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Background. Most frontline nurses lack sufficient readiness for effective disaster response. Therefore, designing a disaster management training program (DMTP) to promote nurses' readiness for disaster response is imperative. Aim. This study aimed to evaluate the effectiveness of a structured DMTP on nurses' readiness for response to disasters. Methods. A randomized controlled trial was conducted. One hundred eligible nurses, recruited using convenience sampling from a medical centre in northern Taiwan, were randomly assigned to either the experimental (EG, n = 50) or control (CG, n = 50) group. Both groups received regular continuous nursing education. The EG received an extra two‐day (16 h) structured DMTP delivered by transdisciplinary collaborations through multiple teaching strategies (lectures, simulations, problem‐solving lessons, demonstrations, tabletop exercises, discussions, group presentations, and reflections). Readiness for disaster response, consisting of four subscales (emergency response, clinical management, self‐protection, and personal preparation), was assessed at baseline and 12 weeks after the intervention. Generalized estimating equations were used as the primary method of data analyses to evaluate the intervention effects. Results. Ninety‐four nurses (94%) completed the study, and 100 nurses were included in the intention‐to‐treat analysis. While participants in the EG had increased readiness for disaster response after training and at the 12‐week follow‐up, those in the CG exhibited no differences between baseline and 12‐week follow‐up. When the group × time interaction was examined, the EG had a greater increase in readiness for disaster response and its four domains, including emergency response, clinical management, self‐protection, and personal preparedness after 12 weeks, than the CG. Conclusion. A two‐day structured DMTP utilizing multiple teaching strategies through transdisciplinary collaborations is recommended to enhance hospital nurses' readiness for disaster response. Implications for Nursing Management. Nursing leaders should consider incorporating such a structured DMTP into ongoing nursing training as a critical component of professional development programs, thereby strengthening nurses' disaster readiness in hospital settings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years.Effective diabetes self‐care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications.Few studies have investigated diabetes self‐care behaviours and their associations with health literacy and self‐efficacy in people diagnosed with serious mental illness. What the paper adds to existing knowledge?: Diabetes self‐care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self‐care activities were self‐monitoring of blood glucose.Factors associated with diabetes self‐care behaviours are gender, age, communicative and critical health literacy and self‐efficacy.Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. What are the implications of practice?: Mental health nurses should assess diabetes‐specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self‐care.When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes‐related distress and increase their confidence in managing comorbid diabetes. Introduction: People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim: This study investigated diabetes self‐care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods: A cross‐sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self‐report questionnaires and a chart review. Three‐step hierarchical multiple regression analysis was used to identify factors associated with diabetes self‐care behaviours. Results: Diabetes self‐care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p =.037) and self‐efficacy (β = 0.27, p =.004) significantly associated with diabetes self‐care behaviours. Discussion: Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice: Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM. [ABSTRACT FROM AUTHOR]

The prevalence of chronic diseases (such as diabetes, obesity, cancer, heart disease, and chronic obstructive pulmonary disease) continues to increase among patients with mental illness. This cross‐sectional study investigated the factors affecting nurses' views on the provision of physical healthcare to patients with comorbid mental illness and chronic disease. In total, 369 nurses working in mental health were assessed for the physical healthcare attitudes and practices using the Physical Health Attitude Scale for Mental Health Nurses. The results of generalized linear modelling indicated that nurses' involvement in physical healthcare was associated with psychiatric mental health nurse credentials (B = 1.560, 95% CI = 0.292–2.828, P = 0.016) and their confidence in delivering physical healthcare was associated with prior physical healthcare training (B = 0.639, 95% CI = 0.104–1.174, P = 0.019). In addition, the frequency with which the nurses engaged in physical healthcare practices was associated with working in a community unit (B = −7.416, 95% CI = −9.652 to −5.180, P < 0.001), involvement in physical healthcare (B = 0.349, 95% CI = 0.162–0.535, P < 0.001), and confidence in delivering physical healthcare (B = 1.148, 95% CI = 0.776–1.519, P < 0.001). Our findings suggest that interventions aiming to help nurses assess and improve their own physical healthcare practices should consider nurses' background and patients' physical health needs in various settings and focus on cultivating an organizational culture that gives nurses confidence in providing physical healthcare. [ABSTRACT FROM AUTHOR]

