Community-based multiple screening for metabolic syndrome by innovative theory: A longitudinal study.

The purpose of this research is to elucidate whether metabolic syndrome affects the rate of adoption of a new multiple cancer screening programme, based on the Diffusion of Innovation theory. The time to attend the screening programme, conducted in Keelung, Taiwan, within 10 years was assessed by innovativeness (innovators, early adaptors, early majority, late majority and laggard) using data from 79,303 residents, with the information on metabolic syndrome accrued from routine adult health check-ups. The median time of adopting the programme and the relative rates of early adoption by metabolic syndrome and its severity score were estimated. The results show that the estimated times to adopt the programme ranged from 3 months for innovators to 10 years for the laggard. The rate of early adoption was 34% higher for participants without metabolic syndrome than for those with the disease, and the gradient relationship of disease severity was noted. The adjusted median time to adopt innovativeness was 0.82 years earlier for participants who were disease-free than those with the disease. Meanwhile, the adjusted median time was wider by up to 2.25 years for those with severe disease. The study suggests that innovation should prioritise the potential risk of the metabolic syndrome population.

Perspectives of patients with non-insulin-treated type 2 diabetes on self-monitoring of blood glucose: A qualitative study.

AIMS AND OBJECTIVES: To explore experiences of self-monitoring of blood glucose among patients with non-insulin-treated type 2 diabetes. BACKGROUND: Self-monitoring of blood glucose is essential to diabetes care and facilitates glycaemic control. Patients' perspectives of self-monitoring of blood glucose have seldom been discussed in the literature, and engagement in self-monitoring of blood glucose is consistently low. DESIGN: The descriptive phenomenological method was used. METHODS: Purposive sampling was conducted to recruit participants from the endocrinology departments of medical institutions in Taiwan based on the following criteria: (i) having a medical diagnosis of type 2 diabetes, (ii) not being treated with insulin, (iii) having engaged in self-monitoring of blood glucose at least once within the preceding 6 months, (iv) being at least 20 years old and (v) not having any major mental or cognitive disorders. Data were collected in outpatient consultation rooms, the participants' homes and other settings where the participants felt secure and comfortable. In-depth interviews were conducted to collect data from 16 patients with diabetes. RESULTS: The participants perceived that lifestyle affected blood glucose levels and did not know how to handle high or low blood glucose levels. Their willingness to continue self-monitoring of blood glucose depended on whether healthcare professionals checked or discussed their blood glucose levels with them. CONCLUSIONS: The patients' knowledge regarding blood glucose variation and healthcare professionals' attitudes affected the patients' self-monitoring of blood glucose behaviours. The empirical findings illustrated self-monitoring of blood glucose experiences and recommended that healthcare professionals' closely attend to patients' requirements and responses to diabetes and incorporate the self-monitoring of blood glucose into therapy plans. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals should reinforce patients' knowledge on appropriate responses to high and low blood glucose levels, intervene appropriately, discuss self-monitoring of blood glucose results with patients and track these results.

Assessing the impact of diabetes on quality of life: validation of the Chinese version of the 19-item Audit of Diabetes-Dependent Quality of Life for Taiwan.

OBJECTIVE: To examine the reliability and validity of the Chinese version of the 19-item Audit of Diabetes-Dependent Quality of Life for Taiwan (ADDQoL-CnTW). METHODS: Linguistic validation procedures for patient-reported outcome measures were used to translate the Taiwan version from the original 19-item UK-English ADDQoL. The psychometric properties of the ADDQoL-CnTW were evaluated in a convenience sample, recruited from outpatient facilities, of 260 patients diagnosed with diabetes mellitus. RESULTS: The forced one-factor solution supported one general 19-item factor with all items loading above 0.43, accounting for 51.5% of the variance, although the results of confirmatory factory analysis did not strictly adhere to a one-factor structure. Using Kaiser's Criterion, exploratory factor analysis identified four sub-dimensions but the pattern of loading also confirmed the presence of a large general factor with 11 of 19 items loading ≥0.4 on the first component, accounting for 49.73% of the variance. Internal consistency for the entire scale was 0.94. Convergent and discriminant validity were suggested by a stronger correlation of average weighted impact (AWI) scores with the overview Diabetes-specific QoL item than with the Present QoL item. The Present QoL item correlated better with the World Health Organization Quality of Life-BREF(TW) dimension scores than the Diabetes-specific QoL scores or the AWI scores. Insulin-treated patients reported significantly more negative AWI scores and Diabetes-specific QoL scores than those treated with tablets and/or diet, demonstrating known-groups validity. CONCLUSIONS: The ADDQoL-CnTW revealed excellent internal consistency reliability, and showed evidence of validity for use in Taiwanese people with diabetes.

