Effects of a nurse-led therapeutic conversations intervention in stroke patient-family caregiver dyads: A randomized control trial.

BACKGROUND: Few studies have evaluated the effectiveness of family functional care interventions among stroke caregiver dyads. This study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and quality of life (QoL) in stroke family caregiver dyads. AIMS: This study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and QoL in stroke-family caregiver dyads. DESIGN: This study was a single-blind (evaluator) randomized controlled trial. The planned execution time was from August 2021 to December 2022, in the rehabilitation ward of a medical university hospital. METHODS: A total of 82 dyads were included in this analysis. Dyads randomized to the intervention group received nurse-led therapeutic conversations intervention one at four weeks after the patient's hospitalization for a stroke. The family caregiver dyads of stroke survivors in the control group received routine care. An effectiveness analysis that included patients' resilience, self-efficacy, and patient-family caregiver dyads' family function and QoL was conducted at one month. We used the CONSORT Checklist for reporting parallel group randomized trials in this study. RESULTS: The patients in the intervention group showed improvement in resilience and self-efficacy after one month. Furthermore, the effects on resilience (Cohen's d = 0.49) and self-efficacy (Cohen's d = 0.46) were significantly higher than in the control group. Family functioning was significantly higher in patient-family caregiver dyads in the intervention group than in the control group (Cohen's d = 0.55; Cohen's d = 0.50). However, no significant difference in QoL was found between patients and caregivers in either group. CONCLUSIONS: The intervention was effective in promoting family functioning and can also promote patient resilience and self-efficacy in disease management. However, the intervention did not have a significant effect on the QoL of patient-family caregiver dyads.

Association Between Family Functioning and Health-related Quality of Life in Stroke Survivor-Informal Family Caregiver Dyads.

PURPOSE: Stroke survivors and their informal family caregivers may share the impact of the disease, which may affect family functioning and quality of life (QoL) for both. This study compared the perceptions of stroke survivors and informal family caregivers regarding family functioning and QoL and examined the QoL of those reporting effective versus ineffective family functioning. METHODS: A cross-sectional study design and convenience sampling were used. Stroke survivor-informal family caregiver dyads were recruited from a medical university hospital. We assessed participants' demographic and clinical variables, including disease severity, family functioning, and QoL. Independent t-test, paired t-test, Wilcoxon signed-rank test, and Mann-Whitney U test were used to analyze the data. RESULTS: Seventy-one stroke survivor-informal family caregiver dyads participated in the current study. Most stroke survivors and informal family caregivers reported effective family functioning, with no significant differences. However, significant differences existed in the seven domains (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, and role-emotional) of QoL, except emotional health. Stroke survivors reporting ineffective family functioning had a significantly lower mental component summary score, unlike informal family caregivers. CONCLUSION: Our findings suggest that family functioning is crucial to ensure stroke survivors' QoL, particularly regarding their mental health. Health professionals should prioritize mental health assessments and provide appropriate care interventions for stroke survivors in the first 1-6 months after stroke onset.

Development of the ethical decision-making competence scale.

BACKGROUND: Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students' competence in ethical decision-making. AIM: This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students. PARTICIPANTS AND RESEARCH CONTEXT: Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale's reliability and validity were assessed. The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 (n = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model's fitness based on data from group 2 (n = 248). This study was conducted between August 2022 and July 2023. ETHICAL CONSIDERATIONS: The Institutional Review Board of OO Medical University Hospital approved this study's design and procedure. RESULTS: From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed 'ethical decision-making competence' with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, p < .001), which indicated good convergent validity. Cronbach's alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales. DISCUSSION AND CONCLUSION: The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students' ethical decision-making abilities and to develop education strategies to improve their ethical care competence.

Predictive Factors of Apathy in Stroke Survivors During the Recovery Period.

ABSTRACT: BACKGROUND: Apathy may be an important predictor of depression and significantly negatively affect the quality of life and functional recovery of stroke survivors. However, the evidence reflects the inconsistent findings of studies on the impact of individual-related variables on apathy in patients with stroke. OBJECTIVES: This study examines the relationships among stroke survivors' individual characteristics, background variables, disease-related variables, and apathy; furthermore, we identify predictors of apathy. METHODS: In this cross-sectional correlational study, the participants were recruited from a medical university hospital. Three measurement tools were used: individual and background variables, the modified Rankin Scale, and the Apathy Evaluation Scale. Hierarchical multiple regression analysis was used to identify the predictors of apathy. RESULTS: Participants included 100 stroke survivors with a mean age of 59.9 (12.1) years. The prevalence of apathy among stroke survivors was 27%. Stroke survivors' economic sources (ß = 0.430, P = .001), perceived family support (ß = -0.163, P = .048), and modified Rankin Scale (ß = 0.283, P = .001) accounted for 43.7% of the variance in survivor apathy. CONCLUSION: The results of this study clarified which individual characteristics, background variables, and disease-related variables are key predictors of apathy in patients with stroke.

