Validity, reliability, and cross-validation of a new questionnaire developed using the Theory of Planned Behavior: The Dating Violence Bystander Help-giving Intention Questionnaire (DVBHIQ).

The present study aimed to develop and psychometrically test a scale by using the Theory of Planned Behavior (TPB) comprising two types of measurement (direct and belief-based [indirect]) to assess bystander help-giving intention to victims of dating violence among youth. A two-phase, mixed-method design was adopted. The primary source of the samples was five universities, each in the northern, central, southern, eastern, and outer islands regions of Taiwan. Phase I involved developing an instrument based on the TPB (n = 10) and pilot testing (n = 220). Phase II conducted the psychometric evaluation (n = 622). The study used item analysis, explanatory factor analysis, confirmatory factor analysis, internal consistency, and cross-validation to examine the psychometric properties of the Dating Violence Bystander Help-giving Intention Questionnaire (DVBHIQ) with two types of measure (direct and belief-based). Explanatory factor analysis resulted in a four-factor solution (attitude/behavioral beliefs, subjective norms/normative beliefs, perceived behavioral control/control belief, and intention) of the direct and belief-based measures of the DVBHIQ, accounting for 72.67% and 76.62% of total variance respectively. Confirmatory factor analysis and cross-validation confirmed the proposed four-factor model and demonstrated good internal consistency reliability. The two types of DVBHIQ had good validity, reliability, and measurement invariance which may help address the core cognitive determinants for bystander help-giving intention. Healthcare providers (e.g., school nurses) could use the DVBHIQ to evaluate how bystander education programs affect youth and conduct related research in the future.

Psychiatric Nurses' Knowledge and Practice Barriers to Administering Long-Acting Injectable (LAI) Antipsychotics in Taiwan: A Mixed-Methods Study.

Long-acting antipsychotic injections require that psychiatric nurses choose the proper injection site and technique to avoid harming patients. This research conducted a mixed-method study to examine the long-acting injectable antipsychotic (LAI) knowledge, practice, and administrative barriers in a sample of 269 psychiatric nurses from 3 public psychiatric hospitals in Taiwan. Self-report questionnaires showed female nurses exhibiting higher scores and older nurses demonstrating more knowledge. The dorsogluteal (DG) site was the most widely used for injections, with 57.6% of nurses using the Z-track method. Qualitative data analysis was performed on 20 psychiatric nurses who chose the DG site as their preferred injection site. There were two key themes. The first was a gap between the nurses' knowledge of LAI administration and their actual practice. The second needed more confidence and training in using the ventrogluteal injection site. These results highlight the need for continued education and training to improve LAI practice among psychiatric nurses.

Resilience among women with breast cancer surviving longer than five years: The relationship with illness perception and body image.

PURPOSE: This study aimed to investigate the correlations and identify the relationships between the resilience, perception of illness and body image of women with breast cancer in the 5-year-or-above survivorship. METHODS: We used convenient sampling to recruit from an outpatient department 106 women with breast cancer. The inclusion criteria were participants aged >20 years currently in a stable condition and were able to understand the Chinese language. Those women with mental health illness were excluded. All participants completed questionnaires on the following: demographic information, revision of illness perception (IPQ-R), body image scale (BIS), Eysenck personality questionnaire (EPQ), and resilience scale (RS). We conducted the structural equation modeling (SEM) to explore the factor structure. RESULTS: SEM results showed a good fit to the data (comparative fit index = 0.97, Tucker-Lewis index = 0.94). Findings F indicated the existence of significant relationships between resilience and either illness perception or body image. Personality had a direct association with illness perception (ß = 0.73, P < 0.05). Body image had an indirect effect on the relationship between resilience and illness perception (coefficient = -2.52; 95% bootstrapping CI = -31.36, -0.62). CONCLUSIONS: Results indicated that illness perception is a crucial predictor for better resilience as mediated through body image. To provide adequate information to women with breast cancer can improve their perception of breast cancer more positively. Hence, their body image and their way of coping with survival life turn better.

