Factors associated with continuing education needs in medication administration among school nurses.

AIM: To investigate the continuing education requirements and factors influencing school nurses' needs in relation to medication administration on school campuses. DESIGN: A total of 391 school nurses working in K-12 schools in Taiwan were invited to participate in an online questionnaire survey. METHODS: This cross-sectional study employed a probability proportionate to size technique along with a random sampling method. Data were collected from February to April 2023. RESULTS: School nurses reported a significant demand for continuing education and perceived moderate levels of stress and government support related to medication administration. Among the various dimensions, the highest demand was observed for 'definition of campus medication errors' and 'regulations for campus medical orders.' Moreover, the 'identifying drug interactions' and 'adverse drug effects and referrals' dimensions were identified as the most stressful aspects. Notably, perceived stress emerged as the sole predictive factor for continuing education demand, accounting for 16.1% of the variance. CONCLUSIONS: The study found that there was a significant demand for and moderate stress related to continuing education among school nurses. Therefore, it is crucial for the government and school nursing organizations to develop targeted programs focusing on medication administration. These initiatives should be designed to enhance nurses' capabilities and reduce their stress, thereby ensuring safe medication administration on campuses. IMPACT: Continuing education enables school nurses to acquire up-to-date knowledge and improve the workflow in their practice. This study highlights a strong need for education in medication administration with a focus on 'campus medication error definitions' and 'campus medical order regulations.' The government and relevant school nursing organizations should prioritize the development and implementation of continuing education programs to decrease the school nurses' stress related to medication administration. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

Competence and Stress of Medication Administration Practices for School Nurses in K-12 Taiwan Schools.

We investigated school nurses' experiences, perceived government support, school nurses' acceptance of responsibility for medication administration, perceived stress, and perceived competence of medication administration and analyzed factors associated with perceived competence. In this cross-sectional study, from February to April 2023, we conducted an online survey of 269 school nurses serving at K-12 schools in Taiwan. The results revealed that although 71% of the participants had prior experience with medication administration, they reported low competence and high stress in areas such as drug interactions, adverse drug effects, and referrals. The school nurses' disagreement with responsibilities for medication administration emerged as the only factor to be significantly associated with perceived medication administration competence, accounting for 22.8% of the variance. We recommend implementing continuing training programs to provide school nurses with up-to-date medication information. Additionally, the development of practice guidelines is suggested as a means of enhancing nurses' competence and reducing their stress levels for the administration of medications.

Factors related to hospital-to-home transitional self-monitoring blood glucose behaviour among patients with diabetes-related foot ulcer.

AIMS: To explore the factors related to hospital-to-home transitional self-monitoring blood glucose behaviour among patients with diabetes-related foot ulcer. BACKGROUND: The 30-day readmission rate of patients with diabetes-related foot ulcer can be reduced when good glycaemic control is achieved. The practice of self-monitoring blood glucose promotes optimal glycaemic control. DESIGN: A comparative descriptive study. METHODS: In this study, 200 participants, who had been hospitalized due to diabetes-related foot ulcer, were recruited from August 2017 to July 2018. Before participants were discharged from the hospital, psychosocial factors (family support, threat belief, self-efficacy and knowledge) and pre-hospitalization self-monitoring blood glucose behaviour were collected using a structured questionnaire. Then, after discharge, self-monitoring blood glucose behaviour delivery was collected again. RESULTS: Five variables explained 47% of the variance in the delivery of self-monitoring of blood glucose at home. The delivery of hospital-to-home transitional self-monitoring blood glucose behaviour was more likely for individuals with higher pre-discharge self-efficacy, higher post-discharge self-efficacy, more attention to pre-hospitalization glycaemic status and post-discharge insulin usage and those without an insensitive foot. CONCLUSION: Self-monitoring blood-glucose behaviour should be promoted among post-discharge patients with diabetes-related foot ulcer. The modifiable factors identified in this study can be integrated into the discharge plan.

Nurse administrators' intentions and considerations in recruiting inactive nurses.

AIMS: To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. BACKGROUND: Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. METHODS: A census survey collected data from 392 nurse administrators via a mailing method. RESULTS: Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. CONCLUSIONS: Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence.

Inactive nurses in Taiwan: human capital, intention to return to hospital nursing, and incentives for returning.

