Nurse administrators' intentions and considerations in recruiting inactive nurses.

AIMS: To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. BACKGROUND: Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. METHODS: A census survey collected data from 392 nurse administrators via a mailing method. RESULTS: Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. CONCLUSIONS: Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence.

Inactive nurses in Taiwan: human capital, intention to return to hospital nursing, and incentives for returning.

AIMS: To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. BACKGROUND: Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. METHOD: Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. RESULTS: Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. CONCLUSIONS: Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. IMPLICATIONS FOR NURSING MANAGEMENT: The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing.

[The evolution of national health and the development of the nursing practice in Taiwan].

Nursing is an applied science. While there is a wide range of nursing theories and nursing care models, resolving the health problems and meeting the health needs of clients is the common objective of all in the nursing profession. The nursing profession may be subdivided into hospital clinical nursing and community health nursing (CHN). CHN is further subdivided into public health nursing, school health nursing, and industrial health nursing. The past 60 years has been a period of significant growth and improvement in Taiwan that has enhanced the nation's socioeconomic condition, general living standards, and general public health. The nursing profession has seen profound progress as well, not only in terms of content but also in terms of nursing care models, which are increasingly framed around core public health needs and take into consideration different health perspectives. Nursing in Taiwan has gradually established its own professional function and autonomy.

Prenatal examination utilization and its determinants for immigrant women in Taiwan: an exploratory study.

The purpose of this study was to understand and explore determinants of prenatal examination utilization by pregnant immigrant women in Taiwan. This cross-sectional study surveyed 101 pregnant Vietnamese women living in northern Taiwan. Data collection employed face-to-face interviews using a structured questionnaire. Main findings included that participants were relatively young (M +/- SD = 23.3 +/- 3.15 years old) and that length of residency in Taiwan averaged just over 1 year (M +/- SD = 13.3 +/- 9.48 months). Results also indicated the prenatal examination rate for this target group to be relatively high. First prenatal examinations were conducted, on average, 10.8 weeks into pregnancy (SD = 4.37 weeks). Most participants (83.2%) received prenatal examinations in accordance with the recommended schedule. Regional hospitals (35.6%) and local obstetrics clinics (35.6%) were the most frequently chosen locations for prenatal examinations followed by medical centers (15.8%) and district hospitals (12.9%). Participant spouses and/or mother-in-laws heavily influenced the decision regarding where to conduct prenatal examinations. The average general language ability score was 9.5 (SD = 2.05, range = 4-16), indicating a low to moderate average language ability. However, only 9.9% (n = 10) of participants utilized translation services offered by the hospital. In terms of factors influencing utilization of the prenatal examination service, this study identified significantly positive relationships between utilization and the variables life adaptation and perceived importance of the examination. In contrast, results showed loneliness to be negatively related to prenatal examination utilization. On the basis of these results, we suggest that more accessible information on the prenatal examination service needs to be provided to improve adaptation by immigrant women to life in Taiwan and that psychiatric support be offered to help reduce the feelings of depression felt by these women. The importance of prenatal examination to enable women to acquire more appropriate and comprehensive prenatal care and to improve prenatal care quality should be emphasized.

A comparison of the cost-effectiveness of hospital-based home care with that of a conventional outpatient follow-up for patients with mental illness.

The purpose of this study was to compare the outcomes of a hospital-based home-care model with those of a conventional outpatient follow-up for mentally ill patients in Taiwan by means of cost-effectiveness analysis. The study design was a two group posthoc design. We interviewed 40 mentally ill patients who were followed up in the psychiatric outpatient department. Another 40 mentally ill patients who participated in a hospital based home care program were also interviewed. The outcome measures we used for interviews were disease maintenance behavior, psychotic symptoms, social function, service satisfaction, and cost. The cost for each patient was the sum of costs for all direct mental health services. The cost-effectiveness ratio showed that the costs of the hospital-based home care model (4.3) were lower than those of conventional outpatient follow-up (13.5) and that over a one-year period, the hospital-based home care model was associated with improvements in mental conditions, social functional outcomes, and service satisfaction. The improved outcomes and the lower costs in the hospital-based home care program support the view that it is the most cost-effective of the two. Policy makers may consider this analysis as they allocate resources and develop policy for the care of mentally ill patients.

