Team-based learning complemented by interactive response system: Application of a strategy on the course of human growth and development for nursing students.

OBJECTIVE: Lecture-based learning (LBL) strategy cannot stimulate learners' ability to think and learn independently. Recently team-based learning (TBL), a learner-centered strategy, gained popularity in health education. An interactive response system (IRS) assists educators in providing instant feedback on classroom activities. This study was to evaluate the TBL strategy supplemented by IRS (TBL/IRS) on the learning effects of the core course, the human growth and development (HGD), in nursing education. MATERIALS AND METHODS: A quasi-experimental study design with two-group, pretests and posttests was employed with year-one students enrolled in two HGD classes in the nursing department of a university in central Taiwan. Both HGD classes employed the LBL method at the beginning of a semester. TBL/IRS strategy was introduced to the experimental class 6 weeks later. Three scales were used to measure self-directed learning, classroom engagement, and team learning. Individual and group readiness assurance tests (IRATs and GRATs) were administered. Final exams were also compared between the groups. For thematic analysis, learners' experience with TBL/IRS was collected from learner reports and a semi-structured questionnaire designed for the study. RESULTS: A total of 105 learners-48 in TBL/IRS and 55 in LBL-were recruited. Self-directed learning, classroom engagement and team learning were improved significantly in TBL/IRS whereas only self-directed learning was improved in LBL. In the TBL/IRS group, GRAT scores were significantly higher than IRAT. However, the difference in final exams between the groups was non-significant. Four themes emerged from learners' experiences with TBL/IRS: stimulate self-learning; a diverse and flexible learning method; promote high-level thinking and deepen learning results; and, cultivate teamwork and application. CONCLUSIONS: This study confirmed that TBL/IRS was effective in enhancing learners' abilities to integrate concepts and skills, thereby cultivating competence in problem-solving and teamwork. The TBL/IRS strategy was cost-effective in promoting active learning of HGD in nursing students.

The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis.

OBJECTIVE: Postpartum depression (PPD) is common and detrimental affecting both maternal health and child development. The purpose of this study was to determine the prevalence and factors of PPD screened immediately after delivery. MATERIALS AND METHODS: A retrospective study design using secondary data analysis is applied. Four years of data, containing linkable maternal, neonate and PPD screen records between 2014 and 2018, was retrieved and combined from the electronic medical systems of MacKay Memorial Hospital in Taiwan. For each woman, the PPD screen record contained self-reported depressive symptoms assessed by the Edinburgh Postnatal Depression Scale (EPDS) within 48-72 h after delivery. A set of factors pertaining to maternal, pregnancy and obstetric, neonatal and breastfeeding were selected from the combined data set. RESULTS: In total, 10.2% (1244 of 12,198) of women reported with the symptoms of PPD (EPDS ≥10). Through logistic regression analysis, eight predictors of PPD were identified. Specifically, PPD was shown to be associated with educational level of high school or lower (odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.27-1.93), marital status of unmarried (OR = 1.52, 95% CI 1.18-1.99), unemployed (OR = 1.26, 95% CI 1.11-1.42), Cesarean section (OR = 1.7, 95% CI 1.5-1.93), unplanned pregnancy (OR = 1.38, 95% CI = 1.22-1.57), gestational age at 24-36 weeks (OR = 1.3, 95% CI 1.08-1.56), non-intention of breastfeeding (OR = 1.7, 95% CI 1.18-2.45) and Apgar at 5 min < 7 (OR = 2.18, 95% CI 1.11-4.29). CONCLUSION: Low educational level, unmarried, unemployed, Caesarean section, unplanned pregnancy, preterm delivery, not breastfeeding and low Apgar at 5 min are predictors for postpartum women to develop PPD. These predictors are easily recognized in the clinical environment for patient guidance, support and referral as early as possible to ensure the health and well-being of the mothers and the neonates.

FIGO recommendations: Use of midurethral slings for the treatment of stress urinary incontinence.

