care practice questionnaire, spirituality and spiritual care-related scales. Data were analysed using descriptive and linear regression. This report followed the STROBE checklist. RESULTS: Spiritual care competence ranged from 44-123 (mean 84.67 ± 12.88; range 27-135). The majority of clinical nurses rated their spiritual care competence as moderate (64-98). The significant factors associated with nurses' spiritual care competence were education, religion, interest in spiritual care, having role models, past life events, barriers to providing spiritual care of the spiritual care practice score, and spiritual attitude and involvement score. The overall model was significant (p < .001) and accounted for 55.0% of variance (adjusted R2  = .488). CONCLUSIONS: Most clinical nurses have moderate spiritual care competence. Objective factors identified affect clinical nurses' spiritual care competencies. RELEVANCE TO CLINICAL PRACTICE: To improve nurses' spiritual care competencies, objective factors that affect clinical nurses' spiritual care competencies must be emphasised. Multiple strategies for enhancing nurses' own spiritual well-being can be provided via employee health promotion projects and activities, and promoting nurses' spirituality and spiritual care competencies can be explored in clinical settings through bedside teaching, situational simulation, objective structured clinical examinations and self-reflection.

The role of professional commitment in improving nurses' professional capabilities and reducing their intention to leave: Two-wave surveys.

BACKGROUND: Social cognitive career theory (SCCT) can explain the mechanism underlying the formulation of nurse turnover intention. However, little is known about the role of professional commitment in such a mechanism. AIMS: The aim of this study was to explore how elements of SCCT have an impact on the three aspects of professional commitment and thus nurses' intention to leave the profession. DESIGN: This study used surveys to collect two-wave data. METHODS: The participants were sampled in all available units of a major medical centre in 2017. By using proportionate random sampling methods, we successfully followed up a representative sample of 524 full-time nurses. Most participants (98.1%) were female. Items came from Cunningham et al.'s Self-Efficacy Scale, Outcome Expectations Scale, Human Capital Scale and Vocational Interest Scale; Meyer et al.'s Professional Commitment Scale; and Teng et al.'s Turnover Intention Scale. Structural equation modelling was used to test the hypotheses. RESULTS: Self-efficacy was positively related to outcome expectation. Outcome expectation was positively related to career interest. Career interest was positively related to affective professional commitment. Human capital was positively related to normative professional commitment. Affective professional commitment was positively related to intention to improve professional capabilities, which was further negatively related to intention to leave the profession. CONCLUSION: Aspects of professional commitment are important process variables in the impact of self-efficacy and outcome expectation on nurses' turnover intention.

Multimedia-assisted instruction on pain assessment learning of new nurses: a quasi-experimental study.

BACKGROUND: Pain assessment and treatment are key factors affecting the quality and safety of care for patients and capabilities related to them are crucial for new nursing staff. Consequently, we developed a multimedia-assisted teaching program for nursing newcomers' pain assessment learning to facilitate their practical pain assessment ability. The goal of this study was to evaluate a multimedia instructional program to boost new nurses' ability to conduct pain assessment and treatment, through simulated scenario instruction. METHODS: A quasi-experimental, pretest-posttest design with purposive sampling was used in this study. Eighty-six nurses were enrolled (control group, n = 39; experimental group, n = 47). Both groups underwent traditional pain assessment training in the classroom. The control group received lectures using PowerPoint files; while the experimental group undertook pain assessment training with the same content but delivered via multimedia-assisted instruction based on the ADDIE model. Pre- and post-instruction questionnaires relating to pain knowledge were completed. Participants' competence in performing pain assessment was subsequently evaluated one-month post instruction. RESULTS: The experimental group had significantly higher satisfaction scores (27.67 ± 3.76 vs. 31.36 ± 3.42, p < .01, respectively), and demonstrated greater knowledge of pain assessment (7.73 ± 0.67 vs. 7.08 ± 0.90, p < .05, respectively) than did the control group. Additionally, when evaluated at the one month follow-up, newcomers in the experimental group had better communication ability to perform pain assessment (26.58 ± 3.01 vs. 25.08 ± 3.32, p < .05, respectively). CONCLUSIONS: The program can improve nurses' pain assessment knowledge and competence. Newcomers were able to better respond to patients in pain, which is essential for pain assessment. This pilot study thus suggests a new, multimedia program for training nursing newcomers in pain assessment.

