Psychometric evaluation of Suicide Management Competency Scale for nursing students: A cross-sectional study.

Suicide management skills are essential for nursing students, as they are often the initial healthcare contact for individuals at risk of suicide. Recognising signs of suicidal ideation and behaviour is critical for initiating timely interventions. This study aimed to develop and access the psychometric evaluation of the Suicide Management Competency Scale (SMCS) for nursing students. A first draft of the SMCS was initially developed following literature and focus group, and a scale containing 28 items was constructed. We recruited 216 participants from two nursing schools. Construct validity was evaluated with exploratory factor analysis (EFA). Internal consistency reliability was determined with Cronbach's alpha, and test-retest reliability was examined with intra-class correlation. After four rounds of EFA and item analysis, we reduced the number of items to 16. We deleted 12 items, including 4 items for communalities less than 0.40, 3 items for cross-loading, 3 items for factor loading less than 0.40, and 2 items for low corrected item-total correlation. The final 16-item SMCS resulted in three subscales, which explained 55.813% of the total variance: emotional challenges in suicide risk assessment, delivering suicide interventions, and suicide risk nursing competence and confidence. Cronbach's alpha was 0.854 for the total score and 0.748 to 0.847 for the subscales. The newly developed SMCS was found to have good reliability and validity, suggesting that this scale could be used to evaluate nursing students' perceived competency in managing suicide, which might help cultivate competence in nurses' ability to effectively manage and prevent suicide, thus contributing to saving lives.

Association of the AhR, ARNT, and AhRR gene polymorphisms and cord blood AhR levels with elevated cord blood IgE susceptibility in Taiwan mother-infant pairs: a nested case-control study.

The roles of aryl hydrocarbon receptor (AhR), AhR-nuclear translocator (ARNT), and AhR repressor (AhRR) genes in the elevation of cord blood IgE (CbIgE) remained unclear. Our aims were to determine the polymorphisms of AhR, ARNT, and AhRR genes, cord blood AhR (CBAhR) level, and susceptibility to elevation of CbIgE. 206 infant-mother pairs with CbIgE>=0.35 IU/ml and 421 randomly selected controls recruited from our previous study. Genotyping was determined using TaqMan assays. Statistical analysis showed AhR rs2066853 (GG vs. AA+AG: adjusted OR (AOR)=1.5, 95%CI=1.10-2.31 and AOR=1.60, 95%CI=1.06-2.43, respectively) and the combination of AhR rs2066853 and maternal total IgE (mtIgE)>=100 IU/ml were significantly correlated with CbIgE>=0.35 IU/ml or CbIgE>=0.5 IU/ml. CBAhR in a random subsample and CbIgE levels were significantly higher in infants with rs2066853GG genotype. We suggest that infant AhR rs2066853 and their interactions with mtIgE>=100 IU/ml significantly correlate with elevated CbIgE, but AhRR and ARNT polymorphisms do not.

Nurses' perspectives on child-friendly care needs in emergency departments: A qualitative study.

BACKGROUND: Children can become anxious when undergoing emergency medical treatment. Therefore, emergency departments should be child friendly. This study explored emergency nurses' perspectives on children's needs during emergency care. METHOD: This qualitative study employed purposive sampling to recruit 17 emergency nurses from 3 medical centers in northern and central Taiwan. Individual interviews were conducted between January and August 2021. Data were analyzed through qualitative content analysis. RESULTS: The participants had 2-23 years of experience in caring for children in emergency departments. We identified 208 unique meaning units in the interview data, 79 of which were related to child-friendly emergency care. These were classified into 42 codes across 6 categories and 27 subcategories. The six categories were timely comfort, emotional care, frontline safety, emergency response, human resources support, and treatment efficiency. CONCLUSION: Emergency nurses have professional competencies, play a crucial role as care providers for children in the emergency department, and ensure the comfort and safety of children seeking treatment. The categories related to child-friendly emergency care identified in this study can serve as a basis for developing child-friendly care emergency guidelines.