BACKGROUND: Stress urinary incontinence (SUI) is a global problem. It can significantly adversely impact a woman's quality of life. The use of synthetic mesh in vaginal surgery is controversial, especially when used for pelvic organ prolapse surgery. Although negative effects have been reported, the synthetic mesh midurethral sling (MUS) is considered to be safe and effective in the surgical treatment of SUI. OBJECTIVES: To provide evidence-based data and recommendations for the obstetrician/gynecologist who treats women with SUI and performs or plans to perform MUS procedures. METHODS: Academic searches of MEDLINE, the Cochrane Library, Embase, and Google Scholar articles published between 1987 and March 2020 were performed by a subgroup of the Urogynecology and Pelvic Floor Committee, International Federation of Gynecology and Obstetrics (FIGO). SELECTION CRITERIA: The obtained scientific data were associated with a level of evidence according to the Oxford University Centre for Evidence-Based Medicine and GRADE Working Group system. In the absence of concrete scientific evidence, the recommendations were made via professional consensus. RESULTS: The FIGO Urogynecology and Pelvic Floor Committee reviewed the literature and prepared this evidence-based recommendations document for the use of MUS for women with SUI. CONCLUSIONS: Despite the extensive literature, there is a lack of consensus in the optimal surgical treatment of SUI. These recommendations provide a direction for surgeons to make appropriate decisions regarding management of SUI. The MUS is considered safe and effective in the treatment of SUI, based on many high-quality scientific publications and professional society recommendations. Comprehensive long-term data and systemic reviews are still needed, and these data will become increasingly important as women live longer. These recommendations will be continuously updated through future literature reviews.

Key determinates of job satisfaction for acute care nurse practitioners in Taiwan.

BACKGROUND: Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout. METHODS: Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction. RESULTS: The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction. CONCLUSIONS: This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs' job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.

Corrigendum: Pregnancy-related stress among pregnant women receiving tocolytic and non-tocolytic treatments where both used complementary medicine.

[This corrects the article DOI: 10.3389/fphar.2022.870659.].

Comparing Prodrugs with Acyclovir for Treating Postherpetic Neuralgia among Herpes Zoster Patients: A Systematic Review and Meta-Analysis.

Postherpetic neuralgia (PHN) is a common, painful, and long-term complication of herpes zoster (HZ). PHN increases the demand for healthcare services and, previous studies showed that patients who received antiviral agents were less likely to develop PHN. The objective of this study was to compare the efficacy of prodrugs and acyclovir in treating PHN among patients with HZ. The search included the PubMed, Medline, Embase, and Cochrane Center of Register of Controlled Trails databases through February 2022. Clinical trials and randomized controlled trials (RCTs) involving antiviral agent intervention for HZ patients diagnosed with PHN were eligible for inclusion. A meta-analysis was conducted to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs) with a fix-effect model. Five RCTs with 1147 HZ patients met our eligibility criteria. Our meta-analysis found that there was a significantly lower risk of PHN for members of the prodrugs group (famciclovir and valaciclovir) compared with those who received acyclovir (RR = 0.86, 95%, CI: 0.75 to 0.98, p = 0.03). The review of studies indicated that the efficacy of prodrugs was better than acyclovir for reliving PHN.

Factors facilitating clinical application of and adherence to evidence-based healthcare among medical professionals attending national competitions in Taiwan: a study based on the decomposed theory of planned behaviour.