The impact of mentor-mentee rapport on nurses' professional turnover intention: Perspectives of social capital theory and social cognitive career theory.

AIMS AND OBJECTIVES: This study examines the impacts of mentor-mentee rapport on willingness to mentor/be mentored, self-efficacy, outcome expectations, career interest and subsequently on nurses' professional turnover intention. BACKGROUND: Workplace relationships, whether positive or negative, influence nurse turnover within an organisation. Yet little is known about the effects of mentoring on nurses' intentions to leave the nursing profession. DESIGN: A cross-sectional, survey-based research design was used to collect data from a large medical centre in Northern Taiwan. METHODS: Study concepts were measured using scales from social capital theory (SCT), social cognitive career theory (SCCT) and the nursing literature. Partial least square structural equation modelling was used to test all study hypotheses. The STROBE statement was chosen as the EQUATOR checklist. RESULTS: For mentors, rapport was positively related to willingness to mentor, which was positively related to outcome expectations, and further, positively related to career interest and negatively related to professional turnover intention. For mentees, rapport was positively related to willingness to be mentored, which was positively related to self-efficacy, outcome expectations and ultimately to career interest. Career interest was negatively related to professional turnover intentions. CONCLUSIONS: Rapport between mentors and mentees may be an important means to retain nurses in the profession. RELEVANCE TO CLINICAL PRACTICE: Managers should consider taking steps to enhance rapport between mentors and mentees. In doing so, managers improve nurse retention, a critical component of providing high-quality patient care.

How do career barriers and supports impact nurse professional commitment and professional turnover intention?

AIMS: This study examines how career barriers and supports (i.e., perceived discrimination, lack of advancement, human capital, and social capital) impact affective, normative, and continuance aspects of professional commitment and thus nurses' professional turnover intention. BACKGROUND: Professional commitment is known to influence professional turnover intention. However, little is known about how career barriers and supports contribute to professional commitment and reduce professional turnover intention. METHODS: This study adopted a cross-sectional design and a survey to collect representative data in a major hospital in northern Taiwan. We used proportionate random sampling to ensure sample representativeness and obtained 524 responses. RESULTS: Perceived discrimination and lack of advancement were negatively related to affective professional commitment. Human capital was positively related to affective, normative, and continuance professional commitment. Social capital was positively related to normative professional commitment. All aspects of professional commitment were negatively related to professional turnover intention. CONCLUSION: Career barriers and supports have an important influence on professional commitment. Reduced barriers and enhanced support may therefore help reduce nurses' professional turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers could aim to lessen career barriers while increasing career support for nurses, helping strengthen nurses' professional commitment and retention.

Mediating effects of burden on quality of life for caregivers of first-time stroke patients discharged from the hospital within one year.

BACKGROUND: Caregiver burden may be either a predictor or an outcome of caregiver quality of life (QoL). Patient or caregiver factors that directly affect caregiver QoL, predictors that are simultaneously shared with caregiver burden and QoL, and factors that affect caregiver QoL through caregiver burden are not well understood. This study explored predictors of caregiver QoL and identified whether caregiver burden is a mediator for caregivers of first-time stroke patients. METHODS: This is a cross-sectional study. We recruited first-time stroke patients who had been discharged from the hospital within 1 year. We screened caregivers with two major inclusion criteria: age > 20 years old and being the family member who provides the most patient-care hours out of all family caregivers. Caregiver burden (Caregiver Strain Index, CSI), QoL (Caregiver Quality of Life Index, CQLI), and patient and caregiver characteristics were assessed with structured questionnaires. Multiple-regression and bootstrap analysis were conducted for data analysis. RESULTS: A total of 126 caregivers completed the questionnaires. Higher caregiver burdens, lower caregiver education level, lower self-rated health, lower monthly family income, and spouses who were responsible for medical fees were significant predictors of lower caregiver QoL. Poor self-rated health and monthly family income of $ 666 USD or below were the strongest predictors of caregiver QoL. Spouses who were responsible for medical fees and lower monthly family income had direct negative effects on caregiver QoL, but these factors exhibited no indirect mediating effect between caregiver characteristics and QoL through caregiver burden as a mediator. Caregiver education level at or below elementary school and poor or fair self-rated-health had direct negative effects on caregiver QoL, which were mediated by caregiver burden. CONCLUSIONS: Our study indicated predictors of caregiver QoL and the relationships with caregiver burden among first-time stroke survivors in the early stage. Caregivers' financial factors affected caregiver QoL directly. Caregivers' poor self-rated health and lower education level negatively affected caregiver QoL indirectly through caregiver burden as a mediator. Interventions to make appropriate policies for financial subsidies, to enhance caregivers' health and to provide tailored stroke-related education through multidisciplinary cooperation may effectively promote caregiver QoL.

