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COVID-19 has been a global pandemic for three years. Symptoms experienced by patients with this disease include fever, cough, fatigue, muscle pain, and diarrhea as well as mental health issues. The terms "coronasomnia" and "COVID-somnia" emerged in 2021 to describe sleep disorders attributable to stress associated with the COVID-19 pandemic. In this study, the concept analysis method proposed by Walker & Avant (2019) was utilized to define the concept of coronasomnia (Walker & Avant, 2019), with three key attributes identified, including COVID-related anxiety or depression; insomnia that emerges after the pandemic; and experiencing difficulty falling asleep, interrupted sleep, or early morning awakenings accompanied by difficulty returning to sleep. Furthermore, the concept was elucidated in this study using typical, borderline, opposite, and relative cases. Lastly, evidence-based tools for validating the antecedents and consequences of coronasomnia were introduced. We hope the results of this concept analysis enhance nurses' understanding of coronasomnia and facilitate the implementation of clinical care and research in this area.

Social inclusion is a concept that is being widely discussed within the realms of politics and policy in the 21st century. Social inclusion is an essential element of social policy in Taiwan. Although fostering social inclusion for patients with mental disorders is a main focus of global health concern, this issue has been little explored in the nursing literature. Employment is both an important path by which patients with mental disorders return to the community and one of the sustainable development goals of the United Nations. Although the government of Taiwan has made significant efforts to improve employment services for patients with mental disorders, the results have been disappointing. Nurses must better understand the meaning of work for patients with mental disorders and the difficulties they face; reflect on the deficiencies and limitations of nursing practice; and strengthen their professional abilities to provide effective employment support care to patients with mental disorders. We also need to advocate for appropriate employment transition services to be provided by various government departments and civil organizations, for the development of an effective case management system, and for the provision of ongoing employment support to patients with mental disorders. The above activities and actions can assist patients with mental disorders to increase their social participation by taking stable and safe jobs, which will reduce the risk of their isolation from society and help nurses fulfill their responsibility for providing social care to patients with mental disorders.

Background & Problems: Early rehabilitation exercise has been shown to reduce the onset of disability in patients following acute stroke. However, the clinical execution rate of early rehabilitation exercise for those patients remains low. Our medical team developed an early rehabilitation care plan for patients with acute stroke in 2013, at which time the execution rate of early rehabilitation exercise for these patients in our hospital was only 37.1%. The survey found that patients and caregivers had insufficient awareness of early rehabilitation exercise; hospital staffs lacked appropriate assistive devices, rehabilitation equipment, nursing guidance tools, and handover records; and new nursing staffs were insufficiently aware of the importance of early rehabilitation exercise. This care plan was developed to improve the execution rate of early rehabilitation exercise in patients with acute stroke to slow the progression of their disability., Purpose: The project was designed to improve the knowledge of new nursing staffs regarding early rehabilitation care and the early rehabilitation exercise completion rate of nursing staffs to raise the execution rate of early rehabilitation exercise in patients with acute stroke., Resolution: After completing the cause analysis, multiple strategies were pursued: (1) nursing education sheets with texts, illustrations, video, and posters were used; (2) group in-service educational training was organized; (3) an innovative transfer belt was designed; (4) facilities were set up to deliver virtual-reality (VR) training; (5) standard procedures on early rehabilitation exercise in patients with acute stroke were revised and implemented; (6) nursing handover procedures were revised; and (7) education courses on early rehabilitation exercise for post-stroke patients were developed., Results: The accuracy of knowledge related to early rehabilitation exercise among new nursing staff improved from 31.3% to 80%; the completion rate for nursing education increased from 53.6% to 98%; and the early rehabilitation exercise execution rate increased from 37.1% to 82.8%., Conclusions: This project successfully increased the motivation and confidence of patients in rehabilitation and the rate of exercise program execution, which may be expected to impact positively on patients' quality of life.