The development of a questionnaire measure of diabetes-related distress in Chinese-speaking patients: the Diabetes-Related Distress Questionnaire (DRDQ).

PURPOSE: To develop and evaluate the reliability and validity of a Diabetes-Related Distress Questionnaire for Chinese-speaking patients with diabetes. METHODS: The Diabetes-Related Distress Questionnaire (DRDQ) included 11 quality-of-life questions translated from a Diabetes, Attitudes, Wishes, and Needs study and four native items developed by researchers based on patients' experiences. A sample of 981 Chinese-speaking patients with diabetes in Taiwan was invited to complete the questionnaire. RESULTS: A minimum of 4.2 % of patients used each response option for each item. Exploratory factor analysis suggested a two-factor structure, representing treatment-related distress (factor 1) and progression-related distress (factor 2). The mean loading of items on their corresponding factor was high (0.60), while the mean loading on the other factor was low (0.10). A confirmatory factor analysis confirmed a single structure of the DRDQ (root-mean-square error of approximation = 0.063, comparative fit index = 0.93). The Cronbach's alpha was 0.89 for the DRDQ scale, 0.87 for the factor 1, and 0.68 for the factor 2. As expected, people with insulin-treated and HbA1c > 7 % reported significantly greater negative scores than their counterparts on the total score and all items of the DRDQ, with the exception of item 2. A moderate effect size was demonstrated between insulin known groups (ranging from 0.14 to 0.46) and between HbA1c known groups (ranging from 0.08 to 0.87). CONCLUSIONS: The DRDQ is a psychometrically sound instrument that can be used to assess diabetes-related distress in Chinese-speaking patients in Taiwan.

The relationship between insomnia with short sleep duration is associated with hypercholesterolemia: a cross-sectional study.

AIM: To examine the association between insomnia with short sleep duration and hypercholesterolemia in Taiwanese adults. BACKGROUND: Previous studies mostly focused on the association between sleep duration and hyperlipidemia, but the results were not consistent. Besides, very few studies extensively examined the association between insomnia and hypercholesterolemia. This study hypothesized that insomnia with short sleep duration is associated with hypercholesterolemia. DESIGN: Secondary data analysis. This study analysed the latest database of the cross-sectional Nutrition and Health Survey in Taiwan which was released on 2011 (data collected between 2005-2008) and collected data using stratified three-staged probability sampling design. METHODS: This study analysed 1533 participants aged between 19-64 (733 males and 800 females) and used logistic regression model to calculate the odds ratio and the 95% confidence interval of insomnia with short sleep duration to hypercholesterolemia. Controlled confounders included age, gender, sample weight, body mass index, waist circumference, fasting plasma glucose, hypertension and diabetes. RESULTS: Insomnia with 5-6 hours of sleep duration was significantly associated with hypercholesterolemia. The odds ratio of mild insomnia or moderate/severe insomnia with 5-6 hours of sleep duration to hypercholesterolemia was higher, compared with the reference group (without insomnia and >6 hours of sleep duration). CONCLUSION: Insomnia with short sleep duration was associated with increased odds of hypercholesterolemia. Caregivers in clinical practice should watch out for the effect brought by this novel factor.

Associations between sleep duration and type 2 diabetes in Taiwanese adults: A population-based study.

