Performative Masculinity: A META-Ethnography of Experiences of Men in Academic and Clinical Nursing.

Gender differences and stereotypes have been widely studied. Performative masculinity or "doing gender" is the adoption of traits considered to be "masculine" to achieve acceptance in society. Performative masculinity, as it relates to career development for men in nursing, could be affected by internal attitudes and career choice, and external influences of culture. There are no critical systematic reviews to describe this process. The aim of this study was to synthesize research on how men in nursing experience masculine identity at work. A systematic literature search and qualitative synthesis using meta-ethnography guided this study. The literature search included studies from the electronic databases of PubMed, CINAHL, Medline, and Airiti Library, published in English or Chinese from 1994 to 2016. Eleven studies met the inclusion criteria. The meta-syntheses identified three themes describing how men in nursing experience masculine identity at work: (1) Nursing could be a gendered-neutral occupation suitable to both genders; (2) performative masculinity; and (3) strategies used when providing bodywork and care. Exploring insights about the tensions of performative masculinity among men in nursing, this study may help to address the challenges encountered in nursing education, practice, and career development. Establishing a male nursing model based on evidence from academic and clinical practice for nursing students and professional nurses could help to meet the increasing demand for nurses.

Development and Psychometric Testing of a Taiwanese Team Interactions and Team Creativity Instrument (TITC-T) for Nursing Students.

BACKGROUND: How well team members work together can be affected by team interactions and creativity. There is no single instrument for measuring both variables in healthcare education settings in Taiwan. The purpose of this study is to develop an instrument to measure team interactions and team creativity for Taiwanese nursing students. METHODS: A 34-item team interactions and team creativity self-report instrument was developed for nursing students in Taiwan (TITC-T). Items consisted of statements about how a participant perceived their team members' constructive controversy, helping behaviors, communication, and creativity. Nursing students (n = 275) were recruited from two campuses of a science and technology university to examine the psychometric properties of the TITC-T. The reliability and psychometric properties were evaluated. RESULTS: The Cronbach's alpha was 0.98. The confirmatory factor analysis resulted in a one-dimensional factor structure that fit well with the model (Comparative Fit Index = 0.995, Tucker Lewis Index = 0.908, Root Mean Square Error of Approximation = 0.098). CONCLUSIONS: The TITC-T is a valid and reliable tool for evaluating team interactions and team creativity for students enrolled in nursing programs in Taiwan.

Effectiveness of Interdisciplinary Teaching on Creativity: A Quasi-Experimental Study.

Little is known about the effectiveness of Interdisciplinary teaching (IDT) in higher education, particularly for healthcare education in Taiwan. It is vital to determine if IDT could enhance divergent creative thinking and team creativity among nursing students. A quasi-experimental study with a pretest-posttest design. Students enrolled in a capstone nursing course for the development of healthcare-related products were divided into two groups. The intervention group (n = 61) was taught creative thinking skills with IDT by faculty. The control group (n = 84) was taught by nursing faculty with traditional teaching. This study found that students who received the IDT intervention scored significantly higher on measures of creative thinking and team creativity compared with students in the control group. These findings suggest integrating IDT from nursing and design faculty into the teaching curriculum to foster students' creative thinking abilities when formulating interdisciplinary student teams to develop innovative, creative healthcare products.

