Search

Aims: Although medical professionals possess a positive attitude toward SDM, they lack of a complete understanding of conceptual shared decision making (SDM). Therefore, a related knowledge base must be constructed to enhance service education. We aimed to examine the effectiveness of an educational program with situational simulation video on nurses' SDM attitude., Methods: A randomized controlled trial with single-blind study design was conducted, and permuted block randomization was employed. Participants were randomly assigned to an experimental group (n = 50) or control group (n = 50). Only the experimental group received education programs within 2 weeks, with the first covering the basic concept of SDM and the second comprising situation simulation teaching. In both groups, data were collected prior to intervention as baseline, immediately after intervention to evaluate its immediate effects, and 2 months after intervention to test the delay effect. A generalized estimating equation, subgroup analysis and descriptive statistics were used to analyse data., Results: A significant main effect over time was discovered. Nevertheless, no significant group-time interaction was noted between the two groups after a 2-month interval. Subgroup analysis reveals that the SDM attitude scores in both the experimental and control groups increase for within group. The improvement of SDM attitude score in the experiment group was better than control group at follow test., Concisions: The findings of this study might provide a reference for health care providers when designing service education courses to improve the execution strategies of SDM and thus the quality of care provided., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Shared decision-making (SDM) is significantly associated with promoting the quality of end-of-life (EOL). The attitude of nurses toward the end of life can affect EOL care, but there are few SDM-related clinical learning programs focused on EOL. In this study, therefore, we evaluated the effectiveness of an EOL-simulation education program on attitudes toward SDM among nurses, using an objective structured clinical examination (OSCE)., Methods: We used a quasi-experimental study design to evaluate nurses working at a medical center in Taiwan. We recruited 100 nurses and assigned them to an experimental group (n = 50) and a control group (n = 50). The experimental group received the SDM attitude (SDMA) cultivation program, and the control group did not. After the intervention, all participants were examined in an OSCE to assess the efficacy of their learning. A p value of.05 was considered statistically significant., Results: The average score of the experimental group was higher than that of the control group in the dimensions "empathic communication" and "mastery learning", but these differences were not significant. SDMA score is significantly and positively correlated with SDMA global score, standardized patient survey (SPS) score, and SPS global score (r = .92, .56, and .50, respectively; p < .01)., Conclusions: Simulations concerning EOL care that incorporate SDM components would be effective for training clinical nurses. This study can serve as a reference for nursing-administration managers who may consider designing SDM-related education programs to improve the quality of clinical nursing care., Competing Interests: The authors have declared that no competing interests exist.

Objective: Shared decision-making (SDM) enhances medical care, but an appropriate tool for evaluating nursing staff's attitudes towards SDM in clinical practice is lacking. The objective of this study is to develop the Nursing Shared Decision-Making Attitude (NSDMA) scale and verify its psychometric properties., Design: Instrument design study., Participants: A sample of 451 nursing staff., Intervention: This study comprised two phases. In phase 1, qualitative research and expert content validity were adopted to develop the first draft of the scale. In phase 2, Taiwanese nursing staff were recruited through convenience sampling, and the sample was divided into a calibration sample and a validation sample. An objective structured clinical examination of SDM attitudes was administered to 100 nursing staff to determine the scale's cut-off score., Main Outcome Measurements: Exploratory factor analysis and confirmatory factor analysis were used to obtain the underlying factors of the NSDMA scale; McDonald's omega value was used to determine the reliability; known-group validity was used to test the construct validity; and the receiver operating characteristic curve was adopted to determine the scale's cut-off score., Results: In total, two factors were identified from the instrument results, which were termed 'empathic communication' and 'mastery learning'. The McDonald's omega value of the overall scale was 0.92. Known-group validity testing was performed based on the staff's participation in SDM courses and experience of SDM, and the results exhibited significant differences (t=5.49, p<0.001; t=2.43, p<0.05). Based on the receiver operating characteristic curve, the optimal cut-off for SDM attitudes was determined as 48.5 points., Conclusions: The NSDMA scale enables the evaluation of SDM attitudes among clinical nursing staff and nursing managers; the results may serve as a reference for incorporation of SDM into nursing policy formulation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The quality of nurses' work has a direct effect on patient health, and poor sleep has been positively associated with nurses' medical errors. The aim of this study was to investigate the relationship between quality of sleep and heart rate variability (HRV) among female nurses. A descriptive cross-sectional correlational&nbsp;study design was used in January 2014 to study female nurses ( n = 393) employed in a medical center in Taiwan. Data were obtained from several questionnaires. HRV was analyzed with five-minute recordings of heart rate signals obtained using a Heart Rater SA-3000P. Approximately 96% of the participants self-reported a poor quality of sleep. Compared to non-shift nurses, significant decreases were found in total power (TP) and low-frequency HRV among shift-work nurses. However, negative correlations were found between sleep quality and HRV, including total power, low frequency, and the low frequency/high frequency ratio ( r = -0.425, p < 0.05; r = -0.269, -0.266, p < 0.05). In a stepwise multiple regression analysis, 23.1% of variance in quality of sleep can be explained by TP and heart rate. The sleep quality of female nurses was poor and this affected their autonomic nervous system, which can contribute unfavorable consequences for their health.

