Search

An estimated one-fifth to one half (17.5%-50.5%) of the older adult residents living in long-term care facilities are either malnourished or at risk of malnourishment. Malnutrition in older adults is related to frailty, sarcopenia, anemia, falls, morbidity, and mortality. Monitoring nutritional status and instituting appropriate nutritional care plans in long-term care facilities can help prevent the development of disabilities in older adult residents and reduce long-term healthcare expenditures. In this article, after introducing the primary diagnostic tests for malnutrition, the three main nutritional care principles are presented in the following categories: non-specific health problems, specific-health problems, and dehydration are presented. Next, the behavioral-environmental factors of nutritional care are defined. Finally, the related challenges and practical recommendations are discussed.

Background: Nurses comprise a group in the healthcare team that is exposed to the highest levels of workplace violence. This not only causes negative emotions in nurses and adversely impacts the institution and the body and spirit of the nurses but also affects the quality of nursing care., Purpose: The aim of this study was to determine the prevalence of physical and psychological workplace violence experienced by the nursing staff and to identify the perpetrators of violence, the reactions of the victims, and the policies developed by employers to prevent violence., Methods: This cross-sectional study was conducted using a stratified sampling method across different levels of healthcare institutions on the nursing personnel registered with the Taipei Nurses Association. The number of subjects was allocated according to hospital level. A total of 2,931 subjects were recruited, of whom 2,627 participated in this study., Results: Over two-thirds (70.6% ) of participants had experienced workplace violence, of whom 31.0% had experienced physical violence and 66.0% had experienced psychological violence. A multiple logistic regression analysis showed that nurses who were married, who had less than one year of work experience, or were over 50 years of age were at lower risk of physical and psychological violence. Those who had a university education or higher faced a higher risk of psychological violence. The most common perpetrators were identified as patients. The aftermath reactions from the victims were varied, with the most prevalent being "telling the perpetrator to stop the violence", "telling friends or family," and "reporting the incident to a senior staff member". The perpetrators were mostly dealt with using a verbal warning, while the second-most common strategy was taking no action. Only 2.3% ‡6.8% of the victims notified the authorities about the violence because of the following primary reasons: "useless," "not important," and "fear of negative consequences." The major strategies that were adopted by employers to prevent violence included "security measures," "improvement of surroundings," and "training.", Conclusions: Prevention of violence must be improved comprehensively using the strategies of physical facilities, management, education, and policies.

Spiritual care is a component of holistic care. Patients with depression often experience body-mind-spirit health problems and may suffer from spiritual crises, particularly during the acute stage of a diseases, due to low self-esteem, negative attitudes toward life goals, daily life issues, and beliefs caused by physical, psychological, and occupational dysfunctions. Nonetheless, psychical care is the main treatment for patients with depression. This paper focuses on patients with depression and addresses the concepts of spiritual needs and spiritual care, identifying the factors that influence spiritual needs, the essentials of spiritual intervention, and the health effects of spiritual intervention outcomes on patients with depression. Courses that teach practical spiritual interventions are recommended for nurses. These courses should address topics such as individual approaches, building trusting relationships, setting diverse goals for spiritual interventions based on disease stage, and spiritual interventions involving the body-mind-spiritual aspects for patients with depression.

In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.

At least half of patients with cancer experience emotional distress (e.g., posttraumatic stress symptoms). Most of the studies on the emotional distress of Taiwanese cancer patients have focused on issues of depression rather than on posttraumatic stress disorder. The scope of the present article covers the definitions of cancer-related posttraumatic stress disorder (CR-PTSD) and cancer-related posttraumatic stress symptoms (CR-PTSS), identifies the differences and similarities between professional interview and self-administered measurement tools and their applications; analyzes the prevalence of CR-PTSD and CR-PTSS; identifies the possible contributing sociodemographic (younger age, female, low education, low socio-economic status), clinical (advanced stage, undergoing chemotherapy, just completed the therapy), and psychosocial (negative psychological traits, poor social support, and insufficient coping strategies) of CR-PTSD and CR-PTSS; and aggregates the effects of cognitive and psychosocial interventions on CR-PTSD and CR-PTSS. Furthermore, recommendations for clinical practice and research are discussed. This article is expected to provide practicing nurses with a basic concept of caring for emotional distress and to inspire researchers to conduct further study of issues related to CR-PTSD and CR-PTSS.