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The prevalence of metabolic syndrome and its components continue to increase among patients with serious mental illness. This cross‐sectional study investigated whether metabolic syndrome prevalence and risk factors differ between male and female patients with serious mental illness. In total, 260 eligible patients were recruited from two hospitals. The data on demographic characteristics, lifestyle behaviour factors, biochemistry, and anthropometry were collected. Analyses were performed using multivariate logistic regression. Metabolic syndrome prevalence was 40.8% (35.1% in men and 46.8% in women). Among patients aged 40–49 years, metabolic syndrome prevalence was higher in men; however, the trend was reversed among patients aged 50 years or older. Notably, gender‐specific metabolic syndrome risk factors were observed. In men, they included low education level, high body mass index (BMI), prolonged illness, comorbid physical illness, and diagnosis of bipolar disorder, whereas they included being married, old age, and high BMI in women. Our findings suggest that mental health professionals should consider the gender‐ and age‐based metabolic syndrome prevalence trend in patients with serious mental illness when designing interventions for the study population to minimize metabolic syndrome prevalence. [ABSTRACT FROM AUTHOR]

Objectives: To examine the mechanisms of coping strategies on nurses' psychological well‐being, practice environments and safety attitudes. Methods: A cross‐sectional study design was used. Structural equation modeling was performed to analyze the results. Five hundred clinical nurses were randomly selected from a large group of 1,500 from a medical center with 1,350 beds in Taipei, Taiwan, from July to October 2015. Self‐report questionnaires were administered to measure coping strategies (Brief COPE), psychological well‐being (Ryff's Psychological Well‐being Scale), nurses' practice environments (Practice Environment Scale of the Nursing Work Index), and safety attitudes (Safety Attitudes Questionnaire). Results: Of the 500 participants who gave written consent, 474 (94.8%) filled out the questionnaire. Results showed that using more approach‐oriented coping strategies and fewer avoidant coping strategies was associated with greater psychological well‐being. Psychological well‐being was directly associated with quality of nurses' practice environments and safety attitudes. The impact of psychological well‐being on safety attitudes was mediated significantly by the quality of the practice environment. The use of approach‐oriented coping strategies was significantly predictive of positive psychological well‐being, a good practice environment, and good safety attitudes. Conclusions and Clinical Relevance: This study found a distinct pathway for the relationships between clinical nurses' psychological well‐being, practice environment, and safety attitudes. Psychological well‐being in clinical nurses was higher for those with more approach‐oriented coping strategies. Psychological well‐being directly impacted safety attitudes, which mediated nurses' practice environments. The practical implications of the results suggest that interventions designed to promote positive psychological well‐being may help improve nurses' practice environments, which, in turn, may result in better safety attitudes and nursing care outcomes. [ABSTRACT FROM AUTHOR]

The aim of this follow-up study was to examine factors related to a suicide attempt within 3 months of a prior attempt. Participants were recruited from a suicide-prevention center. Of 96 suicidal individuals who had participated in the baseline study, only 51 completed all measures at follow-up assessment. Study results showed that suicidal individuals who reattempted suicide during the first 3 months of follow-up care exhibited lower mean scores on all four domains of the brief version of the World Health Organization Quality-of-Life Instrument at follow-up assessment than at baseline. In contrast, individuals who did not reattempt suicide had higher quality-of-life scores across all domains between baseline and 3 months. The reattempt and no-reattempt groups differed significantly in the physical health and environmental domains. These results can be used by nurses to develop their abilities to recognize and prevent suicide reattempts in high-risk groups. [ABSTRACT FROM AUTHOR]

The ethnographic study on which this report is based investigated experiences among patients, their families, friends, colleagues, and health professionals following a suicide attempt. Misunderstanding and ineffective treatment are often based on different explanations of suicide held by patients, their families, and health professionals, even when they share culture and language. In this report we describe how suicide is perceived by psychiatric team members in one regional teaching hospital in northern Taiwan. Twenty-two staff members of the Department of Psychiatry participated in this study. “Making a diagnosis” characterized the psychiatric subculture around the care of suicidal patients. In addition, mental health professionals tended to differentiate the patient's condition through three main avenues: (a) psychotic symptoms versus personality problems, (b) low IQ and high educational level, and (c) high versus low lethality of method. These findings suggest that mental health professionals need to bridge the gap between their knowledge and understanding of suicide and patients' and patients' families' expectations for care and treatment. [ABSTRACT FROM AUTHOR]

