The Relationship between the Second-Generation Antipsychotics Efficacy and the Traditional Chinese Medicine Body Constitutions in Patients with Schizophrenia.

BACKGROUND: Schizophrenia requires lifelong treatment; Second-generation Antipsychotics (SGAs) have become the most prescribed medication for schizophrenia patients. The efficacy of various SGAs treatment may differ in schizophrenia patients with various traditional Chinese medicine (TCM) body constitution (BC) types. METHOD: This study applied a longitudinal quantitative research design, where a total of 66 participants were recruited. The Positive and Negative Symptom Scale (PANSS) and the Clinical Global Impression (CGI) score were used to evaluate patients' psychopathology status in hospitalization, and body constitution questionnaires were conducted by face-to-face interviews in the 1st, 3rd, and 6th week of hospitalization. RESULTS: More than 60% of schizophrenia patients who were treated with SGAs were classified to have unbalanced BC types including Yin-Xu, Yang-Xu and Stasis. Generalized estimating equation analysis revealed significant time effects in CGI and PANSS score improvements in both unbalanced and gentleness (balance) BC types, but no significant changes in the group and group-time interaction in the CGI and PANSS scores in different BC type groups. CONCLUSIONS: Schizophrenia patients under SGAs treatment had a higher proportion of unbalanced BC types which may lead to poorer physical or mental statuses, such as overweight problems. Health care providers could apply interventions according to patients' BC types for disease prevention.

Experiences of interpersonal interaction among patients with chronic schizophrenia: A phenomenological study.

PURPOSE: To explore the subjective interpersonal interaction experiences of patients with chronic schizophrenia. DESIGN AND METHODS: Descriptive phenomenological, purposive sampling, in-depth one-to-one, and unstructured interviews were used. Colaizzi's method was used to analyze narratives. FINDINGS: Three themes and six subthemes were emerged: Feelings associated with interpersonal interactions (pleasant and unpleasant feelings experienced during interpersonal interactions); interpersonal interaction is a dynamic process (Positive and negative dynamic processes); selection of interaction targets (limitations in the selection of interaction targets and selection criteria for interaction targets). PRACTICE IMPLICATIONS: Professionals should understand the interpersonal interactions experiences of patients with schizophrenia to help them have a better interpersonal relationship.

The effectiveness of a clinical reasoning teaching workshop on clinical teaching ability in nurse preceptors.

AIM: To explore the effectiveness of a clinical reasoning teaching workshop (CRTW) in preceptors' teaching ability, self-efficacy of clinical reasoning teaching. BACKGROUND: Preceptors' teaching skills are crucial for training novice nurses. How to enhance preceptors' teaching ability is a pertinent concern in clinical practice. METHODS: This study comprised two stages. At stage I, we administered a pre- to post-test single group with 33 participants to investigate the changes in preceptors' knowledge and self-efficacy in clinical reasoning teaching after clinical reasoning teaching workshop. At stage II, a quasi-experimental design was adopted to assess the effectiveness of the clinical reasoning teaching workshop by comparing the preceptors' teaching ability by novice nurses. There were 22 nurses' preceptors who underwent the clinical reasoning teaching workshop and 70 nurses with preceptors who did not undergo clinical reasoning teaching workshop and matched with preceptors' age and working experience. RESULTS: After clinical reasoning teaching workshop, preceptors' knowledge and self-efficacy of clinical reasoning teaching ware increased significantly. Novice nurses (study group) scored their preceptors' teaching ability significantly higher than nurses' (control group). CONCLUSION: The clinical reasoning teaching workshop can enhance preceptors' teaching ability and confidence, thereby improving their teaching ability. IMPLICATIONS FOR NURSING MANAGEMENT: A well-designed workshop with appropriated teaching method can allow preceptors to learn effectiveness. Clinical reasoning teaching workshop can be used in the training of preceptors.

A mental health home visit service partnership intervention on improving patients' satisfaction.

AIMS: To investigate a partnership intervention of the community-based and hospital-based home visit to improve patients' satisfaction. METHODS: A time series quasi-experimental quantitative design was used. The experimental group had "partnership intervention", while the control group maintained routine home visits. Patient satisfaction was measured pre-intervention, six months and 12 months after the partnership intervention. RESULTS: Six and 12 months after partnership intervention, in the experimental group, items related to stabilizing disease conditions, improving daily living abilities, enhancing communication ability and providing relevant resources were significantly higher than pre-intervention. However, 12 months after the intervention, the influence of the intervention became weaken. CONCLUSIONS: The partnership intervention can significantly improve patients' satisfaction with home visit service.

To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness.

PURPOSE: To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness. DESIGN AND METHODS: A quasi-experimental design was used. Two hundred and sixty-four participants completed a daily living function scale questionnaire and provided disease-related information. FINDINGS: Community rehabilitation was shown to be efficient in helping to stabilize mental illness and enhance daily function. Daily function had a significant and positive correlation with disease stability. PRACTICE IMPLICATIONS: Community rehabilitation for patients with mental illness can effectively stabilize and prevent disability among those with mental illness.