BACKGROUND/PURPOSE: Research on the association between sleep duration and type 2 diabetes in an adult community population has been relatively scarce. The objective of this study was to analyze the association between sleep duration and the risk of diabetes in Taiwanese adults. METHODS: Secondary data analysis was based on the database of Nutrition and Health Survey in Taiwan between 2005 and 2008. A stratified three-staged probability sampling method was used to create a cross-sectional research design and 1533 participants (733 men, 800 women, between 19 years and 64 years of age) were selected in this study. Logistic regression models were conducted to estimate the effect of sleep duration for type 2 diabetes patients. RESULTS: The average sleep duration for all participants in this study was 7.2 ± 1.4 hours, with 35.1% of the participants having a sleep duration less than 7 hours. After controlling related confounders, such as age, sex, body mass index, abdominal circumference, total cholesterol levels, sleep disturbances, and hypertension, the risk of having diabetes for participants with ≤ 5 hours sleep was 2.04-fold (95% confidence interval, 1.05-3.95) higher than for participants with 7-8.9 hours of sleep. In particular, the risk of having diabetes for young adults (between 19 years and 44 years of age) with ≤5 hours of sleep was 5.24-fold (95% confidence interval, 1.17-23.47) higher than for young adults who reported 7-8.9 hours of sleep. CONCLUSION: Our results show that a short sleep duration was associated with a higher prevalence of diabetes and this correlation was particularly strong in young adults.

[The perspectives on palliative nursing education].

The numbers of people who suffer from age-related and chronic diseases have been increased worldwide. This has lead to an increased emphasis in the medical community on end of life care. This paper references the processes followed overseas in developing palliative care education programs as well as the domestic experiences promoting the hospitalization, home care, and "share care" models of palliative care. Particular emphasis is given to considerations of cultural diversity in palliative care. The aim of this paper is to elaborate on the prevalent clinical end-of-life care issues that are faced in Taiwan, to cultivate core capabilities in end-of-life care, to elicit the current status and development of formal nursing education, and to promote continuing education in palliative care. Kern formulated a six-step approach to curriculum development in education and the details has been discussed . Finally, this paper reflects on the current bottlenecks, challenges, and expectations related to palliative care curriculum development in order to help medical professionals further put humanistic and social care into practice, increase ethical reflection in end of life care and nursing competency, and encourage the creation of localized textbooks / multimedia e-teaching materials. The fostering of "patient-centered, family unit and the social-cultural contexture" for palliative care professionals and the ability to respond to the needs of terminal patients and patients with chronic diseases are critical to increasing the quality of Taiwan healthcare.

[Centennial retrospective on the evolution and development of nursing education in Taiwan].

Nursing education in Taiwan has developed significantly over the past one hundred years. Throughout the first half of the 20th century, nursing education in Taiwan ended at the high school level. However, over the most recent 50 years, this level has been gradually raised, and nursing doctoral programs are now offered today. Changes in the nursing profession over the past century have been influenced by social and political factors, war, the health care policies, and national education policies. Areas of nursing education that have presented key challenges to change and innovation include the nursing faculty, curriculum, teaching materials, and quality of teaching. Today, key future goals for nursing education in Taiwan are: Raising the entry level of generic nursing education from junior high to the high-school level, improving the curricula for master's and doctoral students, cultivating advanced practice nurses, improving the quality of nursing faculties, and establishing a mechanism to ensure the consistent quality of nursing education.

The quality of life of adults with type 2 diabetes in a hospital care clinic in Taiwan.

PURPOSE: To assess the impact of diabetes on quality of life (QoL) and identify major determinants affecting that impact using a multiple regression model. METHODS: This was a cross-sectional design. The audit of diabetes-dependent quality of life (ADDQoL) was administered to assess QoL. RESULTS: A sample of 256 outpatients with type 2 diabetes was recruited. A negative impact of diabetes was observed on all life domains. The first three most impacted life domains were 'future', 'freedom to eat', and 'self-confidence'. 'Freedom to eat' was also the domain the most frequently impacted in five previous ADDQoL studies conducted in Singapore, UK, India, the United States, and Slovakia. Factors negatively associated with some domain scores were younger age (future), being male (close personal relationship and sex life), more education (leisure activities, future, dependence, and freedom to drink), low income (leisure activities), having more diabetic complications (do physically and sex life), treatment with insulin (finances and living conditions), and higher HbA1c (freedom to drink). CONCLUSION: QoL is impaired in patients with diabetes, especially for the 'freedom to eat' domain, indicating that an intervention to improve dietary freedom might be a good way of improving QoL. Greater negative impact of diabetes on QoL was associated with being younger, male, more educated with low income, more diabetes complications, higher HbA1c, and using insulin. These need to be considered in responding to patients' individual needs.

The prevalence and determinants of impaired fasting glucose in the population of Taiwan.