Background: Culture influences personal health habits and behavior, and healthcare personnel possess different views of cultural perspectives. Currently, an appropriate instrument to assess cultural competence in clinical practice is limited. The present study aimed to develop and examine the psychometric properties of the Nursing Cultural Competence Scale (NCCS) for clinical nurses., Methods: Developing and assessing the scale was carried out in two phases: Phase I involved a qualitative research to explore the themes of nurses' cultural competence and instrument development; Phase II established construct validity of the scale using a sample of 246 nurses in Taiwan. Data from the questionnaire were analyzed using exploratory factor analysis, confirmatory factor analysis, internal consistency and test-retest reliability. Analysis results were used to determine the reliability and validity of the developed scale., Results: The results showed four factors including cultural awareness ability, cultural action ability, cultural resources application ability, and self-learning cultural ability were generated by exploratory factor analysis, and these factors explained 62.0% of total variance. Cronbach's α of the Nursing Cultural Competence Scale was .88, and test-retest reliability correlation was .70., Conclusions: The establishment of the tool will facilitate accurate monitoring of the cultural competence among nurses and nursing managers, which can inform the construction of nursing policies aimed at pledge cultural competence expansion., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Nurses are often the first responders to in-hospital cardiac emergencies. A positive attitude towards cardiopulmonary resuscitation with defibrillation may contribute to early cardiopulmonary resuscitation and rapid defibrillation, which are associated with enhanced long-term survival. The aim of this study was to translate and adapt the 31-item attitudes towards cardiopulmonary resuscitation with defibrillation and the national resuscitation guidelines (ACPRD) instrument into Chinese and to evaluate its psychometric properties in a sample of Taiwanese hospital nurses., Methods: The ACPRD instrument was translated into Chinese using professional translation services. Content validity index based on five experts to refine the translated instrument. The final instrument was applied to a sample of 290 female nurses, recruited from a regional hospital in southern Taiwan, to assess its internal consistency, factor structure, and discriminative validity., Results: The Chinese ACPRD instrument showed good internal consistency (Cronbach's alpha=0.87). Seven factors emerged from the factor analysis. The instrument showed good discriminative validity and were able to differentiate the attitudes of nurses with more experience of defibrillation or cardiopulmonary resuscitation from those with less experience. Nurses working in emergency ward or intensive care unit also showed significantly higher overall scores compared to those working in other units., Conclusion: The Chinese ACPRD demonstrated adequate content validity, internal consistency, sensible factor structure, and good discriminative validity. Among Chinese-speaking nurses, it may be used as a tool for assessing the effectiveness of educational programs that aim to improve their confidence in performing cardiopulmonary resuscitation with defibrillation., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: The professional nursing clinical ladder program can effectively enhance the professional morale of nursing staff and help retain the best senior nurses in clinical settings. Hence, it is important to explore factors that influence nurse staff intentions to participate in the clinical ladder., Purpose: This study examined factors that affect nurse staff intention to participate in the N3 nurse clinical ladder program., Methods: We used a cross sectional study design and a structured questionnaire survey. We employed purposive sampling to recruit 389 nurse staffs qualified for promotion to the N3 level from a medical center in southern Taiwan., Results: Findings showed: (1) Nearly two-thirds (233, 59.9%) of participants intended to participate in clinical ladder; (2) The factors of age, years of nursing experience, years in current position, project/research experience, promotion experience, and intention all significantly affected intent to participate in the ladder; (3) A significant difference between willingness to participate in the ladder program and each of the following variables--motivation, satisfaction, professional capacity, and sense of achievement; (4) Logistic regression analysis identified only motivation as a valid predictor of willingness to participate the ladder program (95% CI: 1.21-3.78)., Conclusion/implications for Practice: Results provide a useful reference to nursing administrators for planning on-the-job training and increasing nurse staff participation in the ladder. The authors hope results can help promote better human resource management and achievements.

