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Background: Psychiatric patients are affected by diseases and mental symptoms that may worsen their ability to adjust emotionally. Being unable to respond to the emptiness, increases the risk of suicidal behaviors. Purpose: This study was designed to translate the Experienced Level of Existential Emptiness (ELEE) scale, developed by Hazell in 1984, from the original English into Chinese and then to test its reliability and validity. Methods: This research adopted a cross-sectional design and collected data using convenience sampling and a structured questionnaire. The subjects of this study were psychiatric outpatients in the acute and chronic wards of a psychiatric hospital in Taiwan. The instruments used in this research included a demographic datasheet; the ELEE; the University of California, Los Angeles Loneliness Scale, version 3; the Beck Depression Inventory-II; the State- Trait Anxiety Inventory Y form; and the Oxford Happiness Inventory. After the data were obtained, the reliability and validity of the Chinese-version scale was tested. Results: Three hundred subjects were surveyed. The content validity index value of the ELEE was between .88 and 1, and the retest reliability and intrinsic consistency were good. From the analysis of criterion-related validity, a higher degree of emptiness was shown to correlate with more-obvious feelings of loneliness, depression, and anxiety. Conversely, a higher sense of happiness was shown to correlate with less-obvious feelings of these three variables. After the construct validity test, which used confirmatory factor analysis and regarded the co-variation coefficient of association and model fit index as the basis of consideration, the scale was reduced to two sub-scales of seven questions each. After the deletion of items, the scale retained good retest reliability and intrinsic consistency, supporting the retention of the 14 questions in the scale. Conclusions/ Implications for Practice: The findings of this study support using the Chinese version of the ELEE to measure emptiness in patients with mental illness and then providing appropriate medical assistance based on the measured results. [ABSTRACT FROM AUTHOR]

This case report describes a nursing experience caring for a patient with schizophrenia and obsessivecompulsive symptoms. This patient suffered from symptoms of being controlled, obsessive thoughts, and compulsive behaviors. In addition, the patient showed no interest in implementing strategies for dealing with anxiety, no motivation for changing this suffering, and an inability to receive a higher level of rehabilitative job training in daycare. These problems impeded this patient's reintegration into the community. Therefore, the authors employed a five-dimension assessment (physical, emotional, cognitive, social, and spiritual) in order to address the two major nursing problems. The period of nursing care was from October 21, 2016 to January 10, 2017. The two nursing problems addressed included: 1) altered thought processes and 2) ineffective coping. The author provided potentially helpful nursing processes based on the theory of Rational-Emotive Behavior Therapy in order to help the patient cope with symptoms, including being controlled and obsessive-compulsive behaviors. Meanwhile, a relaxation technique was applied to reduce the patient's feelings of discomfort during the nursing processes. As a result, the patient's coping skills to deal with symptoms of being controlled, obsession, and compulsion were improved through refutation of irrational beliefs. In addition to showing rational emotions and appropriate behavior to handle pressures, the patient was also able to apply the relaxation technique to relieve the discomfort from anxiety and pain as needed. This case report suggests that nurses may implement the irrational beliefs refutation training regimen under Rational-Emotive Behavior Therapy for similar cases at the beginning of nursing-patients relationships. Furthermore, providing relaxation techniques in the nursing process may assist patients to deal with stressful life events. The results of this nursing experience are expected to help nursing colleagues apply the above theory and skills with schizophrenia patients with obsessive-compulsive symptoms. [ABSTRACT FROM AUTHOR]

Background: Betel quid chewing plays a significant role in the development of oral cancer, yet the high prevalence of betel quid use remains a serious health problem in Taiwan, especially among indigenous Taiwanese. Purpose: The present study aimed to understand the reasons behind betel-quid chewing among indigenous Taiwanese people by examining the larger context of their culture and traditions. Methods: This descriptive, qualitative study recruited ten regular betel quid indigenous chewers using purposive and snowball sampling. Four of the participants were interviewed individually and the remaining six comprised a focus group. Data were collected using in-depth interviews with semi-structured guidelines and analyzed using qualitative content analysis following the process of open coding, identifying codes, giving meaningful names to codes, putting similar codes in categories, and grouping categories into themes. Results: Most of the participants associated betel quid with significant aspects of life, with betel quid symbolizing social belonging. In indigenous cultures, betel nut embodies the enduring companionship of lifelong friends. For the study participants, chewing betel quid was associated with symbolic meanings associated with the following five themes: betel quid chewing helps reinforce self-identity and sense of belonging; betel quid is considered a traditional symbol of love and marriage; betel quid reflects the celebration of simple abundance in indigenous life; betel quid represents an attitude toward life that accentuates the importance of learning to live in everlasting harmony with the environment and nature; and betel quid chewing is used to cure physical ailments and mitigate dental problems. Conclusions / Implications for Practice: Beliefs related to chewing betel quid deeply impact the attitudes of indigenous people toward this behavior. Because chewing betel quid is an essential part of Taiwanese indigenous community life, the cultural and symbolic meanings of this practice must be taken into consideration when drafting related policies and developing cessation programs in order to help indigenous betel-quid chewers effectively reduce the risk of developing oral cancers. [ABSTRACT FROM AUTHOR]

Background: Spirituality is the essence of being human and the capacity to express caring for others. Emergency room (ER) nurses are required to deal regularly with patients in critical condition. Nourishing the spirituality of ER nurses is widely recognized as an important way to help nurses provide care to patients in clinics. However, few studies have explored the spiritual nature of ER nurses. Purpose: This study explored perceptions of spirituality among ER nurses. Methods: This study used a descriptive-qualitative design and purposive sampling; we recruited 15 ER nurses as participants and collected data using face-to-face, semi-structured interviews; Tesch's qualitative data analysis was employed to analyze data. Results: Nurse perceptions of spirituality were classified into 3 dimensions with 9 subthemes, namely (1) "an inner force" (with the 4 subthemes of real spiritual power, indescribable abstract state, change comes agonizingly slowly, and healing power), (2) "the value and mission of a jointly shaped one and the other" (with the 2 subthemes of making good use of one's ability and satisfying others to enrich oneself), and (3) "test of resilience" (with the 3 subthemes of being more responsible, interaction of sense and sensibility, and facing reality with reasons). Conclusions: This study introduced the idea of spirituality as an inner power as perceived by ER nurses. Findings may provide a basis for spiritual education in nursing schools and the workplace as well as suggest spiritual growth guidelines for nursing leaders and staffs. [ABSTRACT FROM AUTHOR]

Macrophage migration inhibitory factor (MIF), a type of pleiotropic immunoregulatory cytokine with a specific structure, participates in the regulation of host cell growth and migration and immune responses. Following parasitic infections, hosts may produce MIF and then participate in the parasite-host interactions. In addition, parasites may secrete parasite-derived MIF, and they jointly participate in parasite-host interactions. This paper reviews the regulation of MIF gene expression following parasitic infections, the role of MIF in parasite-host immune system interactions, and important signaling pathways of MIF-mediated immune responses.