BACKGROUND: Implementing evidence-based healthcare (EBHC) to improve the quality of patient care is a key issue for physicians and nurses. One of the most effective activities for achieving this is the annual topic-oriented clinical application national competition in Taiwan. Hundreds of clinical issues have been presented in this competition. By using the decomposed theory of planned behaviour (DTPB), this study explored physicians' and nurses' behaviour and adherence to the clinical application of EBHC after participating in the competitions. METHODS: We conducted a 3-month cross-sectional online survey using a structured questionnaire adapted from the original study of the DTPB to collect behavioural and intention-related data. We also used a model of seven action stages (from aware of to adhered to) to assess target behaviours. We targeted contestants of the EBHC competitions between 1999 and 2017 as study participants. Of 631 teams, 321 teams completed the questionnaire, representing a 49.5% response rate. We applied structural equation modelling to test model fit. Moreover, we executed multivariate logistic regression to identify potential predictors. RESULTS: Of the respondents, 33.3% reportedly reached the final adhered to stage. The DTPB model exhibited a good fit to the observed data. All constructs (usefulness, compatibility, peer influence, superior influence, self-efficacy, resource facilitating conditions, attitude, subjective norms, behavioural control, and intentions) were positively associated with the target behaviours, except for ease of use and technology facilitating conditions. Furthermore, the study model explained the variance in the target behaviours (37.0%). Having managerial duties (odds ratio [OR] =2.03, 95% confidence interval [CI] =1.10-3.77), resource facilitating conditions (OR = 1.06, 95% CI = 1.01-1.11), behavioural control (OR = 2.21, 95% CI = 1.47-3.32), and intentions (OR = 1.96, 95% CI = 1.40-2.73) were significant predictors of the achievement of the adhered to stage. CONCLUSIONS: The study demonstrated the association between determinants of behaviour and clinical applications and factors influencing adherence to EBHC among competition participants. The adherence rate was not high after the competitions, and this may be improved by promoting certain factors associated with the target behaviours.

Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine.

Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women's health studies.

Together through the valley of death: Lived experience of case managers to meet the informational needs of gynecologic cancer survivors.

OBJECTIVES: Case managers are crucial providers of health education and consultation for patients with gynecologic cancer to satisfy their informational needs. The purpose of this study is to understand the experience of case managers working to meet the needs of these patients in order to further improve their overall quality of care. MATERIALS AND METHODS: A qualitative study employed. Twenty case managers recruited from Taiwanese healthcare institutes using purposive sampling. Participants were interviewed in semi-structure fashion. All interviews were verbatim transcribed. The steps of Giorgi's phenomenological method were used to analyze the transcripts. RESULTS: Three major themes and twelve subthemes emerged. Major themes were associated with cancer development: (1) during diagnosis, build a communication bridge and provide appropriate treatment early on, become consultants; (2) during treatment, provide comprehensive medical care for cancer, become the patient's manager; (3) during follow-ups, assist patients to comprehend and adapt to living with cancer, return to society and the original pace of life. CONCLUSION: Case managers accompany patients with gynecologic cancer and address their problems to other medical professional. The informational needs of patients with gynecologic cancer differ along the course of the disease. It is important for cancer care manager to deliver the information of individualized health care in timely manner to ensure the overall quality of care for patients with gynecologic cancer.

The impact of organisational commitment and leadership style on job satisfaction of nurse practitioners in acute care practices.

AIM: This study aimed to determine the main factors that affect nurse practitioners' (NPs) job satisfaction, especially the relationship between organisational commitment and leadership styles in acute care practices. BACKGROUND: There is little known about the influence of organisational commitment and leadership on NPs' job satisfaction within acute care hospitals. METHODS: A cross-sectional design with a national online survey enrolled 1205 NPs from the Taiwan Association of Nurse Practitioners. A multiple regression model was applied to identify potential variables that associated with job satisfaction. RESULTS: Organisational commitment (mean = 59.47), job satisfaction (mean = 173.47) and leadership style (mean ranged from 13.29 to 28) were at a moderate level. Organisational commitment, leadership style, patient load and NP advancement levels explained 63% of the variance in NPs' job satisfaction. CONCLUSIONS: Organisational commitment and leadership styles, such as idealized influence and individual consideration, are major factors that impact NPs' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organisations should develop policies targeting organisational commitment and managers' leadership styles to improve NPs' job satisfaction.

Cultural Adaptation and Validation of Mullen Scales of Early Learning in Taiwanese children with Autism Spectrum Disorder, Global Developmental Delay, and Typically Developing Children.