Impact of a Care Task Design Program on Novice Nursing Students' Self-Reflection and Insight, Teamwork Skills, and Holistic Nursing Competency.

AIM: The aims of this study were to evaluate the effects of a self-appraisal of clinical simulation care tasks in novice nursing students and assess their self-reflection and insight, teamwork skills, and holistic nursing competence in four different periods. METHOD: A single group pre- and post-test design was conducted. Data were collected between September 2019 and February 2020. Nursing students who participated in the fundamental nursing laboratory courses in the second year of the nursing department at a medical university were invited to participate in the study. Data were collected at four time points using the Self-Reflection and Insight Scale, Holistic Nursing Competence Scale, and the Teamwork Skills Scale. A generalized estimating equation was used for all statistical analyses. RESULTS: Across the four measurements, the score of self-reflection and insight ranged from 76.68 to 78.00, teamwork skills from 68.83 to 71.21, and holistic nursing competence from 134.48 to 146.46. Student performance was above average on all research variables. The results confirm the hypotheses that the program improves self-reflection and insight, teamwork skills, and holistic nursing competencies in nursing students. CONCLUSION: These findings suggest that the program can be used to improve students' self-reflection, and it may also help to enhance their teamwork skills and holistic nursing competence.

Relationship Between Trunk Control Ability and Respiratory Function in Stroke Patients: A Scoping Review and Meta-Analysis.

PURPOSE: Hemiparesis in stroke survivors has been reported to affect respiratory function. The relationship between trunk control and respiratory function, however, is not well understood. We aimed to map the state of the association between the trunk and respiratory function as well as evaluate the effect of a respiratory function training intervention on trunk control for stroke survivors. METHODS: A scoping review and meta-analysis of observational and interventional studies were performed. Cochrane Library, CINAHL with Full Text (EBSCO), Medline (Ovid), and PubMed were searched using the terms stroke, respiratory, and trunk control. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was used to examine the sections of each report. RESULTS: A total of 102 studies were identified, of which 12, published between 2011 and 2022, were included in the meta-analysis or narrative synthesis. Three studies were included in the meta-analysis of the correlation between trunk control and respiratory function parameters (forced vital capacity [FVC], forced expiratory volume during the first breath [FEV1], maximal inspiratory pressure [MIP], and maximal expiratory pressure [MEP]) with effect sizes (Fisher's z) for all outcomes, which ranged from small to intermediate (between 0.21 and 0.39). Furthermore, five studies were included in the meta-analysis of the effect of respiratory function training intervention on trunk control. An overall effect size (Cohen's d) of 1.47 corresponds to a large effect. We also found significant improvements in MIP and MEP but not in FVC and FEV1 for stroke survivors with the interventions. CONCLUSIONS: Respiratory training, use of diaphragmatic resistance exercise or abdominal breathing, use of a pressure threshold-loading device, and the performance of functional strengthening exercises for the trunk muscles were found to increase patients' trunk control and improve their respiratory muscle strength.

Factors Affecting the Relationship Between Stress and Anxiety in Critically Ill Patients: A Partial Least Squares Structural Equation Modeling Approach.

This study aimed to examine the factors affecting the relationship between stress and anxiety in critically ill patients. A cross-sectional research paradigm was employed to enroll patients admitted to the medical intensive care unit (ICU) of a medical university hospital. Partial least squares structural equation modeling (PLS-SEM) was used to examine the data. A total of 90 ICU patients were included in this study; 56 were men and 34 were women. The patients' mean age was 65.3 years. Only the emotional responses dimension of illness was significantly positively correlated with stress. However, the emotional responses dimension of illness representation, acute physiology and chronic health evaluation system (APACHE) score, age, and education level were significantly positively correlated with anxiety. Nevertheless, treatment control was significantly negatively correlated with anxiety. Overall, illness representations (emotional responses and treatment control), APACHE score, age, and education were important predictors of anxiety, with an explanatory power of 37.9%. We recommend that for clinically relevant practice, besides focusing on ICU patients' illness representation, attention should also be paid to their individual characteristics, such as differences in age and education levels.