Effects of a weight-loss program for obese children: a "mix of attributes" approach.

Childhood obesity is an important global public health issue. There is a need for more effective, low cost and child-centered intervention programs for reducing body weight. In response to this need, we developed a mix of attributes approach (including content, interactivity, control, channel, and objectivity) to help obese children (weight-for-length index, WLI >/= 1.20) reduce their body weight and improve their knowledge, attitude, and behavior. The prevalence of obesity in our sample was 15.9 % (140 obese children out of 882 children studying in the fourth grade) . An experimental, randomized research design was conducted in this study. Anthropometric measurements (including Body Mass Index [BMI] , WLI, body fat percentage, triceps, and subscapular skinfold thickness) and questionnaires (including the Scale of Obesity and Body Weight Loss Knowledge, Attitude, and Practice) were evaluated at baseline (pretest) and after one month of the intervention (posttest) for all obese children. Of 140 obese children, 118 completed this study (66 in the experimental group, 52 in the control group). The mix of attributes approach significantly reduced the degree of obesity revealed in anthropometric measurements. (p < .05). This approach also significantly improved obese children ' s knowledge (p < .001) and slightly improved their behaviors (p = .057); however, this program did not change the children ' s attitudes so easily (p = .597). To more effectively lose weight, we suggest an additional attribute, " individuality, " as a means of increasing efforts to change attitudes in obese children.

[Future trends in school health nursing].

School health nursing is one of the "frontline" professional community nursing services. School nurses need both theoretical professional knowledge and practical skills. The tasks of school nurses are becoming increasingly important due to the changing social environment, changes in disease patterns, decreasing birth rates, and the increasing demands of today's customers. But the field of school health nursing enjoys a certain independence. In line with society's demands, the essential trend in school health nursing is specialization. Planned and well-arranged pre-service education is required to develop programs for school nurse specialists, and, more importantly, we need to return to the advancement system. Nurses working at schools need plenty of clinical, practical experience, ideally having completed in-service education at N3 level in a medical institution, so that they can bring their professional competence into play, and satisfy the demands of their work. In this way, the nurses work in medical institutions will still have opportunities to contribute their skills when they are elderly. This is a constructive and positive development for the nursing profession.

An exploration of work stressors and correlators for nurse's aides in long-term care facilities.

The purpose of this study was to analyze the work stressors of nurse s aides in long-term care facilities and the factors related to work stressors. One hundred two nurse s aides in long-term care facilities in the Shihlin and Peitou districts of Taipei City were interviewed about work stressors. Of the six types of work stressors, the type patient care tasks was found to be the most stressful as reported by nurse aides, whereas the type the relationship with one s supervisor was the least stressful. Variables such as age, nationality, identity, resident care time and the number of residents a nurse took care of were significantly related to the work stressors. The findings of this study suggest that it is necessary to provide prevocational training, and even on-the-job training for nurse s aides. In addition, it is important to build a supportive work environment for nurse s aides, especially for those who are foreign.

Weight-control behavior among obese children: association with family-related factors.