BACKGROUND: The Mullen Scales of Early Learning (MSEL) is a standardized comprehensive developmental assessment tool for children aged 0-68 months. However, few Asia-based studies have explored cultural and linguistic adaptations of the MSEL or investigated its psychometric properties in populations with autism spectrum disorder (ASD). AIMS: This study evaluated the reliability and validity of the MSEL-Taiwan version (MSEL-T) for Taiwanese children with ASD, global developmental delay (GDD), and typical development (TD). METHODS AND PROCEDURES: The MSEL items were translated and modified according to the language and culture in Taiwan. In total, 191 children (ASD, 69; GDD, 36; and TD, 86) aged 19-68 months were assessed using the MSEL-T and Peabody Developmental Motor Scales 2 (PDMS-2) at enrollment, followed by the assessments of Vineland Adaptive Behavior Scale-Chinese version (VABS-C) at the age of 36 months or later. OUTCOMES AND RESULTS: All subscales were verified to have good interrater reliability and internal consistency, and subscale scores indicated moderate to high correlations with PDMS-2 and VABS-C scores. Significant differences in MSEL-T scores were observed between same-aged pairs of children with TD and GDD and between pairs of children with TD and ASD. CONCLUSIONS AND IMPLICATIONS: The findings provide evidence of validity and reliability of the MSEL-T. And it is suggested that the culturally and linguistically adapted MSEL-T is a good tool for the clinical assessment of children with and without ASD.

Food Away From Home and Self-Perceived Gastrointestinal Health.

Dietary behavior is a critical lifestyle factor affecting health. This study aimed to investigate food away from home (FAFH) and its effect on gastrointestinal (GI) health. A questionnaire-based survey was conducted with 300 participants at a hospital in Liouying, Taiwan. The survey collected demographic information and data on FAFH and GI health. The association of GI health with FAFH consumption behavior was significant (t-test, p < 0.05). Bodyweight status was associated with age (F = 5.01, p = 0.01), dietary situation (F = 1.96, p = 0.04), number of meals (F = 1.85, p = 0.03), dietary preferences (F = 2.84, p = 0), reasons for FAFH (F = 1.86, p = 0.02), FAFH types (F = 2.01, p = 0), and outcomes associated with FAFH (F = 2.51, p = 0). Gastrointestinal condition was associated with the number of meals (F = 2.55, p = 0), the level of activity after meals (F = 2.16, p = 0.02), and FAFH type (F = 1.48, p = 0.04). The results indicated that the participants aged 20-40 years had more problems related to their self-perceived body weight status than those aged 41-50 years. The results of this study clarify the FAFH among people in Taiwan and the effects on GI health and may serve as a reference for relevant behavioral research in food and health studies.

Life experiences and disease trajectories in women coexisting with ovarian cancer.

OBJECTIVE: This study investigated the lived experiences of ovarian cancer survivors amid the disease trajectory and psychosocial adaptation. MATERIALS AND METHODS: Twenty-one women, all of whom were ovarian cancer survivors, were recruited from medical centers in Taiwan. In-depth, face-to-face, semi-structured interviews were conducted and transcribed verbatim from audio recordings. The sample size was determined by information saturation during data collection. The steps of data process and analysis were performed using Giorgi's phenomenology. RESULTS: Three themes and 12 subthemes were extracted: (1) a depressed state, as if facing a fierce enemy: being sentenced to a death penalty like facing an insurmountable challenge; contradictory information and helplessness; turnaround for treatment decision; and facing stigmatization from society; (2) shadow of cancer recurrence: side-effects of cancer treatment; falling into desperation and frustration; worrying about cancer recurrence; and continuing to fight cancer; (3) a change of mindset to move forward: experiencing changes in outlook on life; activating the self-healing process; coexisting with cancer and treating it as a chronic disease; and experiencing physical and mental purification and enhancement. CONCLUSION: The conventional models caring for patients with ovarian cancer are based on disease and unable to meet their needs because the lengthy rehabilitation journey. Therefore, medical personnel should emphasize patients' medical autonomy and combine professional care and social resources to help patients developing adjustment strategies and establishing support systems in timely manner for body, mind, and soul of these patients.