Background: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality., Purpose: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM., Methods: A case-control study design was employed in which cases (Michigan Neuropathy Screening Instrument, MNSI) ≥ 2 were matched to controls based on age and gender in a medical center. A total of 114 patients diagnosed with T2DM in a medical center were recruited as participants. Data were collected using a structured questionnaire. The collected data were analyzed using Fisher's exact test, Mann-Whitney U test, and logistic regression., Results: The results of multiple logistic regression showed that glycated hemoglobin (B = 1.696, p = .041) and communication and critical health literacy (B = -0.082, p = .034) were significant factors of diabetic foot neuropathy., Conclusions / Implications for Practice: The findings of this study suggest that nurses should assess the health literacy of patients with T2DM before providing health education and should develop a specific foot-care intervention for individuals with poor glycemic control.

Background: In the context of professional nursing, the concept of job satisfaction includes the degree to which a nurse is satisfied with the nursing profession, his/her personal adaptation to this profession, and his/her current working environment. No validated scale that addresses the job satisfaction of nurses working in hospitals currently exists in Taiwan., Purpose: To develop a reliable and validated scale for measuring the job satisfaction of hospital nurses in Taiwan., Methods: A three-phase, cross-sectional study design was used. First, a literature review and expert focus group discussion were conducted to develop the initial scale items. Second, experts were invited to validate the content of the draft scale. Finally, convenience sampling was used to recruit 427 hospital nurses from 6 hospitals. These nurses completed the scale and the results were analyzed using item analysis, factor analysis, and internal consistency analysis., Results: The 31-item Taiwanese hospital nurse job satisfaction scale developed in the present study addresses 5 factors, including supportive working environment, professional autonomy and growth, interpersonal interaction and collaboration, leadership style, and nursing workload. The overall Cronbach's α was .96. The results indicate that the developed scale provides good reliability and validity., Conclusions / Implications for Practice: This study confirms the validity and reliability of the developed scale. It may be used to measure the job satisfaction of nurses working in hospitals.

Background: Inpatient nursing care satisfaction is an important indicator of medical care quality. However, no reliable and validated tool is currently available in Taiwan to measure the satisfaction of inpatients with nursing care., Purpose: This pilot study developed a reliable and validated scale for measuring inpatient nursing care satisfaction in Taiwan., Methods: First phase: literature review and expert focus group discussion constructs the content of the questionnaire to be used to assess inpatient nursing care satisfaction. Second phase: experts were requested to validate questionnaire content. Third phase: convenience sampling was used to recruit 766 inpatients from 6 hospitals to complete the validated questionnaire. The data collected from the questionnaire were analyzed using item analysis, construct validity, and internal consistency. The results of analysis were used to determine the reliability and validity of the developed scale., Results: The 20-item Taiwanese inpatient nursing care satisfaction scale was developed, with a CVI (content validity index) of expert validity of .97, item discrimination CR (critical ratio) of 28.61-50.25 (p < .001), and item-total correlation of .68-.84 (p < .001). Two factors, including "professional knowledge & skill" and "environmental control" were extracted by exploratory factor analysis after the deletion of 5 items, with item factor loadings ranging from .61 to .84. The factors explained 71.40% of total variance. The internal consistency of the two categories of Cronbach's α was .94-.97 coefficient and the overall internal consistency coefficient was .97., Conclusions/implications for Practice: This study confirms the validity of the developed Taiwanese inpatient nursing care satisfaction scale and suggests that this instrument is reliable for measuring the satisfaction of inpatients with nursing care in Taiwan.

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.

Charcoal-burning is the second major cause of suicide death in Taiwan. Predicting the variable damage and sequelae in this suicide mode is difficult due to the rapid combination of carbon monoxide with red blood cells. Delayed neuropsychological sequelae (DNS) may result in significantly extended recovery times, causing additional stress to the family. Nurses may help increase family understanding and support and guide family members to more positive intra-family interactions, shared perspectives on the recovery process, and resource seeking behavior by depicting subsequent family life and helping the entire family develop coping strategies those allow all members to effect cognitive, emotional and behavioral change. This result may help families of attempted suicide individuals recover successfully.