The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden.

AIMS AND OBJECTIVES: To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. BACKGROUND: The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. DESIGN: A longitudinal quasi-experimental quantitative design. METHODS: The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. RESULTS: Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. CONCLUSIONS: This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. RELEVANCE TO CLINICAL PRACTICE: The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance.

The chronic sorrow experiences of caregivers of clients with schizophrenia in Taiwan: A phenomenological study.

PURPOSE: The aim of the article is to explore the chronic sorrow experiences of the caregivers of clients with schizophrenia in Taiwan. DESIGN AND METHODS: Descriptive, phenomenological, and purposive sampling and one-to-one, in-depth, and unstructured interviews were used. Data saturation was achieved after interviewing 12 participants. Narratives were analyzed using Colaizzi's (1978) method. FINDINGS: Three themes and eight subthemes emerged, including encountering sorrow (disordered life, disintegrated self-esteem, little prospect for hope, and collapsed sense of security), talking with sorrow (cognitive change and transformation of action), and living with sorrow (living with defects and living with responsibilities). PRACTICE IMPLICATIONS: Advanced practice psychiatric nurses should take the emotional stability of caregivers into consideration. Caregivers should be encouraged and taught effective culture-oriented strategies for living with sorrow.

The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety.

PURPOSE: To evaluate the effectiveness on reducing anxiety of a diaphragmatic breathing relaxation (DBR) training program. DESIGN AND METHODS: This experimental, pre-test-post-test randomized controlled trial with repeated measures collected data using the Beck Anxiety Inventory and biofeedback tests for skin conductivity, peripheral blood flow, heart rate, and breathing rate. FINDINGS: The experimental group achieved significant reductions in Beck Anxiety Inventory scores (p < .05), peripheral temperature (p = .026), heart rate (p = .005), and breathing rate (p = .004) over the 8-week training period. The experimental group further achieved a significant reduction in breathing rate (p < .001). PRACTICE IMPLICATIONS: The findings provide guidance for providing quality care that effectively reduces the anxiety level of care recipients in clinical and community settings.

The Relationship between Body Weight Change and Body Constitutions of Traditional Chinese Medicine in Patients with Schizophrenia.

Objective. To explore the relationship between body constitution (BC) types and weight change in patients with schizophrenia and who underwent second-generation antipsychotics (SGAs) treatment. Method. Body weight and waist circumference of eighty-five participants were measured for 6 consecutive weeks. Constitutions of Yin-Xu, Yang-Xu, and Stasis were assessed using the Body Constitution Questionnaire (BCQ). Results. Participants with body constitutions Yin-Xu (50.6%), Yang-Xu (49.4%), or Stasis (38.8%) exhibited worse physical condition and unhealthy daily habits, particularly in Stasis constitution. Moreover, Stasis constitution was significantly associated with several factors, including BMI, body weight, waist circumference, perception of stress, perception of health, staying up late, and less physical exercise. However, perception of stress showed significant difference in Yin-Xu, Yang-Xu, and Stasis. Generalized estimating equation (GEE) analysis revealed that significant time effects in body weight increase in the imbalanced BC types and gentleness BC type. SGAs induced weight gain in imbalanced BC type as well as gentleness BC type, especially treated with olanzapine. Conclusions. This is the first study to explore the longitudinal relationship between BC and weight gain in schizophrenia patients undergoing SGAs treatment. Health care providers should focus on weight gain problems in schizophrenia patients who underwent SGAs treatment.

[The Usage of Auricular Acupressure in Clinical Nursing and Evidence-Based Research].

Auricular acupressure is a non-invasive physiotherapy that was developed based on the traditional Chinese meridian theory. Because it is non-invasive, simple to implement, and easy to learn, and because it presents minimal side effects and may be executed independently, this therapy may be used as an alternative or auxiliary approach to symptom management as well as to self-care. The increasing support for auricular acupressure from evidence-based research in Taiwan and elsewhere offers the opportunity to include auricular acupressure as a treatment option in evidence-based nursing interventions. Because nursing education in Taiwan is guided by Western medical concepts and principles, most nurses are not familiar with auricular acupressure, which is derived from traditional Chinese medicine. Therefore, this article not only systemically introduces the definition and theoretical basis of auricular acupressure but also includes the principles and application-related knowledge. Furthermore, this article analyzes the common problems encountered in auricular acupressure research in order to improve the familiarity of nurses with this therapy, to provide references for clinical application, and to provide a basis for designing new evidence-based nursing research efforts.

Intervening conditions of hospital-based home care for people with severe mental illness.

