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No feasible screening instrument is available for early detection of children with autism in Taiwan. The existing instruments may not be appropriate for use in Taiwan due to different health care systems and child-rearing cultures. The purpose of this study was to develop and test a screening questionnaire for generic autism. The initial 18-item screening questionnaire was developed by a child psychiatrist using face-to-face interviews with 10 families of children with autism and then tested on a sample of families of 18 children with autism and of 59 typically developing children. Of these 18 items, 15 had fair or better item discrimination (kappa greater than 0.20) and were selected for the revised screening questionnaire. In the revised questionnaire, cutoff scores of 5 and 6 offered 100% sensitivity and 96.5% specificity, with the area under the receiver operating characteristic curve of 0.983. The revised screening instrument has high sensitivity and specificity, making it potentially useful for screening Taiwanese children at risk for autism. This instrument should be further tested in a population-based study. (Contains 1 figure and 2 tables.)

Parental explanatory models about autism influence the type of therapy a child receives, the child's well-being, and the parents' own psychological adaptation. This qualitative study explored explanatory models used by parents of children with autism. In-depth interviews were conducted with 13 parents of children with autism from a medical center in Taiwan. Despite high educational background, most of these parents attributed their child's autism to both biomedical and supernatural etiologies without apparent conflicts. These parents chose a wide variety of treatment strategies, including biomedical and alternative treatments, which often created time/energy pressures and financial burden, and were influenced by parents' cause attribution. Parents' illness explanations influence their treatment selections and need to be understood and accepted by health care providers. (Contains 1 table.)

A critical shortage of nurses worldwide makes research necessary to address the problem. Research examining whether and how temperament and character may lead to nurses' professional turnover intention can offer insights to address the nurse shortage issue. To examine the impact of temperament and character on nurses' intention and actions to improve professional capabilities and professional turnover intention. This study surveyed 502 nurses in a major medical centre in Taiwan in 2018. The measures came from the literature. Structural Equation Modeling was used for analysis. Self-directedness, cooperativeness, and persistence were positively related to intention (or actions) to improve professional capabilities. Harm avoidance was negatively related to actions to improve professional capabilities. Such actions were subsequently negatively related to nurses' professional turnover intention. This study contributes to the literature by being the first to clarify how nurses' temperament and character dimensions may lead to professional turnover intention. Our findings contribute insights for healthcare managers, i.e. they should pay particular attention to nurses with high levels of harm avoidance or low levels of persistence, self-directedness, and cooperativeness to retain nurses and, thus, improve the quality of a healthcare system. [ABSTRACT FROM AUTHOR]