The effect of action modules on resilience and psychological health of stroke patients: A pilot non-randomised control trial.

AIMS AND OBJECTIVES: To determine whether interventions that use the Specific Thematic Nursing Care Action Modules (STNC-AM) platform improve patients' psychological health over a two-month period. BACKGROUND: Stroke survivors often are left with a disability after a stroke, which can have an impact on their physical and mental health. Therefore, it is necessary for stroke patients to have tailored programmes in the face of post-stroke mental health concerns and the need for care information. DESIGN: A non-randomised controlled pilot study was conducted. METHODS: Participants included 44 post-stroke patients at a medical university hospital, between 1 August 2019-28 February 2021, of whom 24 were assigned to the control group and 20 were assigned to the intervention (STNC-AM). Data were analysed on an intention-to-treat basis. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist (case-control studies) for this study. RESULTS: There were no statistical differences between the two groups at baseline. At the end of two months, however, the scores for resilience, depression and positive factors illness representation were statistically different between the two groups (p < .05). The results of the generalised estimating equation model analysis indicated that resilience and anxiety remained more significant in decreasing depression in the intervention group than in the control group. CONCLUSION: This preliminary trial suggests that, although action modules may be associated with a decrease in depression post-stroke, part of this effect was likely associated with an increase in resilience and a decrease in anxiety of the patients. RELEVANCE TO CLINICAL PRACTICE: The STNC-AM platform provides a coaching platform that helps patients and caregivers to be effective and accessible.

Minimal Clinically Important Differences and Changes in Stroke Disease-Specific Quality of Life in Stroke Survivors: A Prospective Cohort Study.

The aims of the present study were to investigate changes in QOL in post-stroke patients during the first 3 months of rehabilitation treatment. We estimate minimal detectable changes (MDCs) and minimal clinically important differences (MCIDs) of the eight dimensions of QOL and assess the proportion of patients' change scores that exceed MDCs and MCIDs in stroke survivors who receive rehabilitation in a hospital ward. This prospective cohort study enrolled 40 stroke survivors (57.5% male; Mage = 58.3 years) who received in-hospital rehabilitation for a total of 3 months. The Stroke Impact Scale 3.0, which has eight subscales-strength, activities of daily living (ADLs)/instrumental ADLs (IADLs), mobility, hand function, communication, memory and thinking, emotion, and social participation-was used for assessment on the third day of rehabilitation (Time 1), 1 month later (Time 2), and 3 months later (Time 3). Our findings indicated that the MDC95 and MCID proportions varied from 7.5% to 30% and 7.5% to 65%, respectively, of individuals who exhibited change based on individual change scores. The findings show compliance with MDC and MCID values in physical function, with the lowest proportion in hand function.

Effect of cryotherapy on paclitaxel-induced peripheral neuropathy of the hand in female breast cancer patients: A prospective self-controlled study.

AIMS: The purpose of this study was to examine the efficacy of cryotherapy with frozen gloves for the prevention of the chemotherapy-induced peripheral neuropathy of the hand. BACKGROUND: Most breast cancer patients receive chemotherapy; consequently, patients frequently experience adverse effects of chemotherapy-induced peripheral neuropathy. METHODS: A quasi-experimental and prospective self-controlled study was conducted. Breast cancer patients wore frozen glove on the dominant hand for 90 min during their weekly treatment with paclitaxel (80 mg/m2 ). Treatment of the dominant hand, the intervention group, was continued for 12 weeks. The non-dominant hand was considered the control group. RESULTS: A total of 22 patients participated in this study, and only one patient did not reach the cumulative dose (960 mg/m2 ). Findings show that the incidences of sensory and motor symptoms of chemotherapy-induced peripheral neuropathies at the following times (Time 1 to Time 4) were significantly lower in the intervention group than in the control group. However, although the incidences of motor symptoms were lower in the experimental group than in the control group, a significant difference was shown only at Time 4. Additionally, both groups of patients reported that their incidence of sensory symptoms were higher than those of motor symptoms. CONCLUSION: Cryotherapy with frozen gloves is useful in reducing both the sensory and motor symptoms of the chemotherapy-induced peripheral neuropathy of the hands.