Experience of Indigenous Peoples' Access to Long-Term Care Services in Taiwan: A Qualitative Study among Bunun Tribes.

Indigenous communities usually have poorer access to long-term care services than non-indigenous communities because of their remote locations and unique cultural backgrounds. However, there was little exploration into the experience of indigenous people's access to the official long-term care services in Taiwan-the gap this study aimed to fill. A qualitative study design using semi-structured interviews was used to obtain data from a purposive sample. Fourteen participants who were disabled and lived among the indigenous communities of the Bunun tribes in central Taiwan were interviewed individually. The data were analyzed using Graneheim and Lundman's qualitative content analysis. The theme-"helpful but still difficult and unfit"-and three categories with eight subcategories emerged. While official long-term care services provided by the government can benefit people with disabilities in indigenous tribes, their use of such services faces a number of obstacles, which points to the need for considering culturally appropriate care. To protect the rights and interests of indigenous tribal communities, long-term care policies and practical planning must be adopted, cultural differences at play must be respected and recognized, and the necessary support must be offered to eliminate inequalities in healthcare.

Interpenetrated metal-organic frameworks with enhanced photoluminescence for selective recognition of m-xylene from xylene isomers.

Two novel luminescent metal-organic frameworks (MOFs), [Zn3(TCA)2(BPB)2]n (DZU-101, where H3TCA = 4,4',4''-tricarboxyltriphenylamine and BPB = 1,4-bis(pyrid-4-yl)benzene) and [Zn3(TCA)2(BPB)DMA]n (DZU-102), based on the same ligands and metal ions were synthesized by regulating the amount of water in the solvothermal reaction system. Structural analyses show that the two MOFs have pillar-layered frameworks with Zn3 clusters connected by the TCA3- and BPB ligands. Interestingly, DZU-102 possessed a two-fold interpenetrated framework distinct from the individual network of DZU-101. As a result, DZU-102 showed a visual fluorescence color change from chartreuse to azure in m-xylene, while the fluorescence color was turquoise in p-/o-xylene with no change. Furthermore, compared with p/o-xylene, the fluorescence emission peak of DZU-102 in m-xylene suspension produced an obvious blue shift. Moreover, selective fluorescence sensing experiments were also carried out, which demonstrated that the degree of peak shift was related to the concentration of m-xylene, indicating the potential application of DZU-102 in fluorescence sensing of m-xylene from xylene isomers and further revealed the application of structural interpenetration for luminescence tuning of MOFs.

Mental Health Nurses' Tacit Knowledge of Strategies for Improving Medication Adherence for Schizophrenia: A Qualitative Study.

Non-adherence to medication among patients with schizophrenia is an important clinical issue with very complex reasons. Since medication administration is an essential nursing responsibility, improving strategies for patient medication compliance must be fully understood. This study aimed to explore the strategies mental health nurses (MHNs) implement in clinically improving patients with schizophrenia and to describe the nurses' tacit knowledge of application strategies. A qualitative study with purposeful sampling was used. Twenty-five experienced MHNs in a psychiatric hospital in central Taiwan were given an in-depth interview. The texts were content-analyzed using NVivo 12 Pro software. MHNs promote medication adherence among patients with schizophrenia using the following strategies: establishing a conversational relationship, overall assessment of non-adherence to medication, understanding the disease and adjusting the concept of medication, incorporating interpersonal connection feedback, and building supportive resources. This study explored the strategies of MHNs that incorporated knowledge in managing treatment adherence in patients with schizophrenia. The findings add knowledge to clinical nursing practice about medication adherence among patients with schizophrenia.

Psychometric Testing of Three COVID-19-Related Scales Among People with Mental Illness.