• Persons with cognitive impairment may not receive goal-concordant care during end-of-life treatment for dementia. • Advance care planning (ACP) can improve the likelihood of goal-concordant care. • Predictors of intention to engage in ACP among persons with cognitive impairment in Taiwan were identified. • Predictors were level of education, a proxy signed do-not-resuscitate document, and necessity of explaining future care in advance. • Providing family-centered ACP could enable persons with cognitive impairment to participate in their care plans to achieve goal-concordant care. This study examined factors associated with the intention to engage in advance care planning among persons with cognitive impairment. This cross-sectional study recruited 116 persons with cognitive impairment by convenience sampling from two teaching hospitals in Northern Taiwan from November 1, 2018, to December 31, 2020. Fewer than 50% of the participants intended to engage in advance care planning, and less than 10% signed the living will for hospice and palliative care. Multivariate linear regression determined factors influencing advance care planning intention included education level, a proxy signed do-not-resuscitate document, belief that family members would provide a signed do-not-resuscitate at their end-of-life, and necessity of explaining future care in advance. It is recommended to popularize advance care planning education and ensure the rights of persons with cognitive impairment to enable them to fully participate in their own care plans through family-centered advance care planning. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To test how the three components of professional commitment (i.e. affective, continuance and normative professional commitment) are associated with nurse‐reported patient‐centred care and care quality. Background: Patient‐centred care and care quality are the two critical care outcomes. However, no study has yet examined how the three components of professional commitment are related to nurse‐reported patient‐centred care and care quality, showing a research gap. Design: This study adopted a two‐wave design (first wave in 2017 and second wave in 2019), which is known to reduce the possibility of reverse causality, and which was conducted in a large hospital in Northern Taiwan. Methods: Proportionate random sampling was used. Full‐time nurses were surveyed, while nursing students, interns, nurse practitioners and nursing supervisors were excluded. The first wave included 524 nurses, and 438 nurses were retained in the second wave. We used confirmatory factor analysis to verify the psychometric properties of the measures. Structural equation modelling was used to implement hypothesis testing. We used the Professional Commitment Scale of Meyer et al. (Journal of Applied Psychology, 1993, 78, 538), the Patient‐Centered Care Scale of Laird‐Fick et al. (Patient Education and Counseling, 2011, 84, 90) and the Care Quality Perceptions Scale of Teng et al. (Journal of Nursing Management, 2010, 18, 275). The STROBE statement was chosen as the EQUATOR checklist. Results: Affective professional commitment was positively associated with nurse‐reported patient‐centred care (β =.18, p =.002 and.01), which was positively associated with nurse‐reported care quality (β =.85, p <.001). Affective and normative professional commitment were also positively associated with nurse‐reported care quality (β =.17, p <.001). Conclusions: Our findings offer insights for nursing managers that nurses' affective and normative professional commitment could help upgrade care outcomes. Hospital managers should consider professional commitment as relevant to their workforce. Relevance to clinical practice: Nursing managers could publicise reports documenting nurses' significant contributions to public health. This could strengthen affective professional commitment among nurses. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations. Background: Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown. Methods: This study used a two‐wave follow‐up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves. Results: EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure. Conclusion: Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces. Implications for Nursing Management: Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to examine the relationship between psychological ownership of the nursing profession and turnover intention. Background: There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated. Methods: This study adopted a cross‐sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical centre in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self‐Efficacy Scale and developed Having a Place Scale. Results: Psychological ownership comprises three dimensions: self‐efficacy, nurse identity and 'having a place' in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self‐efficacy and 'having a place' are negatively related to nurses' intention to leave a hospital (r = −.23 and −.31, p <.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r = −.38, p <.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r =.76, p <.001). Conclusion: The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management: Nurse managers can enhance nurses' self‐efficacy and sense of 'having a place' to retain nurses in hospitals, while enhancing nurse identity to retain nurses in the profession. [ABSTRACT FROM AUTHOR]

When a child is ill, it is commonplace for his/her mother to become the major caretaker. However, little information could be found on the process by which mothers of children with intellectual disability care for their children in the context of a specific disorder. To explore this phenomenon in mothers of children with autism, this study used a grounded theory approach to develop a substantive theory for explaining the parenting and behavior/symptom management processes for such mothers in Taiwan. Data were collected by in-depth, tape-recorded interviews with 12 mothers of a child with autism, ages 3-7 years. Analysis of interview transcripts revealed that the process used by these mothers to deal with the complex needs of their children was 'integrating nurturer-trainer roles.' This process had four components: searching effective treatments, developing training and nurturing competencies, negotiating roles, and adjusting expectations. Different types of 'integrating nurturer-trainer' processes were found: trying it all, going along, insisting on training, and facilitating the child's strengths. The 'strength-facilitating' type of mothers seemed to he better at integrating the nurturer-trainer roles and had better role preparedness, less role strain, and positive emotional reactions. These results can sensitize health care providers to the conditions of these mothers, thus helping them to develop appropriate interventions to facilitate the process of integrating the nurturer-trainer roles. Keywords: Taiwan Autism Parental process Role integration Behavior management Symptom management Mothers Children

The problems of caregivers are identified as one of the major causes, as well as a preventable one, for the unplanned hospital readmissions of elderly patients. Family caregivers are found to be under intense stress and burden, and to encounter many difficulties preparing themselves, both physically and mentally, for the return home from the hospital of an elderly family member. However, few studies of rehospitalization of the elderly have focused on the point of view of the family caregiver. The purpose of this study was to explore the predictors, especially the needs of the family caregiver, for rehospitalization, within a month after having been discharged, for elderly patients in Taiwan. A prospective, descriptive and correlational study, using 216 elderly patients and their family caregivers from the internal medicine wards of a medical center in Northern Taiwan was conducted. It was found that elderly patients with caregivers requesting help from a support group were 5.3 times more likely to he rehospitalized than those with caregivers that did not request such help. In addition, the odds of rehospitalization for elderly patients with some self-care ability, whose caregiver reported at least one need for social services, was 9.03 (CI = 2.32 35.16) times that of those whose caregivers reported no need for social services. Based on the findings of this study, health care providers need to assess the self-care ability of their elderly patients. In addition they should assess the need for support groups and social services to caregivers before the hospital discharge of Taiwanese elders, and perhaps other Chinese populations as well. Keywords: Rehospitalization; Elderly persons; Discharge transition; Predictors; Needs of caregiver; Taiwan