Search

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 offcampus 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. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had an unprecedented impact on society, especially in densely populated areas. Schools have implemented distance learning, which has spawned many related problems. This paper focuses on the difficulties arising from the epidemic in indigenous communities and how appropriate information strategies may be used to solve these. Four main suggestions are provided to assist indigenous students and their teachers to protect themselves and learn during the pandemic and to ensure that educational goals are achieved. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Research is an indispensable element that shapes every profession and discipline. "Employ evidencebased 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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-manage- ment 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The Ministry of Education launched the University Social Responsibility (USR) Program in 2018. Since then, universities have actively promoted inter-disciplinary cooperation and implemented highend knowledge to meet community needs. Universities are using social responsibility to enhance the level of social participation engaged in by their students to achieve the sustainable development goals set by the United Nations. The aim of this paper was to share the experience of the Taipei Medical University (TMU) system in practicing social responsibility by integrating TMU resources with those of TMU-affiliated hospitals. The USR program at Taipei Medical University promotes the reform of school governance through encouraging university faculties to collaborate with hospital physicians to develop a specific curriculum that implements an innovative social-prescribing model. This curriculum is designed to provide opportunities for students to step out the classroom and into the community. Through clinical observations, home visits, and community service, students gain a deep understanding of community health issues from residents in the surrounding neighborhoods. Medical humanities education is achieved through students' involvement in both patient individual care and community health issues. In addition, faculties guide students in reflective learning from holistic healthcare perspectives. Students are encouraged to use evidence-based methods to develop innovative models of care in the community. Medical staff participation in this program helps ensure that social prescribing to community residents accurately reflects professional assessments. These prescriptions refer patients to local health promotion units involved in community collaboration. The medical university students build a bridge between the medical system and the community to implement the goals of health education. The impact of social prescribing on the social determinants of health is known to be significantly greater than that of medicine prescriptions. The expected outcomes of this project are to reduce the health inequalities experienced by vulnerable groups in the community and to share Taiwan's experiences with the academic community worldwide. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing is the property of Taiwan Nurses Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing is the property of Taiwan Nurses Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Achieving enhanced healthcare quality by participating in cross-disciplinary medical teams and providing specialized, precision nursing are core professional values of clinical nurse specialists (CNSs). Although CNSs are crucial in the healthcare field, the development of CNSs in Taiwan remains in its infancy. The Taiwan Nurses Association has already announced regulations related to professional frameworks and scope of practice for advanced practice nurses and has reached a preliminary consensus and plans on the definition, qualifications, and indicators of care for CNSs. The clinical application, job titles, and certification of the professional core values of CNSs require continuous and joint deliberation and development by professional nurse organizations. In this study, the results of empirical research into professional organizational frameworks and certification of CNSs in Europe, the United States, and Australia were used to derive a reference model for CNS education and training development for advanced practice nurse specialties in Taiwan. The fundamental elements of the roles and professional frameworks and feasible qualification certification systems were also explored. [ABSTRACT FROM AUTHOR]

Background: The application of palliative care is limited and challenging in intensive care units (ICUs) because of complex factors such as time constraints and unpredictable disease progression. Although research results and international consensus stress the early use of palliative care, utilization remains low, resulting in increased risks of ineffective medical care and poor quality of death. Improving this situation requires a comprehensive understanding of the palliative condition in ICUs. Purpose: This study was designed to investigate the utilization of hospice resources in adult ICUs and to compare this utilization between users and non-users. Methods: This retrospective correlation study recruited cases from the adult ICU database of a medical center in northern Taiwan between June and July 2022. Descriptive statistics, independent t-test and chi-square were used to analyze the data. Results: A total of 1,181 records were analyzed, including 458 (38.8%) females and 723 (61.2%) males. Two hundred and seventeen cases (18.4%) used hospice resources. Although 124 (10.4%) of the 1181 cases were identified as "in urgent need of hospice resources" (i.e., died within 30 days of ICU admission), 25 (20.2%) did not use these resources. Significant differences between the urgent-need cases who did and did not use hospice resources were found in terms of age, disease type, degree of frailty, cardiac arrest, infection, state of consciousness, intubation and tracheostomy status, inotropic and vasopressor medication, renal replacement, ECMO placement, delirium, and Acute Physiology and Chronic Health Evaluation III and Sequential Organ Failure Assessment Scores. Conclusions/ Implications for Practice: The roughly 20% of ICU patients in urgent needs of palliative care who did not utilize palliative care resources highlight the needs for continued discussion to better assist patients on palliative care decision-making. The findings show multifaceted differences between those who did and did not access palliative care. Future studies should design and test strategies to facilitate the identification of palliative care needs and ensure the effective allocation of palliative care resources in ICUs. [ABSTRACT FROM AUTHOR]

