[Exploring Coping Strategies of Nursing Staff for Influenza Vaccination Among Pregnant Women].

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses.

Development and psychometric testing of an energy retention behavior scale for children.

BACKGROUND: Obesity is the consequence of energy retention due to energy-dense food intake (E-intake behavior) and sedentary behavior (S-behavior). PURPOSE: The purpose of this study was to develop and psychometrically test the Energy Retention Behavior Scale for Children (ERB-C scale). METHODS: The ERB-C scale was developed, consisting of an 11-item E-intake behavior subscale and a six-item S-behavior subscale. Confirmatory factor analysis and known-group validity were conducted on 371 children to examine the construct validity of this scale, and internal consistency and test-retest reliability were used to examine its reliability. RESULTS: Confirmatory factor analysis indicates that the ERB-C scale, including its subscales of E-intake behavior (10 items) and S-behavior (four items), fits the data well. The fit indices were as follows: χ = 268.22, df = 74, p < .001, normed fit index = .91, and nonnormed fit index = .92. The Cronbach's α and test-retest reliability of the ERB-C scale were .81 and .86, respectively. The mean ERB-C scale score for overweight/obese children was significantly higher than for underweight/normal-weight children (z = 3.81, p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The ERB-C scale showed satisfactory validity and reliability. This scale may help health professionals comprehensively assess the energy retention behavior of children.

Psychometric testing of the Chinese version of the Contraceptive Behavior Scale: a preliminary study.

AIMS AND OBJECTIVES: To test the psychometric characteristics of a five-item Chinese Contraceptive Behavior Scale (CBS) among female adolescents in Taiwan. BACKGROUND: Improving contraceptive practice is important for reducing adolescent pregnancy. A scale for measuring contraceptive behaviour of sexually active female adolescents will help nurses promote contraceptive practices to sexually active female adolescents. DESIGN: A cross-sectional design. METHODS: Based on literature review and interview with female adolescents, a five-item CBS was developed. Using convenience sampling, 525 sexually active female adolescents were invited to complete the (anonymous) CBS. Exploratory factor analysis, confirmatory factor analysis (CFA), contrasting group validity and concurrent validity were tested to examine the validity of CBS. A multiple-group analysis was used to test the cross-validation of the structure of CBS in two groups. Cronbach's α and test-retest reliability were used to examine the reliability of CBS. RESULTS: One factor was produced by exploratory factor analysis. Each item significantly loaded on the CBS by CFA. A multiple-group analysis indicated that the structure of CBS was reliable across two different samples. The overall chi-square and model fit indices were χ(2)=13.554, df=8, p=0.094, normed fit index=0.992, comparative fit index=0.994 and root mean square error of approximation=0.036 (90% CI=0.001, 0.069). The scores of CBS significantly correlated with subscales of perceptions of benefits to contraception (r=0.47, p<0.001) and subscales of perceptions of barriers to contraception (r=-0.29, p<0.001). CBS mean scores significantly differed between the participants who used and did not use contraceptives at first sexual intercourse (t=10.00, p<0.001). Cronbach's α for the CBS was 0.81. The intraclass correlation coefficient was 0.94. Conclusions. The CBS had satisfactory validity and reliability. Relevance to clinical practice. Nurses can use CBS to initiate discussions with sexually active female adolescents about their contraceptive practices and provide them with useful strategies to improve their contraceptive practices.

The health status of postpartum immigrant women in Taiwan.

AIMS: This study aims to contribute to the current body of literature by examining immigrant women's postpartum health in the context of Taiwan, in particular, their experience with postpartum stress and depression as well as the levels of social support available to them. This study also aims to identify predictors of their postpartum health status. BACKGROUND: While there has been considerable research on the risk factors for poor postpartum health in the general population, research on the factors influencing immigrant women's postpartum health has been limited. DESIGN: A non-experimental research design. METHODS: We collected data from a sample of 340 immigrant postpartum women who could speak Mandarin Chinese, recruited from 10 general hospitals and one obstetric clinic in Taiwan from March 2005-September 2006. The Hung Postpartum Stress Scale, Beck Depression Inventory-II, Social Support Scale and Chinese Health Questionnaire were used in this study. RESULTS: We found that immigrant women's postpartum health status differed significantly in relation to their key helpers, depression status, levels of postpartum stress and social support. The logistic regression analysis showed that a one-point increase in immigrant women's postpartum stress increased the probability of suffering from minor psychiatric morbidity by 1·04 times. CONCLUSIONS: These findings suggest that health care professionals should pay attention not only to immigrant postpartum women's basic financial and support needs but also to their postpartum stress and stressors. RELEVANCE TO CLINICAL PRACTICE: The use of trained community health advocates in partnership with registered nurses can help meet the needs of postpartum women and improve maternal and infant health through their home visits. These nursing interventions should be tailored specifically to decrease immigrant Asian women's postpartum stress and improve their overall health status and well-being.