The impact of burnout on self-efficacy, outcome expectations, career interest and nurse turnover.

AIMS: To examine the impact of burnout on self-efficacy, outcome expectations, career interest and on nurses' intentions to leave the profession and to leave the organization. BACKGROUND: Burnout is associated with nurse turnover. Research clarifying the underlying mechanism may provide a novel means to mitigate the impact of burnout on nurse turnover. DESIGN: This study uses a cross-sectional design and proportionate stratified sampling. METHODS: Data were collected from a sample of nurses in one medical centre in northern Taiwan during February - March 2017. This study included nurses employed full-time at the medical centre. Burnout was measured using Maslach Burnout Inventory-Human Service Survey. Self-efficacy, outcome expectations and career interest were measured using the scale of Cunningham et al. Intentions to leave were measured using the scales of Teng et al. Structural equation modelling was used to assess the proposed framework. RESULTS: Burnout was negatively related to self-efficacy and outcome expectations. Self-efficacy was positively related to outcome expectations. Outcome expectations were also positively related to career interest. However, self-efficacy was not related to career interest. Career interest was negatively related to the intention to leave the organization, which was further related to the intention to leave the profession. The model fitted the data acceptably. CONCLUSIONS: When nurses leave the profession, patient outcomes may be affected. Policy makers should evaluate whether the healthcare system can instil expectations for satisfaction, power and adequate compensation in the profession and thus retain nurses.

How does burnout impact the three components of nursing professional commitment?

BACKGROUND: While the impact of burnout on organisational commitment has been widely observed, its impact on nursing professional commitment has not previously been investigated. The literature has clarified that professional commitment has three distinct components: affective, continuance and normative. AIMS: This study aims to investigate the relationships between burnout and the three components of nursing professional commitment. METHODS: This was a cross-sectional study using questionnaires to collect data in one large medical centre. Responses from 571 nurses were used for regression analysis. Among the sampled nurses, 90.9% had <15 years of nursing experience. MBI-HSS was used for measuring burnout. Three components of nursing professional commitment came from Meyer et al. (J Appl Psychol, 78, 1993 and 538) a formally validated instrument. RESULTS: Analytical results indicated that burnout is negatively related to affective and normative professional commitment (B ≤ -0.09, p < 0.01), but not related to continuance professional commitment (B = 0.05, p > 0.05). LINKING EVIDENCE TO ACTION: Nurse managers aiming to improve nurses' professional commitment should consider reducing nurses' burnout, for example improving nursing optimism and reducing administrative tasks, as suggested by the literature.

Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study.

BACKGROUND: With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. OBJECTIVE: The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women-Chinese American and Korean American midlife women-and to provide implications for future research. METHODS: While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. RESULTS: We identified practical issues in 4 major idea categories: (1) bilingual translators' language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. CONCLUSIONS: Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics.

The impact of nurses' spiritual health on their attitudes toward spiritual care, professional commitment, and caring.

BACKGROUND: The personal spiritual health of nurses may play an important role in improving their attitudes toward spiritual care and their professional commitment and caring capabilities. PURPOSE: The purpose of this study was to explore the impact of nurses' personal spiritual health on their attitudes toward spiritual care, professional commitment, and caring. METHODS: A total of 619 clinical nurses were included in this cross-sectional survey. The measurements included the spiritual health scale-short form, the spiritual care attitude scale, the nurses' professional commitment scale, and the caring behaviors scale. Structural equation modeling was used to establish associations between the main research variables. RESULTS: The hypothetical model provided a good fit with the data. Nurses' spiritual health had a positive effect on nurses' professional commitment and caring. Nurses' attitudes toward spiritual care could therefore mediate their personal spiritual health, professional commitment, and caring. CONCLUSIONS: The findings indicated that nurses' personal spiritual health is an important value and belief system and can influence their attitudes toward spiritual care, professional commitment, and caring.

Openness to experience, work experience and patient safety.

