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The post-operative intensive care experience of a school-aged child who received living-donor bilateral lobar lung transplantation due to acute respiratory distress syndrome and interstitial pulmonary fibrosis is discussed in this paper. The patient received lungs donated by her parents in a "living-donor bilateral lobar lung transplantation" due to severe lung function impairment. The patient felt anxious due to her long-term hospitalization for preoperative evaluation, various invasive treatments, and postoperative rehabilitation. During the care period from October 25th, 2022, to December 29th, 2022, the author collected data via direct care, interviews, medical record reviews, and interactions with the patient and her family. An assessment of the patient's physical, mental, and social integrity was made, and the collected data were organized and analyzed to identify health issues such as lack of activity endurance, imbalanced nutrition below bodily requirements, and anxiety. After the lung transplantation operation, the interdisciplinary team worked collaboratively to develop a care plan to improve cardiopulmonary endurance and enhance the quality of care for the patient through early care and rehabilitation via proactive care. This care plan included encouraging the patient and her parents to express their fears and feelings and using flashcards to teach them about dietary management and the proper performance of lung rehabilitation. These measures encouraged the parents to engage in care, properly prepare for discharge care, and receive care education. As this is the first case of living-donor lobar lung transplantation in Taiwan, this valuable nursing experience is expected to provide future care teams with a reference on the related nursing process and care experience for similar cases.

The Journal of Nursing (JN) was first published in Taiwan seventy years ago in 1953 under its former name, Nursing Quarterly. The first issue of JN under its current name was published in 1961. JN mainly publishes academic papers. Despite the vicissitudes of history, the Taiwan Nurses Association (TWNA) remained true to its mission of serving its members, and resumed publication of JN after relocating to Taiwan from China after 1949. JN articles published over the past seven decades have focused on promoting professional competence, advocating clinical practice, advancing nursing education, introducing new concepts of administrative reform, and disseminating research findings and clinical case reports with goals of promoting nurses' understanding of nursing professional theory, cultivating critical thinking and creativity, helping nurses acquire and accumulate knowledge and skills in scientific language, and solving problems encountered in clinical care and education. In addition, in response to advances in medical care and the COVID-19 pandemic, the content of JN published in 2020 highlighted the current pandemic situation in special articles, research, and case reports to provide readers with knowledge about related care and research results. Through the publication of journal papers, we are promoting more interactions and inspiring more sparks of insight. JN is valued by readers around the world because the contributions and support of its many authors have allowed the journal to grow and thrive. At the same time, I would also like to thank the editor of each topic for their enthusiasm and enthusiastic welcoming of manuscript contributions and all Review Committee members for their careful review of manuscripts and tireless modification and review of articles, so as to provide readers with reliable reference resources. Therefore, the quality of the content published in JN has been recognized globally, and has been successively indexed in the globally recognized databases, including MEDLINE/PubMed (indexed from 2004), CINAHL (Cumulative Index to Nursing & Allied Health Literature; indexed from 1996), EBSCO Publishing (indexed from 2002), Scopus (indexed from 2004), ProQuest (indexed from 2012), and Airiti Library (indexed from 2004). Moreover, JN has been a RIHSS-accredited tier three journal since 2019. In addition, JN has won awards for five consecutive years since 2017. The excellent content quality of JN has made it an important source of knowledge dissemination and influence in domestic academic circles. Since becoming Editor-in-Chief of JN, I have read many contributors' articles and feel regularly grateful to the authors for their submissions, whether their articles are accepted for publication or not. With the efforts of previous Editors-in-Chief and Editorial Committee members, JN has continuously adjusted its mode of operations to meet social changes and has gradually established a comprehensive process for submission, review and publication. In recognition of JN's 70th anniversary in publication, we look forward to continued, sustainable development of the journal and of service for our global readership. We look forward for JN to do even more in the coming decade and beyond!

The COVID-19 pandemic has imposed an extremely heavy burden on the medical system in Taiwan. Thus, improving the effectiveness of epidemic prevention efforts and reducing the related burdens on medical staff are critical. Between the initial outbreak of COVID-19 in Taiwan in early 2022 until May of that same year, two townships with high percentages of indigenous (Malayo-Polynesian) residents reported the highest rates of infection nationwide. As the indigenous culture in these and other similar townships differs significantly from Taiwan's mainstream culture, determining how to improve health awareness and provide culturally appropriate treatments during this pandemic in indigenous communities is vital. In the context of Taiwan's indigenous population, this paper addresses the importance of improving health awareness, proposes how to foster a more-friendly health awareness environment, and suggests a strategy for providing effective healthcare under current pandemic conditions. Prevention measures include improving the ability of indigenous citizens to assess the correctness of information provided, improving compliance with epidemic prevention measures, improving knowledge regarding vaccines and rapid screening reagents, and improving the notification process for diagnoses. A culturally appropriate township-based promotion strategy for epidemic prevention should be proposed to increase the effectiveness of epidemic prevention and health promotion to improve health conditions in indigenous communities.

In hospitals, safety climate refers to the safety policies and regulations established by medical institutions and the measures taken to ensure medical personnel feel safe while working at these institutions. Safety climate can directly affect the overall work performance of medical personnel and indirectly affect patient care quality, which in turn impacts the rate of occupational hazards. Common occupational hazards in the medical workplace include contracting infectious diseases, overwork, irregular circadian rhythm due to working shifts, changes in sleep patterns and dietary habits, musculoskeletal discomfort, workplace violence, workplace stress, and needlestick injuries. This paper was developed to explore the history of promoting needlestick prevention in Taiwan, and discusses how to use the results of empirical research as scientific evidence and critical proofs to advocate for needlestick prevention and to establish related policies. In addition, the process of how improvements to the hospital safety climate and the prevention of occupational hazard incidents mutually influence and complement each other was examined. Future studies are encouraged to explore this topic to further elucidate the sources of workplace stress and to devise methods to ameliorate their influence on workplace stress in medical institutions. The results of these studies may be referenced by relevant government agencies and medical institutions when developing policies promoting safe environments in hospitals that improve the safe-work perceptions of nursing personnel and create comfortable and friendly medical environments.