Background: Staff caregivers of day care centers provide many activities for older people. However, there is a lack of a systematic curriculum based on Taiwanese culture to improve cognitive function, self-care ability, and depressive mood status in these individuals. Purpose: This study was designed to test the effectiveness of a series of localized cognitive stimulation training courses implemented by direct caregivers and aimed at improving cognitive function, self-care ability, and depressive mood in older people at day care centers. Methods: This cluster-randomized controlled trial research was conducted over a four-month period. The participants were randomly assigned to the experimental, comparison, or control groups based on their day care center affiliation. The experimental group received a series of localized cognitive stimulation training sessions with musical rhythm courses from day care center direct caregivers. The cognitive function, self-care ability, and depression mood state of the three groups were then tested. Results: The experimental group reported statistically significant changes in average scores for attention, feeding, and depressive mood. After controlling for time and degree of participation in activities, the comparison group reported a lower average score for cognitive function at timepoint 3. Conclusions/Implications for Practice: The results of this study support caregivers at day care centers implementing a series of localized cognitive stimulation training course interventions to prevent declines in activities of daily living and cognitive function and ameliorate depressive mood in older adults. In the future, a larger sample size should be used to improve the effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

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". Conclusion: 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. [ABSTRACT FROM AUTHOR]

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 socialnetworking 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. [ABSTRACT FROM AUTHOR]

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 certiication 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, undeined training requirements, and a lack of a clear qualiication / certiication system. This paper introduces the role functions and professional growth of informatics nurses and introduces the framework for a certiication 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Taking antibiotics in strict adherence to physician prescriptions is crucial for maintaining the stability of the drug concentration in the blood and for achieving the best therapeutic effects. The increasing antimicrobial resistance in recent decades has led the Ministry of Health and Welfare to promote the rational use of antibiotics and the use of a computer monitoring system to control the use of antibiotics in hospitals. Although non-adherence is considered as the major factor contributing to antimicrobial resistance, patient non-adherence to antibiotic prescriptions is an issue that has been largely overlooked. This paper explores this issue due to the serious threat from antimicrobial resistance and the few studies that have investigated patient adherence to antibiotic treatments for acute infections in Taiwan. Purpose: The aims of the study include: (1) describe patient's adherence to antibiotic therapy for acute infections and (2) explore the potential factors of influence on antibiotic adherence such as demographics, disease characteristics, and knowledge of antibiotic treatment. Methods: The study used a descriptive correlational design. A convenience sample of 162 patients with acute infections was recruited from outpatient infectious disease clinics in Taoyuan City. Data were collected using the study questionnaire and analyzed using the chi-square test, Mann-Whitney U test, and logistic regression. Results: The study results showed that only 40.1% of patients followed their prescription to take antibiotics completely. The remainder earned lower scores than their prescription-adhering counterparts for knowledge regarding the effects of antibiotics (U = 2654.5, p = .046). Results of logistic regression showed that knowledge regarding the effects of antibiotics was the most significant predictor (B = .481, p = .046) of adherence to antibiotic therapies. Conclusion: Non-adherence to prescriptions is prevalent in short-term antibiotic treatments prescribed for acute infections. This finding reminds healthcare providers to provide proper education to the recipients of antibiotic treatments, even those treated for a very short duration for acute infections in outpatient settings. Special attention should be pay to enhancing the understanding and appreciation of patients for the therapeutic effects of antibiotics. [ABSTRACT FROM AUTHOR]

