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This study explores how parents experienced the surgical decision-making process for their child with a congenital heart disease (CHD). Purposive sampling was used in this qualitative descriptive study at a medical center in Northern Taiwan. Twelve parents whose children had cardiac corrective surgery participated in one-to-one in-depth interviews. The interview content subsequently was transcribed verbatim and analyzed by content analysis. Five themes, with 2 to 3 subthemes, were identified: 1) accumulating medical knowledge in a short time, 2) trusting the medical teams but parents needing clear communication, 3) feeling pervasive uncertainty, 4) using self-talk to calm down, and 5) looking for positive energy from various sources. For the parents of these children with CHD, participating in surgical decision-making can be a difficult and stressful experience. When explaining the disease and treatment procedures, it is important for medical professionals to make sure of the individual parent's information needs, to use plain language and encourage parents to ask questions. Although the surgery is imperative and inevitable, understanding the parents' worries and providing adequate support can help them reduce feelings of uncertainty during the decision-making and surgical processes. • Parents enrich their knowledge from the websites of professional and parent groups. • Surgeons should make sure of the parent's information needs, use plain language and encourage them to ask questions. • Nurses can play an important role in providing adequate preparation and support to reduce the parents' worries and feelings of uncertainty. [ABSTRACT FROM AUTHOR]

Abstract Aims To generate a descriptive theory framework regarding the experiences of the cultural competencies among clinical nurses in Taiwan. Background With the advances in, and the easy accessibility to health care services, frontline nurses require a higher cultural competence to perceive and satisfy the needs of the culturally diverse patients. Methods A qualitative approach using a grounded theory was applied. There were 30 nurses recruited by purposive sampling. Results 'Unprepared when encountering different cultures' was the core theme for describing and guiding the process of examining the nurses' experiences with a cultural competence. 'Awareness of value differences' was identified as the antecedent condition. The nurses revealed that they have had difficulty implementing their nursing work and seeking resources that represented situations in which interactive behavioral characteristics appeared to improve their cultural competencies. The nurses managing different cultural situations ultimately learned to tolerate the different cultures and to give patients culturally appropriate care, which thereby enhanced the care quality. Conclusions This study highlights the multiple layers of cultural competence experienced by the nurses and the understanding of cultural diversity among patients and caregivers. These results will assist the healthcare providers by offering references for clinical healthcare based on the patients' subjectively different cultural perspectives. Medical organizations should design an in-service educational program/instructions concerning culture to help strengthen the nursing specialists' relevant cultural competencies, to meet the individual patients' cultural care needs, and thereby boost the clinical care quality. Highlights • The findings of this study provided great of information regarding to the experiences of cultural competencies among nurses. • The ability accepting the multicultural background of patients should be prioritized as taking caring various ethnic groups. • It is crucial to offer continuing education related to health issue with diverse cultural backgrounds to clinical nurses. [ABSTRACT FROM AUTHOR]

Introduction Nurses are often the first responders to in-hospital cardiac emergencies. A positive attitude towards cardiopulmonary resuscitation with defibrillation may contribute to early cardiopulmonary resuscitation and rapid defibrillation, which are associated with enhanced long-term survival. The aim of this study was to translate and adapt the 31-item attitudes towards cardiopulmonary resuscitation with defibrillation and the national resuscitation guidelines (ACPRD) instrument into Chinese and to evaluate its psychometric properties in a sample of Taiwanese hospital nurses. Methods The ACPRD instrument was translated into Chinese using professional translation services. Content validity index based on five experts to refine the translated instrument. The final instrument was applied to a sample of 290 female nurses, recruited from a regional hospital in southern Taiwan, to assess its internal consistency, factor structure, and discriminative validity. Results The Chinese ACPRD instrument showed good internal consistency (Cronbach’s alpha = 0.87). Seven factors emerged from the factor analysis. The instrument showed good discriminative validity and were able to differentiate the attitudes of nurses with more experience of defibrillation or cardiopulmonary resuscitation from those with less experience. Nurses working in emergency ward or intensive care unit also showed significantly higher overall scores compared to those working in other units. Conclusion The Chinese ACPRD demonstrated adequate content validity, internal consistency, sensible factor structure, and good discriminative validity. Among Chinese-speaking nurses, it may be used as a tool for assessing the effectiveness of educational programs that aim to improve their confidence in performing cardiopulmonary resuscitation with defibrillation. [ABSTRACT FROM AUTHOR]