Professional nursing organizations represent an important channel for the nursing profession to influence health policy, represent and protect the interests of nurses, and advocate for the further development of the profession. Facing the rapidly increasing aging population and emerging needs of long-term care in Taiwan, the Taiwan Nurses Association launched an integrated project to propose policy advice on the development of nursing in long-term care. In this paper, the relevant findings in the domestic and foreign literature are summarized to better define the role function and core competence of long-term care nurses. In addition, the current tasks, perceived competence, and training needs of nurses working in long term care settings are presented, and the consensus on various advocacy strategies are summarized. The findings presented in this study may be referenced when developing evidence-based policy recommendations related to education, practice, legal / regulatory amendments, and professional organizations.

Residing across this island for over 8,000 years, Taiwan`s indigenous people represent the world`s northernmost population of Austronesian islanders. Although Taiwan`s more than 500,000 indigenous citizens today account for only 0.11% of the 300 million Austronesians worldwide, Taiwan and Taiwan`s long-thriving Austronesian culture played an indispensable role in the historical migrations of ancient Austronesian peoples from Mainland Asia and their proliferation throughout the Pacific (Council on Indigenous Peoples, n.d.). The cultural diversity of Taiwan`s indigenous people allowed their many ethnic groups to adapt to the island`s climatic and environmental diversity, ranging from high, temperate mountains to tropical coastlines, for thousands of years. These groups have adapted well to local conditions, developing living habits, livelihood patterns, life customs, and ceremonies suited to their lives. Traditional wisdom and knowledge, like a colorful rainbow, have shone from ancient times up through the present and are woven deeply through the unique life values of the 16 ethnic tribal groups on Taiwan Island. However, the modernization and transformation of Taiwan`s economy during the past three decades have left indigenous citizens significantly behind mainstream society in many important aspects, including average lifespan, income, education level, and access to medical resources, with mainstream society enjoying more social advantages and a longer average life span (Health Promotion Administration, 2017). Thus, social determinants have promoted various inequalities in health, and the rainbow is no longer beautiful under the impact of modern values. The inequitable distribution of healthcare resources and inadequate human resources have cast a shadow of sadness over this originally beautiful rainbow. Some scholars have raised the cultural security model as a possible framework for formulating policies and regulations to protect the health rights of disadvantaged groups (Coffin, 2007). Using knowledge and values to emphasize cultural safety in the health field and cultural awareness holds the potential of reversing the role of traditional wisdom and knowledge transmitters to gain a deep understanding of the health needs of ethnic groups and of implementing related strategies in acute, chronic, and long-term medical care. This issue is rooted in the current, inequitable deployment of long-term care resources and provision of policy recommendations. In this paper, we discuss strategies for considering and actualizing the main concerns and priorities of ethnic groups, cultivating long-term care 2.0 cultural safety seed tutors, and employing ethnically indigenous nurses in their hometowns / communities. Furthermore, in terms of caring for minorities, we also discuss the long-term care needs of disadvantaged groups such as individuals with mental health needs to achieve the goal of holistic care. We look forward to seeing the bright and colorful rainbow once again. From systemic, educational, and practice perspectives, we will jointly promote public health for all and work to let the beauty of the rainbow surpass the traces of sorrow.

Background: Team-Based Learning (TBL) is a potentially effective method of instruction that has been applied only infrequently in nursing education in Taiwan., Purpose: This study was developed to examine the effects of incorporating the TBL strategy into the course "Advanced Medical Nursing English"., Methods: A quasi-experimental, single group, and pre-post test design was adopted. Nursing students who took the "Advanced Medical Nursing English" elective course used the TBL strategy for 8-weeks. Students were assigned to heterogenic groups of 12 students each based on their scores on an English pre-test. The collected data included the scores on individual and group readiness tests, a self-directed learning questionnaire, learning satisfaction, and an English posttest. Self-completed reflection papers and focused group interviews were used for qualitative appraisal., Results: A total of 72 students were enrolled. Nearly all (93.1%) were female and 21-22 years of age. The results of a paired samples t-test applied to examine the effects of the TBL strategy on learning outcomes showed that English posttest and self-directed learning ability scores had both improved significantly (all p < .05). The results of ANOVA tests showed that students with lower pre-test scores improved more than those with higher pre-test scores. The results of a sample t-test with a test value of 4.0 applied to examine learning satisfaction found a non-significant change (p > .05), indicating no change in perceived satisfaction. The qualitative analysis identified four themes regarding perceptions of the TBL strategy, including "friendships in learning", "harmonious atmosphere and participations", "inertial shock and adjustments", and " excessive learning load"., Conclusions: TBL was shown to be an effective learning strategy for RN-BSN students in a Medical Nursing English Course, particularly those with relatively low pre-test scores. Future studies should focus attention on reading assignments to avoid overburdening students. The results of this study may serve as a reference for medical nursing English education.

Background & Problems: Medical management protocols prioritize the safety of patients during emergency resuscitation situations. According to a medical center in Taiwan statistics gathered in 2017, the unnecessary activation of resuscitation teams by new nurses because of their improper assessment of patient conditions was a significant cause of anxiety in patient relatives and source of complaints directed at the medical center. In June 2018, 18.7% of the emergency resuscitation calls in the emergency department (ED) were false alarms or absent treatment incidents. After investigation, lack of clearly stated resuscitation team member responsibilities and insufficient practical training for new nurses were primary factors associated with the high rate of false alarm/absent treatment incidents in the ED., Purpose: To decrease the rate of absent treatment by nurses during resuscitation from 18.7% to 0% in the ED., Resolution: The assignments of emergency team members were revised, a new "Emergency app" was introduced, the assignment schedule of the emergency resuscitation team was distributed, SIM realistic education training was held, stronger team work was promoted, and a standard assignment review schedule was established and regularly monitored., Results: After the introduction of the resolution measures, the false alarm / absent treatment incidents in the ED caused by ED nurses dropped from 18.7% to 0%., Conclusions: Resuscitation workflow is closely related to patient safety, and teamwork among colleagues critical to successful resuscitation. The project revised resuscitation teamwork assignments and organized resuscitation education training, including simulation courses, to enhance the understanding of team members. The strategy outlined in this paper may be used to raise awareness using posters and resuscitation record checklists to track and manage the team`s progress. This project was designed to enhance teamwork to decrease the rate of absent treatment and to provide safe and quality resuscitation care in order to improve resource management by the team to increase productivity.

