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Aim. The aim of this paper was to explore nurses’ stress experiences of working under the current health care system in Tawain (the context) using a qualitative approach. Background. Although most global health care institutions have been changing in response to the economic contraction, there is a deficit of information in understanding the changes of the ecology of the health care system in Taiwan from nurses’ perspectives. Design. Grounded theory. Methods. A grounded theory approach was used to collect the data from a sample of 28 critical care nurses from seven hospitals in Taiwan. Data were analysed using a multi-step analytic procedure, based on the approaches of Glaser, Chesler and Strauss and Corbin. Findings. The health care system changes were found to increase critical care nurses’ occupational stress and work dilemmas. For the purpose of this study, the two categories that emerged in the ‘context’ component of the paradigm model are investigated. They were: hospital reorganisation and cultural burden of the nurse’s role. Conclusions. The findings indicated that hospital organisational changes and people’s own belief of the nurse’s role were recognised as the environmental pressures which increase critical care nurses’ occupational stress. Cultural background may play an important role in influencing nurses’ work atmosphere and their ways of being seen. Relevance to clinical practice. Critical care nurses perceived that their hospitals were under huge demands due to the changes in health care policies; these had subsequently caused them a high level of occupational stress. Beliefs in the embedded culture were also identified as significant factors in causing nurses’ role stress. These findings could enhance the knowledge of critical care nurses’ occupational stress and identify the most appropriate stress management skills available to them. Findings will add to the understanding of Chinese nurses who may work globally. [ABSTRACT FROM AUTHOR]

lee t-t (2005) Journal of Clinical Nursing14, 344–353Nurses’ concerns about using information systems: analysis of comments on a computerized nursing care plan system in TaiwanThe purpose of this study was to pursue a deeper understanding of nurses’ perceptions of a computerized nursing care plan as written in comments on a survey.Studies have examined nurses’ perceptions of computer use, but comments written on surveys of computerized nursing care planning have never been reported and the pattern and meaning of such feedback have not been systematically analysed.Of 738 nurses in Taiwan who completed a two-part survey to evaluate a computerized nursing care plan, 202 responded on part II to an open-ended question about overall perceptions of a nursing information system.A sample of 10 questionnaires with comments was subjected to qualitative content analysis. Key words and phrases were identified, then grouped into categories, which were used to code the remaining respondents’ comments. Another 20 were used to pilot test these coding categories. The final coding categories were applied to all 202 questionnaires with comments for data analysis.Nurses were concerned about inconvenient access to computers; reduced work efficiency; inability to individualize patient care and nursing specialty deficiencies; poor content design, system function, and system integration; using the system as a policy requirement; and privacy and legal issues.Hardware availability, content design and user training/education programmes are critical issues that affect nurses’ use of computers in their daily practice.These comments can be applied in strategic planning and staff development programmes to further use of information systems in patient care. [ABSTRACT FROM AUTHOR]

Aims. To describe the attitudes toward and the use of folk remedies among caregivers of children who were hospitalised in Taiwan. Background. Parents incorporate folk remedies into the care of sick children in many cultures, including Taiwan. Twelve common folk remedies are commonly used in the Taiwanese culture for the care of sick children. Design. The study employed a descriptive, exploratory design using survey methods. Participants were 92 caregivers (parents) whose children were hospitalised for at least three days in a hospital in the middle district of Taiwan. Results. Sixty per cent of the participants used some form of folk remedies in the care of their hospitalised children. The most frequently used remedies were: spirit-calling (63%); carrying a cross or incense bag (47%), praying a Buddhist mantra (36%). There was a positive relationship between a positive attitude towards folk remedies and current use with children ( p < 0·05). Logistic regression analysis revealed that parents’ previous experience of using folk remedies (odds ratio = 0·272, p = 0·037), and parents’ knowledge of the care of disease (odds ratio = 18·044, p = 0·015) were the strongest predictors of use of folk remedies. Almost three-fourths (73%) of all participants expected that health care providers would respect and not interfere with their use of folk remedies; 72% of parents stated that they would not tell healthcare providers about the use of folk remedies. Conclusions. The majority of the parents of hospitalised children in Taiwan can be expected to use folk remedies for the purpose of psychological and spiritual support during child hospitalised. Relevance to clinical practice. Healthcare providers need to be aware of the folk remedies used within various cultural groups so that culturally appropriate and safe care can be provided for the child and family. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: The purpose of this study was to explore factors that may affect nurses' use of nursing diagnoses in charting standardized nursing care plans in their daily practice. BACKGROUND: Care plans have been viewed as providing a structured approach to the assessment, planning and delivery of patient care. Nonetheless, the challenge for many institutions is to help professional nursing staff refine their understanding of nursing diagnoses and charting skills, to identify patient problems and propose appropriate care plans. METHOD: Twelve clinical nurses working at a medical center in Taiwan underwent one-on-one in-depth interviews from May to July 2000. Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process to investigate the charting process. FINDINGS: Nurses tended to match patient conditions to the designated nursing diagnoses, be unfamiliar with statements of related factors, use objective data to describe patient conditions, ignore descriptions of nursing goals, dutifully check interventions without always executing them, and choose the same evaluation to meet hospital requirements. CONCLUSIONS: These findings suggest that using educational programmes for enhancing nurses' ability to use nursing diagnoses and exploring the process of diagnostic reasoning would improve the quality of patient documentation. RELEVANCE TO CLINICAL PRACTICE: The trend in health care is to focus on chart audit to reveal indicators of quality of care. Therefore, the experience of nurses in this study could be applied to in-service training programmes by institutions that are replacing traditional, manually written care plans with a standardized care planning system, thus helping other nurses through this transition process. [ABSTRACT FROM AUTHOR]