Impact of Chemotherapy-Induced Peripheral Neuropathy on Quality of Life in Patients with Advanced Lung Cancer Receiving Platinum-Based Chemotherapy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of neurotoxic anticancer drugs that may affect quality of life (QoL). Purpose: The purposes of this study were to: assess the levels of CIPN, anxiety, depression, CIPN-related QoL, and general QoL; and identify the factors related to CIPN-related QoL and general QoL in patients with advanced lung cancer (LC) receiving platinum-based chemotherapy. This cross-sectional study examined patients with advanced LC who received platinum-based chemotherapy from the thoracic oncology inpatient wards of a medical center in northern Taiwan. Structured questionnaires were used to measure patients' CIPN (European Organization for Research and Treatment of Cancer quality of life questionnaire-chemotherapy-induced peripheral neuropathy 20), anxiety (Hospital Anxiety and Depression Scale Depression Scale [HADS]), depression (HADS), CIPN-related QoL (Functional Assessment of Cancer Therapy /Gynecologic Oncology Group-Neurotoxicity subscale [FACT/GOG-Ntx]), and general QoL (Functional Assessment of Cancer Therapy-General Input [FACT-G]). Of 93 patients with advanced LC, 53.8% reported CIPN-sensory impairment and 47.3% reported CIPN-motor impairment. The most common CIPN symptoms were difficulty getting or maintaining an erection (only for men > 65 years) and difficulty in climbing stairs or getting up out of a chair. Poor CIPN-related QoL (FACT/GOG-Ntx) was associated with more CIPN-sensory and more CIPN-motor impairment. Poor general QoL (FACT-G) was associated with a higher level of depression, a higher level of anxiety, and receipt of more chemotherapy cycles. More than half of LC patients report impairment related to CIPN, calling for holistic treatment to improve QoL.

Evaluation of a self-management intervention for adults with epilepsy in Taiwan: A longitudinal randomized controlled trial.

PURPOSE: Epilepsy is a neurological disease that causes recurrent seizures and can have a significant impact on a person's quality of life (QOL). A self-management intervention (SMI) can allow adults with epilepsy to modify behaviors in order to manage their seizures and evaluate the impact of medication and treatments on their daily lives. The purpose of this study was to investigate the effects of a SMI for adults with epilepsy. METHODS: This was a longitudinal randomized controlled trial. Adults with epilepsy between the age of 20 and 65 years were recruited from a medical center in northern Taiwan. Participants were assigned to an intervention group (IG) or control group (CG) through simple randomization. Data regarding demographic and clinical characteristics were collected at baseline (T0). In addition, participants answered nine validated self-report questionnaires, which were used as outcome measures. Following collection of baseline data, the CG received routine monthly counseling over the next 3 months. The IG received the routine monthly counseling, as well as individual face-to-face health counseling on self-management 1 h/month and remote counseling via the phone or computer network at least twice per month. After the first month (T1) and at the end of the third (T2) and sixth months (T3) participants answered the nine questionnaires again. Differences in outcomes between the IGs and CGs were analyzed by comparing scores for the nine outcome variables at T0 with scores at T1, T2, and T3 with generalized estimating equations. RESULTS: A total of 210 adults agreed to participate in the study; however, only 155 participants completed the questionnaires for all three time points: 75 in the CG and 80 in the IG. The mean age of the 155 participants was 39.6 years (SD = 10.9). There was no significant difference between demographic or clinical variables between the two groups. The only difference in baseline scores (T0) among the nine self-report questionnaires was in epilepsy knowledge, measured with the Epilepsy Knowledge Profile questionnaire, which were significantly higher for the CG (mean = 32.28, SD = 3.92) than the IG (mean = 23.01, SD = 2.79) (p < 0.001). Generalized estimating equations (GEE) analysis showed scores decreased significantly at T3 from baseline for the CG for epilepsy knowledge and QOL (p < 0.001). Improvements in scores for sleep quality, anxiety, depression, self-efficacy, coping, and social support did not differ between groups. Classification of the IG by gender showed a significantly greater increase for males compared with females from baseline to T3 for epilepsy knowledge (p < 0.001). If we further classified the IGs by seizure frequency, participants with a seizure frequency of ≥1 per year had a more significant increase in epilepsy knowledge and increase in QOL compared with participants with a seizure frequency of <1 per year at T3 compared with T0. CONCLUSION: The lack of improvement in health-related quality of life (HRQoL) following the SMI may indicate that additional time is required to change behaviors that impact this variable for patients with epilepsy. Additional research should focus on variables associated with medication compliance, epilepsy knowledge, medicine symptom distress, self-efficacy, anxiety, and HRQoL.

Psychometric Testing of the Chinese-Version Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ-C) for the Identification of Nicotine Dependence in Adult Smokers in Taiwan.