The Publication Manual of the American Psychological Association is an academic writing format reference manual commonly used in the field of social sciences. The current, seventh edition of this manual was published in October 2019. The two main issues spotlighted in this edition are the increasingly common citation of online material and the use of inclusive and bias-free language in academic writing. APA (American Psychological Association) style guidelines are widely used in nursing academia, in papers written for N3 and N4 nursing clinical ladder qualification, and in papers submitted to nursing journals. The lengthy and detailed content of the APA publication manual frequently overwhelms and confuses clinical nurses and students, and Taiwan Nursing Association members regularly submit APA-style-related questions to the Association. Thus, this article was written to address the origin and evolution of APA formatting guidelines and their importance in academic writing, highlight the major changes in the seventh edition, answer common questions about the APA citation format, and share APA online resources. It is hoped that the information in this article assists readers to improve the quality of their academic writing.

The COVID-19 epidemic continues to spread, and frontline health professionals have unfortunately contracted this virus because of exposure while providing clinical care. Based on the painful experience of the previous SARS epidemic in Taiwan, nurses have adopted a standard of care for infection protection that incorporates early prevention and detection. However, international public health experts remain unable to control the infectivity and variability of the COVID19 virus, which increases the mental stress on frontline nurses when performing care. In this paper, which uses a medical center in the north of Taiwan as an example, JBI clinical guidelines, infection control experience, and nurses' awareness, perceived support, and self-efficacy are applied to suggest ways to improve epidemic prevention and mental construction, enhance nurses' psychological empowerment and refection, promote role identity in nursing and self-value, establish health team awareness, strengthen infection protection concepts, and integrate infection control concepts into the nursing models to develop effective standard operating procedures for epidemic prevention management and effectively prevent the spread of the virus and maintain public health.

The COVID-19 pandemic has greatly impacted first-line medical staff as well as nursing-student clinical practicum programs. How to cooperate with the government's pandemic-prevention policies and reduce the gap between education and clinical practice represent significant challenges. In this paper, Chang Gung University of Science and Technology (CCUST) is used as an example to show how schools in Taiwan have effectively adapted the fundamentals of nursing practicum programs to the current pandemic using e-learning, group discussions, case analysis, clinical skill practice, and clinical case simulation scenario exercises. The program at CCUST both takes into account the safety of students and has achieved all critical nursing practice goals. After implementation of these adjustments, satisfaction among nursing students with the practicum environment and the clinical instructors was found to be significantly higher for the on-campus clinical practicum than for the off-campus clinical practicum. Furthermore, the results of qualitative data analyses show that nursing students in the on-campus practicum gained significant knowledge and experience and commented positively on their experience. For example, the students indicated that they were satisfied with the simulated clinical environment of the CCC, the teaching strategies and adaptability of the instructor, and the application of virtual reality scenario cases to enhance skill proficiency and learning outcomes. The adjusted nursing clinical practicum described in this paper may be used as a reference to ensure the quality of nursing clinical practicum programs is maintained during epidemics.

The focus of this article is on a male patient with hearing loss who was diagnosed with COVID-19 after returning to Taiwan from overseas. Due to the severe pneumonia infiltration, the patient received the clinical-trial treatment Remdesivir. In addition to facing the isolation and new-drug-related anxieties of the patient, the medical team faced difficulties in communicating effectively with the patient and in helping him through the isolation period. During the period of hospitalization (March 14th to April 13th, 2020), the author used Roy's adaptation model to perform a nursing assessment, which confirmed that the patient faced the following problems: (1) ineffective breathing pattern related to COVID-19, (2) impaired verbal communication related to hearing impairment, and (3) social isolation related to the isolation experience and the communication barrier with healthcare workers. During the nursing care process, the author helped the patient receive the antiviral treatment and taught him how to do diaphragmatic breathing in a comfortable, recumbent position to improve his breathing pattern. To reduce the difficulty of communication, the author made a pile of cards with common care-related words, provided pen and paper to write, and used a mobile-phone-based social-networking application to communicate with the patient. The author used writing to communicate with the patient and learned some simple signs from him to enable interaction. Moreover, the intervention helped him adapt to the isolation and treatment protocols to reach holistic nursing care. Based on this experience, the author suggests that hospitals cooperate with sign language organizations to teach healthcare workers simple communication skills, including sign language and cards to provide more complete care for patients with hearing loss during hospitalization.

The outbreak of COVID-19 triggered the largest human-virus war in this century. Current evidence indicates that the SARS-CoV-2 strain of coronavirus is mainly transmitted by droplets either by direct or indirect contact. The duration of infectiousness of COVID-19 ranges from 1-2 days before and 7-10 days after the onset of symptoms. It is often difficult to detect the signs and symptoms of infection and to implement timely intervention during the very early stage of infection. Thus, finding and isolating symptomatic patients may not be sufficient to contain this epidemic. Therefore, it is very important to wear masks, take personal precautions, and practice recommended social distancing to achieve source control and stop transmission. Taiwan has learned from its previous experience with the SARS epidemic and prepared for the potential of new disease outbreaks for at least 17 years. This helped the government to implement a multifaceted strategy in the early stages of the COVID-19 outbreak. Taiwan's effective response has made the country a model for pandemic response policy that has been appreciated internationally. This paper examines COVID-19 epidemic prevention from the perspective of infection control strategies. In Taiwan, hospital infection control, which is practiced nationwide, emphasizes the importance to epidemic prevention of collecting and tracking travel history, occupation, contact history, cluster (TOCC) information; practicing hand hygiene; promoting the correct use of personal protective equipment; and maintaining safe distances from others. Personal control measures are recognized as critical to providing a safe environment for patients and staff.

