Search

Aims: The study compares the differences in self‐care knowledge, self‐efficacy, psychological distress and self‐management between patients with early‐ and end‐stage chronic kidney disease (CKD), and predicts the influential factors of self‐management. Design: A cross‐sectional study. Methods: A total of 185 subjects by using convenience sampling from one teaching hospital were collected. The research instruments included the Chronic Kidney Disease Self‐Care Instrument Knowledge, the Chronic Kidney Disease Self‐Efficacy Instrument, the Hospital Anxiety and Depression Scale, and the Chronic Kidney Disease Self‐Management Instrument. Descriptive statistics is used frequency, percentage, mean and standard deviation. Inferential statistics is used independent t‐test, one‐way ANOVA and multiple linear regression analysis. STROBE checklist was used as the guideline for this study. Results: Our results showed that a significant difference was found in the age (p = 0.005), systolic pressure (p =.006), self‐care knowledge (p =.011) and depression level (p =.003) between patients with early‐ and end‐stage CKD. Furthermore, patients with early‐stage CKD have less self‐care knowledge and lower depression levels compared with patients with end‐stage CKD. However, self‐efficacy is the most significant predictor of self‐management for patients with early‐ and end‐stage CKD. For patients with early‐stage CKD, self‐efficacy explained 69.1% of the variation in self‐management. Conclusion: According to our results, the management of depression in patients with CKD may improve their outcomes. Improving self‐care knowledge of patients with end‐stage CKD may improve their self‐management. Therefore, our findings suggest various interventions with different necessary and prioritised precision care at early‐ and late‐stage of CKD. Relevance to clinical practice: Nurses should strive to improve the self‐care knowledge of patients with early‐stage CKD to delay the progression of the disease to end‐stage. Screening for depression among patients with end‐stage CKD is relevant, and these patients should be referred to professional counsellors when necessary. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aims of the study were to (i) estimate the prevalence of frailty among older adults with type 2 diabetes, and (ii) investigate risk factors associated with frailty in the study group. Background: The high prevalence of frailty among older adults and its adverse health impacts including higher risks for physical disabilities and a higher mortality rate is quickly evolving to become an important public health issue. Design: A cross‐sectional design. Methods: Data were collected from the Clinical Diabetes Centre of our study group. Frailty was assessed using the Chinese version of the Tilburg frailty indicator. Other questionnaires included Activities of Daily Living, Mini‐Mental State Examination, Taiwan Geriatric Depression Scale and Instrumental Activities of Daily Living. Multivariable logistic regression was established to identify factors associated with frailty. The STrengthening the Reporting of OBservational studies in Epidemiology checklist was used preparing the manuscript. Results: A total of 248 subjects were recruited in this study, a total of 66 participants had frailty (26.6%). Our results showed that factors including age, number of chronic diseases, cerebrovascular accident, renal diseases, frequency of falling, frequency of hyperglycaemia, Activities of Daily Living, depression, Mini‐Mental State Examination, and Instrumental Activities of Daily Living ≧1 task disability were correlated with frailty in older adults with type 2 diabetes. After adjusting for confounding factors, multivariate logistic regression analyses showed a significant increase in the probability of frailty by 1.72‐times when comparing type 2 diabetes subjects with depression to those without depression. Conclusion: This study revealed that depression is a significant factor associated with the occurrence of frailty among older adults with type 2 diabetes. Relevance to clinical practice: Our results provided strong clinical evidence showing depression as an important factor associated with the risk of frailty in older individuals with type 2 diabetes. We recommend early detection via routine screenings for symptoms of depression during diabetes care to achieve early prevention or the delay of frailty and its implicated adverse health consequences. [ABSTRACT FROM AUTHOR]

Aims and objectives: The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. Background: As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health‐related quality of life. Design: This study adopted a cross‐sectional correlational research design. The STROBE checklist for cross‐sectional studies was used as a reference for reporting the study. Methods: A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. Results: Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = −0.38), comorbidity index (ß = −0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. Conclusions: Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. Relevance to clinical practice: The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore risk factors for a single fall and multiple falls in the first and second postoperative years among older hip fracture patients. Background Older hip fracture patients have a high probability of falling again after a fall incident. Risk factors for postoperative falls among older hip fracture patients in Taiwan remain to be confirmed. Design Secondary analysis. Methods Data collected from control groups of two clinical trials conducted during 2001-2004 and during 2005-2009 were selected. Overall, 181 older adults who underwent hip fracture surgery were assessed at predischarge and postdischarge. Participant data were collected through home