Fear of novel coronavirus 2019 (COVID-19) may result in psychological health problems among different populations. Moreover, believing COVID-19 information and preventive COVID-19 infection behaviors are relevant constructs associated with fear of COVID-19. Therefore, the present study validated three instruments assessing fear, beliefs, and preventive behaviors related to COVID-19 among individuals with mental illness. Moreover, relationships between the three constructs were examined. Individuals with mental illness (N = 400; 178 females; mean age = 46.91 years) completed the Fear of COVID-19 Scale (FCV-19S), Believing COVID-19 Information Scale (BCIS), Preventive COVID-19 Infection Behaviors Scale (PCIBS), and Depression Anxiety Stress Scale-21 (DASS-21). The FCV-19S, BCIS, and PCIBS demonstrated a single-factor structure with satisfactory fit indices. Moreover, believing COVID-19 information positively and significantly associated with fear of COVID-19, and fear of COVID-19 negatively and significantly associated with preventive behaviors and positively and significantly associated with psychological distress. The FCV-19S, BCIS, and PCIBS may assist healthcare providers in assessing COVID-19-related information among individuals with mental illness. Consequently, relevant programs may be designed to help individuals with mental illness going through the period of crisis.

The Relationship Between Children's Problematic Internet-related Behaviors and Psychological Distress During the Onset of the COVID-19 Pandemic: A Longitudinal Study.

BACKGROUND: The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has generated negative effects on psychological well-being worldwide, including in schoolchildren. Government requirements to stay at home and avoid social and school settings may impact psychological well-being by modifying various behaviors such as problematic phone and Internet use, yet there is a paucity of research on this issue. This study examined whether the COVID-19 outbreak may have impacted problematic smartphone use (PSU), problematic gaming (PG), and psychological distress, specifically the pattern of relationships between PSU, PG, and psychological distress in schoolchildren. METHODS: Longitudinal data on psychological distress, PSU, and PG were collected from 575 children in primary schools in 3 waves: Waves 1 and 2 were conducted before the COVID-19 outbreak and Wave 3 during the outbreak. Cross-lagged panel models were used to examine relationships between factors across the 3 waves. RESULTS: Cross-lagged models found that higher levels of PSU were not significantly related prospectively to greater psychological distress before the COVID-19 outbreak, but this prospective relationship became significant during the COVID-19 outbreak. Whereas PG was associated prospectively with psychological distress before the COVID-19 outbreak (ie, between Waves 1 and 2), this association became nonsignificant during the COVID-19 lockdown (ie, between Waves 2 and 3). CONCLUSIONS: The COVID-19 outbreak has seemed to change prospective relationships between PSU and psychological distress and PG and psychological distress in schoolchildren. Future research should examine whether restrictions on or information provided to schoolchildren may exacerbate PSUs effects on psychological distress.

Nurses' experiences of emergency department triage during the COVID-19 pandemic in Indonesia.

PURPOSE: To explore the experiences of nurses working in emergency departments in selecting and triaging patients during the COVID-19 pandemic. DESIGN: Descriptive phenomenology was applied in this study. METHODS: Data were collected from nurses working at hospitals in Indonesia using snowball sampling and telephone interviews. A total of 10 emergency nurses participated, and Colaizzi's method of data analysis was applied. FINDINGS: Six themes and 10 subthemes emerged. The main themes were "extreme challenges in triage," "feeling of responsibility under uncontrolled spread and infection," "physical and psychological exhaustion," "discovering strategies under difficult circumstances," "looking for positive reinforcement," and "optimism in togetherness." Nurses had to deal with the challenge of COVID-19 in the ED triage, interestingly so, the nurses they have shown the development of professional responsibility. Nurses are also experienced in finding patient selection and triage strategies and the sense of optimism that may influence strategy and practice during the COVID-19 pandemic. CONCLUSIONS: This findings identify nurses' experiences in dealing with the extreme challenges of emergency department triage as well as their associated strategies and optimism. CLINICAL RELEVANCE: Providing support to emergency nurses, improving emergency department triage, and community empowerment are suggested as strategies to improve nursing care during the COVID-19 pandemic.