The ongoing new coronavirus disease (COVID-19) pandemic, which arose at the end of 2019, poses a severe challenge to world public health systems. Frontline medical staffs bear a great burden to provide health care services. The Taiwan government has taken rapid and decisive actions to reduce the risk of community transmission and campus cluster infection. Nursing education includes both classroom teaching and clinical practicum components. In preparing for their practicum, students must learn not only fundamental nursing care knowledge but also basic knowledge on emerging infectious diseases. All schools nationwide have complied with the Ministry of Education order to postpone the opening of the fall semester in response to the rapid evolution of the COVID-19 pandemic. Campus epidemic prevention measures were implemented through student counseling networks, and flexible teaching strategies, including online teaching and distance teaching, were implemented to protect the learning rights of students. This paper explores the strategies implemented in response to emerging infectious diseases in nursing education based on the core values of professional nursing. Examining the precautions taken at campuses and teaching strategies adopted in response to the COVID 19 pandemic may provide valuable insights that may be applied to the future development of nursing education.

Research is an indispensable element that shapes every profession and discipline. "Employ evidence-based research into practice" is one of the five core competences highlighted by the American Institute of Medicine (IOM) in 2001 that all healthcare professionals should possess. With the development of evidence-based medicine, "Nursing research competence" has gradually become a core competence that all nurses must have. In light of the major demographic changes and multicultural social revolution underway worldwide, nursing research trends must be adapted to meet new, global challenges rooted in changing environmental, populational, geographical, and ethnic conditions. This paper analyzed the Web of Science database using VOSviewer and inputting the names of schools and departments as key words in consideration of QS rankings among European, American, and Asia regions for the years 2014 - 2018. Analyses of keywords, themes, and countries of international cooperation were conducted on 6333 original nursing articles published in journals indexed on the Science Citation Index (SCI) and/or Social Science Citation Index (SSCI). The results indicate that the cooperation between scholars from Taiwan and scholars from the United States, the United Kingdom, and China is relatively common. With regard to both global and Asia-specific research study trends, the top-five key words used to describe nursing research papers were health, care, depression, prevalence, and quality of life. The differences between Europe and the United States and Taiwan were the "risk, intervention, experience, adolescent" and "risk and impact" depicted by visual analysis. In addition, this research examined the themes of academic nursing conferences announced online for 2020, and found that a majority highlighted "nursing and healthcare" as a major theme. In twenty-two Chinese nursing journals indexed on the Huayi Online Database (2017-2020), geriatric nursing, long-term care and improvement in nursing care quality were the most commonly used research topics. In general, the aims of nursing research are to enhance the professional image and status of global nurses and to achieve the goals of global health. To create a better nursing research environment in Taiwan, nurses should improve their research abilities and cultivate cultural nursing sensitivity with the goals of maximizing the quality and quantity of research and of strengthening international cooperation, with the ultimate aim of enhancing the health and well-being of all. The international visibility of nursing in Taiwan must be increased to improve our international profile.

The objective of international nursing education in Taiwan is to prepare nursing elites to improve the quality of global healthcare. Nurses are on the frontlines in terms of helping the public through increasingly frequent climate-change disasters, helping care for the rising populations of older adults and patients with chronic diseases, and dealing with the emergence of new infectious diseases. Advancing the knowledge and capabilities of global nursing elites is imperative. The main purpose of nursing education is to educate future nursing leaders. This paper describes the internationalization of nursing education in the Department of Nursing at National Cheng Kung University as well as the process of establishing the Asia-Pacific Nursing Education Alliance to highlight the international characteristics of nursing education, the related global social influence, and the pursuit of sustainable development goals.

With Taiwan now an "aged society", home safety for older individuals has become a very important issue. The purpose of establishing early warning systems in homes and/or communities is to generate and disseminate meaningful warning information to medical institutions or rescue units in a timely manner so that they may take timely and appropriate action. The main purpose of this paper is to introduce the current application of information and communication technology (ICT, especially the Internet of Things and artificial intelligence) in early warning systems for home and community care. Two approaches to developing these systems are introduced: instant detection and prevention monitoring. Instant detection facilitates fall detection and personnel tracking, while the focus of prevention monitoring is on preventing falls and physiological status monitoring. The challenges faced by in incorporating ICT into these early monitoring systems are discussed as well.

Diabetes is one of the most prevalent chronic diseases affecting public health. The Taiwan government implemented the Diabetes Shared Care Program to deliver continuous medical care and provide health education in order to help clients with diabetes learn self-management. However, rural older adults with diabetes often have poor access to medical resources and thus face obstacles to obtaining and using the services of this program. This paper introduces the current status of the Diabetes Shared Care Program, discusses the concept of self-management education and support for diabetes cases, and proposes community-based strategies, including (1) provide DSMES (diabetes self-management education and support) with multi-types of services, (2) increase non-professional personnel training, and (3) provide culture-congruent health education, in order to strengthen the diabetes self-management capabilities of rural older adults.

The prevalence of potentially inappropriate medication (PIM) use is high, presenting a serious public health problem. In older adults, PIM increases the risks of adverse drug events, falls, hospitalizations, and emergency treatments as well as related medical expenses. The currently popular criteria for determining medication appropriateness and several common medication appropriateness assessment tools are introduced in this paper, including the Medication Appropriateness Index, the Beers criteria series, the Screening Tool of Older Person's Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) series, Thailand criteria, and the PIM-Taiwan criteria, with the goal of facilitating their application by medical professionals in clinical practice.