The relationship between selected developmental assets and health-promoting behaviours of adolescents in Southern Taiwan.

AIMS AND OBJECTIVES: To examine the relationship between selected developmental assets and health-promoting behaviours of adolescents. BACKGROUND: Developmental assets can be considered as potential health assets for adolescents. Understanding the relationship between developmental assets and health-promoting behaviours among adolescents could provide nurses with a new approach to design intervention programmes for adolescent health-promoting behaviours. DESIGN: A cross-sectional study design. METHODS: Anonymous questionnaires were administered to 453 adolescents aged between 13-16 years. Canonical correlation analysis was used to examine the relationship between selected developmental assets and health-promoting behaviours. RESULTS: Canonical correlation analysis indicated two significantly meaningful variate pairs between selected developmental assets and health-promoting behaviour sets. The first pair variate accounted for 51.3% of the total variance, which showed that adolescents who had better self-esteem, future aspirations, responsible choices, family communication, non-parental adult role models, peer role models and community involvement had better behaviours of life appreciation, health responsibility, social support, stress management, nutrition and exercise. The second pair variate accounted for 9.6% of the total variance, which showed that adolescents who had better responsible choices had better stress management behaviours. CONCLUSION: Developmental assets are important to adolescents' health-promoting behaviours. Interventions focusing on strengthening developmental assets can potentially provide an innovative approach for nurses to improve health-promoting behaviours of adolescents. RELEVANCE TO CLINICAL PRACTICE: Strengthening developmental assets can potentially improve the health-promoting behaviours of adolescents. Individual and sociopolitical domains should be incorporated into programmes for enhancement of developmental assets. School nurses can cooperate with family and community and provide environments improving adolescents' developmental assets. Nurses should actively engage in developmental asset programmes for adolescents. The tools for measuring developmental assets modified and developed in this study were valid and reliable. They can be used for further examination of the developmental assets for adolescents in various subset populations.

The effectiveness of problem-based learning and concept mapping among Taiwanese registered nursing students.

The purpose of this study was to investigate the effectiveness of adopting problem-based learning (PBL) and concept mapping (CM) in the educational programs for Taiwanese registered nursing (RN) students. We used a quasi-experimental design with experimental and control groups to evaluate the effectiveness of PBL-CM in three time schedules: before the course began (pre-test), at the end of the course (post-test), and six months after the end of the course (follow-up test). A convenience sample of 120 RN students participated, 51in the experimental group and 69 in the control group. Finding showed that the experimental group had higher scores than the control group for the Critical-Thinking Scale, Self-Directed Learning Scale, and Students' Performance in PBL Tutorial Sessions Questionnaire at the post-test and follow-up test stages. The PBL-CM increased students' critical-thinking skills and personal accountability for self-directed learning, and it would enhance the skills of independent study, reasoning, group interaction and active participation. This study offers guidelines for new nurse-training programs and continuing nursing education in clinical practice.

A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation.

A cross-sectional and comparative research design with convenience sampling was used to recruit pregnant women from prenatal clinics in southern Taiwan between 2002 and 2003 to examine the differences in perceived stress, social support, and maternal psychosocial adaptation among women with different severities (mild or less than mild, moderate, and severe) of nausea and vomiting during pregnancy. A total of 150 pregnant women participated in this study. One-way analysis of variance indicated that perceived stress was significantly different among the 3 groups. The least significant difference post-hoc test revealed that pregnant women with mild nausea and vomiting had significantly lower stress than did pregnant women with severe nausea and vomiting. The severity of nausea and vomiting was significantly associated with the Prenatal Self Evaluation Questionnaire subscales for "acceptance of pregnancy" and "fear of helplessness and loss of control in labor." Social support and maternal psychosocial adaptation were not significantly different among these three groups. The degree of perceived stress and maternal psychosocial adaptation may be related to the severity of nausea and vomiting during pregnancy.

Correlates for consistency of contraceptive use among sexually active female adolescents.

This study explored the correlates for consistency of contraceptive use among sexually active female adolescents in Kaohsiung County, Taiwan. Overall, 164 female adolescents who had engaged in sexual behavior within the last 6 months and were not pregnant at the time of the study were selected from two vocational high schools in Kaohsiung County, Taiwan. An anonymous questionnaire was used to measure demographic data, contraceptive attitudes, contraceptive knowledge, contraceptive self-efficacy, perception of peers' use of contraceptives, sexual history, and contraceptive use. The results showed that 45.7% of subjects had sex once or more per week, and that 39.6% of subjects always used contraceptives while 15.2% never used contraceptives. Condoms were the most popular contraceptives (51.2%) and the withdrawal method was the second most popular (23.8%). Stepwise logistic regression showed that higher contraceptive attitudes (odds ratio, OR, 1.148) and previous contraceptive education in school (OR, 3.394) increased the probability of consistently using contraceptives, correctly classifying 67.2% of the sample.