Background: Obesity is a worldwide epidemic that threats the health and body image of those who suffer from this condition. While bariatric surgery has been shown to effectively assist patients to achieve weight loss goals and to improve body image, related research on this intervention is lacking in Taiwan. Purpose: The purpose of this research is to investigate the effect of bariatric surgery on body image in obese patients. Method: This study used a longitudinal design. Data was collected from 2 hospitals located in northern and southern Taiwan. A total of 56 obese patients who had undergone bariatric surgery enrolled as participants, and the completion rate was 93.3%. Participants responded to a validated body image questionnaire immediately prior to and 3 months after bariatric surgery, with data used to assess the effects of the surgery. SPSS 20.0 software for windows was used for data analysis. Result: Participant scores for body image were low on the questionnaire administered prior to surgery, with a significant negative correlation identified between body mass index (BMI) and the value of appearance (r = -.36, p < .01). After bariatric surgery, the average EWL was 42.08%, which effectively achieved expected weight loss goals. Variables including overall body image, appearance evaluation, orientation, and body satisfaction of participants were significantly improved. Only the variable of muscle tension did not improve significantly. Postoperative body image did not correlate with either BMI or EWL. Conclusion: Three months after the bariatric surgery, the body image, appearance evaluation, and physical appearance satisfaction of participants had significantly improved. However, there was no improvement in muscle tension scores. In order to improve the post-surgery body image of patients, we recommend that healthcare workers provide patients with proper expectations of bariatric surgery and teach patients appropriate muscle-tension exercises. This paper reports the relation between bariatric surgery and body image. The results provide evidence for clinical and future research in this field. [ABSTRACT FROM AUTHOR]

The Gender Equality in Employment Act was enacted to protect gender equality in the workplace. Increasingly tight controls over operating costs by employers and the increasingly heavy workloads of nurses pose major challenges to the labor rights of female nurses. This article introduces the labor rights of female nurses as stated in relevant laws and regulations such as the Gender Equality in Employment Act, the Labor Standards Act, the Labor Insurance Act, Regulations on Leave-Taking for Workers, Regulations on Implementing Unpaid Parental Leave for Raising Children Pension Act, and the Employment Insurance Act. In addition, this paper introduces three judicial decisions that highlight domestic judicial practice with regard to labor rights in nursing. It is hoped that nurses may gain a better understanding of their rights and challenges from these judicial decisions. Finally, this article makes recommendations to help nurses overcome the difficulties in implementing labor rights. It is hoped that this article helps increase the general awareness among nurses of their labor rights and encourages nurses to pursue and secure their rightful labor rights from their employer. [ABSTRACT FROM AUTHOR]

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 ield 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. This 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Mental health is a human right and fundamental to good personal health. Developing, planning, and implementing mental health programs is a key part of health policies worldwide. This paper uses the perspective of "mental health mainstreaming" to define mental health and explore its relationship with mental illness and psychiatric disease. Further, we apply this perspective to Taiwan's three-tiered community mental illness prevention strategy as a reference for mental health promotion and rehabilitation programs in hopes that all healthcare providers help facilitate holistic community health. [ABSTRACT FROM AUTHOR]

Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 0 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The Ministries of Justice and Education have implemented adolescent substance abuse prevention programs for many years. Rates of substance abuse among high school students continue to rise in spite of such programs. Purpose: This study investigates adolescents' substance abuse-related knowledge and attitudes and self-confidence to resist substance use in order to identify predictive factors of poor adolescent resistance to substance use. Methods: A cross-sectional study survey gathered data on substance abuse-related knowledge and attitudes and self-confidence to resist substance use from 243 second-year senior high school students studying at two schools in northern Taiwan. Results: Participants were most knowledgeable about tobacco (80.2%), followed by alcohol (72.0%), ecstasy (56.0%), and marijuana (30.0%). Only 19.3% demonstrated an understanding of the harmful effects of using Ketamine. A 10-point Likert scale measured participant substance use attitudes. Alcohol was the substance participants were most willing to use (2.18 ± 3.27), followed by tobacco (0.66 ± 2.19), ecstasy (0.45 ± 1.88), Ketamine (0.43 ± 1.93), and marijuana (0.38 ± 1.83). Participants had higher awareness of the harmful effects of Ketamine (t = -2.37, p = .018), marijuana (t = -2.33, p = .021), and tobacco (t = -2.02, p = .044), with participants reporting greater self-confidence to resist using these three substances. Multiple regression analysis found the three most important factors affecting participant self-confidence to resist substance use to be gender (ß = .26, p < .001), knowledge about the substance (ß = .15, p = .028), and attitude toward substance use (ß = -.20, p < .001). Conclusions / Implications for Practice: Level of harmful effects knowledge and attitudes toward use varied among the various substances considered in this paper. Being female, having strong knowledge about the substance, and negative attitude toward substance use correlated with higher levels of self-confidence to resist substance use. Study results will be used in ongoing research designed to establish an empirical basis for adolescent substance use prevention and research, the results of which may be used directly by school nurses and military training education nurses. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Taiwan has been an aging society since 2018. As a result, long-term care, end-of-life autonomy, and hospice care have received increasing attention. The government of Taiwan promotes home-based healthcare through the National Health Insurance System to enable the efficient utilization of medical resources and reduce overall medical costs. Taiwan's community hospice and palliative care network is expected to serve as the main care model supplementing partial hospitalization and institutional care. In this article, we review the history of and policies related to hospice and palliative care in Taiwan using a literature review and examining Pingtung County as a case study. The implementation of home-based palliative care is also outlined and policy revisions are proposed. The results are intended to provide a reference for healthcare authorities and medical institutions to promote community hospice and palliative care policies. The integrated care model can enhance the capacity of community-based palliative care, support patients receiving palliative care and their family members and caregivers, and ensure physical and psychological comfort for patients. This model contributes to the realization of older adults' preference for dying at home, which is especially pronounced in cultures where traditional Chinese ideas are deeply rooted. [ABSTRACT FROM AUTHOR]