UNLABELLED: The purpose of this study was to investigate the weight-control behavior of obese children, to understand parents' supervision and to explore related factors that influenced the weight-control behavior. A structured questionnaire was employed in this study. A random sample of 287 children and their parents was recruited from six elementary schools in Shihlin and Peitou districts of Taipei City. Criteria employed for recruitment of subjects were: third and fourth grade in elementary schools, and weight-for-length index > or = 1.2. RESULTS: Fifty-six percent of the obese children were mildly obese and eleven percent were severely obese. Ninety-seven percent of the subjects adopted weight-control behavior, the most frequent one being avoiding fried food. The exercise frequency and time duration consistency were generally insufficient. Twenty-seven percent of the obese children were not in the habit of exercising. Factors that influenced the execution of weight-control behavior by the obese children included obesity level, mother's education, family structure, socioeconomic status of the family, parents' perception of their children's weight, parents' concern, and supervision. Our study found that severely obese children attempted to lose weight with inappropriate methods. Children staying in foster families or with grandparents, or from families of low socioeconomic status, had poorer weight-control behavior. Children whose parents were more concerned about their weight problem tended to have better weight-control behavior. Therefore, it is important to assist the parents of obese children to confront the issue of obesity and help the children solve their weight problem. It is also important to help foster families with low income to make the most of social resources to reinforce the family function.

A study of sexuality education performance and associated factors among elementary school nurses in Taipei.

The purpose of this study was to investigate the performance and associated factors of sexuality education by elementary school nurses in Taipei. A structured questionnaire was utilized to collect data from a convenience sample of 145 elementary school nurses. The Kuder-Richarson reliability for sex knowledge scale was.73, and Cronbach's agr; for sex attitude scale was.93. The findings of the study were as followed: (1) Sex knowledge was high among study samples. The average scores for sex knowledge regarding " masturbation ", " sexual harassment and sexual abuse " were among the highest; those regarding " secondary sexual characteristics ", " ovulation ", " menstruation health care ", and " sexually transmitted diseases " were among the lowest. (2) Sex attitude was positive. Eighty percent of the study subjects agreed that school nurses were responsible for the promotion of sexual health in schools. More than 90% of the study subjects were willing to participate actively in sexuality education program in school, providing health consultation and guidance. (3) Twenty percent of the study subjects were not involved in sex education because they were not invited or due to busy working schedule.(4) Marital status, highest level of education, job title, job seniority, continuing education or training experience were the factors associated with the implementation of sexuality education among school nurses.

Patient falls and open visiting hours: a case study in a Taiwanese medical center.

This study investigated the linkages between patient falls and open visiting hours in an acute care setting in Taiwan. The activities of the accompanying family members/aides when patients fell were analyzed. More than 35% of the family members/aides who were watching patients were ineffective in preventing the falls.

Using a citizen consensus conference to revise the code of ethics for nurses in Taiwan.

PURPOSE: To revise the code of ethics for nurses in Taiwan. DESIGN: Citizen consensus conference, Delphi-technique, and questionnaire survey were used in the revising process. METHODS: Citizen representatives were recruited for a 5-day citizen consensus conference to develop a first draft of the revised code. Further modification resulted from three rounds of communication with Delphi technique among experts. Three conferences for nursing professionals were conducted where questionnaire surveys were administered. The final draft was approved by the general assembly of Taiwan National Union of Nurses Associations. FINDINGS: A revised code of ethics for nurses in Taiwan was proposed in six parts and 27 articles including: the fundamental responsibilities of nurses (1), nurses and clients (12), nurses and professional services (4), nurses and social interactions (4), nurses and teamwork (3), and nurses and professional growth (3). CONCLUSIONS: The citizen consensus conference was helpful in identifying the general public's expectation of nurses in the revision process. The revised Taiwanese code of ethics for nurses has new elements, including environmental protection, personal safety, lifetime learning, and self-care.

The effectiveness of empowering in-service training programs for foreign nurse aides in community-based long-term care facilities.

The objective of the study was to examine the effectiveness of empowering in-service training programs for foreign nurse aides working in community-based long-term care (LTC) facilities. The design was a pretest and post-test design with experiment and control groups. The sample consisted of purposeful sampling from 10 LTC facilities in the Shihlin and Peitou areas of Taipei. A total of 35 foreign nurse aides participated in this study; 16 in the experimental group and 19 in the control group. The experimental group attended the training program for a 3-month period, whereas the control group did not receive any training. The research findings reveal that the training program was effective in increasing the work stress of workload/scheduling (Z = 2.01, p

An exploration of the skills needed for inhalation therapy in schoolchildren with asthma in Taiwan.