Factors associated with facial pressure injury in patients receiving non-invasive positive pressure ventilation mask: A retrospective case-control study.

AIMS AND OBJECTIVES: This study aimed to investigate factors associated with facial pressure injury (FPI) in patients receiving non-invasive positive pressure ventilation (NIPPV) during hospitalisation in the intensive care unit (ICU) and to identify predictors of FPI. BACKGROUND: Non-invasive positive pressure ventilation is a method of treating patients with acute and chronic respiratory failure. However, FPI may occur due to unsuitable nasal-oral NIPPV masks and discomfort in contact with the skin surface. DESIGN: A retrospective case-control study. METHODS: From January 2018 to October 2020, a total of 397 patients admitted to a national hospital in Taiwan were enrolled. Patients received NIPPV and routinely used under-mask prophylactic dressings during hospitalisation. Patients were divided into the non-FPI group (n = 357) and the FPI group (n = 40). Demographic, clinical characteristics, acute physiology and chronic health evaluation II scores, and Braden Scale scores were collected from medical records. Logistic regression analysis was performed to examine the contribution of each factor to the FPI, and odds ratios were reported. The STROBE checklist was used in this retrospective case-control study. RESULTS: There were significant differences between the groups in age, serum albumin, C-reactive protein, body mass index (BMI), disease severity, Braden Scale score, length of stay, duration of mechanical ventilation and use of corticosteroids. Logistic regression analysis revealed that the risk factor for FPI was the Braden Scale score [OR = 1.630 (1.176-2.260)], BMI [OR = 0.396 (0.210-1.784)] and corticosteroids [OR = 0.394 (0.159-1.811)], which were predictors of FPI in patients with NIPPV. CONCLUSIONS: Facial pressure injury may still occur in patients who routinely use prophylactic dressings under NIPPV masks. This study provides information on continuing education training for FPI to more accurately identify high-risk and timely preventive measures to reduce FPI. RELEVANCE TO CLINICAL PRACTICE: Addressing FPI-related factors to prevent facial skin damage and reduce comorbidities in patients using NIPPV masks.

Development and Validation of Clinical Nursing Teacher Self-Efficacy Scale and Investigation of Self-Efficacy among Clinical Nursing Teachers.

PURPOSE: The purpose of this study was to (1) add relevant contemporary items to develop an assessment instrument for the self-efficacy of clinical nursing teachers, to verify and evaluate the validity and reliability of the instrument, and (2) investigate the self-efficacy of clinical nursing teachers. METHOD: A cross-sectional study was designed. A total of 205 clinical nursing teachers were recruited in Taiwan. Data were collected using the Clinical Nursing Teacher Self-efficacy Scale. An exploratory factor analysis was performed to examine the scale. RESULTS: The degree of self-efficacy of clinical nursing teachers was moderate to high. The 35-item scale showed great psychometric qualities. The Cronbach coefficient of the overall scale was 0.92; and 0.83, 0.91, 0.93, and 0.87 on the four subscales were acceptable. Four factors were extracted by exploratory factor analysis and explained 68.53% of the total variance. Four factors were (i) teachers' professional growth ability, (ii) teaching ability, (iii) clinical nursing competencies, and (iv) personality traits. The highest self-efficacy category evaluated by teachers was personality traits; the second was clinical nursing competencies; after that, teaching ability and teachers' professional growth ability. The item with the lowest self-efficacy was foreign language ability (English). CONCLUSION: Clinical nursing teachers have a moderate to high degree of self-efficacy. This scale with good reliability and validity can be used for the training and evaluation of the self-efficacy of clinical nursing teachers.

Effects of an ethical decision-making reasoning scheme in nursing students: A randomized, open-label, controlled trial.