BACKGROUND: A current prevalence and relevant risk factors for impaired fasting glucose (IFG) have been reported by various ethnic groups and countries. By contrast, nationwide data for the incidence of IFG in Taiwan have not been presented in the past 15 years. The aim for this manuscript was to estimate the prevalence of IFG and associated risk factors in the population of Taiwan. METHODS: For this cross-sectional research, we used a nationally representative sample (N = 2604) obtained from the 2005-2008 Nutrition and Health Survey in Taiwan (NAHSIT), and adopted a stratified multistage sampling design. The tools employed for data collection included questionnaire interviews, anthropometry measurements, and laboratory analysis. RESULTS: The prevalence of IFG among adults in Taiwan is 35.8% (a fasting glucose level between 100 and 125 mg/dl is considered abnormal). An estimated number of people with IFG is 6.5 million. A higher prevalence of IFG is observed in men younger than 65 years compared to women. However, this trend is reversed for the elderly population. The factors significantly associated with IFG include the following: sex, age, overweight (27 > BMI ≥ 24), obesity (BMI ≥ 27), waist circumference (men ≥ 90 cm, women ≥ 80 cm), hypertension, and hyperlipidemia. CONCLUSIONS: IFG among adults in Taiwan is a health concern that requires attention. We recommend targeting the younger population, especially overweight and obese men between the ages of 19 and 40 years, to provide applicable healthy lifestyle counseling and services. Furthermore, appropriate screening of elderly people is required to detect undiagnosed IFG cases and provide early intervention and treatment.

Psychological resistance to insulin therapy in adults with type 2 diabetes: mixed-method systematic review.

AIM: This paper is a report of a review that aimed to describe the phenomenon of psychological resistance to insulin therapy from the perspective of adults with type 2 diabetes mellitus. BACKGROUND: Although the benefits of insulin for people with diabetes who are poorly controlled by oral agents have been established, delay in transition to insulin treatment is common. An understanding of the barriers to insulin from the client's viewpoint provides information to facilitate appropriate and effective care. DATA SOURCES: Searches were carried out between 1999 and 2009 using computerized databases, three in English language and one in Chinese. REVIEW METHODS: Review design was a mixed-method systematic review, and data abstraction and synthesis were undertaken by thematic synthesis. Reviewed articles were restricted to adults with type 2 diabetes and published in English or Chinese. RESULTS: Sixteen articles were included. For adults with type 2 diabetes, psychological resistance to insulin therapy could be explained by five themes. Three themes were categorized as cognitive appraisal, including 'people do not see the necessity for insulin and actively seek ways to control blood sugars without insulin', 'people have a holistic view of the consequences of insulin' and 'people see insulin therapy as less feasible'. Two themes were categorized as emotional reactions: 'people see insulin as a source of fear/anxiety', and 'the necessity to start insulin therapy has a very negative connotation for them and is associated with dysfunctional emotions'. CONCLUSION: Psychological resistance to insulin therapy can result from a range of personal viewpoints involving cognitive appraisal and/or emotional reactions.

[Challenges and strategies for nursing education in Taiwan from a public health needs perspective].

An increasingly elderly population and prevalence of chronic health problems have transformed the healthcare landscape in Taiwan and necessitated a shift in the focus of healthcare toward chronic rather than acute illnesses. This is a challenge to the domestic healthcare system, which was initially designed to address and cure primarily acute illness. Traditional nursing education and training programs are no longer adequate to meet current population healthcare needs. The first part of this article highlights the challenges posed by changing healthcare needs, e.g., the rise in prevalence of age-related chronic conditions and the increased acuity of hospitalized patients. Such developments are making new demands and expectations of nurses in terms of education, skills and roles. The second part of this article explores the weaknesses of current nursing education. Recommendations for the future include: making high school graduation a minimum requirement for entering nursing college and university programs, restructuring the nursing master's education program to prepare advanced nurse practitioners, redesigning curriculum content, and teaching approaches based on public healthcare needs. Upgrading clinical competencies and increasing nursing school faculty numbers are issues of the most immediate priority.

The dilemma of diabetic patients living with hypoglycaemia.

