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Background The complexity of healthcare and concurrent advances in technology have promoted Interprofessional Education (IPE) in healthcare schools to prepare students to collaborate on interdisciplinary teams. Since 2016, healthcare curricula in Taiwan have incorporated IPE-based capstone courses to enhance creativity. To better understand the predictors of team creativity could help educators improve IPE and outcomes for nursing students and patients. Purpose To determine whether nursing students' demographic characteristics, individual creativity, and perceived team interaction behaviors, team swift trust, team conflict, and team task interdependence may predict high perceived team creativity in IPE settings. Methods A cross-sectional study design included nursing students (N = 99) at a science and technology university in Taiwan. Data from self-report questionnaires included variables for demographic characteristics, individual creativity, and perceived team characteristics. A hierarchical multiple regression analysis revealed predictors of high perceived team creativity. Results Nursing students who perceived high team creativity also perceived higher interaction behaviors and lower process conflict than those who perceived less creativity. Spontaneous communication and team task conflict predicted high perceived team creativity. Conclusions Nursing educators could increase team creativity in IPE by encouraging spontaneous communication and constructive task-oriented conflict management. This may benefit patient outcomes in the future.

Objective: Patient safety is a worldwide problem and a focus of academic research. Human factors and ergonomics (HFE) is an approach to improving healthcare work systems and processes. From the perspective of the cognitive ergonomics of HFE, the aim of this study is to improve the flow level, communication skills, and safety attitudes of surgeons through focused-attention meditation (FAM) training, thus helping to reduce adverse clinical events. Methods: In total, 140 surgeons were recruited from three hospitals in China and randomly divided into two groups (FAM group and control group). The FAM group received 8 weeks of FAM training, while the control group was on the waiting list and did not receive any interventions. Three scales (WOLF, LCSAS, and SAQ-C) were used to measure the data of three variables (flow, communication skills, and safety attitude), respectively, at two times, before and after the intervention (pre-test and post-test). The incidence of adverse events during the intervention was also collected for both groups. Results: The ANOVA results showed that all three variables had a significant main effect of time and significant interactions between time and group. The independent-sample T-test results showed that the incidence of adverse events during the intervention was significantly lower in the FAM group than in the control group. Conclusions: The intervention of FAM could significantly improve surgeons’ flow levels, communication skills, and safety attitudes, potentially helping to reduce adverse clinical events.

Objective: This study investigated the effects of mindfulness meditation on doctors’ mindfulness, patient safety culture, patient safety competency, and adverse events. Methods: We recruited 91 doctors from a hospital in China and randomized them to mindfulness meditation group (n = 46) and a waiting control group (n = 45). The mindfulness meditation group underwent an 8-week mindfulness meditation intervention, while the control group underwent no intervention. We measured four main variables (mindfulness, patient safety culture, patient safety competency, and adverse event) before and after the mindfulness meditation intervention. Results: In the experimental group, mindfulness, patient safety culture and patient safety competency were significantly higher compared with those of the control group. In the control group, there were no significant differences in any of the three variables between the pre-test and post-test. Adverse events in the experimental group were significantly lower than in the control group. Conclusions: The intervention of mindfulness meditation significantly improved the level of mindfulness, patient safety culture and patient safety competency. During the mindfulness meditation intervention, the rate of adverse events in the meditation group was also significantly lower than in the control group. As a simple and effective intervention, mindfulness meditation plays a positive role in improving patient safety and has certain promotional value.