AIMS: The purpose of this study is to examine how the interaction between nurse openness and work experience is related to patient safety. BACKGROUND: No study has yet examined the interactions between these, and how openness and work experience jointly impact patient safety. METHODS: This study adopts a cross-sectional design, using self-reported work experience, perceived time pressure and measures of patient safety, and was conducted in a major medical centre. The sample consisted of 421 full-time nurses from all available units in the centre. Proportionate random sampling was used. Patient safety was measured using the self-reported frequency of common adverse events. Openness was self-rated using items identified in the relevant literature. RESULTS: Nurse openness is positively related to the patient safety construct (B = 0.08, P = 0.03). Moreover, work experience reduces the relation between openness and patient safety (B = -0.12, P < 0.01). CONCLUSIONS: The relationship between openness, work experience and patient safety suggests a new means of improving patient care in a health system setting. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers may enhance patient safety by assessing nurse openness and assigning highly open nurses to duties that make maximum use of that trait.

Which Aspects of Professional Commitment Can Effectively Retain Nurses in the Nursing Profession?

PURPOSE: This study examined which aspects of professional commitment can effectively retain nurses in the nursing profession. DESIGN, SETTINGS, AND PARTICIPANTS: This study used a longitudinal design, simple random sampling, and two-wave data collection to survey and follow up a representative sample of 579 nurses for 1 year in a major medical center in northern Taiwan. METHODS: Items measuring each aspect of professional commitment came from Meyer et al.'s scale. In the second wave, administrative data were culled to determine whether these nurses remain employed as nurses. Structural equation modeling is used to analyze the data. RESULTS: Analytical results indicate that continuance commitment predicts nurse retention in the nursing profession (path coefficient = 0.34, p < .01). CONCLUSIONS: Institutional efforts to improve continuance commitment (e.g., improved salary structures and enhanced professional development opportunities) likely retain nurses in the nursing profession. CLINICAL RELEVANCE: The findings of this study indicate the importance of continuance intention in retaining nurses. Nursing managers who face staff retention issues may consider making efforts to improve nurse salary and employer-sponsored benefits.

Religion and Spiritual Health in Patients With and Without Depression Receiving Hemodialysis: A Cross-Sectional Correlational Study.

BACKGROUND: Hemodialysis is the most common therapy for managing patients with end-stage renal disease. Depression is one of the most common psychological problems faced by dialysis patients, and there is limited research on the influences of religion and spirituality on dialysis patients. PURPOSE: This study was designed to compare religion and spiritual health status between hemodialysis patients with and without depressive symptoms. METHODS: A cross-sectional survey was conducted on 137 hemodialysis patients living in Taiwan. The self-report instruments used included the Religious Beliefs Scale, Spiritual Health Scale-Short Form, and Beck Depression Inventory-II. Data were analyzed using t test, chi-square test, point-biserial correlation of variance, and logistic regression. RESULTS: Most (63.5%) of the participants were classified with depression, of which most were male (70.1%), older (mean = 62.56 years), and unemployed (73.6%) and had less formal education. Fifty-two of the participants with depression had a 1- to 5-year duration of hemodialysis, whereas the nondepressed group had a higher mean score for number of religious activities, positive religious beliefs, and total score for spiritual health. Logistic regression showed an increased odds ratio ( OR ) of depression for participants with a duration of hemodialysis of 1-5 years ( OR = 3.64, 95% CI [1.01, 13.15]). Participants with higher scores for spiritual health had a lower risk of depression ( OR = 0.82, 95% CI [0.75, 0.90]), indicating a positive association between spiritual health and lower depression risk. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The prevalence rate of depression in hemodialysis patients is higher than that in the general population. Providing screenings for spiritual health and depression as part of routine medical care for hemodialysis patients is recommended to detect spiritual distress and depression early.

Mediating role of spirituality on the relationships between posttraumatic stress and posttraumatic growth among patients with cancer: A cross-sectional study.