Changes in climate and global warming trends impact the ecological balance as well as human health. The recent development of geospatial information technologies such as Geographic Information Systems (GIS) and remote sensing provides useful tools to assess the impacts of climate changes on human health over large areas. This article aimed to conduct a literature review related to the application of geospatial information technologies in order to assess climate-change-related health risks in Taiwan, with primary outcomes of interest including physiological and mental health and infectious diseases. Three environmental factors, including temperature, precipitation, and air pollution, and their impacts on human health were considered. Comments were raised for future studies in Taiwan on this subject area. Among the hundred papers reviewed, 28 were related to the target topic, and air pollution and fine particle studies were the focus of most of these 28 papers. Studies related to extreme temperature indicted growing concern with this issue. However, limited research was found related to precipitation and environmental greenness. Therefore, future studies should pay greater attention to these two environmental issues. We hope that the findings of this literature review will encourage more researchers to investigate this subject.

Adhering to ethics protocols has become increasingly important in the process of doing research in Taiwan since the introduction of research-ethics mechanisms. Adhering to these protocols affects research on Taiwan's indigenous peoples due to the vulnerability of indigenous groups and to their increasing rights consciousness. The present paper explains the context of group rights from a national self-determination perspective and then discusses the current indigenous research-ethics mechanisms in Taiwan. The ethical guidelines for indigenous research in Canada, TCPS2 2014-Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans are referenced as a model for protocols that may foster positive and mutually trusting relationships between academic researchers and indigenous communities in Taiwan.

Gender and race issues have caused rapid cultural and societal changes to affect the healthcare of indigenous women, which involves complicated, cultural meanings. The present paper begins by outlining the gender perspective and then elaborates on the present gender mainstreaming and status of indigenous women's healthcare in Taiwan. Furthermore, this paper identifies the current difficulties experienced by Taiwanese indigenous women, including those related to the lack of adequate healthcare data and gender analyses on indigenous women and the lack of regular research on healthcare strategies for indigenous women. Therefore, the present paper proposes to establish health policy references that are gender and race sensitive. The health policy not only addresses racial and gender concerns regarding healthcare information but also focuses on the analysis of indigenous healthcare information. Indigenous women's health concerns are discussed here within the framework of healthcare policy through the perspective of gender mainstreaming. Additionally, we will analyze and evaluate the effects of gender in order to establish inspection and management processes that integrate the concept of gender into policy development and implementation, thus promoting relevant health policies. During the processes of planning, implementing, and evaluating healthcare policies, women should unite to contribute toward indigenous women's health policies and gender mainstreaming.

Clinical practice guidelines (CPGs), representing the current best-practice guidelines and recommendations for care, are supported by systematic review and evidence-based research. CPGs provide an effective and efficient approach to caring for patients and improving quality of care. Recently, the National Health Insurance Administration and National Institutes of Health developed CPGs for major diseases in Taiwan. This paper introduces the process that was used to develop one of these CPGs, the Taiwan Chronic Kidney Disease Clinical Guidelines, which was published in 2015. Further, we introduce the general development of published nursing guidelines in Taiwan. These CPGs are expected to initiate various renal-care guidelines and to promote the quality of renal care in the country.

This paper will explore the fire and explosion characteristics of cornstarch powder as well as strategies for protecting the safety of people who are involved a dust fire or dust explosion. We discuss the 5 elements of dust explosions and conduct tests to analyze the fire and explosion characteristics of differently colored powders (yellow, golden yellow, pink, purple, orange and green). The results show that, while all of the tested powders were difficult to ignite, low moisture content was associated with significantly greater risks of ignition and flame spread. We found the auto-ignition temperature (AIT) of air-borne cornstarch powder to be between 385°C and 405°C, with yellow-colored cornstarch powder showing the highest AIT and pink-colored cornstarch powder showing the lowest AIT. The volume resistivity of all powder samples was approximately 108 Ω.m, indicating that they were nonconductive. Lighters and cigarettes are effective ignition sources, as their lit temperatures are higher than the AIT of cornstarch powder. In order to better protect the safety of individuals at venues where cornstarch powder is released, explosion control measures such as explosion containment facilities, vents, and explosion suppression and isolation devices should be installed. Furthermore, employees that work at these venues should be better trained in explosion prevention and control measures. We hope this article is a reminder to the public to recognize the fire and explosion characteristics of flammable powders as well as the preventive and control measures for dust explosions.

Active ageing is one of the most important issues taken up by the WHO in regard to ageing societies. "Prolonging Healthy Life Expectance" and "Decreasing the Depression Rate Among Older People" are critical indicators for "2020 Healthy People in Taiwan". This paper conducts a trial run of the program planning and evaluation of mental-social health promotion using focus group research that surveys 29 administrative districts and a depression survey that randomly samples older individuals in Taichung City. We also introduce how we apply local characteristics to develop the 3-level and innovative-action plans to meet the needs of self-identity and social participation for older people. For example, the "Learning Mobile Classroom" program promotes health promotion using activities that are tailored to the lifestyle and culture characteristics of target individuals. Another example is the "Seniors Show", which uses community groups and annual active-ageing shows to promote a positive concept of aging and to promote social participation for older people. Finally, the "Navigator APP of Active Ageing", created using a geographic information system, addresses the resource information needs of older people. This experience in Taichung City uniquely empowers older people, allowing them to take the initiative to make a difference not only for mental-social wellness but also for the hope of life and for graceful ageing.

According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses.