PURPOSE: The purposes of this study were to evaluate the psychometric properties, reliability, and validity of the Chinese-version Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ-C) and assess the behavioral nicotine dependence among community-dwelling adult smokers in Taiwan. METHOD: The methods used were survey design, administration, and validation. A total of 202 adult smokers completed a survey to assess behavioral dependence, nicotine dependence, depression, social support, and demographic and smoking characteristics. Data analysis included descriptive statistics, internal consistency reliability, t test, exploratory factor analysis, independent t test, and Pearson product moment correlation. RESULTS: The results showed that (1) the GN-SBQ-C has good internal consistency reliability and stability (2-week test-retest reliability); (2) the extracted one factor explained 41.80 % of the variance, indicating construct validity; (3) the scale has acceptable concurrent validity, with significant positive correlation between the GN-SBQ-C and nicotine dependence, depression, and time smoking and negative correlation between the GN-SBQ-C and age and exercise habit; and (4) the instrument has discriminant validity, supported by significant differences between those with high and low-to-moderate nicotine dependence, smokers greater than 43 years old and those 43 years old and younger, and those who smoked 10 years or less and those smoking more than 10 years. CONCLUSION: The 11-item GN-SBQ-C has satisfactory psychometric properties when applied in a sample of Taiwanese adult smokers. The scale is feasible and valid to use to assess smoking behavioral dependence.

Development and psychometric testing of the Protective Reasons Against Suicide Inventory for assessing older Chinese-speaking outpatients in primary care settings.

AIM: To develop and psychometrically test the Protective Reasons against Suicide Inventory among older Chinese-speaking outpatients. BACKGROUND: Tools currently exist to test reasons for living among individuals of all ages in western countries, but few are available to assess older adults' protective reasons against suicide in Asia. DESIGN: A cross-sectional survey to investigate protective reasons against suicide among older Chinese-speaking outpatients. METHODS: The Protective Reasons against Suicide Inventory was developed based on individual interviews with 83 older outpatients in Taiwan, the literature and the authors' clinical experiences. The resulting Inventory was examined in 2013 for content validity, face validity, construct validity, criterion-related validity, internal consistency reliability and test-retest reliability. RESULTS: The Inventory had excellent content validity and face validity. Factor analysis yielded a seven-factor solution, accounting for 87·7% of the variance. Scores on the global Inventory and its subscales tended to be higher in outpatients diagnosed without suicidal ideation than in outpatients diagnosed with suicidal ideation, indicating good criterion validity. Inventory reliability and the intraclass correlation coefficient were satisfactory. CONCLUSIONS: The Protective Reasons against Suicide Inventory can be completed in 5 minutes and is perceived as easy to complete. Moreover, the Inventory yielded highly acceptable parameters for validity and reliability. The Protective Reasons against Suicide Inventory can be used to assess older Chinese-speaking outpatients for factors that protect them from attempting suicide.

Factors affecting quality of life in adults with epilepsy in Taiwan: A cross-sectional, correlational study.

PURPOSE: The purpose of this study was to assess eight factors considered important for quality of life in persons with epilepsy in order to determine which of these components affect quality of life in adults with epilepsy in Taiwan. METHODS: A cross-sectional, correlational study using structured questionnaires assessed 260 patients with epilepsy purposively sampled from a medical center in Northern Taiwan. Health-related quality of life (HRQoL) was evaluated with the Quality of Life in Epilepsy-31 (QOLIE-31) questionnaire. Data also included personal and health-related characteristics, knowledge of epilepsy, efficacy in the self-management of epilepsy, and social support. RESULTS: Scores for the QOLIE-31 were correlated with the following factors: (1) demographic characteristics of age, gender, and income; (2) sleep quality; (3) symptoms of anxiety and depression; (4) epilepsy-specific variables: seizure frequency; types, number, and frequency of antiepileptic drugs (AEDs); and adverse events of AEDs; and (5) social support. Stepwise regression analysis showed that seven factors were predictive for quality of life: anxiety, depression, adverse events of AEDs, social support, seizure frequency of at least once in three months, household income of NT$ 40,001-100,000, and male gender. These factors accounted for 58.2% of the variance of quality of life. SIGNIFICANCE: Our study assessed multiple factors in an examination of relationships and predictive factors for quality of life in adults with epilepsy in Taiwan. Knowledge of these contributing factors can assist health-care providers when evaluating patients with epilepsy to help target interventions for improving quality of life.