The expected and nearing approach of a super-aged society and dementia "tsunami" in Taiwan must be prioritized by healthcare professionals to help family caregivers of patients with dementia find effective health information and social support and become more empowered in their caregiving roles. The multiple information and communication technology (ICT) platforms currently available for dementia education and family caregivers range from websites and apps designed by healthcare professionals to social media outlets such as Facebook and Twitter. This article discusses the characteristics of social media, lists the various ICT applications available for dementia care, and highlights the advantages of using Facebook groups created by family caregivers over other digital tools in terms of empowering family caregivers. Finally, the author shares his own field observations of family caregivers FB groups, with the findings expected to assist healthcare professionals, including nurses, to develop and implement more-effective social media strategies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Participating in advance care planning (ACP) discussions during the early stages of dementia is crucial to ensuring the quality of end-of-life (EoL) care. Inadequate discussions regarding ACP and EoL care between persons with dementia and family caregivers often lead to decisional conflicts when persons with dementia are in the later stages of their disease. Purpose: To explore the impact of a family-centered ACP information intervention on the EoL care decision--making conflicts between persons with dementia and their family caregivers. Methods: A one-group, pretest--posttest, pre-experimental design was applied. Data were collected at outpatient clinics in regional teaching hospitals in northern Taiwan. Participants included 43 dyads of persons diagnosed with mild cognitive impairment or mild dementia and their family caregivers. The intervention was implemented by an ACPtrained senior registered nurse and was guided using ACP manuals and family-centered strategies. The decisional conflict scale was the main measure used. Paired t tests were used to compare differences between pre-intervention data and 4-weeks' post-intervention data. Results: The ACP information intervention significantly reduced the decisional conflict score for end-of-life decision making in the participants with mild dementia (p < .001). In addition, significant declines were observed in all aspects of decision-making conflicts, including value clarification, uncertainty, and effective decision-making. The mean total conflict score of the family caregivers was also significantly reduced (p < .001), but no significant difference was found in the aspect of support. Conclusions: Family-centered care strategies provide knowledge about end-of-life care for persons with dementia. These strategies also facilitate regular and continuous communication between family caregivers, persons with dementia, and medical professionals, reducing decisional conflicts in EoL care. [ABSTRACT FROM AUTHOR]

Labor issues related to the nursing profession have been gaining prominence in Taiwan as well as overseas. In 2016, the United Nations highlighted the importance of societies investing sufficient funds in their professional nurses to support and promote public health, gender equality, and economic growth. Good-quality care requires that nurses have good physical and mental health, while creating and maintaining a friendly nursing work environment rely on cooperation among the government, labor unions, and hospitals. Over the past decade, the Taiwan government has increasingly promoted relevant regulations and established a friendly platform to allow nursing staffs to identify problems and report labor rights violations. In addition, nurses have formed unions to defend and advocate for their professional rights. After the outbreak of COVID-19 in late 2019, the Department of Nursing and Health Care of the Ministry of Health and Welfare actively proposed policies related to creating and maintaining good nursing work environments. The Taiwan Nursing and Medical Industries Union took a supervisory role in this process, providing feedback on policies from the perspective of Taiwan's professional nurses and arguing for the reasonable and fair subsidization of epidemic prevention facilities, implementation of mask and protective equipment, nursing labor rights, and social respect for the nursing profession. Much work still needs to be done to improve the domestic working environment for nursing staffs, including improving and expanding education, normalizing and effectively utilizing nursing staff feedback and whistleblowing information, promoting information transparency, and implementing better policies. We hope that a friendlier nursing work environment will attract many more outstanding young persons to pursue a career in nursing. [ABSTRACT FROM AUTHOR]