BACKGROUND: Clinical observation has shown that many asthma-affected children and their parents are not familiar with appropriate techniques for inhaler use. This may result in misuse, overdose, or diminished response of the administered therapeutic drugs, or may even result in unnecessary, repeated hospitalization. Inappropriate inhalation technique is hazardous to the safety of children with asthma and unnecessarily increases costs resulting from unnecessary rehospitalization. OBJECTIVE: We designed a study to evaluate the skills needed for inhaler use among children with asthma in Taiwan. SUBJECTS AND METHODS: Schoolchildren with asthma, aged 8 to 13 years, were asked to demonstrate their inhalation technique. The inhalers used in this study were either metered-dose inhalers or dry-power inhalers. Assessment of the inhalation technique was made using a standardized inhaler checklist. A higher score indicates greater skill using the inhaler. RESULTS: This study surveyed 132 schoolchildren with asthma. Of those, only 23 (17.4%) asthmatic children who received inhalation therapy revealed good compliance with their medication regimens. No child was observed to have completed all inhaler techniques correctly. Those family members who participated in educational programs and who received instruction from health teams had higher scores for the inhaler checklist (P < 0.05). It was found that children who inhaled medication unaided had a better knowledge of asthma, and their drug inhalation technique was also more skillful (P < 0.03). By multiple regression analysis, we found that determinants of a child's skill at performing the inhalation maneuver included: number of asthma attacks within the preceding year, unaided application of inhaler therapy, older subject age, potential for subjects to receive instructions from parents regarding inhaler use, subjects reading related publications, and the family's degree of satisfaction with the physician's educational program. These variables contributed a total of 23% to variance in the subjects' inhalation technique. CONCLUSION: This study revealed that most asthmatic children being treated with inhaler medication do not use such devices appropriately. More aggressive asthma education is necessary in Taiwan.

The development and establishment of a care map in children with asthma in Taiwan.

BACKGROUND: It is often difficult to predict the timing and frequency of asthma attacks. In addition to interrupting the daily life of both the affected child and his/her family, asthma can also pose sudden danger to a child. Based on clinical observations, many asthma-affected children and their parents must constantly adjust themselves to the uncertainty of the disease, which leads to increased stress on the family. The use of care maps has demonstrated increased efficiency and effectiveness in the care of asthma patients from a variety of settings. OBJECTIVE: We designed this study to construct and evaluate a care map for asthmatic children in Taiwan. Specific attention was placed on comparing the study and control subjects by parental knowledge of asthma, medication used for asthma, hospital readmission, and health care resource usage. SUBJECTS AND METHODS: The care map was constructed by in-depth interviews with eight sets of parents of children with asthma. Forty-four parents of 42 asthma children were randomized into two groups in the Allergic Clinic of the Chang Gung Children's Hospital. The experimental group of 22 parents received individual instruction and training sessions in addition to the regular care provided to the control group of 22 parents. RESULTS: Forty-two children with asthma were surveyed in this study. To examine the reliability and validity of a care map for children with asthma, a quantitative survey was conducted with 42 outpatient parents with asthmatic children. There was less emergency room attending rate in experimental group (6/month; p<0.05) The understanding of the disease was much improved in parents of experimental group (13.85+/-1.04 vs. 10.91+/-2.14; p<0.01). Furthermore, parents acquired a more positive attitude to asthma, and almost all of the control group had irregular follow-ups by a physician and had irregular use of medication. CONCLUSION: This study emphasizes that a care map in children with asthma (CACM) can be used to educate parents in how to provide the best treatment plan for their children. This study also shows how a CACM can help parents train their children in the best behaviors during asthma attacks. Empathetic assessment and elimination of cultural barriers, a well-designed educational program, and a mutually developed treatment plan could significantly improve the quality of life for families and specific asthma outcomes.