visits. Results Decline in unaffected limb quadriceps muscle endurance was a crucial predictor of a single fall in the first postoperative year for older hip fracture patients. Advanced age and more severe depressive symptoms were the crucial predictor for multiple falls. Engagement in activities of daily living was the crucial predictor for falls during the first to second postoperative years among older hip fracture patients. Conclusion In Taiwan, postoperative falls that occur within 1-2 years of a hip fracture are associated with a high incidence of single and multiple falls in older people. The crucial predictors of falls in the first and second year after a hip fracture include unaffected limb quadriceps endurance, age, depression status and postdischarge activities of daily livings in older people. Relevance to clinical practice The identified factors associated with subsequent falls within one and two years of a hip fracture should be incorporated into clinical strategies and taught in nursing courses. Early postoperative lower extremity muscular endurance rehabilitation must be provided. Furthermore, as part of the healthcare plan before hospital discharge, it must be ensured that the community where the older adults live has nutritional education, cognitive screening and psychological support. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the levels and causes of work-related frustration among senior nurses. Background Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. Design A cross-sectional questionnaire study. Methods Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. Results The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. Conclusions Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. Relevance to clinical practice The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations. [ABSTRACT FROM AUTHOR]

Aims and objectives This study investigated nurse practitioners' clinical decision-making abilities and the factors that affect these abilities. Background Nurse practitioners play an important role in clinical care decision-making; however, studies exploring the factors that affect their decision-making abilities are lacking. Design A cross-sectional descriptive survey was employed. Methods A purposive sample of 197 nurse practitioners was recruited from a medical centre in central Taiwan. Structured questionnaires consisting of the Knowledge Readiness Scale, the Critical Thinking Disposition Inventory and the Clinical Decision-Making Model Inventory were used to collect data. Results The intuitive-analytical type was the most commonly used decision-making model, and the intuitive type was the least frequently used model. The decision-making model used was significantly related to the nurse practitioners' work unit. Significant differences were noted between the nurse practitioners' clinical decision-making models and their critical thinking dispositions (openness and empathy). The nurse practitioners' years of work experience, work unit, professional knowledge and critical thinking disposition (openness and empathy as well as holistic and reflective dispositions) predicted the nurse practitioners' analytical decision-making scores. Age, years of nurse practitioner work experience, work unit and critical thinking disposition (holistic and reflective) predicted the nurse practitioners' intuitive decision-making scores. Conclusions This study contributes to the topic of clinical decision-making by describing various types of nurse practitioner decision-making. The factors associated with analytic and intuitive decision-making scores were identified. These findings might be beneficial when planning continuing education programmes to enhance the clinical decision-making abilities of nurse practitioners. Relevance to clinical practice The study results showed that nurse practitioners demonstrated various clinical decision-making types across different work units. Consideration of nurse practitioners' knowledge readiness and their specific needs while planning on-duty education programmes is necessary. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. Background Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. Design An experimental research design with a repeated measure was used. Methods Eighty-nine participants completed this study and entered data analysed. The experimental group ( n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group ( n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. Results After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. Conclusions This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. Relevance to clinical practice The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing, participants could modulate their heart rate variability and share feeling about good sleep as well relaxation. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the fatigue levels and important fatigue predictors for patients undergoing haemodialysis. Background Fatigue is a common symptom for haemodialysis patients. With its debilitating and distressing effects, it impacts patients in terms of their quality of life while also increasing their mortality rate. Design A descriptive correlational study. Methods Convenience sampling was conducted at six chosen haemodialysis centres in Southern Taiwan. Data were collected via a structured questionnaire from 193 haemodialysis patients. The scales involved in this study were socio-demographic details, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Scale for haemodialysis patients. Data analysis included percentages, means, standard deviations and hierarchical multiple regression analysis. Results The fatigue level for haemodialysis patients was in the moderate range. Results from the hierarchical multiple regression analysis indicated that age, employment status, types of medications, physical