[Reflections on the Prospective Professional Competency of Taiwan Public Health Nurses].

Societal ageing, the rising prevalence of chronic diseases, and the COVID-19 pandemic have changed the global healthcare environment dramatically. These challenges have significantly burdened community medical and healthcare systems and complicated the work of public health nursing. As an important care provider on the frontlines of primary care, public health nurses (PHNs) must keep up with the current state of the medical environment and statistical data interpretation, scientific data translation, community resource sharing, and telehealth applications. These demands have greatly impacted the traditional routines and existing professional core competencies of PHNs. Discussions among 12 Taiwanese public healthcare experts and the definition of public health nursing capacity from World Health Organization were considered in this review. In addition to reflecting on social changes and the professional development of public health nursing, eight prospective recommendations were provided in this review to enhance the professional competence of PHNs and better prepare them for future changes in the health environment and primary healthcare. The suggestions provide a reference for updating the position statement of PHNs.

Taboo in the Workplace: A Qualitative Study of Taiwanese Nurses' "Not-Eating Pineapple" in Clinical Practice.

There has been an increased emphasis on nurses' mental health and well-being in the workplace. Psychologists have established a correlative link between individual's beliefs on luck and mental health. The pineapple taboo has been observed among Taiwanese hospital nurses as a prevalent superstitious belief for bringing luck or warding off increased clinical workloads, but how and why the ritual persists in the hospital workplace remains unknown. This article aims to explore the latent meaning of observance of the taboo and how it is related to nurses' clinical practice and possibly affects their mental health at work. A qualitative research was designed in line with the hermeneutic phenomenological method. Through purposive sampling, 18 nurse participants were recruited for in-depth semistructured interviews. Resulting from the ensuing analysis, 3 modalities were identified as constituting the spectrum of observance of the taboo: (a) "strictly not eating pineapple"; (b) "not eating pineapple at work"; and (c) "eating pineapple without admitting to doing so." Each reflects the position of nurses revealed in relation to the pineapple taboo in clinical settings. Based on the subjective narratives of nurses, it may be understood as an active moral attempt at "being right" rather than a passive avoidance of bad luck in the taboo observation. The findings facilitate an appropriate understanding of the embedded meaning of nurses' workplace-related belief and its seminal function of empowerment for nurses in holistic nursing practice.

On My Own: A Qualitative Phenomenological Study of Mothers of Young Children with Autism Spectrum Disorder in Taiwan.

BACKGROUND: There has been a dramatic increase in autism around the world. However, little is known about the impact of the Taiwanese primogeniture system on mothers of children with ASD. Greater knowledge is needed to understand the life experiences of Taiwanese mothers with ASD children when a healthy male descendent is expected. MATERIALS AND METHODS: Research follows the hermeneutic phenomenological approach with in-depth interviews and participant observation (Agar, Speaking of Ethnography. Sage, California, 1986). The researchers collected and analysed stories from seven mothers who are the major caregivers of their school-aged autistic children. RESULTS: The data revealed the following themes that represented the mothers' experiences: taking the blame, my world was turned upside down, a child-centred life and two lives as one. CONCLUSIONS: The findings provide a deeper understanding of common expectations of, and behaviours directed towards, Taiwanese mothers of children with autism. This offers healthcare professionals ways of reconceptualizing therapeutic practice, thus benefitting these mothers.

[New opportunities for nursing in the future of intermediate care].

Intermediate care is an important focus of the Taiwan Government, domestic diagnosis groups, and the Ten-Year Long-Term Care Project. The objective of intermediate care is to bridge acute and long-term care in order to deliver more comprehensive healthcare to the population. It is an emerging healthcare service model. Intermediate care and a supportive environment should facilitate the functional recovery of patients and their successful return to the community. This article first describes the origins of intermediate care, its definitions and components, service models and related research. It then proposes the role of nursing in intermediate care and implications for nursing in the future of domestic intermediate care policy. We hope that academia, the government and health industry can work together to facilitate intermediate care in order to extend and expand nursing roles.

Psychometric Evaluation of the Chinese Version of the Knowledge and Beliefs About Pain in Elderly Patients With Dementia Questionnaire.