BACKGROUND: Previous research suggests that, to design a program to help students to develop ethical decision making, competence and courage to confront ethical dilemmas should be critical components. PURPOSE: This study examines the effect of an ethical decision-making reasoning scheme in ethical decision making and communication self-efficacy in nursing students. METHODS: This study was a prospective and randomized, open-label, controlled trial design. Nursing students from a medical university served as participants. Students were randomly assigned to an intervention group (IG), which received the ethical decision-making reasoning scheme intervention, or a control group (CG), which received a standard general course. The effect was measured with the Ethical Decision-Making Scale-Revised and the Self-efficacy for Communication Scale. Analysis of covariance (ANCOVA) was used to measure between-group differences, and paired t-tests were used to measure pre- and post-IG/CG differences. RESULTS: A total of 101 nursing students were included and randomly assigned to the IG (n = 50) and CG (n = 51), and 41 IG and 43 CG students completed all aspects of the study. The findings show that there was significant improvement in self-efficacy in communication (t = 2.341, p = .024) and a decrease in difficulty in communication (t = 2.330, p = .025) in the IG. Ethical decision-making competencies improved more in the IG compared to the CG (F = 4.856, p = .034). Ethical decision-making competencies increased in both males and females, but there were no significant differences between males and females at the end of study (F = 0.264, p = .610). CONCLUSION: These findings suggest that ethical decision-making training can improve students' confidence in communicating with patients and may help to improve students' more complex ethical decision making.

Job stress and occupational burnout among clinical nursing teachers: A cross-sectional study.

BACKGROUND: Clinical nursing teachers face conflicts and challenges while instructing nursing students in the clinical setting. They may be under job stress, which can lead to occupational burnout. PURPOSE: This study investigated the current state and relationship between job stress and occupational burnout, as well as explore the significant predictors of occupational burnout among clinical nursing teachers. METHODS: A cross-sectional study design and convenience sampling was conducted. A total of 205 clinical nursing teachers from 43 nursing schools in Taiwan. Used the Chinese version of the job content questions and occupational burnout inventory to collect data. Multiple linear regression was used to determine the predictors of occupational burnout. RESULTS: The degree of perception of life stress by teachers was moderate, and occupational burnout was mild to moderate. Multiple regression analyses showed that perceived life stress and job stress were significant predictors of occupational burnout; perceived life stress was the strongest predictor of occupational burnout, explained 26.4% of the variance; and the workload explained 16.6% of the variance. CONCLUSION: Perceived life stress and job stress influence occupational burnout. This study results may help administrators recognize the vulnerability of clinical nursing teachers to different stressors and develop strategies to improve occupational burnout.

The effect of a situation model nursing education action program on gender-bias awareness and gender-friendliness barriers in novice nursing students.

AIM: This study presents a workshop on the Situation Model Nursing Education Action program, examines how to promote gender awareness and decrease barriers related to differences in gender friendliness through the implementation of this program and tracks the trends of the relevant variables. DESIGN: Pre- and post-observations and a cohort study were conducted. METHODS: A total of 58 nursing students (42 females and 16 males) were included. Nursing students were offered a gender-care intervention as two 90-minute workshops and surveys that measure gender awareness and gender friendliness were administered. RESULTS: The results concerned gender-bias awareness and gender-friendliness barriers scores across the four weeks of the program intervention, with the generalized estimated difference score compared with the Week 1 baseline. Mean student scores showed that gender-bias awareness was significantly decreased at Week 2 (p < .001) and Week 4 (p < .001) and that mean gender-friendliness barrier scores significantly declined at Week 4 (p < .001). CONCLUSIONS: The findings indicate that a faculty professional learning community workshop that facilitates intentional behavioral change can help faculty to become aware of gender bias, which can improve students' gender awareness through clinical case discussion and lead to a decline in barriers to students' gender friendliness.

Illness Representation and Self-Efficacy: An Exploration of Fatigue Factors in Middle-Aged Stroke Survivors.

The purpose of this study is twofold: to examine the relationship between illness representation and self-efficacy and to test the determinants and the effect of self-efficacy, resilience, and stroke impact on fatigue in middle-aged stroke survivors. This study used a cross-sectional and quantitative approach. The instruments included the Chronic Disease Self-Efficacy Scale, Stroke Impact Scale, Resilience Scale, and Fatigue Impact Scale. Structural equation modeling (SEM) was performed to analyze the data. A total of 63 patients with stroke (39 male and 24 female) were recruited form a medical university hospital. The results showed that patients' illness representation had a significantly effect on self-efficacy for managing disease. In addition, SEM analysis demonstrated that self-efficacy, resilience and stroke impact influenced fatigue, explaining 20.6% of the variance in fatigue. It was concluded that to improve patient fatigue, we believe it is imperative to design interventions that improve patients' self-efficacy, promote patients' resilience, and better function.

Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease.