The ongoing COVID-19 pandemic has currently spread to over 100 countries, infecting over thirty million people and causing nearly one million deaths. The COVID-19 pandemic is the most serious pandemic crisis faced by the world medical system for at least a century. To address the impacts pandemic prevention and control measures and of societal concerns regarding risks of contraction healthcare environments, related policies and management must be adopted to provide effective and future prevention. The author introduces the prevention policies implemented during the pandemic under coordinated medical systems, the National Health Insurance program, pandemic management, and national and international governmental organizations to provide readers with a reference for current situation of the pandemic in Taiwan and the world. [ABSTRACT FROM AUTHOR]

Background: The rapid aging of the global population has sharply increased the prevalence of dementia. Most people with dementia (PwD) live at home and are cared for by family caregivers. The complicated care needs of PwD and family caregivers necessitate the provision of comprehensive and transdisciplinary assessment and service support. Purpose: The purpose of this study was to construct the contents of the "Assessment Tool for Family Care Needs of People with Dementia" using a transdisciplinary perspective and to establish the reliability and validity of this tool. Methods: Based on a literature review and clinical experience, the preliminary items of the assessment tool were drawn up and pilot tests of the case were conducted in the Clinic for Dementia Care. The transdisciplinary research team discussed the pilot tests and verified the preliminary items, and then experts were invited to assess the content validity of the assessment tool. Next, quota sampling was conducted in accordance with the national proportion of the severity of dementia and the questionnaire surveys were administered in an outpatient department of neurology at a medical center in southern Taiwan. Two hundred dyads of PwD and their family caregivers participated in the survey. Reliability and validity analysis of the data were completed. Results: The assessment tool contains 21 items of demographic data and 31 items in the eight subscales of "language and communication", "activities of daily living", "sleep", "activity arrangements", "nutrition and diet", "behavioral and psychological symptoms of dementia", "care stress", and "obtaining resources". The overall content validity of the assessment tool was .99 and the Cronbach's alpha of each subscale ranged between .625 and .905. The concurrent validities of the "activities of daily living" subscale and the "behavioral and psychological symptoms of dementia" subscale were, respectively, correlated with the Barthel Index (r = -.889, p < .001) and the Neuropsychiatric Inventory Questionnaire (r = .750, p < .001). Conclusions/ Implications for Practice: The assessment tool was assessed as having satisfactory validity and reliability. Moreover, the tool was clear and concise, and was able to be completed quickly by the caregivers. Transdisciplinary professionals involved in dementia care may use this assessment tool in outpatient departments, centers for integrated dementia care, and discharge preparation services to acquire information related to family care needs. The results of the assessment tool may be used as a reference in developing appropriate transdisciplinary care plans to improve the quality of care and quality of life of families of patients with dementia. [ABSTRACT FROM AUTHOR]

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses. [ABSTRACT FROM AUTHOR]

Urbanization, a rapidly rising trend worldwide, is being felt particularly strongly in East Asia. The World Health Organization (WHO) launched a healthy-cities plan in 1986 as a platform to encourage cities around the world to eliminate the problems resulting from increasingly dense urban population densities. The health and quality of life of city residents are seriously affected by the problems associated with urbanization, including environmental pollution, traffic congestion, public insecurity, and inadequate infrastructure, which may exceed the scope of local government plans and expectations. Rather than dealing with these problems individually, urban planners must take a global approach to issue of urbanization. Public and private-sector inputs are critical to facilitating good urban planning and community development by local governments in order to help cities achieve a well-managed urban environment that gives citizens a good environment in which to live, work, and play. The promotion healthy-city plans in Taiwan will foster the creation of cities of health through the integration or cooperation of government health, urban-planning, environmental-protection, industrialdevelopment, transportation, cultural-education, and other departments and agencies. Based on the vision of a healthy city, Taiwan's cities should gradually attain a sustainable, healthy society and healthy environment that promotes the holistic health of their residents. Therefore, we look forward to fulfilling the vision of "health without borders, creating healthy cities" through the implementation of the healthy city plan. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing is the property of Taiwan Nurses Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)