Dignity in care in the hospital setting from patients' perspectives in Taiwan: a descriptive qualitative study.

AIM: The aim of this study was to explore dignity in care from patients' perspectives in Taiwan. BACKGROUND: Dignity is a core element of nursing care. In nurses' clinical practice, maintaining the dignity of patients is an important issue because a lack of dignity in care can affect the health and recovery of patients. In Western countries, patient dignity has been well researched, but only one study has examined this topic in an Asian country. DESIGN: Descriptive qualitative methods were used in this study. METHODS: Interviews were conducted with 40 patients purposively sampled at a teaching hospital in eastern Taiwan from May-August 2009. Audiotaped interviews were transcribed verbatim, and data in transcripts were coded and analysed by content analysis. RESULTS: The major findings revealed that many hospitalised patients were satisfied with the maintenance of their dignity. Six themes that contribute to the preservation of their dignity were identified: sense of control and autonomy, being respected as a person, avoidance of body exposure, caring from the nursing staff, confidentiality of disease information and prompt response to needs. CONCLUSIONS: The findings can help nurses better understand dignity in care because it is described from the patient viewpoint. RELEVANCE TO CLINICAL PRACTICE: By identifying the most important factors from patients' perspectives that contribute to dignity, nursing interventions in clinical practice can be further developed and improved.

Validation of the Chinese version of the Liverpool Adverse Events Profile in patients with epilepsy.

The objective of the study was to validate the Chinese version of The Liverpool Adverse Events Profile (LAEP) in patients with epilepsy. The scale was translated from the English version into a Chinese version and was then back-translated to examine its accuracy. Content validity, concurrent validity, and construct validity were then used to examine the overall validity of this scale. A cross-sectional design with convenience sampling was used to recruit participants from three medical centers. The LAEP Chinese version was tested with respect to validity and reliability in 357 patients with epilepsy, and another 28 patients were invited to evaluate the test-retest reliability of the scale in a 2-week interval. There was a good content validity index (CVI=1.0). Patients undergoing polytherapy had more adverse effects (χ(2)=6.10, p<0.01) and higher LAEP scores (t=-2.91, p<0.01) than patients undergoing monotherapy, indicating a good concurrent validity. Factor analysis included three factors classified by symptoms in the 22-item Chinese version of the LAEP. The total variance of these three factors was 39.3% for the scale. Internal consistency (Cronbach's α=0.92) and the intraclass correlation coefficient (ICC=0.80) were satisfactory. Moreover, the LAEP can be completed in a short time, is perceived as easy to complete, and there was no relevant information missing. The results indicated that the Chinese version of the LAEP yielded highly acceptable parameters of validity and reliability and can be used for measuring adverse effects of antiepileptic drugs among Chinese-speaking patients with epilepsy in Taiwan.

The relationships among medicine symptom distress, self-efficacy, patient-provider relationship, and medication compliance in patients with epilepsy.

The purpose of this study was to investigate the relationships among medicine symptom distress, self-efficacy, patient-provider relationship, and medication compliance in patients with epilepsy. Patients with epilepsy (n=357) were recruited using convenience sampling from three medical centers in northern Taiwan. Results showed significant differences in relationships between medication compliance and the following factors: gender, employment status, comorbid chronic diseases, self-driving, daily drug dosing frequency, seizure after a missed dose, and self-efficacy. Logistic regression analysis indicated that comorbid chronic disease, self-driving, seizure after a missed dose, and self-efficacy were significantly associated with medication compliance. These data suggest that health care providers of patients with epilepsy pay more attention to treatment of comorbid chronic diseases, the safety issues of self-driving, seizures occurring after missed doses, and awareness of self-efficacy.