Translation and validation of Taiwan Chinese version of the self-regulation questionnaire for gynecologic cancer survivors.

OBJECTIVE: To culturally adapt the self-regulation questionnaire to the Taiwan Chinese version (TC-SRQ) and to evaluate its psychometric properties for gynecologic cancer survivors. MATERIALS AND METHODS: A cross-sectional study was employed with a purposive sample of 287 gynecologic cancer survivors. The TC-SRQ was adapted from a Germany version through back-translation to ensure its quality. For construct validity, confirmatory factor analysis (CFA) was used to assess the TC-SRQ measurement model with fit indexes including the χ2 test, the root mean square error of approximation (RMSEA), and the normed fit index (NFI), the comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Taiwanese version of the European Organization for Research and Treatment of Cancer's 30-item core quality of life (EORTC QLQ-C30) questionnaire was used as a criterion measure for quality of life (QOL). Reliability was evaluated by internal consistency and test-retest reliability. RESULTS: For a modified measurement model of TC-SRQ, the model fit (χ2 = 311.23, P = .0; RMSEA = .088; NFI = .97, CFI = .98, NNFI = .97) was acceptable. The evidence of construct validity of TC-SRQ scale was confirmed by the model estimates. TC-SRQ correlated positively with the global QOL, physical, cognitive, emotional, and social functioning domains, and negatively with fatigue and pain domains of EORTC QLQ-C30. For known groups validity, TC-SRQ was correlated with groups attributed by age, family support, health status, and sleep quality. A Cronbach's α of .91 indicated good internal consistency; the test-retest reliability was .82. CONCLUSIONS: TC-SRQ is a valid and reliable instrument for assessing self-regulation in gynecologic cancer survivors.

Chinese Version of the Assessment of Survivor Concerns Scale for Gynecological Cancer Survivors: A Psychometric Study in Taiwan.

BACKGROUND: Most gynecological cancer survivors outlive the acute stage, and many reach permanent survival. However, the fear of cancer recurrence (FCR) is stressful and affects quality of life. PURPOSE: This study was designed to validate a Chinese version of the Assessment of Survivor Concerns (ASC) questionnaire in terms of its ability to assess FCR in gynecological cancer survivors. METHODS: A two-stage study procedure was employed. The first stage involved the translation of the ASC questionnaire from English into Chinese using the methods proposed by Guillemin, which include translation, back-translation, consensus meetings, and a trial of potential users. In the second stage, a pilot study was completed with 37 gynecological cancer survivors followed by a psychometric property study with 287 gynecological cancer survivors. Construct validity was determined using confirmatory factor analysis (CFA) with structural equation modeling. Convergent validity was determined using composite reliability and the average variance extracted values of the ASC model. Discriminant validity was determined by comparing the model fitness of the ASC model against the model fitness of a one-construct model. Concurrent criterion validity was assessed using the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30 as the auxiliary instrument. Reliability was determined by measuring the internal consistency reliability using Cronbach's α in addition to the 3-week test-retest reliability with a 95% confidence interval of the intraclass correlation coefficient. RESULTS: The process of translation and back-translation was performed to ensure the conceptual equivalence of the Chinese version with the original ASC questionnaire. For CFA, the fit indices of the ASC model (χ = 9.87, p > .05; root mean square error of approximation = .03. comparative fit index = 1, nonnormed fit index = 1) indicated appropriate model fitness. For convergent validity, the composite reliability and average variance extracted values of the ASC model were satisfactory. For discriminant validity, the model fitness of the ASC model was significantly improved over the one-construct model. For concurrent criterion validity, the ASC scores correlated negatively with the scores of the global quality of life and the five functions (physical, role, cognition, emotions, and social) of the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30, as hypothesized. For reliability, the Cronbach's α and the 95% confidence interval of intraclass correlation coefficient for the ASC model were .91 and [.18, .68], respectively. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Chinese version of the ASC questionnaire is a valid and reliable instrument that is suitable for assessing FCR in gynecological cancer survivors in clinical and research settings.

Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers.