AIMS: To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. BACKGROUND: Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. METHOD: Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. RESULTS: Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. CONCLUSIONS: Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. IMPLICATIONS FOR NURSING MANAGEMENT: The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing.

Organisational support, organisational identification and organisational citizenship behaviour among male nurses.

AIMS: The purpose of this study was to explore the relationship between organisational support, organisational identification, and organisational citizenship behaviour and the predictors of organisational citizenship behaviour in Taiwanese male nurses. BACKGROUND: The turnover rate among male nurses is twice that of female nurses. Organisational citizenship behaviour is the predictor of turnover intention. Little information is available on the relationship between organisational support, organisational identification and organisational citizenship behaviour, particularly for male nurses. METHODS: Data were collected in 2010 from a questionnaire mailed to 167 male nurses in Taiwan. A cross-sectional survey with simple sampling was used in this study. RESULTS: The results showed that organisational identification and organisational support were correlated with organisational citizenship behaviour. Organisational distinctiveness, organisational support of work conditions and the type of organisation were the main predictors of organisational citizenship behaviour. Together they accounted for 40.7% of the total variation in organisational citizenship behaviour. Organisational distinctiveness was the most critical predictor, accounting for 29.6% of the variation. CONCLUSION: Organisational support and organisational identification have positive relationships with organisational behaviour. Organisational distinctiveness is an important factor in explaining organisational citizenship behaviour in male nurses. IMPLICATIONS FOR NURSING MANAGEMENT: This finding provides concrete directions for managers to follow when providing organisational identification, in particular, the organisational distinctiveness will help male nurses to display increasingly more organisational citizenship behaviour.

Developing the "Healthcare CEO App" for patients with type 1 diabetes transitioning from adolescence to young adulthood: A mixed-methods study.

AIM: To develop and test a mobile application that supports the disease self-management of adolescents with type 1 diabetes during their transition to early adulthood. DESIGN: A sequential mixed-methods design was employed. METHODS: The application content was designed according to previously identified care needs and expectations, followed by application development on the Android operating system. From the outpatient clinic of the Department of Paediatric Endocrinology and Metabolism at a medical centre in northern Taiwan, 35 individuals aged between 16-25 years participated in application testing. RESULTS: The overall median score of the QUIS was 4-5, most of the 25% quartile was 4-5, and all of the 75% quartile was 5, indicating adequate user interaction satisfaction.

Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies.

Relationships among sexual self-concept, sexual risk cognition and sexual communication in adolescents: a structural equation model.

AIM: The purpose of this study was to test a model of sexual self-concept and sexual risk cognition affecting sexual communication in Taiwanese adolescents. BACKGROUND: Parent-adolescent sexual communication has been shown to influence adolescent sexual behaviour. Self-concept is an important predictor of human behaviour, especially sexual behaviour. Few researchers have assessed sexual self-concept in adolescents, despite its clear relevance to understanding adolescent sexual behaviour. DESIGN: A cross-sectional survey with convenience sampling was used in this study. METHOD: In 2009, data were collected by questionnaire from 748 adolescent students at a junior college in Taiwan. RESULTS: The results revealed that the postulated model fits the data from this study well. Sexual self-concept significantly predicts sexual risk cognition and sexual communication. Sexual risk cognition significantly predicts sexual communication and has an intervening effect on the relationship between sexual self-concept and sexual communication. CONCLUSIONS: Sexual risk cognition is important in explaining sexuality in adolescents. Sexual self-concept has both direct and indirect effects on sexual communication. Our findings provide concrete directions for school educators in developing sexual health programmes to increase adolescent sexual self-concept and sexual communication with their parents. RELEVANCE TO CLINICAL PRACTICE: Future sexual health programmes about sexual self-concept and sexual risk cognition must add for increasing adolescent's sexual communication with their parents.

Relationships among self-esteem, job adjustment and service attitude amongst male nurses: a structural equation model.

