Using Virtual Reality in a Rehabilitation Program for Patients With Breast Cancer: Phenomenological Study.

Background: Surgery is an essential treatment for early-stage breast cancer. However, various side effects of breast cancer surgery, such as arm dysfunction and lymphedema, remain causes for concern. Rehabilitation exercises to prevent such side effects should be initiated within 24 hours after surgery. Virtual reality (VR) can assist the process of rehabilitation; however, the feasibility of applying VR for rehabilitation must be explored, in addition to experiences of this application. Objective: This study explored patients' attitudes toward and experiences of using VR for their rehabilitation to determine the feasibility of such VR use and to identify potential barriers. Methods: A phenomenological qualitative study was conducted from September to December 2021. A total of 18 patients with breast cancer who had undergone surgical treatment were interviewed using open-ended questions. The Colaizzi 7-step procedure for phenomenological analysis was used for data analysis. To ensure high study reliability, this study followed previously reported quality criteria for trustworthiness. Results: Three themes were identified: (1) VR was powerful in facilitating rehabilitation, (2) early and repetitive upper limb movements were an advantage of VR rehabilitation, and (3) extensive VR use had challenges to be overcome. Most of the interviewed patients reported positive experiences of using VR for rehabilitation. Specifically, VR helped these patients identify appropriate motion and angle limits while exercising; in other words, knowledge gained through VR can play a key role in the rehabilitation process. In addition, the patients reported that the use of VR provided them company, similar to when a physiotherapist is present. Finally, the gamified nature of the VR system seemed to make VR-based rehabilitation more engaging than traditional rehabilitation, particularly with respect to early rehabilitation; however, the high cost of VR equipment made VR-based rehabilitation difficult to implement at home. Conclusions: The interviewed patients with breast cancer had positive experiences in using VR for rehabilitation. The high cost of both VR equipment and software development presents a challenge for applying VR-based rehabilitation.

[Nursing education: integrating gender equity consciousness].

Gender sensitivity influences the way a nurse handles the nursing process and can influence both patient care and public perception of the nursing profession. Nurses unaware of the influences of gender are unable to perform holistic nursing, the practice of which centers on patient-centered care. Education is essential to promote gender consciousness. Providing scenario-based education to apply gender consciousness can help nursing students integrate gender and nursing care concepts and improve nursing care quality. In addition to raising attention to this important issue, this article makes comprehensive suggestions on how to apply gender concepts in nursing education. These suggestions include requiring instructors to consider and assess their own gender consciousness in order to enhance positive gender consciousness; reviewing teaching materials to identify and remove content tainted by sexual discrimination, and emphasizing gender education in the nursing education curriculum.

Roles and functions of community mental health nurses caring for people with schizophrenia in Taiwan.

AIMS AND OBJECTIVES: The study aimed to understand the nursing roles and functions of public health nurses and home health nurses in Taiwan and the factors that affect nursing roles and functions of nurses that provide community mental health home visiting services. BACKGROUND: Although community nurses provide more psychiatric home visiting services than other psychiatric professionals, little research on their roles and functions has been conducted. DESIGN: Nursing roles and functions were developed through use of grounded theory method of Strauss and Corbin. METHODS: Data were collected using semi-structured face-to-face in-depth interviews and unstructured non-participant observations. The constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected using theoretical sampling. Final sample size in this study comprised a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home visiting. Public health nurses conducted a total of 16 (eight carers and eight clients) services and home health nurses conducted 16 (eight carers and eight clients) services. RESULTS: Fourteen nursing roles were identified. These roles included assessor, supporter, educator, consultant, counselor, negotiator, harmoniser, collaborator, advocate, placement coordinator, resource provider, care provider, case manager and case finder. Moreover, several factors that affect nursing roles and functions in the community mental health home visiting service in Taiwan were also identified. CONCLUSION: This is the first study to identify the role of public health and home health nurses caring for people with schizophrenia in the community in Taiwan. RELEVANCE TO CLINICAL PRACTICE: The recommendations based on the findings of this research can be used as a guide to improve the delivery of psychiatric home visiting services to community-dwelling clients with schizophrenia and their carers.

Risk of Subsequent Hypertension and Diabetes in Women With Hypertension During Pregnancy and Gestational Diabetes.

OBJECTIVE: To assess risks of postpartum hypertension and diabetes mellitus (DM) for women with hypertension during pregnancy (HDP) with and without gestational DM (GDM). PATIENTS AND METHODS: From insurance data of 15- to 44-year-old women with pregnancy in 2000-2011, we established an HDP/GDM cohort (n=1270), an HDP/non-GDM cohort (n=5077), and a comparison cohort without either disorder (n=12,594), frequency matched by age and year of pregnancy. Postpartum hypertension and DM were assessed before 2012. RESULTS: The postpartum hypertension incidence increased with age in all cohorts, with overall rates of 13.1, 8.82, and 0.79 per 1000 person-years in the HDP/GDM, HDP/non-GDM, and comparison cohorts, respectively. The adjusted hazard ratios (aHRs) of hypertension were 16.8 (95% CI, 11.8-24.1) for the HDP/GDM cohort and 11.2 (95% CI, 8.19-15.2) for the HDP/non-GDM cohort relative to the comparison cohort. The corresponding incident DM rates were 41.9 and 8.06 vs 2.55 per 1000 person-years in the 3 cohorts, respectively, with aHRs of 16.2 (95% CI, 13.2-19.9) for the HDP/GDM cohort and 3.15 (95% CI, 2.55-3.89) for the HDP/non-GDM cohort relative to the comparison cohort. Incident DM in the HDP/GDM cohort was 44% greater in 15- to 29-year-old women vs 40- to 44-year-old women (49.1 vs 34.2 per 1000 person-years), with aHRs of 39.2 (95% CI, 24.5-62.7) and 5.52 (95% CI, 2.92-10.4), respectively, relative to comparisons of respective age groups. CONCLUSION: Subsequent hypertension and DM risks are greater in women with HDP/GDM than in women with HDP only compared with women without these complications. Younger women with HDP/GDM should be particularly cautious.