activity and depression were significant. Of those variables, depression had the greatest impact on the patients' fatigue level, accounting for up to 30·6% of the explanatory power. The total explanatory power of the regression model was 64·2%. Conclusion This study determined that for haemodialysis patients, unemployment, increased age, taking more medications or lower exercise frequencies resulted in more severe depression, which translated in turn to higher levels of fatigue. Among all these factors, depression had the greatest impact on the patients' fatigue levels. Relevance to clinical practice Not only is this finding beneficial to future studies on fatigue as a source of reference, it is also helpful in our understanding of important predictors relating to fatigue in the everyday lives of haemodialysis patients. It is recommended that when caring for fatigued patients, more care should be dedicated to their psychological states, and assistance should be provided in a timely way so as to reduce the amount of fatigue suffered. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate Taiwanese women's mental health trajectories from the third trimester of pregnancy to four weeks postpartum and the correlations of these trajectories with perceived social support and demographic characteristics. Background Previous studies have reported differences between prenatal and postpartum mental health status. Design A repeated design study was conducted in a medical hospital in Southern Taiwan. Methods One-hundred and ninety-four Taiwanese women completed the Chinese Health Questionnaire and Social Support Scale at the 36th prenatal week and first and fourth week postpartum. Results Three linear mental health trajectories for perinatal women were identified. Consistently poor perinatal mental health was reported by 16·0% of the participants. Less social support was associated with lower prenatal mental health scores. Younger age was a risk factor for consistently poor perinatal health. Vaginal delivery was associated with improved mental health after childbirth. Conclusions Mental health was worse in the third trimester of pregnancy than postpartum. Less social support was associated with lower prenatal mental health scores, and this association was similarly distributed between women with consistently poor and improved mental health after birth. Relevance to clinical practice Health care providers should assess women's mental health status and provide timely interventions during the perinatal period. Social support should be provided for pregnant women, especially younger women or those with lower perceived social support. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Background Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Design Cluster randomised trial design. Methods Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group ( n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group ( n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. Results After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Conclusion Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Relevance to clinical practice Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. [ABSTRACT FROM AUTHOR]

Aims and objectives To better understand chronic obstructive pulmonary disease patients' informational needs and associated factors using the Predisposing, Reinforcing and Enabling Causes in Educational Diagnosis and Evaluation model. Background Despite the increase in the incidence of chronic obstructive pulmonary disease, little research has been carried out on the information needs from a patient perspective. Design A cross-sectional, correlational design was used. Methods A convenience sample of 107 subjects was recruited from four Taiwanese hospitals. Multiple regression analyses were conducted to identify the total informational needs and related factors. Results Major findings were that (1) patients' top informational need was daily care, and (2) variables associated with the total information needs were younger age, greater health internal locus of control, less dyspnoea severity and greater social support. Conclusions Patients' perceived chronic obstructive pulmonary disease informational needs are not congruent with the information received from healthcare professionals. Relevance to clinical practice Healthcare professionals need to be sensitive to the fact that treatment-related information was not the top priority of patients with chronic obstructive pulmonary disease. Healthcare professionals also need to target the special subpopulation of chronic obstructive pulmonary disease patients with greater total informational need to maximise educational impact. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate nursing students' attitudes towards providing sexual health care in clinical practice and to identify associated factors. Background Sexual health care is an important component of holistic health care. Nurses' personal sexual knowledge and attitudes are shown to influence provision of sexual health care. Design This is a descriptive, cross-sectional study. Methods We selected 146 senior nursing students by convenience sampling from nursing schools in two medical universities in central Taiwan. Data were collected using the Nursing Attitudes on Sexual Health Care scale developed based on the 'Permission/Limited Information/Specific Suggestions/Intensive Therapy' model. Higher scores indicated more positive attitudes. Results Participants' mean age was 22·15 years. Mean total Nursing Attitudes on Sexual Health Care scores ranged from 45-75 (61·40 ± 10·17). Nursing students' most positive attitudes towards Permission/Limited Information/Specific Suggestions/Intensive Therapy sexual healthcare interventions were at the Permission level, and least positive attitudes were at levels of Specific