AIM: The purpose of this study was to test a relationship model of self-esteem and job adjustment affecting the service attitude of male nurses in Taiwan. BACKGROUND: Service attitude of nurses may affect their intention to leave and the quality of health care for their patients. Self-esteem is an important predictor of service attitude. Very few researchers have assessed job adjustment and service attitude in male nurses. Reducing job stress and burnout would help to increase job satisfaction. DESIGN: A cross-sectional research design was used in this study. METHOD: In 2009, 338 male nurses were invited to participate in this study. Finally, 284 participants completed the questionnaire, and the response rate was 84.0%. RESULTS: The results revealed that the postulated model fits the data from this study well. Self-esteem did not significantly correlate to service attitude. Job adjustment was a significantly influencing factor on service attitude. CONCLUSIONS: We conclude that job adjustment was indeed important in explaining the service attitude of male nurses. Nurse managers must help male nurses adjust their job as soon as possible to improve their service attitude. RELEVANCE TO CLINICAL PRACTICE: In clinical practice and management, our findings provide concrete directions for nursing management and professionals in helping male nurses adjust to their job to improve male nurses' service attitude. More clinical situation must be provided and practiced before male nursing students graduate from school. We suggest future study is needed to generalise this model to different populations.

Factors affecting the career development of male nurses: a structural equation model.

AIM: This paper is a report of a study conducted to test a theory of the relations of emotional labour and professional empowerment to nursing career development. BACKGROUND: Nurses are required to show high emotional labour, but this can bring about excessive pressure and emotional exhaustion. Male nurses usually perceive societal expectations in line with a more traditionally masculine role. Greater professional empowerment might assist them in attaining promotion and career success. METHOD: The study had a cross-sectional correlational design. Data were collected in 2007 using a mailed questionnaire. We used a database published by the National Union of Nurses' Associations, Republic of China, to find medical care institutions at which male nurses were working. A convenience sample of male nurses (308) working at clinical nursing centres completed the mailed questionnaires. RESULT: Emotional labour was not statistically significantly related to nursing career development, but was statistically significantly related to professional empowerment. Professional empowerment was statistically significantly related to nursing career development. Professional empowerment a mediating factor in the influence of emotional labour on nursing career development. We found that 75% of the variance in nursing career development could be explained by emotional labour and professional empowerment. CONCLUSION: The expected result, that emotional labour has a direct effect on nursing career development, was not supported by the analyses. Emotional labour has only an indirect effect on nursing career development. Professional empowerment was directly linked to nursing career development. Male nurses who perceived higher professional empowerment had better career development.

Job stress, achievement motivation and occupational burnout among male nurses.

AIM: This paper is a report of an exploration of job stress, achievement motivation and occupational burnout in male nurses and to identify predictors of occupational burnout. BACKGROUND: Since the Nightingale era, the nursing profession has been recognized as 'women's work'. The data indicate that there are more female nurses than male nurses in Taiwan. However, the turnover rate for male nurses is twice that of female nurses. Understanding the factors that affect occupational burnout of male nurses may help researchers find ways to reduce the likelihood that they will quit. METHOD: A survey was conducted in Taiwan in 2008 using a cross-sectional design. A total of 121 male nurses participated in the study. Mailed questionnaires were used to collect data, which were analysed using descriptive statistics and stepwise multiple regression. RESULTS: The job stress of male nurses was strongly correlated with occupational burnout (r = 0.64, P < 0.001). Stepwise multiple regression analyses indicated that job stress was the only factor to have a statistically significant direct influence on occupational burnout, accounting for 45.8% of the variance in this. Job stress was comprised of three dimensions, of which role conflict accounted for 40.8% of the variance in occupational burnout. CONCLUSION: The contribution of job stress to occupational burnout of male nurses was confirmed. As occupational burnout may influence the quality of care by these nurses, nurse managers should strive to decrease male nurses' job stress as this should lead to a reduction of negative outcomes of occupational burnout.

Emergence of a butterfly: the life experiences of type 1 diabetes Taiwanese patients during the 16-25 years old transition period.

Purpose: To explore the life experiences of patients with type 1 diabetes transition from adolescence into adulthood in Taiwan.Methods: Descriptive phenomenological design was used. Fourteen participants were individually interviewed using a semi-structured interview.Results: The life experiences of patients with type 1 diabetes transition from adolescence into adulthood experience a metamorphosis from awareness of responsibility to figuring out a way to care for themselves. Six themes emerged: (1) hibernation: awareness of responsibility; (2) emergence: attempts to take responsibility; (3) perseverance: encountering difficulties; (4) anxiety: multiple worries; (5) hesitation: back-and-forth," and (6) exit: finding a way out."Conclusions: During the transition phase, the participants experienced the trials of various situations. Regardless of whether they are able to independently bear the responsibilities of self-management, they all hope to turn around the challenges of disease control and take ownership of their disease. Like a butterfly that emerges from a cocoon, they hoped to overcome the dangers of taking flight through trial and error and navigating the world. The results of this study can serve as a reference for clinical care and developing localized intervention strategies targeted to the transition period between adolescence and young adulthood.