Effect of an Anti-Stigma Program on Self-Stigma for Chinese Individuals With Schizophrenia: A Pilot Study With a Quasi-Experimental Design.

The current study explored the effectiveness of an anti-stigma group program for people with schizophrenia. Thirty-four participants recruited from a psychiatric day hospital were allocated to the experimental group (EG) or control group (CG). The Internalized Stigma of Mental Illness Scale (ISMIS), Perceived Psychiatric Stigma Scale (PPSS), and Beck Depression Inventory-II (BDI-II) were used to measure outcomes, which were evaluated at baseline, immediately post program, and 3-month follow up. Generalized estimating equations showed that the EG attained a greater reduction in the stigma resistance subscale of the ISMIS than the CG at posttest and 3-month follow up. Scores on the self-deprecation subscales (p = 0.025) and concerns about marital preclusion (p = 0.037) on the PPSS and BDI-II (p = 0.027) in the EG showed significant improvement over those of the CG at 3-month follow up. The anti-stigma group program seems to be effective in reducing self-stigma and depressive symptoms in people with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 37-45.].

Effects of Baduanjin Qigong in Individuals With Schizophrenia: A Preliminary Quasi-Experimental Pilot Study.

The current quasi-experimental study explored the effects of Baduanjin qigong on body mass index (BMI) and five metabolic indexes in people with schizophrenia. Inclusion criteria were body mass index >25 kg/m2 or metabolic syndrome. Twenty-two service users were recruited from a psychiatric center and were assigned to the experimental group (EG) or control group (CG) using blocked randomization. The EG performed Baduanjin qigong lasting 1 hour for 12 weeks three times per week, whereas the CG received routine care. Generalized estimating equations showed that the EG achieved a greater decrease in BMI and waist circumference (WC) than the CG post-intervention. Baduanjin qigong may provide an effective nonpharmacological approach to reducing BMI and WC in people with schizophrenia. This study showed that performing Baduanjin qigong for 12 weeks is a feasible and effective strategy for improving the body shape of individuals with chronic schizophrenia, thus providing results that can serve as a reference for health professionals working in psychiatry departments. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 41-48.].

The association of social support and hope with self-stigma and perceived recovery among people with schizophrenia: The serial mediation effect.

BACKGROUND: It is essential to assist individuals with a mental illness who have achieved clinical recovery in their personal recovery. Understanding the relationship between self-stigma and social support and the effects on perceived recovery can be valuable for clinical professionals in helping patients lead meaningful lives. AIM: To examine the serial mediating roles of social support and perceived hope in self-stigma and the effects on perceived recovery. DESIGN: A cross-sectional study. METHODS: The study was conducted from September 2019 to June 2020. One hundred and fifty-seven patients with schizophrenia in seven chronic rehabilitation wards were enrolled. Each patient had a Positive and Negative Syndrome Scale score ≤ 60 points, and they regularly participated in occupational rehabilitation. Research tools included demographic data, the Internalized Stigma of Mental Illness Scale (ISMIS), Multidimensional Scale of Perceived Social Support (MSPSS), Herth Hope Index (HHI), and Perceived Recovery Inventory (PRI). IBM SPSS 24.0 was used to analyse the data. Pearson correlation was used to analyse the relationships between variables, and models 4 and 6 of PROCESS macro V3.4 for SPSS were used to examine the mediation model. RESULTS: The results indicated that self-stigma and perceived recovery in patients with schizophrenia are negatively correlated, that peer support and perceived hope mediate the relationship between them, and that peer support and perceived hope also have a statistically significant serial mediating effect. CONCLUSION: The serial mediation effect of peer support and perceived hope on the relationship between self-stigma and perceived recovery was statistically significant in this study. IMPACT: This research delves into strategies to assist psychiatric patients in reducing self-stigma and achieving recovery. The findings underscore the heightened significance of peer support for patients in rehabilitative wards and offer valuable insights for medical staff. REPORTING METHOD: STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Exploring the Effectiveness of Group Cognitive Stimulation Training in People With Schizophrenia: A Randomized Controlled Trial.