Suggestion and Intensive Therapy. The top three positive items were as follows: accept patients' expression of sexual concerns, initiate discussions and encourage patients to talk. Male nursing students had negative attitudes towards sexual healthcare interventions, which became more positive as age increased, especially at the Limited Information level. Conclusions Nursing students had different attitudes towards different levels of sexual health care in the Permission/Limited Information/Specific Suggestions/Intensive Therapy model. Attitudes were associated with age and gender. The Nursing Attitudes on Sexual Health Care scale is useful and reliable for identifying nurses' attitudes towards providing sexual health care. Relevance to clinical practice The Permission/Limited Information/Specific Suggestions/Intensive Therapy-based Nursing Attitudes on Sexual Health Care scale helps to identify nurses' attitudes. A better understanding of nurses' attitudes towards provisional sexual health care will provide information needed to develop appropriate education programmes to improve delivery of sexual health care. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe factors associated with the subjective quality of life of individuals who had attempted suicide. Background Although quality of life has been a focus of concern in mental health care, data are lacking on what life is like and what factors are related to an individual's quality of life after a suicide attempt. Design A cross-sectional, descriptive design was used. Methods Participants comprised a convenience sample of 103 individuals who had attempted suicide within the previous three months and received follow-up care from one suicide-prevention centre in northern Taiwan. Participants were assessed for depression and quality of life using the Beck Depression Inventory, Taiwan version and the World Health Organisation Quality of Life Instrument- BREF, Taiwan version, respectively. Results Almost half the participants ( n = 49) had severe depression and one-third of them ( n = 30) reattempted suicide while receiving follow-up care. Depression and quality-of-life scores were statistically significantly inversely correlated. participants' quality-of-life scores were most associated with their depressive level, reattempting suicide during suicidal follow-up care, high educational level and older age. Conclusions The present study indicates that factors associated with quality of life decreased more in individuals with moderate/severe depression than in those with mild depression. In addition, individuals who reattempted suicide during follow-up care were more likely to suffer from poor life quality. Relevance to clinical practice Mental health professionals should include frequent evaluation of depressive status and quality of life in follow-up care for patients who have recently attempted suicide. Particularly, mental health professionals must treat suicidal individuals with a high tendency to reattempt suicide by establishing trust with them and allowing them to narrate their painful experiences during follow-up care. [ABSTRACT FROM AUTHOR]

Aims and objectives To compare the levels of self-care behaviour, social support and quality of life among type 2 diabetes mellitus patients who underwent three regimens: taking medicine, taking-medicine-while dieting and taking-medicine-while-dieting-with exercise. Background Diabetes treatment is a critical concern worldwide. However, studies on self-care behaviour, social support and quality of life based on diabetes patients' diverse regimens are few. Design This study was a cross-sectional design. Methods We enroled 127 outpatients aged over 40 years who visited a metabolism clinic at a medical centre in Southern Taiwan. The Self-care Behaviour Scale, Social Support Scale and Quality of Life Scale were used to collect data. Results The results indicated that patients with a combined regimen of taking-medicine-while-dieting-with-regular exercise had the highest score at the levels of social support, self-care behaviour and quality of life. Conclusion The study results could offer evidence-based knowledge for healthcare professionals to guide and promote social support, self-care behaviour and quality of life for people diagnosed with type 2 diabetes. Relevance to clinical practice These findings will help healthcare professionals to establish appropriate nursing strategies for type 2 diabetes patients who need to exercise regularly as part of their daily care to enhance their self-care behaviour, social support and quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the factors associated with the numbers of remaining teeth among type 2 diabetes community residents. Background Promoting oral health is an important nursing role for patients with diabetes, especially in disadvantaged areas. However, limited research has been carried out on the relationship between numbers of remaining teeth, diabetes-related biomarkers and personal oral hygiene among diabetic rural residents. Design A cross-sectional, descriptive design with a simple random sample was used. Methods This study was part of a longitudinal cohort study of health promotion for preventing diabetic foot among rural community diabetic residents. It was carried out in 18 western coastal and inland districts of Chiayi County in central Taiwan. In total, 703 participants were enrolled in this study. Results The findings indicated that a high percentage of the participants (26%) had no remaining natural teeth. Nearly three quarters (74%) had fewer than 20 natural teeth. After controlling for the potential confounding factors, multivariate analysis demonstrated that the factors determining numbers of remaining teeth were age ( p < 0·001), education ( p < 0·001), using dental floss ( p = 0·003), ankle brachial pressure index ( p = 0·028), waist circumference ( p = 0·024) and Hb A1 C ( p = 0·033). Conclusions Except for some unmodifiable factors, the factors most significantly associated with numbers of remaining teeth were less tooth-brushing with dental floss, abnormal ankle brachial pressure and poor glycemic control. Relevance to clinical practice This study highlights the importance of nursing intervention in oral hygiene for patients with type 2 diabetes. It is necessary to initiate oral health promotion activities when diabetes is first diagnosed, especially for older diabetic residents of rural or coastal areas who are poorly educated. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore the prevalence, types and sources of violence in the nursing workplace and to assess the factors related to violence. Background. Workplace violence in nursing is not a new phenomenon; in recent years, much more attention has been paid to the issue in Taiwan. Few studies, however, have investigated the overall distribution of violence and the reasons for not reporting these incidents in nursing workplaces. Design. This descriptive, correlational study used structured questionnaires to collecting information about workplace violence experienced by nurses over the last year. Methods. Nurses ( n = 880) working in a public hospital in southern Taiwan were invited to complete the questionnaires, with a response rate of 89·9%. Results. Nurses working in outpatient units and emergency rooms experienced more frequent violence than those on surgical wards and intensive care units. Conclusion. These findings provide evidence of workplace violence in hospitals and may aid hospital and nursing administration to reduce and control violence. Relevance to nursing practice. These results provide evidence in relation to the importance of effective communication training to nurses and will assist hospital administrations in establishing higher-quality, healthy workplace environments. [ABSTRACT FROM AUTHOR]

Aims and objectives. To evaluate the symptoms and self-assessment of quality of life in men with localised prostate cancer after having had a radical prostatectomy or brachytherapy treatment. Background. Prostate cancer is a significant growing disease among men in Taiwan. Quality of life issues for the men who are living with this disease and the consequences of treatment. Design. A postal questionnaire survey. Methods. The study population came from one 1170-bed hospital in Kaohsiung County, Taiwan. Data was collected from 20 August 2007-20 November 2009. Seventy-eight men met the inclusion criteria. The researchers mailed a survey to each participant, which they completed at home and returned in a pre-stamped, addressed envelope. Sixty-four subjects participated and self-reported using a structured questionnaire. The reliability of overall prostate cancer index was 0·90 and 0·85, 0·93 and 0·72 for each subscale, respectively. Results. The results indicate that the number of months post-treatment was positively correlated with urinary function and age was negatively correlated with sexual, bowel function and bowel bothers. One predictor (month post-treatment) was related to urinary function; one predictor (treatment method) was related to bowel function and four predictors (marital status, age, treatment method and month post-treatment) were related to sexual function. Findings showed that patients who received brachytherapy have better urinary functions, as compared with prostatectomy patients. Conclusion. Study findings suggest that healthcare providers should have a better understanding of patients' complications after treatment and this can ultimately raise the quality of life for prostate cancer patients. Relevance to clinical practice. The impact of quality of life among post prostate cancer treatment is common. Urological nurses should therefore take the responsibility regarding the consequence of urinary incontinence and sexual function and seeking appropriate nursing interventions for these complications. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the associations between pain-related psychological and social factors and pregnancy-related lumbopelvic pain intensity and interference after controlling biological factors. Background. Pregnancy-related lumbopelvic pain is prevalent and has been shown to interfere with women's quality of life. Although pain is a multidimensional phenomenon known to be influenced by psychosocial factors, the majority of previous research on this pregnancy-related lumbopelvic pain has focused on biological factors. Design. Cross-sectional correlational research. Method. A sample of 183 pregnant women with lumbopelvic pain was recruited from a medical center in northern Taiwan. Study participants provided demographic information and were administered the Brief Pain Inventory and a modified Catastrophising subscale of the Coping Strategies Questionnaire. Multiple regressions were used to examine the associations among the study variables. Results. Analyses indicated that lower education level was associated with higher pain intensity. Higher pain intensity during pregnancy and catastrophising cognitions were associated significantly with higher pain interference. Moreover, age moderated the strength of the association between pain intensity and pain interference. This association was stronger for older than for younger women. Conclusions. This study identified the psychosocial factors associated with pregnancy-related lumbopelvic pain intensity (educational level) and interference (pain intensity and catastrophising) and also a variable (age) that moderated the association between pain intensity and pain interference. The findings support a biopsychosocial approach in understanding the experience and impact of pregnancy-related lumbopelvic pain. Relevance to clinical practice. Nurses should assess pregnant clients' age, educational level, pain intensity and pain catastrophising thoughts to help identify women who are more at risk for higher lumbopelvic pain intensity or interference. Women endorsing catastrophising cognitions should be referred to or provided with treatment to reduce the frequency of these cognitions that are known to have a negative impact on quality of life in other pain populations. [ABSTRACT FROM AUTHOR]