NanoMuscle: controllable contraction and extension of mechanically interlocked DNA origami.

Artificial molecular machines synthesized in supramolecular chemistry have attracted great interest over the past decades. DNA origami presents an alternative approach to construct nano-machines by directly designing its thermodynamically stable state by DNA sequences. Here, we construct a molecular device, named NanoMuscle, with mechanically interlocked DNA origami. NanoMuscle's configuration - either extended or contracted - can be controlled by adding specific DNA strands. We monitored NanoMuscle's multistep synthesis with gel electrophoresis, and verified that monomers of the NanoMuscle are interlocked at correct orientation with transmission electron microscopy (TEM). We then validated that NanoMuscle can switch between extended and contracted configuration. By converting binding energy from DNA hybridization and Brownian motion to mechanical movements, NanoMuscle may serve as a novel building block for future mesoscale machinery.

Knowledge of the Warning Signs of Foot Ulcer Deterioration Among Patients With Diabetes.

BACKGROUND: Seeking treatment in a timely manner may prevent lower limb amputation subsequent to diabetic foot ulcers. Knowledge regarding the warning signs is one importantfactor that is related to the timely treatment seeking of patients with diabetic foot ulcers. However, there is no previousresearch on which aspects of such knowledge that patients with diabetes are lacking. PURPOSE: The aims of this study were to test the psychometric properties of a questionnaire that was designed to assess the knowledge of the warning signs of diabetic foot ulcer deterioration and to determine the knowledge of these warning signs among patients with a history of diabetic foot ulcers. METHODS: A cross-sectional study design was used. Patients with a history of diabetic foot ulcers were recruited using convenience sampling (N = 385). Data were analyzed using Spearman's rank correlation and the Mann-Whitney U test. RESULTS: The questionnaire showed good known-group validity, satisfied internal consistency (Kuder-Richardson Formula 20 = .82), and exhibited acceptable 2-week test-retest reliability (Spearman's rho coefficient = .75). More than 30% of the participants were unaware of the warning signs of peripheral vascular insufficiency and severe infection. Of the participants, 75.8% felt that the time to seek medical treatment of diabetic foot ulcers was when they experienced wound deterioration. Those who held this opinion had significantly less knowledge regarding the warning signs of diabetic foot ulcer deterioration than did those who had not. Other factors that were significantly associated with less knowledge included being older, having less education, not having an existing foot ulcer, having no foot ulcer treatment history, and never having received education regarding foot ulcers. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The questionnaire showed adequate validity and reliability and thus may be used by healthcare practitioners and researchers to assess the knowledge of at-risk patients regarding the warning signs of diabetic foot ulcer deterioration. Patient education regarding the importance of timely treatment seeking and warning signs should be promoted.

Highly Efficient Intracellular Protein Delivery by Cationic Polyethyleneimine-Modified Gelatin Nanoparticles.

Intracellular protein delivery may provide a safe and non-genome integrated strategy for targeting abnormal or specific cells for applications in cell reprogramming therapy. Thus, highly efficient intracellular functional protein delivery would be beneficial for protein drug discovery. In this study, we generated a cationic polyethyleneimine (PEI)-modified gelatin nanoparticle and evaluated its intracellular protein delivery ability in vitro and in vivo. The experimental results showed that the PEI-modified gelatin nanoparticle had a zeta potential of approximately +60 mV and the particle size was approximately 135 nm. The particle was stable at different biological pH values and temperatures and high protein loading efficiency was observed. The fluorescent image results revealed that large numbers of particles were taken up into the mammalian cells and escaped from the endosomes into the cytoplasm. In a mouse C26 cell-xenograft cancer model, particles accumulated in cancer cells. In conclusion, the PEI-modified gelatin particle may provide a biodegradable and highly efficient protein delivery system for use in regenerative medicine and cancer therapy.

A study of role stress, organizational commitment and intention to quit among male nurses in southern Taiwan.