Objective: This study explores the impact of posttraumatic stress (PTS) on posttraumatic growth (PTG) and verifies the mediating effect of spirituality among patients with cancer. Methods: This study used a cross-sectional correlational design. This study surveyed 141 hospitalized patients over 20 years of age diagnosed with cancer. Participants were recruited by convenience sampling from a regional hospital in Taiwan. Data were collected from January to April 2021. Measurements included sociodemographic and disease-related information and data from the following self-report questionnaires: Posttraumatic Stress Reaction Index-Short Form, Posttraumatic Growth Inventory, and Spiritual Health Scale-Short Form. Structural equation modeling and bootstrapping were used to analyze the mediating effect of spiritual health on PTS and PTG. Results: PTS and spirituality were negatively correlated, spirituality, and PTG were positively correlated, and PTS had no correlation with PTG. Spirituality fully presented a mediating role between PTS and PTG. Conclusions: Patients' spirituality should be regarded as an important variable that can impact stress appraisal and improve the patient's PTG when a diagnosis of cancer is received. Assessing spiritual health at regular intervals and integrating spiritual care with clinical care could decrease PTS and improve PTG for patients with cancer.

Impact of nurse agreeableness and negative mood of nursing supervisors on intention to help colleagues.

AIMS: This paper is a report of a correlational study of the relations of nurse agreeableness and negative supervisor mood to nurses' intentions to help their colleagues. BACKGROUND: Nursing collaboration is important to high quality care. Previous studies have identified agreeableness and negative mood of supervisors as influential factors in the workplace. In nursing, however, exactly how these factors and their interactions influence nurses' intention to help their colleagues remains unknown. METHODS: A cross-sectional design and questionnaires were used to collect data in December 2007. Each sample set comprised of one supervisor and three nurses. A total of 53 sets of questionnaires were distributed, and 46 complete sets of responses were received, yielding a response ratio of 86·8%. RESULTS: The analytical results indicate that nurse agreeableness is positively related to nurses' intentions to help colleagues (path coefficient = 0·54, P < 0·01). However, negative supervisor mood is negatively related to nurses' intentions to help colleagues (path coefficient = -0·13, P < 0·05). Moreover, the analytical results indicated that for highly agreeable nurses, the relationship between negative supervisor mood and nurses' intentions to help colleagues is significantly stronger than for less agreeable nurses. This demonstrates that nurse agreeableness amplifies the negative impact of negative supervisor mood on nurses' intentions to help colleagues. CONCLUSION: The study findings suggest the pivotal importance of managing negative supervisor mood to increase nurses' intentions to help colleagues.

Nursing accreditation system and patient safety.

AIMS: This study investigated whether nursing accreditation level affects patient safety. BACKGROUND: The nursing accreditation system evaluates the capabilities of nursing professionals in Taiwan. While this system has been in place for years, few studies have investigated whether nursing accreditation level is associated with patient safety indicators. This study can help in understanding how nursing capabilities affect patient safety and can subsequently contribute to improvements in patient safety. METHODS: This study adopted a cross-sectional research design using questionnaires to collect responses from nurses working in two major medical centres in northern Taiwan. Regression analyses were conducted to test the study hypothesis. RESULTS: The analytical results show that nursing accreditation level is positively related to patient safety indicators. CONCLUSION: Health services managers should encourage nurses to advance their knowledge, skills, and professional capabilities because these may be positively related to patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers who seek to improve patient safety should consider encouraging nurses to advance their accreditation level.

The Effectiveness of the Buzzy Device for Pain Relief in Children During Intravenous Injection: Quasirandomized Study.

BACKGROUND: Intravenous injection is the most common medical treatment and the main cause of pain in hospitalized children. If there is no appropriate health care for pain relief, the proportion of moderate and severe pain often exceeds 70%. With nonpharmaceutical-based pain management, Buzzy is recognized as an effective device for rapidly relieving injection pain in hospitalized children. However, Buzzy is not widely used in Asia and very few experimental studies in Asia have addressed the effectiveness of the Buzzy device at treating needle pain in hospitalized children. OBJECTIVE: The main purpose of this study was to investigate the effectiveness of the Buzzy device for diminishing pain levels among hospitalized children in Taiwan. METHODS: We applied a quasiexperimental design with random assignment. According to the time of admission, child participants were randomly assigned to treatment and nontreatment groups. The Buzzy device was applied as an intervention in this study. The samples size was 30 per group. The study participants were recruited from the pediatric ward of a medical center in northern Taiwan. The research data were collected longitudinally at three time points: before, during, and after intravenous injection. Three instruments were used for assessment: a demographic information sheet, the Wong-Baker Face Scale (WBFS), and the Faces Legs Activity Cry Consolability (FLACC) scale. The data were analyzed by descriptive analysis, the Mann-Whitney U test, the Wilcoxon signed-rank test, and the χ2 test. RESULTS: A total of 60 hospitalized children aged 3 to 7 years participated in this study, including 30 participants in the treatment group and 30 participants in the nontreatment group. The average age of children in the treatment and nontreatment groups was 5.04 years and 4.38 years, respectively. Buzzy significantly mitigated pain in children during intravenous injection with a significant difference between the two groups in pain-related response (FLACC) and actual pain (WBFS) (Z=-3.551, P<.001 and Z=-3.880, P<.001, respectively). The children in the treatment group had a significantly more pleasant experience than those in the nontreatment group (Z=-2.387, P=.02). When Buzzy was employed, the children experienced less pain than they did during previous intravenous injections (Z=-3.643, P<.001). CONCLUSIONS: The intervention of using the Buzzy device was effective in reducing pain levels of intravenous injection among hospitalized children. The specific focus on children in Asia makes a valuable contribution to the literature. For clinical application, the reliable pain relief measure of Buzzy can be used in other Asian children to help health care providers improve noninvasive care among children. For future applications, researchers could integrate Buzzy into therapy-related games and a technology-based app to increase the efficiency of use and provide more data collection functions.