BACKGROUND: Schizophrenia is a chronic degenerative brain disease. Cognitive impairment, the core symptom of this disease, affects the mood and social functioning of patients severely. Nonpharmacological therapies that both improve cognitive function and are suitable for patients with schizophrenia remain underdeveloped. PURPOSE: This article was designed to explore the effects of group cognitive stimulation training (GCST) on cognitive function and social function in people with schizophrenia. METHODS: A randomized controlled trial was conducted. The 76 participants were allocated into either the experimental or control group using blocked randomization. The participants were all patients with chronic schizophrenia recruited from seven rehabilitation units in northern Taiwan who were 20-65 years old and scored 10-25 on the Montreal Cognitive Assessment Taiwan Version. The experimental group received the 60-minute GCST twice a week for 7 weeks, whereas the control group received standard treatment. All outcome indicators were analyzed at baseline and after intervention using generalized estimating equations. The primary outcome indicators included cognitive function assessed using the Taiwan version of the Montreal Cognitive Assessment, working memory assessed using the Wechsler Memory Scale-Third Edition, and executive function assessed using the Taiwanese version of the Frontal Assessment Battery. The secondary outcome indicator was social function assessed using the Social Function Scale-Taiwan short version. RESULTS: Generalized estimating equation modeling revealed the experimental group exhibited significant improvement in Montreal Cognitive Assessment total score ( B = 1.33, SE = 0.65, p = .040) and Social Function Scale-Taiwan short version ( B = 9.55, SE = 2.38, p < .001) after adjusting for nine covariates. No significant differences between the two groups in terms of working memory ( B = 4.79, SE = 2.66, p = .071) or executive function ( B = 0.53, SE = 0.63, p = .399) were found. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results indicate that GCST positively impacts overall cognitive and social functions but not higher-order cognitive function (working memory and executive function). In clinical settings, GCST may be applied to improve cognitive function in people with schizophrenia. The findings of this study may inform the practice of mental health nurses to improve cognitive function in patients in clinical care.

Narrative enhancement and cognitive therapy for perceived stigma of chronic schizophrenia: A multicenter randomized controlled trial study.

This study explored the effects of NECT on self-stigma among people with schizophrenia. Eighty-six participants were recruited and assigned to two groups. The NECT group received 20-session group meetings, while the control group received routine care. Self-stigma was measured by Internalized Stigma of Mental Illness Scale (ISMIS) and Discrimination and Stigma Scale (DISC). Generalized estimating equations were employed to explore the intervention's effectiveness. The NECT group showed a significant reduction in ISMIS total scores after 20 sessions and Stopping Self subscale scores of DISC decreased over time. The intervention is effective for improving self-stigma in people with schizophrenia.

Sleep quality mediates the relationship between lower urinary tract symptoms and health-related quality of life in women with type-II diabetes.