Although medical professionals possess a positive attitude toward SDM, they lack of a complete understanding of conceptual shared decision making (SDM). Therefore, a related knowledge base must be constructed to enhance service education. We aimed to examine the effectiveness of an educational program with situational simulation video on nurses' SDM attitude. A randomized controlled trial with single-blind study design was conducted, and permuted block randomization was employed. Participants were randomly assigned to an experimental group (n = 50) or control group (n = 50). Only the experimental group received education programs within 2 weeks, with the first covering the basic concept of SDM and the second comprising situation simulation teaching. In both groups, data were collected prior to intervention as baseline, immediately after intervention to evaluate its immediate effects, and 2 months after intervention to test the delay effect. A generalized estimating equation, subgroup analysis and descriptive statistics were used to analyse data. A significant main effect over time was discovered. Nevertheless, no significant group-time interaction was noted between the two groups after a 2-month interval. Subgroup analysis reveals that the SDM attitude scores in both the experimental and control groups increase for within group. The improvement of SDM attitude score in the experiment group was better than control group at follow test. The findings of this study might provide a reference for health care providers when designing service education courses to improve the execution strategies of SDM and thus the quality of care provided. • Simulation teaching provides a reference for health care providers when designing service education. • The cultural competence on nurses should be prioritized as taking caring various ethnic groups. • Nurses' positive SDM attitude and thus the quality of care provided [ABSTRACT FROM AUTHOR]

Background: Coumarin is a well-known plant-derived natural product, which is extensively used as a biologically active compound. Coumarins that possess hydroxyl groups in their benzenoid ring were shown to have potent antioxidant and radical-scavenging properties in various experimental models. Purposes: During our search for new types of coumarin derivatives possessing antioxidant activity, we investigated the synthesis of 5,7-dihydroxycoumarin derivatives and attempted to find potential therapeutic candidates to treat oxidative stress. Methods: A series of different cell-free and cell-containing tests was conducted. In cell-free systems, these compounds were tested by means of three electron spin resonance assays [a 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, a xanthine/xanthine oxidase system, and a hydrogen peroxide/sodium hydroxide/dimethyl sulfoxide]. In cell-containing systems, baicalein-induced hydroxyl radical formation by B16F10 cells was used to evaluate the antioxidant properties of the coumarins. Finally, we measured the protective capacity of these coumarins against oxidative damage caused by baicalein-induced cytotoxicity in B16F10 cells. Results: All of the tested compounds were potent DPPH and superoxide radical scavengers in the DPPH and xanthine/xanthine oxidase systems, respectively. In the hydrogen peroxide/sodium hydroxide/dimethyl sulfoxide system, Compound 4 was the best radical scavenger among the 11 compounds tested. Compounds 6 and 8 were also potent hydroxyl radical scavengers but increased the formation of methyl radicals. We further evaluated the effects of the test compounds on living cells, and only Compounds 1, 3, 5, and 6 inhibited baicalein-induced hydroxyl radical formation in B16F10 cells. However, none of them could reduce baicalein-induced cytotoxicity in B16F10 cells. Conclusions: The different methods used to assess the antioxidant activities of the tested compounds can give varying results depending on the specific free radical and solvent system being used. Certain 5,7-dihydroxy-coumarins possess high antioxidant activity in vitro. Baicalein-induced cytotoxicity in B16F10 cells did not seem to be completely related to ROS generation. [Copyright &y& Elsevier]

The purpose of this study was to explore the effectiveness of an essential oil massage on the sleep quality of the critical care nurses. A randomized controlled trial with single blind was conducted. A total of 112 critical care nurses were recruited. Participants were randomly allocated to either the experimental or control group. Only the experimental group received four sessions consisting of a lavender essential oil massage. The results of this study revealed that the overall subjective sleep quality and objective sleep parameters did not reach a significant difference between the two groups before and after the intervention, but a progressive the subjective sleep quality score reduction was observed in the experimental group. The findings of this study might provide information to critical care nurses who are under high pressure to find the optional alternative way of managing their self-sleep health by employing safe and convenient alternatives through aromatherapy. • Aromatherapy has a certain degree of effect on improving the subjective sleep quality of nurses in critical care units. • Participants receiving lavender aromatherapy revealed that the use of sleep pills was decreased. • Critical care nurses might educate themselves on the concept of self-care on aromatherapy to decrease high pressure. [ABSTRACT FROM AUTHOR]

The cultural competence education programme for health professionals aimed to ensure that all people receive effective health care, particularly those from culturally diverse backgrounds. The purpose of this study was to investigate the effect of a cultural competence educational course on nurses' self-assessment of their cultural competence. A single-blind, randomised control trial design was employed. Eligible nurses were recruited from a northern Taiwan medical centre with 2089 beds. A permuted block of four was used to randomly assign participants to the experimental (n = 47) and control groups (n = 50). The educational course comprised four units and was conducted once weekly for four weeks, with each session lasting 3 h. A significant group-time interaction was identified regarding self-learning cultural ability, verifying the education intervention's effect on self-learning cultural ability after a two-month intervention. In addition, a significant main effect over time was discovered for total cultural competence; there was no significant interaction effect. The study provided evidence that an educational programme effectively improved cultural competence in clinical nurses. The results provide a reference for health care providers to design in-service cultural competence education for improving quality of care. • Cultural competence in healthcare services caters to the patients' cultural needs. • Cultural competence is not an innate characteristic; it requires education. • Continuing education is crucial to foster cultural competence among nurses. [ABSTRACT FROM AUTHOR]