Aim. This study investigated intensive care unit nurses' knowledge, attitudes and practices of oral care for intubated patients together with the associated factors of the same. Background. Effective oral care improves patient comfort and prevents oral infection. Although oral care is a common requirement of nursing practice, providing intubated patients with oral care is a challenging task. Design. A descriptive, cross-sectional design. Methods. This study applied purposive sampling method at 12 adult intensive care units in one medical centre in northern Taiwan. Two hundred and five nurses were recruited. Data were collected by structured questionnaires which consisted of four sections: knowledge, attitudes and practices of oral care for intubated patients and demographic information for the nurses. Results. The average percentages indicating the intensive care unit nurses' oral care knowledge, attitudes and practices were 58·8, 79·4 and 49·8%, respectively. Higher scores on oral care knowledge were associated with nurses performing oral care more frequently. Nurses learning about oral care from reading related studies and materials of their own accord may increase the frequency with which they provide oral care to intubated patients. The nurses' age and the type of intensive care unit they work in were significant factors related to the frequency of performing practices related to oral care. Conclusion. Findings show that nurses who have more resources for learning about oral care have greater knowledge about it and provide oral care to intubated patients more frequently. Relevance to clinical practice. Encouraging nurses to learn more about oral care using diverse educational resources will enhance their knowledge and improve their practice. Nursing administrators are encouraged to establish policies and procedures for oral care of intubated patients based on the type of patients cared for, in addition to holding in-service training, with a view to enhancing the quality of oral care for critically ill patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the risk factors and mental health consequences of physical and psychological violence for clinical nurses working in healthcare settings in Taiwan. Registered nurses working in hospitals in Taiwan report high incidences of workplace violence. However, previous studies rarely report psychological abuse among nursing staff, while the relationships between personal factors and workplace violence remain unclear. This is a cross-sectional study. Participants were invited to complete the Workplace Violence Questionnaire, an instrument designed to assess types of workplace violence (physical violence, verbal abuse, bullying/mobbing and sexual harassment), the characteristics of perpetrators and victims and victims' reactions to their abuse. A total of 521 nurses completed the questionnaire. Of the participants, 102 (19·6%) indicated that they had experienced physical violence, 268 (51·4%) had experienced verbal abuse, 155 (29·8%) had experienced bullying/mobbing and 67 (12·9%) had experienced sexual harassment. Multiple logistic analyses indicated that age under 30 years (odds ratio = 2·4; 95% confidence interval = 1·34-4·46) and anxiety (odds ratio = 4·7; 95% confidence interval = 1·24-18·12) increased the odds of verbal abuse, while bullying was associated with anxiety (odds ratio = 2·7, 95% confidence interval = 1·09-6·93). Night work shift increased the odds of experiencing sexual harassment (odds ratio = 2·3, 95% confidence interval = 1·29-4·16), while physical violence was associated with bachelor's degree (odds ratio = 2·8, 95% confidence interval = 1·20-6·73). The most serious psychological harm was post-traumatic stress disorder. Exposure to psychological violence often has a great impact on clinical nurses. For violence prevention, interventions should be sensitive to personal factors. Healthcare institutions should initiate counselling programs to help nurses cope with the stress related to workplace violence. [ABSTRACT FROM AUTHOR]

To predict important factors in women's postpartum stress. The transition to motherhood is often accompanied by stress, but research on predictors of postpartum stress is scant. A cross-sectional survey was used in the study. Proportional stratified quota sampling based on births at 11 registered general hospitals and seven specialty clinics in the Kaohsiung area of southern Taiwan was used to obtain a high degree of representation. Eight hundred and fifty-nine women participated in the study within six weeks postpartum. The Hung postpartum stress scale, the social support scale and the 12-item Chinese Health Questionnaire were used in this study. Women with minor psychiatric morbidity, one or two children, junior college educational level, formula feeding for their infants, preference for an infant boy and a low level of social support were important predictors for women's postpartum stress. Our findings provide information and data for service planning and community care for the prevention and amelioration of postpartum stress. Postpartum women face a constellation of factors that could put them at risk for high levels of postpartum stress. Postpartum stress could significantly negatively impact women's health status. Nursing interventions should be tailored to decrease women's postpartum stress as a means of promoting postpartum women's pursuit of well-being. [ABSTRACT FROM AUTHOR]