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]

Abstract Aims To generate a descriptive theory framework regarding the experiences of the cultural competencies among clinical nurses in Taiwan. Background With the advances in, and the easy accessibility to health care services, frontline nurses require a higher cultural competence to perceive and satisfy the needs of the culturally diverse patients. Methods A qualitative approach using a grounded theory was applied. There were 30 nurses recruited by purposive sampling. Results 'Unprepared when encountering different cultures' was the core theme for describing and guiding the process of examining the nurses' experiences with a cultural competence. 'Awareness of value differences' was identified as the antecedent condition. The nurses revealed that they have had difficulty implementing their nursing work and seeking resources that represented situations in which interactive behavioral characteristics appeared to improve their cultural competencies. The nurses managing different cultural situations ultimately learned to tolerate the different cultures and to give patients culturally appropriate care, which thereby enhanced the care quality. Conclusions This study highlights the multiple layers of cultural competence experienced by the nurses and the understanding of cultural diversity among patients and caregivers. These results will assist the healthcare providers by offering references for clinical healthcare based on the patients' subjectively different cultural perspectives. Medical organizations should design an in-service educational program/instructions concerning culture to help strengthen the nursing specialists' relevant cultural competencies, to meet the individual patients' cultural care needs, and thereby boost the clinical care quality. Highlights • The findings of this study provided great of information regarding to the experiences of cultural competencies among nurses. • The ability accepting the multicultural background of patients should be prioritized as taking caring various ethnic groups. • It is crucial to offer continuing education related to health issue with diverse cultural backgrounds to clinical nurses. [ABSTRACT FROM AUTHOR]

The professional nursing competence ladder system can effectively inspire nurses' work morale, improve quality of life, and avoid the issue of senior staff leaving the clinical setting. The aim of this study was to explore the willingness to participate in the professional nursing competence ladder system and its related factors among nurses. A cross-sectional study design with a structured questionnaire was used. Purposive sampling was employed, and 696 nurses who qualified to be promoted as N2 were recruited from a medical center in southern Taiwan. The results showed most nurses were willing to participate in the nursing ladder system. There were significant differences between willingness to participate in the ladder system and age, education level, as well as promotion experience. This study emphasizes the importance of intensifying internal encouraging factors and strengthening external encouraging factors to improve participation rates. Healthcare institutions could provide instruction on case report writing to increase nurses' willingness to participate in the clinical ladder program. [ABSTRACT FROM AUTHOR]

The cultural competence education programme for health professionals aimed to ensure that all people receive effective health care, particularly those from culturally diverse backgrounds. The purpose of this study was to investigate the effect of a cultural competence educational course on nurses' self-assessment of their cultural competence. A single-blind, randomised control trial design was employed. Eligible nurses were recruited from a northern Taiwan medical centre with 2089 beds. A permuted block of four was used to randomly assign participants to the experimental (n = 47) and control groups (n = 50). The educational course comprised four units and was conducted once weekly for four weeks, with each session lasting 3 h. A significant group-time interaction was identified regarding self-learning cultural ability, verifying the education intervention's effect on self-learning cultural ability after a two-month intervention. In addition, a significant main effect over time was discovered for total cultural competence; there was no significant interaction effect. The study provided evidence that an educational programme effectively improved cultural competence in clinical nurses. The results provide a reference for health care providers to design in-service cultural competence education for improving quality of care. • Cultural competence in healthcare services caters to the patients' cultural needs. • Cultural competence is not an innate characteristic; it requires education. • Continuing education is crucial to foster cultural competence among nurses. [ABSTRACT FROM AUTHOR]