Community mental health is an important area of public health. This study initially elaborates from the perspective of community psychology the concept and basis of the practice of community mental health work, including the importance of prevention over treatment, of valuing personal advantages and capabilities, and of adopting an ecological perspective, a respect for diversity, empowerment, and scientific cooperation and integration. Subsequently, this paper reviews the history of the development of community mental health work in Taiwan and of the operations, developmental issues, and difficulties currently faced by community mental health centers. Finally, this paper addresses the future prospects for community mental health work in Taiwan in hopes that the government will attach greater importance to related policies and implementation plans, optimize the service and delivery systems of community mental health organizations, reinforce community mental health education, develop effective community mental health promotion strategies, provide accessible and continuous direct services, integrate community mental health resources, and support the families of mental health patients in order to consolidate and better promote community-based mental health work.

The development of information technology has changed the world and allowed the innovation of nursing-care services. In recent years, the development of nursing informatics in Taiwan has been catching up with international trends and has been regarded positively by the international medical informatics community. The integration of information technology into medical care system has created the new nursing role of "informatics nurse." Although the certification system and job descriptions for these nurses have become increasingly comprehensive in many nations, Taiwan remains in the early development stage in these regards. Taiwan informatics nurses continue to face unclear and inadequately stated role responsibilities and job titles, undefined training requirements, and a lack of a clear qualification / certification system. This paper introduces the role functions and professional growth of informatics nurses and introduces the framework for a certification system in order to give to various medical and paramedical staffs a better understanding of informatics nursing and to recognize the important role played by informatics nurses in the process of healthcare informatics development.

The numbers of people who suffer from age-related and chronic diseases have been increased worldwide. This has lead to an increased emphasis in the medical community on end of life care. This paper references the processes followed overseas in developing palliative care education programs as well as the domestic experiences promoting the hospitalization, home care, and "share care" models of palliative care. Particular emphasis is given to considerations of cultural diversity in palliative care. The aim of this paper is to elaborate on the prevalent clinical end-of-life care issues that are faced in Taiwan, to cultivate core capabilities in end-of-life care, to elicit the current status and development of formal nursing education, and to promote continuing education in palliative care. Kern formulated a six-step approach to curriculum development in education and the details has been discussed . Finally, this paper reflects on the current bottlenecks, challenges, and expectations related to palliative care curriculum development in order to help medical professionals further put humanistic and social care into practice, increase ethical reflection in end of life care and nursing competency, and encourage the creation of localized textbooks / multimedia e-teaching materials. The fostering of "patient-centered, family unit and the social-cultural contexture" for palliative care professionals and the ability to respond to the needs of terminal patients and patients with chronic diseases are critical to increasing the quality of Taiwan healthcare.

Advances in medical technology mean that organ donation operations hold the potential to significantly improve the health status of organ failure patients. Taiwan registers an average of 100~200 organ donors per year; however, cases awaiting organ transplant regularly number 8,000 annually. According to the Human Organ Transplant Act, health professionals are obliged to promote organ donation. This article introduces the Taiwan Human Organ Transplant Act and illustrates its implementation and relevant provisions in order to increase general awareness among healthcare professionals of the legal aspects of organ donation and transplantation. In addition, this paper cites two judicial decisions that highlight domestic judicial practice with regard to human organ transplantation. These include decisions on AIDS organ donation and the ruling not to establish an organ bank. Healthcare professionals must comprehend the legal requirements and current status of human organ transplantation in order to play a positive role in increasing organ donations in Taiwan. A win-win situation for healthcare provision and patients results when patient safety is the cornerstone of healthcare provider services.

Nursing is a distinct branch of science. Nursing research is not only key to developing professional knowledge and but also to promoting nursing as an independent discipline. This paper describes the development and outcomes of nursing research over the past 100 years and then explores the factors that have influenced the focus of nursing research in the past. Findings may be applied to future efforts to promote nursing research. The authors hope that nurses integrate the best research evidence, the best clinical judgment, and the expectations of patients in order to provide the best quality of nursing care through reflection and praxis in nursing research.

Background: Healthcare and studies related to new immigrants in Taiwan have been influenced by immigrant reproductive health management policy. Some nursing scholars have criticized the top-down approach as potentially not addressing the actual healthcare needs of these immigrants. Medical institutions are being called upon to provide culturally appropriate care., Purpose: Using health networks as its conceptual framework, this paper explores the definition of health as perceived by recent immigrants to Taiwan and their perspectives on seeking and maintaining health., Methods: This paper uses participant observation and depth-interviews to assess how recent immigrants from Mainland China, Vietnam, and Indonesia seek health in their new homeland, evaluate the differences between the healthcare systems in their former and current countries, and recommend actions necessary to ensure the health and wellbeing of this population., Results: The findings are grouped into three themes: "the differences between immigrants and Taiwanese in health care," "local health networks", and "transnational health networks." These themes reflect the views on health and health care of recent female immigrants to Taiwan., Conclusion: Through the actions and narratives of these immigrants, this paper suggests the priority concerns that immigrant agencies should address in order to maintain the health of this group. Additionally, findings give some insight into the gender and ethnic characteristics of immigrant health networks. Immigrants construct and rely upon social relations, cultural identity, and resources to maintain their wellbeing. This study contributes to transcultural nursing theory and to in-service training and helps medical practitioners and nurses provide culturally appropriate care.

The Taiwan Nurses Association (TWNA) is publishing a special centenary issue to commemorate the 100th anniversary of the association in 2014. For this issue, TWNA invited the author to write a review article that addresses the involvement of the TWNA in professional diplomacy and international exchange over the past century. The author reviews the history of both TWNA and the International Council of Nurses and introduces the contributions of the association in the field of professional diplomacy and the positive contributions of many Taiwan nursing leaders to global healthcare and society. The purpose of the paper is to convey the traditions and experiences of TWNA forward to the next generation.

Continued global economic difficulties and Taiwan's health insurance scheme have focused the domestic healthcare system excessively on medical treatments and made this system overly market-oriented. The NHI (national health insurance) Reimbursement Policy lacks adequate flexibility to adjust to current health needs. The situation constrains the medical service budget and causes nursing shortages in hospitals, which in turn marginalizes the public health nurses working at health centers. It is important for the government and professional associations to establish a public healthcare model that adequately meets the needs of the community. In addition to strengthening the role and function of public health nurses, a service model must be developed and piloted. This paper analyzes the situation and problem of maternal and child healthcare in Taiwan, studies the successful experiences of maternal and child healthcare from other counties, and then provides recommendations for the future development of public health nursing in Taiwan.