Gender and sex role stereotyping are recognized as having the potential to limit the professional development of males within the nursing profession. The purpose of this study was to understand the relationships between demographic data and the dimensions of role stress, organizational commitment, and intentions to quit among male nurses in southern Taiwan. Research also investigated the correlations with three dependent variables and identified best predictors of male nurse intentions to quit the nursing profession. A total of 91 male nurses volunteered to participate in this cross-sectional research. Research results were based on data collected from questionnaires sent by mail to participants. A total of 76 valid questionnaires were returned and used in analysis (response rate = 83.5%). Findings pointed to patients, colleagues and society as the major sources of role stress for male nurses. These sources of stress, and the resultant intention to quit on the part of male nurses, are due in significant part to the widespread stereotyping of the profession of nursing as a "woman's occupation". Such stress pressures male nurses to consider quitting to take jobs in other professional fields. Role stress is correlated to intention to quit among male nurses. Role stress and years of service are highly relevant predictors of male nurse intention to quit and leave the nursing profession, explaining 33.8% of variability. We suggest that at various levels of education and society, promotion of male and female equality should be increased. There is also a need for psychological consultation as well as the promotion of male nurse role models to prevent male nurses turning away from nursing careers.

There is nothing wrong with being a nurse: The experiences of male nursing students in Taiwan.

AIM: Male nurses are reported to experience role strain. Fear of gender stereotyping can be stressful and frustrating for male nursing students, which could make them feel isolated and excluded. The aim of this qualitative study was to investigate how male nursing students in Taiwan perceive the barriers to their experience as nursing students and how they manage these barriers in their study environment and social life. METHODS: A qualitative research approach was used in this study. Data were collected during 2014 from 24 male nursing students from three nursing educational institutes in Taiwan who participated in order to share their experiences by using a semistructured interview. All the interviews were recorded, transcribed verbatim, and analyzed by thematic analysis. RESULTS: The main theme that described the experiences of the male nursing students in Taiwan was: "There is nothing wrong with being a male nurse." Contrary to other studies, role strain for the participants was minimal. The students experienced some barriers because of being a male nursing student, both at school and in their social life. Most of these students tended to manage the barriers by developing positive thinking and coping strategies. CONCLUSION: Nursing educators are encouraged to use the findings from this study to provide appropriate support for male nursing students.

Relationships among sexual self-concept and sexual risk cognition toward sexual self-efficacy in adolescents: cause-and-effect model testing.

AIM: Sexual self-efficacy plays an important role in adolescents' sexual health. The aim of this study was to test a cause-and-effect model of sexual self-concept and sexual risk cognition toward sexual self-efficacy in adolescents. METHODS: The study was a cross-sectional survey. Using a random sampling method, a total of 713 junior nursing students were invited to participate in the study, and 465 valid surveys were returned, resulting in a return rate of 65.2%. The data was collected using an anonymous mailed questionnaire. Structural equation modeling was used to test the relationships among sexual self-concept, sexual risk cognition, and sexual self-efficacy, as well as the mediating role of sexual risk cognition. RESULTS: The results revealed that the postulated model fits the data well. Sexual self-concept significantly predicted sexual risk cognition and sexual self-efficacy. Sexual risk cognition significantly predicted sexual self-efficacy and had a mediating effect on the relationship between sexual self-concept and sexual self-efficacy. CONCLUSION: Based on social cognitive theory and a structural equation model technique, this study confirmed the mediating role of sexual risk cognition in the relationship between sexual self-concept and sexual self-efficacy. Also, sexual self-concept's direct and indirect effects explaining adolescents' sexual self-efficacy were found in this study.

Relationships among social support, professional empowerment, and nursing career development of male nurses: a cross-sectional analysis.

The purpose of this study is to explore the relationships among social support, professional empowerment, and nursing career development and to identify the significant factors that affect nursing career development among male nurses. A cross-sectional survey design was used with 314 male nurses in Taiwan. Social support and professional empowerment were significantly and positively correlated with nursing career development among male nurses. Social support, professional empowerment, salary, type of institution, type of clinical level, and nursing discipline were identified as factors that significantly influenced nursing career development. Together, they accounted for 55.9% of the total variation. Professional empowerment was the most critical predictor of nursing career development and accounted for 47.7% of the variation. Nursing managers should follow male nurses' empowerment with interest and specifically address professional empowerment to promote male nurses' career development.