Background: As coronary heart disease (CHD) is a highly complex disease, complex continuity of care (CoC) service should be provided for the patients, and the quality of life (QoL) needs to be regarded as an important measuring indicator for the health-care outcome. Purpose: To understand the general situation of CHD QoL and important predictors. Method: A cross-sectional study design was adopted from August 2019 to July 2020 by structured questionnaires. A total of 163 patients were enrolled, and data were statistically analyzed using SPSS 25.0. Result: The average score of the QoL questionnaire is 56.56/80, and the CoC is 4.32. The overall regression model can explain 58.7% of the variance regarding QoL. Patients' instrumental activities of daily living (IADLs) (26.1%), age (18.1%), living situation (7%), information transfer (4.8%), main source of income (1.8%), and risk of disability are significantly different from their overall QoL in depression (0.9%). Conclusions: In order to improve the QoL of patients, it is suggested that medical teams should assess the needs of patients immediately upon hospitalization, provide patients with individual CoC, encourage them to participate in community health promotion activities, and strengthen the function of IADL to improve the QoL of patients.

Continuity of Care and the Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan.

BACKGROUND: Understanding factors associated with the quality of life (QoL) of patients with type 2 diabetes (T2DM) is an important health issue. This study aimed to explore the correlation between continuity of care and quality of life in patients with T2DM and to probe for important explanatory factors affecting quality of life. METHODS: This study used a cross-sectional correlation research design. Convenience sampling was adopted to recruit 157 patients, aged 20-80 years and diagnosed with T2DM in the medical ward of a regional hospital in central Taiwan. RESULTS: The overall mean (standard deviation, SD) QOL score was 53.42 (9.48). Hierarchical regression linear analysis showed that age, depression, two variables of potential disability (movement and depression), and the inability to see a specific physician or maintain relational continuity with medical providers were important predictors that could effectively explain 62.0% of the variance of the overall QoL. CONCLUSIONS: The relationship between patients and physicians and maintaining relational continuity with the medical providers directly affect patients' QoL during hospitalization and should be prioritized clinically. Timely interventions should be provided for older adult patients with T2DM, depression, or an inability to exercise to maintain their QoL.

Modeling the relationship between nursing competence and professional socialization of novice nursing students using a latent growth curve analysis.

Professional skill development and socialization require appropriate guidance and learning. We aimed to examine the effect of self-appraisal of the clinical simulation care task (CSCT-SA) action program on the self-learning effectiveness, self-reflection and insight, caring behavior, nursing competence, and professional socialization of novice nursing students. This study has a single-group longitudinal research design. Five measurement variables, including students' self-learning effectiveness, self-reflection and insight, caring behavior, nursing competence, and professional socialization, were assessed at the baseline, middle, and termination points of the study. The generalized estimating equation and a latent growth curve model were used to examine research hypotheses. A total of 92 students (22 male and 70 female students) completed three point surveys. Students' learning effectiveness, self-reflection and insight, caring behavior, nursing competence, and professional socialization presented a positive growth trajectory throughout the CSCT-SA action program series. In addition, latent growth curve analyses indicated that the levels of nursing competence and professional socialization, as well as the changes in these variables, were positively associated with each other. Findings support the key role played by nursing competence in enhancing students' professional socialization, which suggests that such competence should be improved to promote professional socialization.

Relationship Between Metabolic Syndrome Severity and Kidney Function as Related to Gender: A Population-Based Longitudinal Study.

The purpose of this study was to explore the relationship between the metabolic syndrome severity Z-score and kidney function by gender. We also examined the estimated glomerular filtration rate in relation to other known risk factors. The study used was a population-based prospective longitudinal research design. A total of 4,838 participants (2,683 females and 2,155 males) included individuals aged >30 years who were undergoing a health examination from 2006 to 2014 in Pingzhen City, Taiwan. In the initial generalized estimated equation model analysis, which included the covariates of age of first visit, period between the first and current visit, and metabolic syndrome severity Z-score, the results indicated that the interaction between age and metabolic syndrome severity Z-score is significantly related to the estimated glomerular filtration rate for males (p = .040). For females, the interaction between age and metabolic syndrome severity Z-score was not significant, but a higher metabolic syndrome severity Z-score was significantly associated with lower estimated glomerular filtration rate (p = .001). After controlling for the confounders, unhealthy behaviors, and comorbidities, the metabolic syndrome severity Z-score was still a negative predictor of estimated glomerular filtration rate in both the male (p = .005) and female (p = .023) models.