Spontaneous fracture is an issue of increasing concern in clinical care. However, this topic has received only limited attention in nursing research. Gaps in understanding related to spontaneous fractures may increase medical-legal risks faced by frontline care nurses, exacerbate nursing pressures, and serve as a disincentive to remain in the already understaffed nursing profession. This article reviews previous research on spontaneous fractures to determine the epidemiological causes of clinical spontaneous fracture and identify effective prevention strategies. We hope this paper may increase clinical practitioner and expert awareness of spontaneous fractures; help establish a screening mechanism to identify high risk spontaneous fracture patients; and help nurses develop and implement proactive prevention / treatment strategies to strengthen awareness of this topic among patients and their families.

An extensive body of literature advocating a "patient-centered" approach to medical care has emerged over the past three decades. This approach is now a mainstream trend in healthcare. Despite its popularity, there remains little consensus regarding the content or definition of patient-centered care. Various quantitative and qualitative research studies have extracted core meanings from "doctor-patient relationship" perspectives and investigated the relationships of these meanings with patient satisfaction, compliance with health promoting behavior, and health status. Mead and Bower's review of the conceptual and empirical literature represented the first attempt to develop a model of the doctor-patient relationship that considered the multiple aspects embraced by the "patient-centered" approach. However, any interpretation of the "patient-centered" concept that fails to consider the perspective of nursing is likely incomplete, as patient-centered care is the essence of nursing. This paper reviewed the concept of "patient-centered care", conducted a systematic review of randomized control trials to explore the effectiveness of patient-centered care, and integrated nursing-related studies that focused on patient-centered care. Our search covered articles published through the end of February 2011 in the Cochrane Controlled Trials Register, JBI, MEDLINE, CINAHL, Pubmed, ProQuest, PsycInfo, and CEPS, with 13 relevant articles identified. The majority of trials addressed by these studies demonstrated a positive "patient-centered care" effect on self-care knowledge and skills but a limited/insignificant effect on disease improvement. The reviewed studies used traditional definitions of "patient-centered care" that were inconsistent with the concepts defined by Mead and Bower. Heterogeneities exist between reviewed studies and the lack of related research in Taiwan. We thus integrated outcome indicators related to "patient-centered care". This study may be referenced by nursing research and clinical care professionals responsible to improve and integrate medical care quality.

Background: Taiwan's Department of Health (DOH) promotes a standardized 2-year training program to raise the competence of newly certified nurses in the realms of patient care, nursing professionalism and communication skills as well as to ensure professional nurse training program quality., Purpose: This study evaluated training program participants' self-perception of nursing competency., Method: We used a cross-sectional approach and structured questionnaire to evaluate the nursing competency of 128 nurse trainees at a medical center. Questionnaires were filled out independently by participants and thus reflect participant self-assessments of questionnaire items. Descriptive and correlation analyses further explored data., Result: Results showed: mean scores were 3.80 ± .60 for clinical technique; 3.78 ± .67 for administrative skill; and 3.21 ± .88 for educational and research skills . Nursing ability correlated significantly with age, seniority, nursing grade, and courses taken. The relationship between participant total score and program completion ratio formed a "V"-shaped distribution., Conclusions / Implications for Practice: The DOH training program was has a positive effect on nursing competency in nurse trainees. Results also provide valuable information and suggestions for revising the DOH's nurse training program in the future.

A year has passed since a major earthquake and tsunami hit northeastern Honshu, Japan in March 2011. Amidst mourning for the tens of thousands of victims, survivors have just begun the difficult and urgent tasks of rebuilding. Many survivors suffer from post-traumatic stress disorder (PTSD). PTSD causes chronic, long-term suffering for patients and their families and inevitably burdens social and medical care systems. This article tries to integrate PTSD evidence-based treatment experiences into a practical and detailed nursing intervention protocol for PTSD. We also elicit the function and effect of "family-centered care." We hope that nursing professionals apply family-centered care principles to PTSD treatment and care approaches in order to promote PTSD patient resilience. Nurses can thus enhance PTSD care efficacy and improve the opportunity for PTSD patients to overcome their symptoms and recover their life.