OBJECTIVE: This study discusses the intervening conditions of hospital-based home care (HBHC) for people with severe mental illness in Taiwan. DESIGN AND SAMPLE: Grounded theory of the Strauss and Corbin approach was used. Participants were selected from six hospitals in Central Taiwan, including 21 clients, 19 caregivers, and 25 professionals. MEASURES: Semi-structured one-on-one interviews were used to collect data. Data analysis consisted of three stages: open, axial, and selective coding. Data analysis, data collection, and sampling were conducted through the constant comparative analysis process. RESULTS: Two categories were generated as positive and negative intervening conditions of HBHC services. Eight positive effects and nine negative effects were generated from the data. CONCLUSIONS: Several positive and negative intervening conditions were found in this study to affect the delivery of HBHC. Government support and several limitations regarding HBHC services quality should be noticed and improved.

The skill mix model: a preliminary study of changing nurse role functions in Taiwan.

BACKGROUND: : Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages. PURPOSE: : The purpose of this study was to investigate changes in nurse perceptions of their role functions under the skill mix model in Taiwan. METHODS: : This was a cross-sectional designed study that employed a structured questionnaire. Participants included 38 registered nurses from three medical wards in three hospitals that had implemented the skill mix model for 6 months. The questionnaire gathered data on participant demographics, perceptions on the role functions, role and job satisfaction of nurses, and patient care quality. Nurses' role functions were grouped into independent, dependent, and interdependent categories. RESULTS: : Results demonstrate that nurses' perceptions of independent and interdependent role function have changed since the implementation of the skill mix model. The most significant role changes in the independent function category included the nurse as educator of NAs, supervisor for patient care, and evaluator for nursing care outcomes. The most significant role changes in the interdependent function category included the nurse as integrator of nursing work and coordinator of the healthcare team. Nurses' perceived changes increase in repetitive confirmation of patient conditions and patient care quality. CONCLUSIONS: : This study revealed that nurses working in skill mix model environments need more authority to delegate and educate NAs and to supervise and integrate nursing care. Study results may serve as a reference for hospital nursing practice in Taiwan.

[Pediatric nurses: cognition of young child development and attitudes and behaviors toward developmental care].

BACKGROUND: The effectiveness of early detection and intervention is emphasized in child development. The knowledge and attitudes of pediatric nurses related to child development is a factor critical to identifying and helping disabled children. PURPOSE: The purpose of this study was to explore general pediatric nurse knowledge of young child development and attitudes and behavior toward child developmental care. METHODS: Researchers collected data for this descriptive study using a structured questionnaire and recruited a sample of 112 pediatric nurses from hospitals in Central Taiwan. Data was analyzed by Mean, Pearson correlation, ANOVA, and Logistic regression. RESULTS: The study revealed pediatric nurses have a good level of knowledge related to children development. Although most participants held positive attitudes toward early intervention and child developmental care, their related behaviors were inadequately reported. Predictive factors of child developmental care behavior in nurses included attending related courses and number of children that has. CONCLUSION: Child development-related programs are an important factor affecting nurse child developmental care behavior. The authors recommend establishing developmental care programs and encouraging nurse participation. Early intervention concepts and models should be introduced in nursing and continued education programs.

A traditional Chinese herbal medicine used to treat dysmenorrhoea among Taiwanese women.

AIM: The purposes of this study were twofold, firstly to ascertain the relative effectiveness of the alternative drug, Si-Wu-Tang (SWT), for dysmenorrhoea treatment and secondly to compare two different timings for consumption of SWT in terms of menstrual pain. DESIGN: A two-group time series experimental design. METHODS: A total of 49 participants were alternately assigned into two study groups. The experimental group was provided with 15 g of SWT daily for seven consecutive days, subsequent to the cessation of menstrual bleeding, for two consecutive menstrual cycles and the comparison group was provided with a similar intervention as soon as menstrual bleeding was noted. The degree of menstrual pain was recorded daily using a visual analogue scale and the duration of pain was also recorded during menstrual bleeding for five consecutive menstrual cycles. RESULTS: The results indicated that the decrease in menstrual pain levels and the duration of pain between the experimental group and the comparison group was not significant. However, the decrease in menstrual pain over the five menstrual cycles within the experimental group (from 2.07 to 1.42; 2.71 to 1.21; p < 0.05) and within the comparison group (from 1.94 to 1.23; 2.66 to 1.68; p < 0.05) were significant. CONCLUSIONS: The SWT formula has been continuously standardised for effective use as part of menstrual health and can be integrated as an alternative therapy within Western medicine. RELEVANCE TO CLINICAL PRACTICE: This study provides information for health care professionals not only about the general principles of traditional Chinese medicine, but also about the selection and consumption of an appropriate SWT formula among Asian women with dysmenorrhoea. Moreover, nurses should build up a partnership with their clients of Asian origins based on the use of an alternative therapy using different assessment criteria that are related to healing and recovery based on bodily constitution balance.