AIM: To examine the mediating effect of sleep quality on the relationship between lower urinary tract symptoms and health-related quality of life in women with type-II diabetes. DESIGN: A cross-sectional study. METHODS: A study questionnaire comprising three valid instruments was used to obtain data about lower urinary tract symptoms, sleep quality and physical and mental component summary health-related quality of life between July 2017 and December 2018 (n = 343). Pearson's correlation coefficients were estimated initially to examine the relationships between the three variables. Multiple regression models were tested using a regression-based approach Hayes PROCESS macro for SPSS to examine the significance of proposed mediation effects. RESULTS: Most participants experienced at least one urinary symptom (n = 268, 78.1%). The total number of types of lower urinary tract symptoms experienced by participants was significantly inversely correlated with physical and mental component summary health-related quality of life, and sleep quality. Participants' sleep quality was significantly correlated with physical and mental component summary health-related quality of life. The relationships of lower urinary tract symptoms with physical and mental component summary health-related quality of life were, respectively, fully and partially mediated by sleep quality. CONCLUSION: Sleep quality played a mediating role on the relationship between lower urinary tract symptoms and health-related quality of life. Our findings could lead to improvements of diabetes care in nursing and healthcare practices. IMPACT: Understanding the role of sleep quality in the adverse effects of lower urinary tract symptoms on health-related quality of life contributes to the development and delivery of appropriate strategies to promote optimal health-related quality of life. We recommended including assessments of lower urinary tract symptoms, sleep and health-related quality of life in routine diabetes management. Nurses and healthcare professionals should concurrently reduce lower urinary tract symptoms and improve sleep to achieve this population's optimal health-related quality of life. PATIENTS OR PUBLIC CONTRIBUTION: We recruited a sample of older women with type-II diabetes at the endocrinology and metabolism outpatient departments of two hospitals. Study participants provided responses on the study questionnaires. The two hospitals provided needed supports (e.g., height/weight scales, suitable places for interview) during the data collection process.

Depressive symptoms and quality of life in people with a diagnosis of schizophrenia: An exploratory study of the potential mediating role of health-promoting lifestyles.

PURPOSE: To examine health-promoting lifestyles mediates the relationship between depressive symptoms and quality of life (QOL) in people with schizophrenia. DESIGN AND METHODS: A cross-sectional exploratory study design was conducted. Two-hundred and seventy-three participants were administered demographic data, health-promoting lifestyle profile, Beck Depression Inventory II, and World Health Organization Quality of Life-BREF. The Hayes PROCESS macro was employed to analyze data. FINDINGS: The results showed self-actualization fully mediated the environmental domain of QOL, physical health, psychological health, and social relationships domains were partial mediation. PRACTICE IMPLICATIONS: This study recommends that professionals reinforce persons' self-actualization when the QOL is affected by depressive symptoms in people with schizophrenia.

Healthcare needs and Quality of Life in Youths with Congenital Heart Disease: Health-Promoting Behaviors as a Mediator.

PURPOSE: The aims of this study were to examine the relationship between healthcare needs, health-promoting behaviors and quality of life (QoL) of youths with congenital heart disease (CHD), and to determine whether health-promoting behaviors were a mediating variable. DESIGN AND METHODS: This cross-sectional descriptive study was conducted recruiting 205 youths aged 15 to 24 with either ventricular septal defect (VSD) or tetralogy of Fallot (TOF). A self-reported questionnaire was used to collect demographic information; furthermore, the thickness of the triceps skinfold was measured. The Healthcare Needs Scale for Youth with CHD, Adolescent Health Promotion-short form scale, and World Health Organization QoL-BREF scale were administered, and Pearson's correlation, multiple regressions, and the Sobel test were conducted. RESULTS: The triceps skinfold of participants with VSD was significantly thicker than that of participants with TOF (p < 0.05). Healthcare needs, health-promoting behaviors, and QoL were positively correlated. The overall health-promoting behaviors served as a partial mediator between overall healthcare needs and QoL, accounting for 40.1% of the total variation. CONCLUSIONS: The study illustrates that health-promoting behaviors have an impact on healthcare needs and QoL of youths with CHD. The development of tailored health consulting interventions to fulfill healthcare needs is required to improve physical and psychosocial wellness among youths with CHD. PRACTICE IMPLICATIONS: Targeting individual and public health strategies for enhancing health-promoting behaviors should be integrated in CHD care planning.

Social interaction skills and depressive symptoms in people diagnosed with schizophrenia: The mediating role of auditory hallucinations.