Gender Differences in How Parents, Peers, and Exposure to Sexually Explicit Materials Influence the Intention to Engage in Casual Sex among Adolescents and Young Adults in Taiwan: Applying the Theory of Planned Behavior.

The aims of this study were to examine gender differences in how parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials affect the intention to engage in casual sex among adolescents and young adults in Taiwan. This cross-sectional survey study recruited 767 participants (348 men and 419 women) aged 15-24 years. The survey collected data on participants' intention to engage in casual sex, their attitude toward and perception of casual sex based on the theory of planned behavior (TPB) (favorable attitude, perceiving positive social norms toward casual sex, and perceived control over involvement), parent-child and peer discussions about sexual issues, and exposure to sexually explicit materials. The results of multiple regression analysis revealed that parent-child discussions on sex issues, peer interactions around sexual issues, and exposure to sexually explicit materials were significantly associated with the intention to engage in casual sex. The results of structural equation modeling (SEM) further supported that favorable attitude, perceiving positive social norms toward casual sex, and control over involvement mediated the associations. For men, decreased favorable attitude mediated the negative association between parent-child discussions and casual sex intention; increased favorable attitudes and decreased control over involvement mediated the positive associations between peer interactions and casual sex intention. For women, decreased control over involvement mediated the positive association between exposure to sexually explicit materials and casual sex intention. The associations between peer interaction and subjective norms of acceptance, perceived control over involvement, and casual sex intention were stronger in men than in women; the association of favorable attitudes with casual sex intention was also stronger in men than in women.

Comparing Fear of COVID-19 and Preventive COVID-19 Infection Behaviors Between Iranian and Taiwanese Older People: Early Reaction May Be a Key.

This study assessed fear of the novel coronavirus-2019 (COVID-19), preventive COVID-19 infection behaviors, and the association between fear of COVID-19 and preventive COVID-19 infection behaviors among older people in Iran and Taiwan. Older people aged over 60 years (n = 144 for Iranians and 139 for Taiwanese) completed the Fear of COVID-19 Scale (FCV-19S) and two items on preventive COVID-19 infection behaviors (i.e., hand washing and mouth covering when sneezing). Iranian older people had a significantly higher level of fear of COVID-19 than did Taiwanese older people. Moreover, Iranian older people had significantly lower frequencies of preventive COVID-19 infection behaviors than did Taiwanese older people. Different timings in implementing COVID-19 infection control policies in Iran and Taiwan may explain why Iranian older people had greater fear of COVID-19 and lower preventive COVID-19 infection behaviors than did Taiwanese older people.

Factors Related to Intentions to Commit Dating Violence among Taiwanese University Students: Application of the Extended Theory of Planned Behavior.

Dating violence (DV) constitutes a major public health and safety issue worldwide; however, only limited research into this important subject has been conducted in Taiwan. This study examined university students' intention to commit DV, based on the expanded theory of planned behavior (TPB), with a history of family violence and gender stereotyping also included as further factors in the original TPB model. A total random sample consisting of 450 university students from four universities in four regions in Taiwan, namely, the northern, southern, central, and eastern regions, participated. Of these participants, 365 (81.1%) completed all of the parts of the questionnaires, which included a survey of demographic data, such as any history of family violence; a gender stereotyping questionnaire; and a DV behavioral intention questionnaire. The results showed that the three main variables of the TPB-that is, subjective norms, attitudes, and perceived behavioral control-significantly related to university students' intentions to commit DV. More specifically, university students' attitudes and subjective norms emerged as significant related factors of their intention to commit DV behaviors. Overall, the expanded TPB explained 30.4% of the variance in DV intentions, and attitude was the most significant factors after controlling the background variables. These findings can hopefully be used to help design and implement programs for the prevention of DV behaviors among university students.

Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues.