The Taiwan Joint Commission on Hospital Accreditation (TJCHA) authorized the Teaching Quality Improvement Program for Teaching Hospitals as a way for the Department of Health to plan and implement improvements. The program assists medical and paramedical professionals to establish a postgraduate clinical training system. The two-year postgraduate training program for nurses is one of the program's regular activities, divided into three phases that include location-based curriculum training (3 months), core curriculum training (9 months), and professional courses training (12 months). This paper describes the origin, current implementation status, and efficacy / key problems of this two-year post graduate training program, Information regarding the opinions of new nurses, preceptors, and nursing managers on the three aspects is drawn from the author's relevant professional experience, interactions with nurses, and a review of the literature. Findings include: (1) nursing departments should operate in accordance with TJCHA guidelines; (2) department training should be adequate to promote the ability and willingness of nurses to train a new generation of clinical preceptors; and (3) participant opinions on project execution progress and difficulties. Findings may be referenced to better achieve Teaching Quality Improvement Program for Teaching Hospital objectives.

Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

This article aims to explore three main concepts related to the professional development of nursing professionals. This paper first critically reviews and reinterprets scientific evidence on the relationship between nurse staff allocation and healthcare outcomes and then challenges some of the common interpretations of this evidence in the professional literature. Secondly, in the absence of solid empirical evidence provided by sophisticated datasets in this field, we consider how Communitarianism may provide a well-defined, highly appropriate ethical framework for further developing and improving the nursing profession and healthcare outcomes. Thirdly, this article examines the role of Communitarian ethics in setting Taiwan's healthcare priorities and promotion nursing's core professional values. In conclusion, we recommend several conceptual health policy frameworks to ensure patient safety.

The Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization and the United Nations Children's Fund to promote breastfeeding in maternity facilities worldwide, has had a global impact on breastfeeding outcomes. However, further interventions are necessary before and after hospital discharge to meet the initiative's recommended 6-month targets. The Baby-Friendly Community Initiative (BFCI), a multifaceted program for community based breastfeeding promotion designed to complement BFHI, addresses this challenge. The purpose of this paper is to introduce the origin of BFCI and its current implementation status in several countries as a reference for effective BFCI promotion in Taiwan.

Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.

Background: Evaluations of higher education programs are increasingly centered on the learner and designed to assess learning effectiveness and core competencies. Although the Taiwan Nursing Accreditation Council (TNAC) has established eight core competencies for college nursing departments, little research has been done to identify the most salient contributors to undergraduate nursing students' perceived competency levels., Purpose: This paper investigates the influence of student demographic factors and learning experience on students' development in terms of a selected sample of core nursing competencies and then identifies factors that significantly predicts such development., Methods: This is a cross-sectional descriptive correlational study. We collected data from a sample of freshmen students currently enrolled in a two-year nursing bachelor degree program at a private vocational university in Taipei, Taiwan. Participants self-assessed abilities in designated core nursing competencies using the Competency Inventory of Nursing Students (CINS). A total of 279 of 290 distributed questionnaires were returned and used in data collection, giving this study a valid return rate of 96.2%., Results: Participants earned a mean CINS score of 5.23 (SD = 0.49). Scale dimensions from highest to lowest mean score rank were: ethics, accountability, caring spirit, communication and cooperation, lifelong learning, general clinical nursing skills, critical thinking, and basic biomedical science. Differentiated analysis revealed that nursing students who expressed a strong interest in nursing, had a clear career plan, held aspirations to pursue higher nursing education, designated "major hospital" as their first workplace of choice, designated a post-college department / workplace preference, had participated in campus activities, were outspoken in classroom discussions and debates, made consistent effort to complete homework assignments and prepare for examinations, and performed relatively strong academically earned CINS scores significantly above the mean. The three factors "having a clear career plan," "having designated a post-college department / workplace preference," and "having participated in campus activities" accounted for 14.4% of variance in subjects' CINS self-rating scores (adjusted R2 = 12.5%)., Conclusion: The CINS is an effective instrument for assessing the core professional competencies of nursing students. We recommend that nursing education strategies may be adjusted to enhance student interest in nursing, encourage their developing career plans, and encourage greater participation in campus activities and classroom discussions as a way to improve core professional competencies.

Many city authorities around the world are enhancing infrastructures and services to make their cities age-friendly, a process that aims to make city services and facilities more accessible to an ageing population and increase opportunities available to older residents. The process of creating age-friendly environments is a key challenge for international policy makers. The purpose of the paper is to introduce age-friendly city ideals and practices and share the age-friendly city planning experience of Taichung city.

Longer average life expectancies and an ageing society have made long-term care an urgent and important issue in Taiwan. Although the implementation of Long-Term Care Ten-year Project four years ago has begun showing success in terms of assessing Taiwan's needs in terms of long-term care services and resources, there has been little forward progress in terms of training, recruiting and maintaining more competent professionals in the long-term care sector. This paper explores the current state of long-term care competency in Taiwan and educational strategies in place to improve the competency of long-term care professionals. Results indicate that the term geriatric competency embraces sub-competencies in direct care, communication, assessment, teamwork, cultural sensitivities and career care competencies. The term long-term care competency embraces the sub-competencies of supervision, management, information technology, resource management, and organizational skill. As a main contributor to effective long-term care, the nursing profession must employ effective strategies to develop competency-based education. Also, the profession must have an adequate supply of competent manpower to effectively respond to Taiwan's aging society.