Past studies have presented evidence that depressive symptoms are affected in different ways by social interaction skills and auditory hallucinatory symptoms in people with schizophrenia. However, few studies have focused on examining the relationship among auditory hallucinatory severity, social interaction skills, and depressive symptoms. This study aimed to explore the mediating effect of auditory hallucinatory severity on social interaction skills and depressive symptoms in people with long-term schizophrenia. We propose that auditory hallucination severity functions as a mechanism through which impaired social interaction skills increase depressive symptoms. In this study, a convenience sample of 186 people with schizophrenia was obtained from hospital-based rehabilitation wards. Four instruments were used: A demographic data questionnaire, the Assessment of Communication and Interaction Skills-Chinese version, the Characteristics of Auditory Hallucinations Questionnaire, and the Beck Depression Inventory II. To investigate the mediating effect of auditory hallucinatory severity after controlling for six covariates, we tested an indirect effect in a simple mediation model using the SPSS macro PROCESS, which is a regression-based approach. The indirect effect and the results of Sobel's test were significant (Z = -2.824, P = 0.005), which confirms that auditory hallucination severity mediates social interaction skills and depressive symptoms. This finding suggests that psychiatric nurses must teach people with schizophrenia to use auditory hallucination management strategies to prevent them from becoming immersed in auditory hallucinations and reducing their social interaction with the real world, so that depressive symptoms can be improved.

Association of auditory hallucination and anxiety symptoms with depressive symptoms in patients with schizophrenia: A three-month follow-up.

This study was to investigate the association of auditory hallucinations and anxiety symptoms with depressive symptoms in patients with schizophrenia for three months. The participants (N = 189) were evaluated using Characteristics of Auditory Hallucination Questionnaire (CAHQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II. Forty-two participants suffered from depressive symptoms at both baseline and 3-month follow-up. Higher CAHQ and BAI at both periods predicted depressive symptoms at three-month end. Being male, increased severity of CAHQ and BAI were risk factors of depressive symptoms. Psychiatric professionals must educate patients to manage auditory hallucinations and anxiety symptoms to decrease depressive symptoms.

Relationship Between Lifestyles That Promote Health and Quality of Life in Patients With Chronic Schizophrenia: A Cross-Sectional Study.

BACKGROUND: Over the last few decades, an increasing number of studies have examined quality of life in patients with chronic schizophrenia. However, little research has addressed the relationship between lifestyles that promote health and quality of life issues in these patients. PURPOSE: The aim of this study was to investigate the relationships between lifestyles that promote health and quality of life in patients with chronic schizophrenia. METHODS: A cross-sectional study design was used. The study was conducted at 10 hospital-based psychiatric rehabilitation units in northern Taiwan. In total, 357 participants completed the World Health Organization Quality of Life-BREF and the Health-Promoting Lifestyle Profile. This study examined the relationships among the six domains of the Health-Promoting Lifestyle Profile and the four domains of the Quality of Life-BREF using canonical correlation analysis. Data collection occurred between April 2013 and April 2014. RESULTS: The results of the canonical correlation analysis showed that the Health-Promoting Lifestyle Profile domains of nutrition, health responsibility, self-actualization, interpersonal support, exercise, and stress management were significantly related to the Quality of Life-BREF results, specifically in the physical, psychological, and social relationships and environment domains. Two canonical correlations were identified (the canonical correlation coefficients were .622 and .317), which showed that 38.6% of the variance in lifestyles that promote health and quality of life was shared. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this study may be useful to practitioners who are responsible for lifestyles that promote health and quality of life issues in patients with chronic schizophrenia.

Effects of a music-creation programme on the anxiety, self-esteem, and quality of life of people with severe mental illness: A quasi-experimental design.