Objective The purpose of this study was to investigate whether animation can help to improve the comprehension of universal healthcare symbols for middle-aged and older adults. Background The Hablamos Juntos (HJ) healthcare symbol system is a set of widely used universal healthcare symbols that were developed in the United States. Some studies indicated that HJ healthcare symbols are not well-understood by users in non-English-speaking areas. Other studies found that animations can improve users’ comprehension of complex symbols. Thus, we wanted to test whether animation could help to improve users’ comprehension of HJ symbols. Methods The participants included 40 middle-aged and 40 older adults in Taiwan. We redesigned the 12 HJ symbols into three visual formats—static, basic animation, and detailed animation—and compared them to find which best improved the participants’ guessability scores. Results (1) Middle-aged adults’ comprehension of static and basic animated symbols was significantly better than that of older adults, but there was no significant difference in the guessability scores between the two age groups in terms of detailed animated symbols; (2) In general, both basic animation and detailed animation significantly improved the guessability score, but the effect with detailed animation was significantly greater than that with basic animation; (3) Older women were more receptive to detailed animation and showed better guessing performance. Conclusion Detailed animation contains more details and provides a more complete explanation of the concept of the static symbols, helping to improve the comprehension of HJ symbols for middle-aged and older adult users. Application Our findings provide a reference for the possibility of new style symbol design in the digital and aging era, which can be applied to improve symbol comprehension.

Background: In the context of increasing doctor–patient tensions in China, the objective of this study was to explore and examine the effects of loving-kindness meditation (LKM) on doctors’ mindfulness, empathy, and communication skills. Methods: A total of 106 doctors were recruited from a hospital in China, and randomly divided into an LKM training group (n = 53) and waiting control group (n = 53). The LKM training group received 8 weeks of LKM training intervention, whereas the control group received no intervention. Three major variables (mindfulness, empathy, and communication skills) were measured before (pre-test) and after (post-test) the LKM training intervention. Results: The empathy and communication skills of the LKM group were significantly improved compared with those of the control group, but the level of mindfulness did not significantly change. Conclusions: The results suggested that LKM may contribute to improving physicians’ empathy and communication skills. However, the mechanisms that underlie the effects of the LKM on mindfulness, empathy, and communication skills and other psychological constructs needs further elucidation.

Postpartum depression (PPD) is a common disease in the world, which often results in many social problems. In recent years, many studies have mentioned that social support enhancement can reduce PPD. According to the etiology and treatment methods of postpartum depression and non-clinical intervention, the importance of psychosocial factors is emphasized. Social support is generally considered as an important factor to effectively prevent and reduce postpartum depression. According to the theoretical framework of social support constructed by Leahi-Warren et al. [1], social support is one of the influencing factors that help predict and reduce the risk of postpartum depression. Social support can also indirectly improve maternal parental self-efficiency and effectively reduce the risk of postpartum depression. E-Mental Health (EMH) system is one of the modern effective solutions to psychological problems. It has become a modern social trend to apply electronic mental health service systems to enhance social support. In the past research, Chiou et al. [2] designed a We’ll App through the application of EMH to enhance social support, and then enhance maternal self-efficacy, so as to reduce or solve PPD and postpartum depression. This study will continue to carry out clinical trials through We’llAPP, and EPDS, social-support, self-efficiency questionnaires are used to understand the status of maternal emotional disorders, social support and self-efficacy, and conduct clinical research analysis.

MBI - PPD refers to Mindfulness-Based Intervention in Postpartum Depression. This study aimed to develop a Chinese version of the Mindfulness-Based Intervention in Postpartum Depression Parenting Self-Efficacy (MBI-PPD S-E) tool and then test its reliability and validity using Taiwanese mothers of hospitalized neonates. For this, the Perceived Maternal Parenting Self-Efficacy (PMP S-E) questionnaire was first translated into Chinese and then back-translated into English (to ensure translation accuracy). After translation, the MBI-PPD S-E was implemented using an app to help pregnant women relieve symptoms of postpartum depression. Participants: We recruited 300 pregnant and lying-in women in Taiwan. Ethical considerations: This study was approved by the Institutional Review Boards, and the anonymity of participants was respected. For construct validity, confirmatory factor analysis (CFA) was used to assess the fit of the PMP S-E measurement model. Specifically, we employed the following fit indices: chi2 test, root mean square error of approximation (RMSEA), normed fit index (NFI), comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Chinese version of the MBI-PPD S-E for research and treatment of pregnant and lying-in woman 20-item core quality of Self-Efficacy (S-E) questionnaire was used as a criterion measure for S-E. Reliability was evaluated according to internal consistency and test-retest reliability measures. Results: The Chinese version of the MBI-PPD S-E comprised four factors and 20 items and showed good reliability and validity. Conclusions: The MBI-PPD S-E was successfully translated into Chinese. Psychometric results indicated good internal consistency and validity for this newly constructed instrument. To further validate the Chinese MBI-PPD S-E, future studies should conduct additional testing and investigate its application in a number of contexts.

