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.

[Exploring Significant Predictors of Retention Willingness in Nurses Diagnosed With COVID-19].

BACKGROUND: COVID-19 affected both the physical and mental health of frontline nurses and the stability of the nursing workforce. PURPOSE: This study was designed to explore the influence of demographic variables, physical and mental health status, perceived work stress, and job satisfaction on intention to continue working as nurses among nursing staff who had been infected by COVID-19. METHODS: In this cross-sectional study, an internal online survey was used to collect data from 152 nurses at a hospital in southern Taiwan. The questionnaires in the survey included the Chinese Health Survey Scale, Stress Scale on COVID-19 Patient Care, McCloskey/ Mueller Satisfaction Scale, and Employee Retention Scale. Data analysis was conducted using SPSS/Windows 22.0. RESULTS: The most significant predictors identified included age, seniority, level of education, job satisfaction, physical and mental wellbeing, and work stress. These predictors collectively explained 32% of the total variance in retention willingness (F [18,128] = 4.78, p < .001). Almost half (46.7%; 71/152) of the participants expressed intent to continue working in nursing. Being a senior staff and having a master's degree or higher were positively associated with retention. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings may be referenced by healthcare organizations and managers to help healthcare staff gain strength and resilience against future pandemics. Key recommendations include reducing staff work stress, increasing job satisfaction, and facilitating a more equitable life-work balance.

[Demographic Variables, Perceived Work Stress, and Job Satisfaction as Predictors of Organizational Commitment in Nurses During the COVID-19 Pandemic].

BACKGROUND: Organizational commitment, defined in nursing as the degree to which nurses identify with the goals and direction of their hospital, affects the willingness of nurses to participate actively in work tasks. PURPOSE: This study was designed to explore the predictive value of demographic variables, perceived work stress, and job satisfaction with regard to organizational commitment in nurses. METHODS: This cross-sectional study used an internet survey that included the Stress Scale on COVID-19 Patient Care, McCloskey/Mueller Satisfaction Scale, and Organizational Commitment Scale to collect data from 189 nurses at a hospital in southern Taiwan. Data analysis was conducted using SPSS/Window 22.0. RESULTS: Societal support and job satisfaction were identified as the most significant predictors of organizational commitment during the COVID-19 pandemic, explaining 47% of the total variance in organizational commitment (F [17, 171] = 8.79, p < .001). Level of perceived work stress averaged 48.3 (SD = 15.4), which is slightly higher than the median, and was highest among the participants who were married and had young children. The stress was mainly associated with social isolation. Those participants with a bachelor's degree or higher, a monthly income >NT$70,000, or with children reported relatively higher levels of job satisfaction and organizational commitment. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results provide a valuable guide to hospital management. To strengthen the organizational commitment and work dedication of nurses and to minimize pandemic-related staff attrition hospital management should work to ensure their nurses receive sufficient societal support and are satisfied with their jobs.

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.

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.

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.

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.

Lived Experiences of Novice Male Nurses in Taiwan.

PURPOSE: Nursing remains a female-dominated profession around the world. The masculinity and male identity of men who choose nursing careers is questioned by the general public in many countries. Few studies report the situation of novice male nurses at their first year. The purpose of this study was to explore the lived experience of novice male nurses when they first enter the workplace. DESIGN AND METHOD: A qualitative descriptive study was conducted using purposive and snowball sampling for recruitment. Fourteen participants, 21 to 25 years old, were recruited, all of whom had at least 5 months of work experience. On average, in-depth, face-to-face interviews lasted 1 hour, with more than one follow-up telephone interview per participant. FINDINGS: The following six themes emerged from the transcribed verbatim data based on content analysis: choosing appropriate work departments based on personality and needs, facing the pressure and frustration of independent work, getting help, obtaining acceptance among female cliques, reflecting on the relationship between gender and profession, and concerns about dependents and financial needs. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study addresses masculinity issues and gender stereotyping. In addition, male nurses were very concerned about their career options and development and the likelihood of promotion. This research not only has implications for better understanding of novice male nurses' needs and the challenges in their social life but also makes suggestions for nursing practice to attract and keep more male nurses in the nursing profession. The results illustrate how culturally congruent nursing care can be achieved when we more concern male nurses' role pressure and address traditional gender sensitivity to promote male nurses' career development.

Push and pull: Exposure of young Taiwanese women to sexually explicit materials.

This study was designed to understand young Taiwanese women's perception of sexually explicit materials (SEMs). Researchers conducted six focus group discussions with 38 young women between the ages of 18 and 22 in Taiwan in 2009-2010 and used content analysis to analyze the data based on the push-pull theory. The results showed that the exposure of young women to SEMs was a sexual exploration process from no sexual activity to future sexual activity. This process was affected by the interactions of three powers: push power, pull power, and personal factors. The push power included factors, such as parents and social values, which failed to satisfy their sexual curiosity and provide them with autonomy. The pull power included SEMs and peer influence, which increased sexual arousal stimuli and curiosity to try sexual activity. The most important personal factors were young women's growth, including sexual curiosity, cognition of SEMs, and gender equity in freedom to make sexual decisions. Understanding this push-pull process regarding SEM can help health-care providers with their own discourses in addressing sex and influence young women's participation in desired, protected, and enjoyable sex when sufficiently ready.

Living with illness and self-transcendence: the lived experience of patients with spinal muscular atrophy.