Background: Little has been published in the literature regarding how patients self-evaluate their degree of readiness for hospital discharge. Furthermore, there is currently no self-evaluation tool available in Chinese able to assess the discharge readiness of patients., Purpose: This study was used to psychometrically test the Chinese version of the readiness for hospital discharge scale (RHDS&#95;C)., Methods: This study used a cross-sectional design. Two samples were recruited in a two-stage process at two hospitals in Southern Taiwan. Two hundred and twenty-three patients with a diagnosis of either colorectal cancer or hepatic cancer were used to conduct an exploratory factor analysis (EFA) in the first stage of the study. Another 323 patients with a diagnosis of stroke were used conduct a confirmatory factor analysis (CFA). The instrument used was the Readiness for Hospital Discharge Scale (RHDS) developed by Weiss & Piacentine., Results: RHDS&#95;C consists of three subscales: personal status (4 items), coping ability (4 items), and expected support (4 items) adapted from the CFA. The assessed goodness-of-fit index (GFI = .92, AGFI = .88, NFI = .97) indicate the model fit the data well based upon the CFA. Criterion-related validity was supported by the correlation between the original RHDS and the RHDS&#95;C (r = .96, p < .001). The Cronbach's alpha coefficients were .89 for the overall scale and .73, .90, and .89 for the 3 subscales, respectively., Conclusions / Implications for Practice: This study confirms the validity of the RHDS&#95;C and suggests this instrument is able to reliably assess the readiness of patients for discharge from the hospital. We recommend the scale be applied in the clinical setting to evaluate the discharge readiness of hospital patients.

The significant changes in nursing manpower utilization in Taiwan over the past two decades are due in large part to the implementation of the National Health Insurance program and the rising need for long-term care. The changes have impacted clinical nursing manpower utilization in two important ways. Firstly, there has been a substantial increase in overall demand for nursing manpower. In particular, the need for clinical nurses has nearly quadrupled during this time period. Secondly, the level of difficulty involved in patient care has risen dramatically, with factors including increased disease severity and increased care quality expectations, among others. These changes, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system. To raise the quality of the nursing work environment, the Ministry of Health and Welfare (MOHW) brought together Taiwan's key professional nursing organizations to promote 10 care-reform strategies, establish the nursing-aid manpower system, and create the nursing classification system as an approach to effectively attract nurses to take positions in the medical system.

A chronic shortage of working nurses has led hospitals in Taiwan to close wards and reduce bed numbers. Work overload and job stress are major causes of this shortage. The purpose of this study is to propose a solution to improve the nursing workload situation. We reviewed literature articles and conference presentations to synthesize relevant measures, which included reforming the current care model; using innovation to simplify nursing practice; and creating a culture of workplace respect and inter-team cooperation. Based on this, we proposed our nursing retention strategy after reviewing national Department of Health development policies on nursing manpower.

Formal caregivers often play an important role in leading activities programs and arranging appropriate therapeutic activities in institutions. Studies have shown that, when elderly patients with dementia have participated in more structured activities, agitated behaviors have been significantly decreased. Also, structured activities have helped in the performance of ADL, as well as improved quality of sleep, decreased anxiety, improved self-expression and social interaction, enhanced caregiver's morale, and resulted in a more positive caring attitude on the part of caregivers. This article will discuss the categories and contents of activities programs for elderly patients with dementia and can be applied as a reference to assist formal caregivers in their efforts to arrange appropriate activities programs in institutions.