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The rise in the number of hemodialysis (HD) patients underscores the importance of culturally competent HD nurses. This study aimed to examine the effectiveness of a situated simulation program on HD nurses' cultural competence. This was a quasi-experimental pilot study with a total of 40 participants who met the inclusion criteria from an HD center in northern Taiwan. Participants took part in two separate 3 h education programs. The first program focused on the basic concepts of cultural competence, while the second program involved situated simulations utilizing the Gather–Analyze–Summarize (GAS) method of debriefing. The generalized estimating equations (GEEs) were employed to estimate the intervention effect. The baseline scores were divided into low-score and high-score groups using the median score for subgroup analysis. The subgroup analysis revealed that a significant group-time interaction was identified regarding cultural competence and subscale, verifying the situated simulation's immediate effect. In this study, an integration of the GAS method of debriefing and situated simulation teaching was implemented. The results showed that this approach empowered HD nurses with the ability to foster positive attitudes and demonstrate professional expertise in an organized manner when facing similar clinical scenarios in the future. [ABSTRACT FROM AUTHOR]

Background: Hypertension is prevalent in older women and is associated with increased cognitive impairment. Exercise has demonstrated beneficial effects on cognitive function, but the impact of exercise on older hypertensive women remains unclear. We investigated the effects of an aerobic walking program on memory, subjective cognitive complaints, and brain-derived neurotrophic factor in older hypertensive women. Methods: A quasi-experimental study with a pretest–posttest design was conducted. Older hypertensive women were randomly assigned to the aerobic walking group or a control group with routine care. The intervention group received a 24-week aerobic walking program. Data were collected at baseline and 24 weeks after enrollment. Participants' characteristics, memory, subjective cognitive complaints, and plasma brain-derived neurotrophic factor were analyzed. Results: The aerobic walking group (n = 30) reported improvements in total recall, delayed recall, and subjective cognitive impairment after 24 weeks of aerobic walking. Compared to the control group (n = 28), the aerobic walking group showed significantly greater improvement in delayed recall at 24 weeks. However, aerobic walking had no significant effect on subjective cognitive complaints or brain-derived neurotrophic factor. Conclusion: The aerobic walking training significantly improved memory performance among older women with hypertension. A longer randomized controlled trial with a larger sample is necessary to confirm and further explore the effects of this intervention. [ABSTRACT FROM AUTHOR]

The major objective of this study was to investigate how smoking behavior mediates the relationship between life stress and depressive symptoms in adolescents. A descriptive correlational study was conducted from February to June 2017 at a vocational high school in northern Taiwan, and 226 students were recruited through convenience sampling. Results indicated that smoking behavior played a pivotal role by partially mediating the relationship between life stress and depressive symptoms in adolescents. Life stress in adolescents significantly increased the risk of experiencing depressive symptoms, and adolescents who smoked were also at a greater risk. Assessments between the objective and self‐reported smoking behavior were significantly correlated. Therefore, integrated methods for assessing life stress, smoking behavior, and depressive symptoms in adolescents are needed for teachers and clinical professionals. Implementing appropriate policies for discouraging tobacco use for adolescents experiencing life stress in order to decrease depressive symptoms in school settings is paramount. [ABSTRACT FROM AUTHOR]

Objectives: We conducted a qualitative process evaluation embedded in a cluster randomized controlled trial in rural Guangxi China, which successfully reduced antibiotic use for children upper respiratory tract infections. This study aims to report on the factors that influenced behaviour change among providers and caregivers in the intervention arm, and to explore contextual considerations which may have influenced trial outcomes. Methods: A total of 35 in-depth interviews were carried out with hospital directors, doctors, and caregivers of children. Participants were recruited from six purposively selected facilities, including two higher performing and two lower performing facilities per trial results. Interviews were conducted in Chinese and translated to English. We also observed guideline training sessions and prescription peer review meetings. Data were analysed using framework analysis. Results: Intervention-arm doctors described that training sessions improved their knowledge, skills and confidence in appropriate prescribing. This was contrasted by control arm participants who did not receive training and reported less agency in reducing prescribing rates. Prescription peer review meetings were seen as an opportunity for further education, action planning and goal setting, particularly in high performing hospitals, where these meetings were led by senior doctors who were perceived to have relevant clinical experience. Caregiver participants reported that intervention educational materials were helpful but they identified information from doctors was more useful. Providers and caregivers also described contextual health system factors, including hospital competition, short consultation times, and antibiotic availability without prescription, which shaped care preferences. Conclusions: This qualitative process evaluation identified a range of factors that may have influenced behaviour among providers and caregivers leading to observed changes in reducing inappropriate antibiotic prescribing in China. Future interventions to reduce antibiotic prescribing should consider system level and wider contextual factors to better understand behaviours and patient care preferences. [ABSTRACT FROM AUTHOR]

Hypnotic susceptibility is a fundamental individual characteristic to consider in studies examining hypnosis. Although there is no existing normative data of group hypnotic susceptibility tests for the Mandarin-speaking Chinese population, the current study administered the Mandarin Chinese translation of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) to 242 subjects (137 females and 105 males). The results indicate that the normative properties—including the score distribution, item pass rates, and reliability—are comparable to 15 reference samples. In general, the Mandarin Chinese version of the HGSHS:A can be used as a viable and reliable instrument for prescreening subjects' hypnotizability in the Mandarin Chinese-speaking population in Taiwan. [ABSTRACT FROM AUTHOR]

Purpose: To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness. Design and Methods: A quasi‐experimental design was used. Two hundred and sixty‐four participants completed a daily living function scale questionnaire and provided disease‐related information. Findings: Community rehabilitation was shown to be efficient in helping to stabilize mental illness and enhance daily function. Daily function had a significant and positive correlation with disease stability. Practice Implications: Community rehabilitation for patients with mental illness can effectively stabilize and prevent disability among those with mental illness. [ABSTRACT FROM AUTHOR]

This study was designed to explore Taiwanese school students’ attitudes toward sexual relationships and premarital sex. This was an exploratory descriptive, qualitative study. Focus groups (N = 8) were conducted with 47 adolescents from three high schools in Taiwan. Transcripts were transcribed and thematically analyzed using Atlas V 5.0. Adolescent attitudes toward sexual relationships and premarital sexual behavior comprise the following three dimensions: (1) external incentives, (2) the developmental process, and (3) internal control. External incentives include the normalization of sexual behavior between peers, the desire to feel included in a group, parental influence, and media influence. The developmental process includes imagining the sexual experience and onset of sexual activity. Internal control includes the fear of pregnancy, the fear of parental rejection, and the fear of being judged. These findings can provide a reference for designing future sex education curricula and counseling programs for adolescents. [ABSTRACT FROM PUBLISHER]

Background: Culture serves as an adhesive to bind the lives of people. There are no objective, useful tools to assess cultural competence and practice. In this study, we evaluated whether the cultural competence of nurses was strengthened through the Cultural Competence Cultivation Programme. Methods: A quasi-experimental research design was used to evaluate nurses working at a medical centre in Taiwan. They were randomly allocated into an experimental group (n = 47), which received the Cultural Competence Cultivation Programme, or a control group (n = 50), which did not receive the educational programme. After the intervention, learning efficacy of the participants was assessed using an Objective Structured Clinical Examination (OSCE). The research data were statistically analysed on SPSS. Results: The average score of the experimental group was significantly higher in the 'communication ability and skill' category. Furthermore, OSCE scores and Standardised Patient Survey assessment and total scores were significantly and positively correlated. Conclusion: The findings of this study can serve as a reference for designing future clinical education programmes. [ABSTRACT FROM AUTHOR]