Historically, positivism has been the dominant approach in the philosophy of science. In nursing, most quantitative researchers tend to employ positivism as their epistemological underpinning, which could be why positivism has long been identified as the epistemology of quantitative research. It can be argued, however, that some of the procedures of qualitative research reflect the perspectives on which positivists insist. This article takes grounded theory and phenomenology as examples, in order to observe how positivism influences their methodologies, evidence obtained is then used to support the aruthors' arguments. The article, furthermore encourages beginning researchers to familiarize themselves with background knowledge of philosophy of social sciences, especially epistemologies and methodologies, in order to make clear the philosophical context in which their research is conducted.

Group cohesion is considered an essential condition for achieving a successful treatment team. High cohesion groups more readily reach their goals, with group members also feeling more secure about their functions and contributions. In clinical practice, nurses use group teaching and group therapy to help patient and family members gain knowledge and skills related to illness treatment and recuperation. Effective group leadership helps minimize non-productive time and manpower and enhance interpersonal interaction. A further advantage of group cohesion is that the more effective administration of nursing programs that results can raise the profession level of staffs and reduce turnover. Walker and Avant (1995) employ concept analysis to use defining attributes in order to apply the same definition and communication to the same profession. The purpose of this paper was to apply this methodology to an analysis of group cohesion. Steps used include a review of the literature on conceptual definitions of group cohesion, a determination of defining attributes, model construction, identification of borderline, contrary, and related cases, and identification of antecedents and consequences and empirical tools. It is hoped that this analysis can help nursing staff to gain a better understanding of the concept of group cohesion and to apply such to clinical practice and nursing administration.

The purpose of this article was to describe a nursing experience with a patient who suffered from delusions and hallucinations due to schizophrenia. Through conversation and observation, the authors gathered both subjective and objective data and identified two major nursing problems, as follows: altered thought processes and sensor/ perceptual alteration (auditory). During the nursing process, the authors established a rapport with the patient and provided cognitive-behavioral therapy to help him to reduce his irrational beliefs and improve his coping methods. The behavioral therapy enabled the patient to face his negative beliefs, and he developed cognitive-behavioral skills to improve his self-management of delusions and hallucinations. From this perspective, cognitive-behavioral therapy was an effective intervention in the nursing process of caring for this patient with positive symptoms.

The purpose of this article is to describe a nursing experience with a patient with schizophrenia who had antipsychotics-induced overweight. The authors assessed the patient's health condition and provided weight management to reduce her hallucinations as well as her body weight between May 1 and June 10, 2004. Three nursing problems had been identified as follows: disturbed sensory perception, imbalanced nutrition, and ineffective health maintenance. During the nursing process, the authors established a rapport relationship with the patient and her mother, educated them in skills for reducing hallucinations, and designed an individual body weight management program. After the interventions, the patient was able to positively face her illness, effectively use methods to reduce the impact of hallucinations, and successfully lose 5.5 kg. From this perspective, an individual body weight management program can be an effective intervention for nurses to care for this group of patients.

Suicide has become a critical mental health problem in Taiwan. Most studies on the issue are related to suicide rates and risk factors, and their relationships with mental illnesses. These findings help health professionals to understand what life might have been like for a suicide victim before the suicide, but not what life is like after a suicide attempt; how to detect the possibility of a subsequent suicide attempt, rather than how to help people who have attempted suicide to construct a good life. The purpose of this article is to encourage nurses to engage in dialogue with suicidal patients by understanding their explanatory models and by self-reflection. This not only enables suicidal patients to move from shame toward taking responsibility for themselves and others, but also enables nurses to rebuild their experiential knowledge.

Sleep is a basic human need. A good night's sleep shapes our physical and mental health. Female nurses experience particularly complex sleep disturbance problems because of after working rotating shifts, as well as because of the effects of the female reproductive hormones. Both issues present a challenge to the understanding of female nurses' sleep. This paper summarizes the existing knowledge about sleep in women, including shift workers in relation to their reproductive status, and introduces practical sleep hygiene concepts and strategies for female nurses.