AIM: The threats of novel coronavirus disease 2019 (COVID-19) have caused fears worldwide. The Fear of COVID-19 Scale (FCV-19S) was recently developed to assess the fear of COVID-19. Although many studies found that the FCV-19S is psychometrically sound, it is unclear whether the FCV-19S is invariant across countries. The present study aimed to examine the measurement invariance of the FCV-19S across eleven countries. DESIGN: Cross-sectional study. METHODS: Using data collected from prior research on Bangladesh (N = 8,550), United Kingdom (N = 344), Brazil (N = 1,843), Taiwan (N = 539), Italy (N = 249), New Zealand (N = 317), Iran (N = 717), Cuba (N = 772), Pakistan (N = 937), Japan (N = 1,079) and France (N = 316), comprising a total 15,663 participants, the present study used the multigroup confirmatory factor analysis (CFA) and Rasch differential item functioning (DIF) to examine the measurement invariance of the FCV-19S across country, gender and age (children aged below 18 years, young to middle-aged adults aged between 18 and 60 years, and older people aged above 60 years). RESULTS: The unidimensional structure of the FCV-19S was confirmed. Multigroup CFA showed that FCV-19S was partially invariant across country and fully invariant across gender and age. DIF findings were consistent with the findings from multigroup CFA. Many DIF items were displayed for country, few DIF items were displayed for age, and no DIF items were displayed for gender. CONCLUSION: Based on the results of the present study, the FCV-19S is a good psychometric instrument to assess fear of COVID-19 during the pandemic period. Moreover, the use of FCV-19S is supported in at least ten countries with satisfactory psychometric properties.

Internet gaming as a coping method among schizophrenic patients facing psychological distress.

BACKGROUND AND AIMS: Patients with schizophrenia are known to use potentially addictive psychoactive substances as self-medication and to ease psychological distress. Other potentially addictive behaviors such as online gaming are also used to self-medicate and ease psychological distress. However, the role of online gaming and problematic gaming (in the form of internet gaming disorder [IGD]) has not previously been investigated for patients with schizophrenia facing distress. METHODS: One hundred and four participants diagnosed with schizophrenia were recruited and completed a number of psychometric scales including the Personal and Social Performance Scale (PSPS), Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Self-Stigma Scale-Short (SSS-S), and Depression, Anxiety, Stress Scale (DASS-21). RESULTS: The results showed significant negative associations between PSPS, IGDS-SF9, and DASS-21, and significant positive correlations between the IGDS-SF-9, SSS-S and DASS-21. Moreover, IGD did not mediate the association between self-stigma and depression. However, IGD significantly mediated the association between self-stigma and anxiety, and the association between self-stigma and stress. In addition, (i) age and self-stigma were significant predictors for IGD; (ii) social function and self-stigma were significant predictors for depression; (iii) social function, self-stigma, and IGD were significant predictors for anxiety; and (iv) self-stigma and IGD were significant predictors for stress. CONCLUSION: The findings suggest that online gaming may be a coping strategy for individuals with schizophrenia with psychological stress and self-stigma and that for some of these individuals, their gaming may be problematic.

Measurement invariance and psychometric properties of Perceived Stigma toward People who use Substances (PSPS) among three types of substance use disorders: Heroin, amphetamine, and alcohol.

BACKGROUND: The 8-item self-report Perceived Stigma toward Substance Users Scale (PSAS) is a commonly used instrument to assess stigma for people with substance use disorders. This study aimed to develop and validate the Taiwan version of the PSAS entitled Perceived Stigma toward People who use Substances - Taiwan version (PSPS-TV) among individuals with substance use disorders. METHODS: Patients with substance use disorders (N = 300; mean age = 45.22; 255 males) completed the PSPS-TV, Self-Stigma Scale-Short (SSS-S), Taiwan Depression Questionnaire (TDQ), and Rosenberg Self-Esteem Scale (RSES). Confirmatory factor analysis was used to test the construct validity and the measurement invariance of the PSPS-TV. Concurrent validity was tested using the correlations between PSPS-TV and SSS-S, TDQ, and RSES scores. RESULTS: The confirmatory factor analysis supported the construct validity and measurement invariance of the PSPS-TV. SSS-S scores explained 13 %, TDQ scores explained 10 % and RSES scores explained 17 % of the PSPS-TV score variance with moderate standardized coefficients (0.38, 0.32 and -0.42, respectively; all p < 0.001). CONCLUSIONS: The PSPS-TV is an appropriate instrument to assess perceived stigma for individuals residing in Taiwan who have substance use disorders. Taiwan healthcare providers may thus consider using the PSPS-TV to assess perceived stigma relating to substance use in Taiwan.