Level of development in the nursing profession affects healthcare quality and safety. The nursing profession in Taiwan today faces myriad external pressures such as the global financial crisis and rapidly changing national health insurance policies and social issues. For example, cutbacks in nursing manpower at medical institutions and increasingly difficult healthcare working conditions are increasing nurse workloads and turnover, conflict in the workplace, and difficulties in recruiting new nursing staff. Such negative developments directly and negatively impact professional development, healthcare quality, healthcare safety, and workplace morale. In terms of maintaining and enhancing the quality of new nurses entering the profession, rapid growth in numbers of technology schools and nursing students have severely strained insufficient resources and resulted in teaching quality and education outcomes below expectations. Poor passing rates on the national nursing license examination and increasingly high new nurse turnover are now significant negative factors influencing clinical manpower availability. Imbalances among education, licensing, and hiring clearly and negatively impact nursing professional development and social needs and cause the inefficient allocation of limited education resources. This article discusses and analyzes the causes underlying current imbalances in nurse hiring, licensing, and education. We provide the following suggestions: (1) Integrate education and licensing activities based on professional recruitment considerations to promote nursing competent and manpower stability; (2) revise the focus and content of the national license examination to resolve the current disconnect between license examination and hiring needs; (3) redesign curricula, update teaching material, and adjust teaching methods based on professional competencies in order to resolve key education and recruitment problems. All nursing schools should prepare their students well to pass the license examination in order to resolve the current state of inconsistent educational standards, and (4) train international nursing talent to address and reflect international medical care trends and policies in Taiwan. This paper is intended to serve as reference for both policymakers and professionals in the nursing and healthcare fields.

Health policies in many advanced countries have been revised and reformed to address increasing public healthcare demands and increasingly limited resources. Upgrading the quality and quantity of community healthcare is the most effective solution. Implementation of the National Health Insurance system in Taiwan has introduced instability into the medical system, as insurance premiums no longer correspond to healthcare demand, Taiwanese live inadequately healthy lifestyles, and expectations of the healthcare system continue to grow. Community nursing now faces many challenges at this historic crossroads. This paper tries to analyze factors in the domestic and international environment that affect Taiwan's national community healthcare. These include changes in population structure, adjustment of governmental policies, the implementation of nursing and medical regulations, and consensus among nursing professional groups. The authors hope to anticipate the trends and prospects and advantages and opportunities in community healthcare in the coming decade in order to help our community healthcare partners prepare a good foundation and establish a model for the national healthcare system and nursing profession.

Taiwan's multicultural population requires that nursing educators address and effectively manage trans-cultural healthcare issues. A longstanding lack of self-reflection on cultural issues has caused a gap between community nursing and the health needs of Taiwan's indigenous people. Taiwan's newer immigrant populations from Southeast Asia, Mainland China and elsewhere have added further cultural complexity to Taiwan's community healthcare landscape. In this paper, the authors apply their practical experience in community nursing to derive the special healthcare needs of indigenous and new immigrant populations based on the unique cultural attributes and health concepts of these populations. We hope to help nursing staff develop cultural self-awareness and sensitivity by admiring, respecting, and learning from their own culture while empathizing with and appreciating the cultures of their healthcare clients. By doing so, healthcare providers can further examine the cultural characteristics of the professional nursing system and conduct trans-cultural evaluations.

Community health nursing is an innovative aspect of healthcare that has grown in response to changing environmental and social structure changes into a worldwide movement. Taiwan's fast growing elderly population, improving health technologies and rising healthcare costs impact significantly upon the development and definition of the scope of practice for community health nurse nurses. This paper explores the innovative community care model development experiences of several countries and reviews the scope of practice of community health nurse practitioners in each. We further explore the current situation of nurse practitioners in Taiwan and suggest a future path for Taiwan community health nurse practitioners development and policymaking.

This paper introduces the authors' journeys into nursing history research and shares their experience with international nursing history academic exchanges. The first section of this paper summarizes a literature review and analysis of nursing history in Taiwan; the second section shares the authors' experiences participating in international nursing history academic exchanges, organizing the International Perspectives of Nursing History Conference along with relevant observations and comments. The authors hope that more scholars will engage in nursing history research in order to enrich the knowledge base and facilitate the further development of nursing history research in Taiwan.

Over the past three decades, chronic disease has replaced communicable disease as the leading collective cause of death in Taiwan. As a result, medical and public healthcare manpower and budgets dedicated to communicable diseases have been reduced. The 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) changed government epidemic prevention policies and marked a renewed focus on preventing and controlling communicable diseases. This study introduces Taiwan's communicable disease control system and reforms, the domestic status of communicable diseases, the infection control policies of Japanese colonial authorities in the early 20th century, and national / community-level communicable disease control mechanisms in place before and after 2003. This paper further examines the actual health management conditions in a county in southern Taiwan to show how the public health system is rooted in communities, how infection control strategies are promoted, and how social organizations influence community life and mores.

Public health personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City Public Health Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that public health staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and public health staff knowledge.

This review considers health professionalism in community practices within a Taiwan social-historical context. The author adopted a contrast-of-context approach to examine the community practices of Taiwan health professionals and intellectual transformation of Professor Byron Good. Focusing on the formation of an international collaborative platform for community mental health, this paper articulates the historical and social values of community health practices, identifies the essence of health practices, and highlights the significance of the Taiwan experience to advancing community mental practice worldwide. It furthermore underscores the strategic role of Taiwan in efforts to bridge Asian community health knowledge with that of the world. This essay first introduces the recent establishment of the international collaborative platform. Community psychiatric rehabilitation practices in Taiwan are then contrasted with the worldwide de-institutionalization intellectual movement. Paradigm shifts in the academic pursuits and intellectual journey of Professor Byron Good are then delineated, then community practices and social missions of Taiwan health professionals are contrasted. The implied connotations of health professionalism and bioethics in large-scale social change are explored next. This paper integrates relationships amongst community practice, health professionalism and civil society. Professor Byron Good and other friends, either domestic or international, will work together to highlight the new values embedded in recent Taiwan experience and the contributions such have made to global knowledge production.