Aim: To examine the associations between physical activity patterns, sleep quality, and stress levels among rotating-shift nurses during the COVID-19 pandemic., Background: Stress adversely impacts hospital nurses, particularly those on rotating shifts. The effects of physical activity patterns and sleep quality on the stress levels of these nurses during the COVID-19 pandemic warrant investigation., Methods: A multicenter cross-sectional study was conducted with 550 eligible registered hospital nurses, randomly selected from four hospitals during the COVID-19 pandemic in Taiwan. The work schedule type of these nurses was categorized into rotating shifts (working at least two shifts in a month, involving day, evening, and night shifts) or fixed-day shifts (working only the day shift). Data were collected on sociodemographic characteristics, physical activity patterns (sedentary or active), sleep quality (poor or adequate), and stress levels for analysis., Results: Rotating-shift nurses with active physical activity patterns exhibited lower stress levels compared with those with sedentary patterns. Nurses who experienced adequate sleep quality had lower stress levels compared with those with poor sleep quality among rotating and fixed-day shift nurses., Conclusions: Active physical activity patterns and adequate sleep quality were associated with lower stress levels among rotating-shift nurses during the pandemic. Promoting active physical activity and enhancing sleep quality are essential strategies for reducing stress in these nurses., Implications for Nursing and Health Policy: Strategies aimed at promoting physical activity and improving sleep quality should be integral components of health promotion programs and policymaking efforts directed at nursing leaders, to foster a healthy and supportive work environment and enhance the welfare of rotating-shift hospital nurses., Reporting Method: The study is reported using the statement of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)., (© 2024 International Council of Nurses.)

Background: Patients with serious mental illness (SMI) are more likely to have Type 2 diabetes mellitus (T2DM). However, studies that discuss the eating habits of patients with both T2DM and SMI are lacking., Purpose: This study was designed to explore the beliefs and experiences of Taiwanese patients with SMI who also have T2DM., Methods: Fieldwork for this study included 2 years of participant observation and individual interviews with 13 patients with SMI. Data from transcripts of observational field notes and interviews were transcribed verbatim and analyzed., Results: The participants described their experiences and concerns regarding dietary management during the period after receiving their T2DM diagnosis. The results of the data analysis were distinguished into three categories, including (a) increased difficulty in life, (b) positive view of dietary control, and (c) inability to abide by dietary restrictions., Conclusions: The findings suggest that healthcare professionals should work to better understand the challenges faced by patients with SMI and T2DM in implementing changes and resisting the temptation to eat unhealthy food and provide suggestions tailored to their cultural background, lifestyle, and eating characteristics., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: Physical activity (PA) is associated with cardiovascular health in general populations, particularly in women. Middle-aged and older women are at high risk of less engagement in PA for unknown and complicated reasons., Objectives: The aim of this study was to investigate whether PA was positively associated with socioeconomic status and psychosocial correlates of PA (self-efficacy and perceived benefits) but inversely correlated with perceived barriers in women (age >40 years)., Methods: A cross-sectional survey of 326 community-dwelling women was conducted. Data on socioeconomic status, PA, and its psychosocial correlates (ie, perceived benefits/barriers and self-efficacy) were collected using self-report questionnaires. Analyses were performed by multiple linear regressions., Results: Monthly income (β = .35, P = .015), employment status (β = .32, P < .001), and perceived barriers to PA (β = -.19, P = .008) were significantly associated with PA. More highly educated women participated in more (β = .13, P = .033) vigorous PA, women with fewer perceived barriers participated in more (β = -.14, P = .047) moderate-intensity PA, and employed women participated in more (β = .35, P < .001) walking. Significantly higher scores of perceived barriers, including "no trainer," "feeling exhausted," "lack of motivation," and "lack of guidance," were identified in women with low PA compared with those with moderate PA., Conclusion: Socioeconomic status and perceived barriers are associated with PA and its intensity level. Some specific barriers provide insights into the key factors that contribute to low PA in middle-aged and older women. These findings can be considered in future interventions to design PA promotion programs for this population to protect against cardiovascular diseases.

Objective: The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan., Materials and Methods: This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units., Results: More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel., Conclusion: Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool.

In this article we present the findings of a qualitative study exploring what suicide survivors in Taiwan experienced after a family member's suicide and how they adjusted to the perceived stigma. Fifteen suicide survivors participated in this study. We found that when a family member's suicide death occurred, survivors first kept a low profile when holding the funeral, and then tried to expel the dead person from their family. They also wished that their grief and painful, shameful feelings could be buried with the dead person. These findings suggest that health care professionals need to work more closely with suicide survivors through understanding the survivors' fear and pain from a sociocultural perspective, and to help them construct a new moral life.

In the ethnographic study on which this article is based, the authors investigate experiences after a suicide attempt from the perspective of patients and their family members in Taiwan. Thirty-four patients and 49 family members or colleagues participated in interviews from the point of patients' hospitalization to their return to the community. The postsuicide stigma suffered by patients and their families was based on such cultural themes as Suicide is bu-hsiao (non-filial piety), Suicide results in an inability to transmigrate the soul, and Suicide is inherited. Patients, family members, and colleagues cope with the stigma through explaining suicide as due to "bad luck" or "a kan-huo (hot energy) problem," or by insisting that it was "not a true suicide." These findings suggest that health professionals can move closer to patients and their families and suggest appropriate health care policy through understanding the patient's and the family's explanation of suicide experiences.