Many studies have shown that music therapy improves patients' symptoms. However, interventions using music creation as their core await further development for patients with severe mental illness (SMI). The current study investigated the effect of a music-creation programme on the anxiety, self-esteem, and quality of life of patients with SMI. A quasi-experimental design using convenience sampling was adopted to recruit patients with SMI from a psychiatric day care centre. Participants were grouped based on their willingness to undergo an intervention (26 patients in the experimental group and 23 patients in the control group). The control groups participated in conventional mental rehabilitation therapy activities. The experimental group participated in a music-creation session for 90 min every week over a 32-week period. The outcome indicators before and after the intervention were assessed using the Hamilton Anxiety Rating Scale (HAM-A), Rosenberg Self-Esteem Scale (RSES), and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Finally, the intervention effect was determined using generalized estimating equations (GEEs). After 32 weeks of intervention activities, the experimental group showed significant improvements in their HAM-A total scores (P < 0.001) and RSES total scores (P = 0.005). Regarding quality of life, the improvements of the experimental group in terms of the psychological (P = 0.016) and social relationship domains (P = 0.033) were superior to those of the control group. Music-creation programmes are recommended for inclusion in the routine rehabilitation activities of patients with SMI.

Auditory Hallucinatory Beliefs in Patients With Schizophrenia: Association of Auditory Hallucinations With Social Interactions, Characteristics and Emotional Behaviors Over 3 Months.

The aims of this study were to explore social interactions, characteristics, and emotional behaviors to detect changes in auditory hallucinatory beliefs in patients with schizophrenia over a 3-month period. Participants (n=189) were evaluated using the Auditory Hallucinations Assessment Scale (AHAS) and the Assessment of Communication and Interaction Skills (ACIS). The characteristics and emotional behaviors measured by the AHAS showed improvements, while auditory hallucinatory beliefs became less influential. Social interaction scores increased regardless of changes in auditory hallucinatory beliefs. Psychiatric professionals need to train those who hear voices to react to them with indifference.

Prevalence and Predictors of Metabolic Syndrome in People With Schizophrenia in Inpatient Rehabilitation Wards.

BACKGROUND: Atypical antipsychotic medications increase the risk of developing metabolic syndrome (MetS) and cardiovascular diseases in people with schizophrenia. AIM: To explore the prevalence of MetS and the predictors associated with the number of MetS components in people with chronic schizophrenia. METHODS: We recruited 357 participants from 10 rehabilitation wards in northern Taiwan. The Beck Anxiety Inventory, Beck Depression Inventory-II, Health-Promoting Lifestyle Profile (HPLP), and modified Baecke physical activity questionnaire were used to evaluate the participants. MetS prevalence was calculated using the modified Adult Treatment Panel III criteria for Asians. RESULTS: The prevalence of MetS in this sample was 37.8%. Multinomial logistic regression revealed that the HPLP-exercise score (odds ratio [OR] = 0.411, p = .002) and depressive symptoms (OR = 0.949, p = .040) were protective factors for ≥4 MetS components. The leisure physical activity level (OR = .536, p = .024) was a protective factor for three MetS components. Body mass index ≥24 kg/m(2) was the strongest risk factor for two MetS components (OR = 8.057, p < .001), three MetS components (OR = 11.287, p < .001), and ≥four MetS components (OR = 15.621, p < .001). Additionally, participants' age >40 (OR = 3.638, p = .012) was a risk factor for ≥four MetS components. CONCLUSION: In this study, the prevalence of MetS was higher than that reported for patients utilizing community-based services in Taiwan. The important risk factors for MetS were being overweight and older than 40. The protective factors for MetS were a high HPLP-exercise score and leisure-based physical activities.

Comparison of the Prevalence and Predictors of Depression in Taiwanese and American Older Patients With Arthritis.

PURPOSE: To compare the prevalence and predictors of depression in Taiwanese and American older patients with arthritis. DESIGN AND METHODS: A secondary analysis was conducted to assess 151 Taiwanese and 70 American arthritic patients in Taipei, Taiwan and Chicago, USA. FINDINGS: The prevalence of depression of Taiwanese and American older arthritic patients was 34% and 40%, respectively. Depression was explained by life satisfaction and functional ability in Taiwanese patients, and by life satisfaction and level of pain in American patients. PRACTICE IMPLICATIONS: Nurses should assess patients' level of pain and functional ability, as well as their life satisfaction and depression.