AIM: The aim of this study was to explore the lived experiences of patients afflicted with spinal muscular atrophy. BACKGROUND: Existing research studies on spinal muscular atrophy address the physical and psychological effects and complications of the disease; they also provide suggestions for how to improve the current management of this disease. However, information is limited on the disease process and the lived experience of spinal muscular atrophy patients. DESIGN: A phenomenological approach was conducted. METHODS: Through 18 in-depth interviews recorded by a pen voice recorder, this study collected data obtained from a purposive sample of nine patients from the, 'Taiwan spinal muscular atrophy Families,' between November 2010-August 2011. The audio recordings were transcribed verbatim and data were analysed using Colaizzi's steps. FINDINGS: Four themes and eight subthemes were identified: a loss of control (loss of muscular strength and independence), breaking limitations (assistive device use and mobility design), transcending limitations (independence/autonomy and social development) and living with hope (cherishing life and self-control). The results showed that the lived experiences of the spinal muscular atrophy patients involved living with illness, transcending the self and pursuing the meaning of life. Facing a life-threatening illness, these patients made self-adjustments in their lifestyles and exerted themselves to positively cope with hardships and maintain dignity and self-control. CONCLUSION: These findings could serve as evidence-based practice resources for healthcare professionals in helping individuals and their family members gain an in-depth understanding of spinal muscular atrophy's progression and life course and assist individuals in improving self-integrity to with hope.

Gender differences? Internet use and parent-child communication about sex toward sexual attitudes among early adolescents in Taiwan.

BACKGROUND: With the progress of information technology, early adolescents are able to access sex-related information through the Internet easily. This information has been shown to have a significant influence on the sexual health of this population. In addition, parent-child communications about sex affect the sexual health of adolescents. Few empirical studies have focused on early adolescents and gender differences. PURPOSE: This study explores gender differences between early adolescents in terms of the use of the Internet to obtain sex-related information, parent-child communication, and sex-related knowledge and attitudes. METHODS: This cross-sectional and comparative study uses an analysis of covariance and a hierarchical regression for data analysis. The researchers recruited 457 sixth-grade boys (n = 204) and girls (n = 253) in southern Taiwan as participants and used a structured questionnaire to collect data. RESULTS: Participants exhibited significant differences in terms of Internet usage behavior, parent-child communications about sex, and sex-related knowledge and sexual attitudes. The male participants spent more time on "recreation and entertainment" activities on the Internet, whereas their female peers spent significantly more time searching for information. Regarding parent-child communications about sex, girls had better mother-child communications than boys. In addition, no gender-based difference was found for father-child communications about sex. The knowledge of physical changes occurring during puberty and of menstrual healthcare among female participants was superior to their male counterparts. Girls had a more informed sexual attitude, particularly with regard to issues of gender roles, relationships with the opposite gender, and the social aspects of sex. Sex-related knowledge and parent-child communication about sex were the two major predictors of sexual attitudes for boys and girls, respectively. CONCLUSIONS: To develop healthy sexual attitudes among early adolescents, nursing professionals, families, and schools should enhance sex-related knowledge and parent-child communications, especially with boys. Early adolescence is a key time to provide sex education and Internet-safety education to both boys and girls to improve their sexual health. This study may serve as a reference for families, schools, researchers, and policymakers for promoting the sexual health of early adolescents.

[Internet use and adolescents' sexual health].

Internet use is an important part of the daily life of adolescents. The ease of searching the internet for information makes finding information on sex, a topic of particular interest to adolescents, easy. Although the internet is replete with sexual information, the influence of internet use on adolescents' sexual health is analogous to a double-edged sword. This article identifies the four main sexual dilemmas facing Taiwan adolescents and analyzes the pros and cons of internet use with regard to adolescents' sexual health. Cons include the predominance of internet pornography and the potential risks of making friends online. Pros include the internet's role as an optimal communications platform and tool for sex-related research. We suggest that nurses have a unique role and functions to play in promoting adolescent sexual health. We also offer recommendations for school health nursing and clinical nursing. Further internet-based quantitative and qualitative research is necessary to clarify relevant sexual health issues. Finally, we offer design suggestions for sexual education homepages.

[Knowledge, attitude, and behaviors related to sex among teenage girls: a comparison between nursing and non-nursing college students].

The purpose of this descriptive, comparative study was to explore differences in sex knowledge, attitudes, and behaviors between teenage girls enrolled at a nursing school and those enrolled at a non-nursing school. A total of 792 students were recruited from one nursing school and one non-nursing school. Compared to non-nursing students, nursing students were more knowledgeable on sex-related issues, held more conservative attitudes toward sex, and had less sexual experience. We found also that the closer an intimate relationship was, the more liberal the sexual activities tended to be. Participants were prone to accept premarital sex, and cared less about the virginity of future spouses. Most perceived having a child before marriage unacceptable. About 23% (n = 179) of participants had intercourse experience, while only 30% of girls surveyed had used contraception every time they had sexual intercourse. Eleven students reported being pregnant, but none chose to take their pregnancy to term. The findings of this study show that nursing education may have a positive influence on teenage girl's sexual knowledge, attitudes, and behaviors with regard to practicing safer sex. This study also suggests that a comprehensive sex-related curriculum, introducing safer sex practices and the health consequences of unprotected sex, should be reinforced in both non-nursing and nursing schools.