AIMS: To examine the impact of the threat of hypoglycaemic episodes on people with diabetes in Taiwan. BACKGROUND: Intensive diabetes treatment in people with diabetes helps them to achieve better glycaemic control. However, it also causes more frequent hypoglycaemic episodes and has an impact on their overall quality of life. Hypoglycaemia is accompanied by various distressing symptoms which may cause excessive fear, affecting decision making in hypoglycaemic management. DESIGN: Purposive sampling and in-depth, face-to-face interviews were used to collect data. METHODS: Semi-structured interviews were conducted from July 2008-January 2009 with 17 individuals treated with insulin who had previous hypoglycaemic episodes. Data were analysed using qualitative content analysis. RESULTS: Four themes were generated from the analysis, 'inability to control fluctuations in health', 'challenges to interpersonal relationships', 'facing the disease alone' and 'finding a balance between competing symptoms'. CONCLUSIONS: Hypoglycaemia is a major health issue for many people with diabetes. Understanding individuals' experiences with hypoglycaemic episodes should help practitioners become more fully involved in promoting self-management. We identified key areas that health care providers should address, including concerns about patient education and professional support for people with diabetes experiencing hypoglycaemia, to enhance problem solving skills for them and their families. RELEVANCE TO CLINICAL PRACTICE: We recommend that health care providers make proper use of support groups for family caregivers or other important individuals in the lives of people with diabetes to provide education, clarification, support and guidance. In addition, health care providers also need to provide clients with hypoglycaemia-related emotional support, while enhancing diabetes self-management and problem-solving skills.

Leisure-time physical activities for community older people with chronic diseases.

AIMS: (1) To explore the types and three components (frequency, duration and caloric expenditure) of leisure-time physical activity in community older people with chronic diseases. (2) To identify leisure-time physical activity-related factors in these community older people. BACKGROUND: Previous research has focused primarily on measuring the actual physiological or psychological benefits of exercise or leisure-time physical activity, little is known about the factors that determine the frequency, intensity and duration of exercise or leisure-time physical activity. The identification of reliable predictors of the various components of leisure-time physical activity will enable healthcare providers to intervene and change the patterns of leisure-time physical activity in the sedentary older people more effectively. DESIGN: A cross-sectional design was used for this study. METHODS: Participants were recruited from the Xinyi District in Taipei, Taiwan. A total of 206 older people were recruited and were asked to complete three questionnaires during a face-to-face interview with a researcher at the activity setting. RESULTS: The results showed that walking leisurely was the most frequent leisure-time physical activity for participants. The age, gender, living arrangement, affective feeling and environmental control were significant variables of leisure-time physical activity. CONCLUSIONS: The study constructs accounted for moderate amounts of variance (22% for leisure-time physical activity frequency, 27% for leisure-time physical activity duration and 24% for leisure-time physical activity caloric expenditure). This study also showed that different variables play different influential roles in the different components of LTPA. RELEVANCE TO CLINICAL PRACTICE: An effective intervention strategy for improving leisure-time physical activity of older people may involve tailoring the type, format, intensity, frequency and duration of a physical activity according to an individual's needs. This study described some environmental barriers to LTPA and recommended an increase in the accessibility to LTPA areas.

A psychometric evaluation of the Taiwan version of the Individual Workload Perception Scale.

AIM: The aim was to evaluate the psychometric properties of the Taiwan version of the Revised Individual Workload Perception Scale on staff nurses in southern Taiwan. BACKGROUND: Most psychometric measures of the nursing work environment were developed in North America and reflect nursing practice in Western health care environments. As these instruments are used most often in translation, it is important to inquire whether they appropriately capture the characteristics of nursing work in environments outside of the original contexts. DESIGN: A descriptive, cross-sectional study was conducted between 1 June-30 September 2009, with a convenience sample of 344 nurses providing direct patient care at a regional teaching hospital in southern Taiwan. The Taiwan version of the Revised Individual Workload Perception Scale was created by translating the original English language Individual Workload Perception Scale-Revised, which is used to measure the staff nurses' perceptions of their work environment. The Taiwan version of the Revised Individual Workload Perception Scale is a 24-item five-point Likert scale measuring manager support, peer support, unit support, workload and intent to stay. Content validity, construct validity and reliability of the Taiwan version of the Revised Individual Workload Perception Scale were evaluated. RESULTS: The content validity index of the Taiwan version of the Revised Individual Workload Perception Scale was 0.93. Cronbach's alpha for the total Taiwan version of the Revised Individual Workload Perception Scale was 0.88, with a range of 0.61-0.85 for the subscales. Factorial validity was supported using a five-factor model solution that accounted for 55.47% of the total variance for nursing work environment. Manager support had the highest explained variance (28.38%). CONCLUSIONS: Acceptable reliability and content validity were found; the Taiwan version of the Revised Individual Workload Perception Scale is recommended for measuring nurses' perceptions of their work environment. RELEVANCE TO CLINICAL PRACTICE: Psychometric properties of a scale such as the Individual Workload Perception Scale translate cross-culturally, with minor adjustments. The Taiwan version of the Revised Individual Workload Perception Scale can be used to provide data and analyses in comparisons with nursing work environment features internationally.