Assessing Related Factors of Intention to Perpetrate Dating Violence among University Students Using the Theory of Planned Behavior.

Dating violence (DV) is a major public health problem among youth. The majority of DV studies in Taiwan involve the assessment of DV without the use of a robust psychological framework to guide research accuracy. Therefore, the purpose of this study was to utilize the Theory of Planned Behavior (TPB) to assess intention and other salient factors related to DV among university students. A two-phase, mixed-method design study was conducted among university students from seven universities in Taiwan, aged 18 to 24 years. In Phase I, questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to DV. In Phase Ⅱ, questionnaire evaluation and related factors were examined through a two-step process of structural equation modelling (SEM) to test the TPB model. The results of this study found that perceived behavioral control, subjective norm, and attitude toward DV on behavioral intention accounting for 37.5% of the total variance. Among the related factors, attitude toward the behavior was the strongest (ß = 0.48, p < 0.001), followed by perceived behavioral control (ß = 0.19, p < 0.05). Findings from this study could expand the knowledge base in this important area and might help prevent DV.

Proteomic and ultrastructural analysis of Clara cell and type II alveolar epithelial cell-type lung cancer cells.

BACKGROUND: Currently, the identification of Clara cell and type II alveolar epithelial cell-type cancer cells requires electron microscopy, which is a time-consuming and expensive process involving a complicated tissue sampling procedure. The aim of this study was to identify unique biomarkers for Clara cell and type II alveolar epithelial cell-type lung cancer cells, respectively, with proteomic profiling. METHODS: Six human lung adenocarcinoma cell lines (A549, NCI-H358, NCI-H1650, HCC827, NCI-H1395, and NCI-H1975) were investigated for their ultrastructural characteristics. The differentially expressed proteins (DEPs) were screened between NCI-H358 cells (Clara cell type) and A549 cells (type II alveolar epithelial cell type) using two-dimensional difference gel electrophoresis (2D-DIGE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS/MS), and then they were validated by western blot. The protein expression levels of endoplasmic reticulum oxidoreductin 1-α (ERO1L), Clara cell 10-kD protein (CC10), and surfactant protein C (SP-C) were also determined in the six cell lines assayed. RESULTS: NCI-H358 cells featured Clara cell differentiation; A549, NCI-H1975, and HCC827 cells had characteristics of type II alveolar epithelial cells; and NCI-H1395 and NCI-H1650 cells had no differentiation characteristics of any lung adenocarcinoma cell type. Five DEPs including ubiquitin carboxyl-terminal hydrolase isozyme L1 (UCHL1), cytokeratin 19 (CK19), cytokeratin 8 (CK8), ERO1L, and peroxiredoxin 2 (PRDX2) between NCI-H358 and A549 cells were identified for further validation; however, none of them showed suitability as an effective biomarker. Similarly, CC10 and SP-C were not appropriate biomarkers. CONCLUSIONS: Cytological subtypes of NCI-H1975 and HCC827 cells were identified, but no promising biomarker was discovered in the present study.

Safe sexual behaviors intention among female youth: The construction on extended theory of planned behavior.