Image and Speech Recognition Technology in the Development of an Elderly Care Robot: Practical Issues Review and Improvement Strategies.

As the world's population is aging and there is a shortage of sufficient caring manpower, the development of intelligent care robots is a feasible solution. At present, plenty of care robots have been developed, but humanized care robots that can suitably respond to the individual behaviors of elderly people, such as pose, expression, gaze, and speech are generally lacking. To achieve the interaction, the main objectives of this study are: (1) conducting a literature review and analyzing the status quo on the following four core tasks of image and speech recognition technology: human pose recognition, human facial expression recognition, eye gazing recognition, and Chinese speech recognition; (2) proposing improvement strategies for these tasks based on the results of the literature review. The results of the study on these improvement strategies will provide the basis for using human facial expression robots in elderly care.

The relationship between spiritual health, health-promoting behaviors, depression and resilience: A longitudinal study of new nurses.

AIM: To determine if levels of spiritual health, health-promoting behaviors, depressive symptoms and resilience change over time and determine if any variables have an impact on resilience among new nurses. BACKGROUND: Nurses provide patients with medical care and emotional support in high-stress environments. Resilience is a characteristic that allows one to adjust to these adverse situations. Resilience can help new nurses withstand the emotional stress of the workplace and improve nurse retention. METHOD: The study was conducted from 2017 to 2019 with a convenience sample of nursing students (N = 195). Data were collected at four timepoints with self-report questionnaires on spiritual health, health-promoting behaviors, resilience and the Beck Depression Inventory-II from 2017 to 2019. Three timepoints were collected during the fourth year of the student stage: fall semester (T1), spring semester (T2) and just prior to graduation (T3); the fourth timepoint was the novice stage (T4), after at least 3 months as a registered nurse. General estimating equations determined predictors of resilience. RESULTS: A total of 124 new nurses completed all questionnaires (63% response rate). Although mean scores fluctuated slightly during the student stage, the scores at T4 were significantly worse for spiritual health (Wald χ2 = 30.23, p < .001), health-promoting behaviors (Wald χ2 = 34.89, p < .001), depressive symptoms (Wald χ2 = 46.75, p < .001) and resilience (Wald χ2 = 21.54, p < .001). Spiritual health, health-promoting behaviors were positively correlated with resilience (p < .001); depressive symptoms were negatively correlated (p < .001). Controlling for the effect of time, resilience of novice nurses was positively associated with nursing school practicum grade, spiritual health and health-promoting behaviors (ß = 10.30, p < .001; ß = 12.14, p < .001; and ß = 14.62, p < .001, respectively) and negatively associated with depressive symptoms (ß = - 0.53, p < .001). CONCLUSIONS: Scores for all variables were similar over the three timepoints of the student stage. However, the significant changes at T4 compared with the student stage suggest the novice stage of nursing was challenging. Increasing resilience could reduce the challenges of transitioning to a hospital environment. Nursing educators and administrators could increase nursing students' resilience by restructuring the educational curricula. This could include helping nurses increase their spirituality and health-related behaviors and providing psychological support to reduce depressive symptoms. Increasing levels of resilience could reduce nurses' emotional stress and improve retention of new nurses.