[Palliative care for persons with dementia].

Dementia is irreversible. Although currently available drugs are typically able to ameliorate symptoms and slow down its progress, there is yet no known cure for this disease. The inevitable consequence of dementia is the gradual deterioration of the condition until final decline into the end of life stage. The priority care plan for patients with end stage dementia, therefore, must focus on palliative care that provides for a comfortable and high as possible quality of life. However, dementia is rarely looked upon as an end-stage disease. In 2009, the Taiwan National Health Insurance began reimbursing the costs of hospice care for patients with end stage dementia. This paper discusses end stage dementia cases in which patients received inappropriate interventions during their final days as well as the barriers faced in developing countries to providing palliative care. This paper also suggests strategies to promote quality of care and quality of life in people with end of life dementia.

[Issues related to quality of life measures for persons with dementia].

The rising population of elderly worldwide has led to an increasing number of people with dementia. Managing and providing quality care for people with dementia has thus become a priority public health issue in developed countries. Dementia is a gradually degenerative disease. In the absence of a cure, improving, maintaining or maximizing quality of life is becoming the primary goal of nursing care for patients with this disease. Quality of life is an important outcome index of medical care and can be a criterion for making health economics decisions. The fact that dementia is a disease that presents steadily declining cognitive function has led to numerous challenges and debates regarding the optimal concepts and methodologies to be used to measure quality of life in those with dementia. This paper reviews relevant debates on these issues and makes suggestions that may serve as guides to monitoring / studying quality of life in dementia patients.

[Perspectives on nursing education, licensing examinations and professional core competence in Taiwan in the context of globalization].

There are today some 130,000 nurses in Taiwan, practicing in different specialties and in various capacities and positions. Good nurses are society's "guardian angels of health" who provide protection and safe healthcare for the people. Improving nursing education quality and ensuring nurse competency by licensure examination are essential to both helping nurses realize the full potential of their role and earning recognition for Taiwan healthcare as positive contributors to the global community of nations. Three themes were explored in this paper, including: (1) Issues and problems with the current nursing education, license examination and nursing education quality monitoring systems in Taiwan; (2) Comparing Taiwan's situation with that in certain other countries; and (3) Recommending changes ÷ revisions in Taiwan's nursing educational system and license examinations based on comparative findings. In order to plug into the rapid pace of globalization, Taiwan should upgrade and limit its pre-licensure nursing programs at the bachelor level. Also, nursing education quality should be continuously improved through peer-review.

[Diabetes case management].

Diabetes case management and self-care education can effectively improve patient clinical outcomes and quality of life. Diabetes case management should be provided by an interdisciplinary team. Diabetes education has evolved from its previous focus on "teaching proper content" to "achieving successful patient outcomes" in line with the current emphasis in health education on patient-centered goals. Behavioral changes are facilitated based on these goals. Behavioral change directed at successful diabetes self-care was adopted as one of the desired outcomes of diabetes case management. The American Association of Diabetes Educators developed seven diabetes self-care behaviors as behavior objectives and evaluation indicators of diabetes education. These indicators include healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks. The process of diabetes case management includes assessment, expected outcome identification, planning, implementation, evaluation, and documentation. In Taiwan, the Diabetes Share Care Network has promoted the advantages and techniques of diabetes case management. Based on network recommendations, the improvement program of National Health Insurance payment for diabetes medical treatment under the Bureau of National Health Insurance now provides package payment and requires quality interdisciplinary care and case management.

Occupational health nursing practice, education, and research in Taiwan.

This article describes occupational health nursing practice, education, research, and future perspectives in Taiwan. It also provides a brief overview of major occupational health and safety problems, laws and regulations, and organizations in Taiwan.