BACKGROUND: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a two-stage screening scale for determining the risk of autism spectrum disorder (ASD) in toddlers. However, the validity of the M-CHAT-R/F for Asian populations has not yet been established. AIMS: This study investigated the psychometric properties of the M-CHAT-R/F, Taiwan version (M-CHAT-R/F-T), among low- and high-risk Taiwanese toddlers aged 16-30 months. The associations among M-CHAT-R/F-T scores, developmental performance at 24 and 30 months, and ASD diagnosis prediction at 36 months were examined. METHODS AND PROCEDURES: A two-stage screening of the M-CHAT-R/F-T was applied to a study sample comprising 25 toddlers with ASD and 71 atypically developing (ATD) and 221 typically developing (TD) toddlers. OUTCOMES AND RESULTS: The M-CHAT-R/F-T exhibited acceptable internal consistency and test-retest reliability. The M-CHAT-R/F-T scores were significantly correlated with several syndrome scores of the Child Behavior Checklist for Ages 1.5-5 and were significantly higher among toddlers with ASD than among ATD or TD toddlers. Furthermore, M-CHAT-R/F-T scores were negatively correlated with developmental scores in the Mullen Scales of Early Learning at 24 and 30 months. Moreover, the screening exhibited acceptable predictive validity (sensitivity = 0.86; specificity = 0.96) for ASD diagnosis at 36 months. CONCLUSIONS AND IMPLICATIONS: The findings indicate that the M-CHAT-R/F-T is a valid and reliable tool for the developmental screening of low- and high-risk Taiwanese toddlers in community and clinical settings.

A correlation study of fear of cancer recurrence, illness representation, self-regulation, and quality of life among gynecologic cancer survivors in Taiwan.

OBJECTIVE: The purpose of this study was to examine the correlations among fear of cancer recurrence (FCR), illness representation (IR), self-regulation (SR), and quality of life (QOL) in gynecologic cancer survivors. MATERIALS AND METHODS: A cross-sectional study was conducted with 287 participants recruited from a medical center in northern Taiwan. Four questionnaires, the Assessment of Survivor Concerns (ASC), the Brief Illness Perception Questionnaire (BIPQ), the Self-Regulation Questionnaire (SRQ), and the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire-Core 30-item (EORTC QLQ-C30), were used to assess FCR, IR, SR, and QOL respectively. Data pertaining to socio-demographic characteristics and self-reported medical status was also collected from the participants. Stepwise regression analysis was performed to identify predictors of QOL. RESULTS: The results showed that FCR (r = -.21, P < .01) and IR (r = -.44, P < .01) was negatively correlated with global QOL subscale of the EORTC QLQ-C30. SR, IR, and health status in the self-reported medical status explained 39% of the variance in global QOL, with SR of the largest. CONCLUSIONS: Our findings provided valuable information to healthcare professionals about the ability of SR to affect QOL and negative impacts of FCR and IR on gynecologic cancer survivors.

The influence of personality traits and socio-demographic characteristics on paediatric nurses' compassion satisfaction and fatigue.

AIMS: To explore the level of and the association between, compassion satisfaction and fatigue of paediatric nurses; to determine the association between personality traits and compassion satisfaction and fatigue; to identify the determinants of compassion satisfaction and fatigue. BACKGROUND: Paediatric nurses are prone to experiencing compassion fatigue associated with caring for children with illness and their families, yet its connection with nurses' personality traits remains unknown. DESIGN: A cross-sectional descriptive study design was used. METHODS: The data collection used three instruments measuring socio-demography, responses to the compassion satisfaction and fatigue test and the revised NEO personality inventory. The study used descriptive, correlation and multiple regression analysis for the data collected between April - July 2014. RESULTS: From 173 female paediatric nurses, two-thirds worked in critical care units and indicated a satisfactory level of compassion satisfaction and a low level of compassion fatigue, despite a lack of association between the two concepts. Four determinants-agreeableness, extraversion, conscientiousness and engaging with outdoor activities-were predictive and explained 43.6% of total variance of compassion satisfaction. Two risk factors of compassion fatigue identified were less emotional stability and singlehood (marital status) and these explained 26.1% of total variance of compassion fatigue. CONCLUSION: Support for improving agreeableness and emotional stability in paediatric nurses' workplaces including involvement in the outdoor activities and an increase in social connection may enhance compassion satisfaction and prevent exhaustive compassion fatigue.