AIM: To examine female youth's intentions for safe sex with the relationship partners based on the extended theory of planned behaviour (TPB) model and explore the direct and indirect impact of parent-child communication about sex, peer interaction related to sexual issues, and exposure to sexually explicit materials on female youth's safe sexual behaviour intentions. DESIGN: A non-experimental, cross-sectional research design. METHODS: A convenience sampling was employed for data collection and 731 female youth aged 15-24 years old were recruited in 2013-2014. An anonymous, self-report structured questionnaire was used as a research instrument to collect participants' basic information and measure the internal and additional variables in the extended TPB model. RESULTS: The extended TPB model explained 42-45% of the total variance. Perceived behavioural control (PBC) and subjective norms had a positive effect on female youth's intentions for contraceptive use, condom use, and dual use with relationship partner; PBC was found to have the greatest influence. Among the additional variables in the extended TPB model, more parent-child communication about sex was found to lead to more positive dual use intentions. More peer interaction related to sexual issues was found to lead to less dual use intentions. CONCLUSIONS: To improve female youth's sexual health, the priorities are to reinforce their PBC and subjective norms and enhance parent-child communication about sex. Future efforts should strengthen sex education in families and schools and shape a social environment that facilitates safe sex. IMPACT: The extended TPB model can successfully predict female youth's safe sexual behaviour intentions. Empowering female youth to establish a sense of subjectivity and awareness of being a mature individual with physical autonomy, is importance for their sexual health.

A qualitative exploration of the fear of recurrence among Taiwanese breast cancer survivors.

OBJECTIVE: Fear of cancer recurrence (FCR) is the most commonly reported problem and unmet need among breast cancer survivors. The aim of this qualitative study was to explore the experience of recurrence fears among Taiwanese breast cancer survivors. METHODS: Three focus groups were included in this study. A purposive sampling technique was used to recruit 11 recurrence-free women at least 20 years of age from southern Taiwan who were diagnosed with breast cancer within the previous 2 years. Data were analysed and interpreted using content analysis. RESULTS: Three themes reflecting the experience of FCR were extracted from the transcript analyses: "Trapped in insecurity," "Suffering in silence," and "Pretending as if nothing happened." Participants endured a complex set of circumstances akin to silently walking the survival tightrope. Breast cancer survivors were still insecure and suffering, rather than celebrating survival, after the completion of treatment. Fear of cancer recurrence silently dominated their lives. CONCLUSIONS: An avoidance mindset and an unspoken FCR leave survivors insecure, resulting in a silent survival journey. These difficult thoughts and feelings that may impact the reconstruction of post-cancer life should be acknowledged. The development of appropriate survivorship care programs and emotional resilience regarding recurrence is needed for Taiwanese breast cancer survivors.

Effects of a strengths-based perspective support group among Taiwanese women who left a violent intimate partner relationship.

AIMS AND OBJECTIVES: To examine the effects of an 8-week strengths-based perspective group intervention on hope, resilience and depression in Taiwanese women who left a violent intimate partner relationship. BACKGROUND: Studies on interventions for abused women have primarily focused on psychological problems. However, the effect of group intervention on the psychological strengths of abused women is still unknown. DESIGN: A two-group, quasi-experimental design using repeated measures was used in this study. METHODS: Twenty-nine Taiwanese women who left violent intimate partner relationships were assigned to two groups and five participants did not complete the study. The experimental group (n = 8) underwent an 8-week strengths-based perspective group intervention developed by the investigators; the control group (n = 16) received no intervention. The effects of the intervention on the participants' hope, resilience and depression levels were evaluated as a pretest, post-test 1 (8th week) and post-test 2 (12th week) and were compared. The Chinese version of the State Hope Scale, the 25-item Resilience Scale, and the Taiwanese Depression Questionnaire were used in this study. RESULTS: On the eighth and twelfth weeks after the strengths-based perspective group intervention, we found significantly lower scores on the depression scale in the experimental group. In the eighth week, participants in the experimental group had significantly lower scores on the pathway of hope subscales than those in the control group. CONCLUSIONS: A strengths-based perspective support group intervention designed specifically for women who left a violent intimate partner relationship significantly reduced the participants' level of depressive symptoms and improved the pathway component of hope. RELEVANCE TO CLINICAL PRACTICE: This research highlights the importance of nurses not only focused on problems but also on the psychological strengths in practice of abused women survivors.