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Background: Hospice shared care is a model of care widely used in patients with terminal cancer. Appropriate interventions to improve related symptoms should be provided during disease progression through the end of life. Purpose: The purpose of this study was to explore the related symptoms and to compare symptom severity before and after the implementation of hospice shared care and medical care interventions. Methods: Fifty patients with terminal cancer were enrolled in this longitudinal, quasi-experimental research. Inclusion criteria included having an expected life span of < 6 months and agreeing to enter hospice shared care. Result: The three most-frequently noted physical symptoms were, in rank order: "pain", "weakness", and "dyspnea". In terms of severity, "pain" was the most severe, followed by "weakness" and "disturbance of sleep". The three most-frequently noted psychological symptoms were, in rank order: "depression", "worry about the disease", and "afraid of dragging others down". In terms of severity, "depression" was the most severe, followed by "anxiety" and "worry about the disease". The frequency and severity of the top-3 social and spiritual distress symptoms were, in rank order: "unfinished wish", "economic difficulties", and "painlessness". During the study period, the severity of physical symptoms improved gradually, while the severity of psychological symptoms improved significantly. The top- 3 items in the original medical team's hospice-care interventions were, in rank order: "tube care", "laboratory test", and "wound care" in the non-pharmacological category; "symptom control medication", "antibiotic injection", and "intravenous fluid infusion" in the pharmacological category; and "cognitive clarification of the prognosis condition", "do not conduct resuscitation discussions and signing", and "emotional stress consoling" in the problem-coordination and interview categories. The interventions implemented by the hospice specialist team included "emotional stress interview", "team communication", and "cognitive clarification of prognosis condition" in the problem coordination and interview categories, and "massage", "consultation", and "nursing advice" in the non-pharmacological category. Conclusions / Implications for Practice: The symptoms identified in this study provide clinical staff with a reference for the rapid assessment of patients with terminal-stage cancer. Manpower from various professional fields are committed to providing diversified services in the care teams, which positively affect the control of related symptoms. The experience presented in this article may be used as a reference to promote the hospice shared care model. [ABSTRACT FROM AUTHOR]

Background: Most advanced lung cancer patients have already received many types of treatment before starting immunotherapy. Compared with advanced lung cancer patients under first-line treatment, those receiving immunotherapy are vulnerable to many health problems and increased frailty. Purpose: This study was designed to investigate frailty in advanced lung cancer patients before starting immunotherapy. Methods: A total of 52 pre-immunotherapy patients completed the survey. Frailty status was determined using the Fried standard and survey questionnaires included the Barthel Index, Center for Epidemiologic Studies Depression Scale, the Chinese version of scales of international physical activities questionnaire (short version). In addition, the handgrip and 4.6-meter walk speed of the participants were measured. Result: The ratio of frailty was 17.3%, with comorbidities (p = .023), body mass index (p = .004), Eastern Cooperative Oncology Group Status (p < .001), activities of daily living status (p < .001), albumin (p = .042), and C-reactive protein (p = .048) all associated with frailty. Conclusions/Implications for Practice: In this study, weight loss and low physical activity were the main symptoms of frailty in patients with advanced lung cancer. Therefore, healthcare workers should assess the nutrition and physical activity status of patients before initiating immunotherapy. We suggest that clinical care workers provide frailty care to patients before administering immunotherapy. [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: The birth regulation experience of Southeast Asian women in transnational marriages in Taiwan has a special historical background and significance. However, previous research on this population has emphasized their cultural, social, and family education needs, with less attention directed toward their birth regulation concerns. Purpose: The aim of this qualitative study was to explore the life experience of birth regulation among Southeast Asian women in transnational marriages in Taiwan. Methods: Phenomenology methodology explored the experiences of 11 participants. Purposive sampling recruited participants from among outpatients registered in the postpartum ward of a local hospital in northern Taiwan. Each semi-structured, in-depth interview was taped, transcribed and analyzed using Colaizzi's framework. Results: Phenomenological description yielded three essential themes: (1) reappearance of the patriarch: carrying on the family name as the marriage mission and investing hope in the child; (2) helplessness in the face of reduced sexual and reproduction rights: birth control autonomy controlled by husband and sexual life controlled by hegemonic thinking; (3) confusion and adjustment to medical and nursing culture shock: limited knowledge and doubt regarding birth regulations and adjustment to the unfamiliar medical environment. Conclusions / Implications for Practice: This woman-centered view of the life experience of birth regulation among Southeast Asian women in transnational marriages in Taiwan may assist healthcare professionals to better understand the educational needs of this population. Policymakers may reference these results to develop an appropriate family-planning educational program for the Southeast Asian women of reproductive age in transnational marriages in Taiwan. [ABSTRACT FROM AUTHOR]