The effects of auditory hallucination symptom management programme for people with schizophrenia: a quasi-experimental design.

AIM: To examine the effectiveness of an auditory hallucinatory symptom management programme in patients with chronic schizophrenia. BACKGROUND: Thirty per cent of chronic schizophrenia patients are still disturbed by hallucinations, which influence their psychological and social well-being, even when they take medication regularly. METHOD: Fifty-eight people experiencing schizophrenia with auditory hallucinations from psychiatric inpatient rehabilitation wards in northern Taiwan participated in the study, with 29 in the experimental group and 29 in the control group. The experimental group received an auditory hallucinatory symptom management programme. The auditory hallucinatory symptom management programme involved 60-minute meetings once a week, for a total of 10 meetings. The control group received routine care, which included free recreation for 40 minutes and walking for 20 minutes. The participants completed three self-report questionnaires: the Beck Depressive Inventory II, the Beck Anxiety Inventory and the Characteristics of Auditory Hallucinations Questionnaire. Data were collected at baseline, immediately following the intervention and at 3 months and 6 months post intervention. Data collection occurred between March 2010-May 2013. RESULTS: The experimental group showed a non-significant improvement in anxiety symptoms over time. Generalized estimating equations revealed that the experimental group achieved a greater drop in Characteristics of Auditory Hallucinations Questionnaire score than the controls at three and 6 months post intervention. Beck Depressive Inventory II scores in the experimental group (n = 29) had significantly improved in 3 months. CONCLUSION: The auditory hallucinatory symptom management programme seems to be effective in improving auditory hallucinatory symptoms and depressive symptoms in patients with schizophrenia.

Short sleep duration is dose-dependently related to job strain and burnout in nurses: a cross sectional survey.

OBJECTIVES: Lack of sleep is a common problem amongst nurses. Short sleep duration has been related to stress and burnout. However, in nurses, the effects of short sleep duration on job strain and burnout are controversial and a clear relationship has been lacking. This study aims to assess whether short sleep duration is related to job strain and burnout statue, and whether such relationship is in a dose-dependent manner. METHODS: A cross-sectional survey among female nurses in secondary referral health centers in Taiwan, using a self-administered structured questionnaire. Stratified sampling by region and patient bed number category was done to select representative centers for this survey. Approximately 10% of all secondary referral centers were randomly selected from each stratum. Non-linear dose-response relationship between sleep duration and job strain and burnout scores was assessed by general additive models (GAM), adjusting for personal characteristics, work condition, and family situation. RESULTS: Among the 2268 full-time nurses in 39 hospitals invited to participate in this study, 1384 (61%) satisfactorily completed the questionnaire. There were 169 nurses (12.2%) who slept less than 6 h per working day. Among the participants, 37% (n=512) were classified into high strain group. The mean scores of personal, work-related, and client-related burnout were 59.4 (SD=22.0), 54.6 (SD=21.7), and 42.3 (SD=18.6). Compared to those slept longer than 7 h, nurse who slept less than 6 h per working day had higher risk for job strain (adjusted odds ratio, AOR=1.8, 95% confidence interval, CI=1.2-2.7), personal burnout (AOR=3.0, CI=1.7-5.2), work-related burnout (AOR=3.4, CI=2.0-6.0), and client-related burnout (AOR=2.0, CI=1.2-3.6). GAM analysis found a linear relationship between sleep duration and job strain, and client-related burnout. For personal and work-related burnout, a linear increase in burnout score between 7 h and 5 h of sleep was observed, followed by a leveling off for durations of less than 5 h. CONCLUSION: Our study found sleep duration at working days was inversely associated with female nurses' job strain and burnout in a dose-dependent manner. Further studies on work factors which affecting sleep duration are warranted.