BACKGROUND: The quality of pain management in hospitalized older adult patients with dementia is a crucial issue in healthcare. The knowledge and beliefs of nurses are known to predict their pain management intentions toward this particularly vulnerable patient population. PURPOSE: This study was designed to evaluate the reliability and validity of the Chinese version of the Knowledge and Beliefs About Pain in Elderly Patients With Dementia (KBPED-C) questionnaire using a sample of hospital nurses. METHODS: A cross-sectional study was conducted. The 17-item KBPED-C was distributed between September 2013 and August 2014 to 350 nurses working at a hospital in northern Taiwan. Consistency assessment was conducted using Cronbach's alpha, and construct validity was examined using principal component analysis. Three hundred five nurses (19 men and 286 women) were enrolled using convenience sampling. RESULTS: The mean age of the participants was 30.8 ± 5.8 years. The Cronbach's alpha for internal consistency was .86. The item-total correlation was acceptable. The observed content validity was strong, with a content validity index of .86. Construct validity testing revealed a four-factor structure that accounted for 55.2% of the total variance. The four factors of the KBPED-C questionnaire were "general beliefs about pain and aging," "pain management in the workplace," "knowledge about pain management in older adult patients with dementia," and "beliefs about pain in older people." CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This preliminary validation study showed the high acceptability, reliability, and validity of the KBPED-C for hospital nurses. Future studies may use this questionnaire to explore the beliefs and knowledge of nurses regarding pain in older adult patients with dementia.

Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study.

AIM: The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. METHODS: This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. RESULTS: The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. CONCLUSIONS: Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285.

What Is the Addiction World Like? Understanding the Lived Experience of the Individuals' Illicit Drug Addiction in Taiwan.

PURPOSE: This study focuses on the participants' lived experience of addiction. DESIGN AND METHODS: The study presents a qualitative method. The use of the fieldwork-based participant observation and in-depth interviews guided the data collection and analysis. FINDINGS: Three major themes of addiction emerge from the analysis: incorrigible conduct, inexcusable compromise, and inevitable corruption. PRACTICE IMPLICATIONS: This study provides a better understanding of what the world is like for people struggling with addiction and also enhances the healthcare professionals' knowledge of the individual's experience of addiction. This knowledge is essential for clinicians to understand this experience as a framework for planning and implementing appropriate treatment.

The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section.

AIMS: The goal of this study was to evaluate the effects of xylitol gum chewing on gastrointestinal recovery after cesarean section. METHODS: Women who underwent cesarean section (N = 120) were randomly allocated into Group A (xylitol gum), Group B (nonxylitol gum), or the control group (no chewing gum). Every 2 hr post-cesarean section and until first flatus, Groups A and B received two pellets of chewing gum and were asked to chew for 15 min. The times to first bowel sounds, first flatus, and first defecation were then compared among the three groups. RESULTS: Group A had the shortest mean time to first bowel sounds (6.9 ± 1.7 hr), followed by Group B (8 ± 1.6 hr) and the control group (12.8 ± 2.5 hr; one-way analysis of variance, p < .001; Scheffe's post hoc comparisons, p < .05). The gum-chewing groups demonstrated a faster return of flatus than the control group did (p < .001), but the time to flatus did not differ significantly between the gum-chewing groups. Additionally, the differences in the time to first defecation were not significant. CONCLUSION: After cesarean section, chewing gum increased participants' return of bowel activity, as measured by the appearance of bowel sounds and the passage of flatus. In this context, xylitol-containing gum may be superior to xylitol-free gum.

Hospital nurse knowledge of and approach to dementia care.

BACKGROUND: : The U.K. Department of Health recently proposed an international dementia strategy to enhance the quality of dementia care in acute hospital care settings. To implement such a strategy, it is necessary to first assess whether nurses have the knowledge and person-centered approach essential to enhancing hospital-based dementia care quality. PURPOSE: : The purpose of this study was to evaluate hospital nurse knowledge of and approach toward dementia care and to explore the relationship between nurse demographic characteristics and these two issues. METHODS: : We distributed a 16-item questionnaire on dementia care knowledge to 124 nurses at a teaching hospital in southern Taiwan. We also distributed to the same participants a 13-item questionnaire designed to assess the approach, either reality oriented or person centered, of participants in providing care to advanced dementia patients. RESULTS: : The total mean score for participant dementia care knowledge was 10.8 (SD = 2.0). Results indicated that most nurses confused dementia with delirium. The advanced dementia care questionnaire suggested care tended to be reality oriented. Licensed registered nurses with more working experience had higher dementia care knowledge scores. Age and working experience both negatively correlated with a reality-oriented approach toward care. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: : Most participants had accurate dementia care knowledge and tended to use a reality-oriented approach. Nurse competency in differentiating delirium from dementia should be enhanced. This study provided initial insight into the dementia care situation at a single hospital in southern Taiwan. Future studies should further explore the relationship between dementia care quality and hospital nurses' knowledge and approaches, respectively.