The Lived Experience of Gynecologic Cancer Survivors in Taiwan.

BACKGROUND: Although it is now possible to achieve permanent remission in a large percentage of gynecologic cancer (GC) cases, many GC patients in remission experience side effects or complications that influence their physical function and family relationships. Compared with other types of cancer patients, survivors of GC face greater challenges in terms of physical and psychological adaptations, and many of these do not receive sufficient assistance. An in-depth understanding of the lived experiences and demands of GC survivors is key to constructing comprehensive related healthcare services. PURPOSE: The aim of this study was to understand the lived experience of GC survivors in Taiwan to help their return to a healthy life. METHODS: This was a phenomenological study. Twenty-three survivors of GC participated in semistructured interviews that were held in a private environment. The transcripts were based on synchronous recordings from the interviews. Giorgi's phenomenology analysis was adopted for data analysis. RESULTS: Three themes with six subthemes were extracted from the data, including (a) the inner struggle of living with cancer and recurrence: repeatedly exploring the causes of cancer and treatment and facing a fear of cancer recurrence, (b) the interpretation and adjustment to cancer treatment: filled with fluctuating physical and mental distress and working to adopt a different perspective, and (c) the long passage of finding a desirable lifestyle: adjusting to long-term coexistence with side effects and realizing the strength of society, body, and mind. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The journey of rehabilitation for GC survivors is very long. The participants in this study faced different respective challenges during the diagnosis, treatment, and adjustment phases. Conventional disease-oriented medical care cannot satisfy the requirements of cancer patients because of patient-decentralized services. Our results indicate that GC survivors face diverse problems, both physically and mentally. Healthcare professionals should work to facilitate the psychological adjustment of cancer survivors and provide timely professional advice in combination with social resources. These results may serve as a reference for cancer care professionals who are navigating healthcare services.

Falls and Related Injuries in Hospitalized Patients With Cancer in Taiwan.

BACKGROUND: Falls and fall-related injuries are important indicators for quality of nursing care in institutions. Few studies have been conducted specifically on this topic for hospitalized patients with cancer in Taiwan. PURPOSE: The aims of this study were to understand falls and levels of injury; to identify associations among fall-related injuries, demographics, and causes of falling; and to predict fall-related injuries in hospitalized patients with cancer. METHODS: A retrospective survey design was used. Data were retrieved from the Taiwan Patient-Safety Reporting system query fall incidences for persons hospitalized with cancer at a medical center in northern Taiwan from 2010 to 2012. Data were encoded and analyzed with descriptive statistics, the chi-square test, and multiple stepwise logistic regression analysis using IBM SPSS Statistics version 18.0. RESULTS: One hundred fifty-six (85%) of the 184 hospitalized patients with cancer had fall-related injuries. Falling tended to be more frequent in men without a history of falls and more prevalentat night. The results of regression analysis showed that the variables being with companions at the time of a fall (OR = 5.411, 95% CI [1.619, 18.081]), lower limb weakness (OR = 0.284, 95% CI [0.097, 0.832]), postural hypotension (OR = 0.101, 95% CI [0.014, 0.733]), total score of fall risk factors (OR = 1.688, 95% CI [1.071, 2.660]), and a fall occurring at the bedside (OR = 3.493, 95% CI [1.119, 10.903]) were all positively associated with fall-related injuries, with a Nagelkerke R of 42.8%. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The risk factors for falls that affect hospitalized patients with cancer are complex. Nursing staff must evaluate the risk factors and treatment methods for each patient and facilitate fall prevention measures to achieve safety-centered quality of care. This study provides an example for nursing staff when assessing factors associated with falls and working to reduce fall-related injuries among patients with cancer.