MBI - PPD refers to mindfulness-based intervention in postpartum depression. The research mainly used mindfulness-based intervention and integrated social support theory into an APP so that depression of maternal can be improved after using the APP. The research was conducted in Chang Gung Hospital, Taipei. Researchers translated and tested the reliability and validity of the MBI-PPD MSPSS Chinese version on 300 maternal. Questionnaire was translated back to English after translated from English to Chinese to confirm the consistency of the questionnaire in Chinese and the questionnaire in English. Subjects: We recruited 300 maternal to conduct the test. Moral consideration: The research was approved by the IRB review committee at Chang Gung Hospital to ensure the safety and confidentiality of each subject. To ensure the validity of questionnaire construction, confirmatory factor analysis (CFA) was used to evaluate MSPSS. Its index includes chi2 inspection results, root mean square error of approximation (RMSEA) and normed fit index (NFI) to compare fit index and non-normed fit index. To ensure its validity at the same time, MBI-PPD MSPSS in Chinese version was used to understand the social support level of maternal. Internal consistency and test-retest reliability were applied to confirm whether the questionnaire can have valid use in future experiment. Results: MBI-PPD MSPSS tool in Chinese version show good reliability and validity at relevant aspect. Conclusion: MBI-PPD MSPSS in Chinese version has good reliability and validity. It can provide a new research tool to the Chinese speaking countries for testing applications in the future.

People in this modern era now live in a stressful environment and in a civilization full of competition to such an extent that their bodies, minds, and souls have contracted to incompleteness. The aims of this study are to improve and identify ways to cope with this condition, by following the process of “question—main factor—coping strategy—case study—research challenge.” The main factors listed are (1) prioritizing mind-body dualism, especially the material body, (2) active sympathetic nerves as a norm, and (3) dominant left brain activity inhibiting the right brain. The coping strategies are (1) transformation through meditation, (2) surrender and self-inquiry on the consciousness of oneness, and (3) spiritual covenant. The case studies analyzed are (1) We’ll app and (2) Corporate Mandala. Following a literature review and reviewing case studies, this study proposes 6 preliminary dimensions and 12 hypotheses aimed to improve the increasing problems in creativity limitation and depression.

This study examined the effect of participant physique on the increase in shank circumference (ISC) for the 2-hr standing. We recruited 20 healthy male participants (10 with normal body mass index (BMI) and 10 who were overweight) and examined their ISC every 20 min under two prolonged standing conditions (static and intermittent standing). Results showed that prolonged standing types, physiques, and sustained time significantly influence the ISC. The ISC during intermittent standing (mean = 0.38 cm) was significantly lower than that observed during static standing (mean = 0.52cm). That is, 1 min of relaxation after every 20 min of standing can effectively relieve the load on the participants’ shank during standing. The normal (BMI = 21.9) group exhibited a significantly higher ISC than the overweight group (BMI = 26.5) did. This increase was also reflected in the subjective discomfort rating results. The standing type may be more dominant than the worker's physique on the lower-limb loading when performing prolonged standing tasks.

Many health care education programs, particularly those in Taiwan, have begun offering capstone product-based curricula, not only to improve nursing students' problem-solving skills but also to foster creativity and innovation regarding health care issues. This study used a cross-sectional quantitative design to explore the efficacy of teaching for creativity among nurse faculty in Taiwan. Results showed knowledge of intellectual property rights was low, as was ability to creatively evaluate trademark and patent designs. Curiosity was the main predictor associated with self-efficacy of teaching for creativity.

Postpartum emotional disorders depending on the severity of symptoms can be divided into postpartum blues, postpartum depression, and postpartum psychosis. Those who develop severe symptoms may intend to commit suicide or harm the newborn. Therefore, these women need professional medical assistance and care services. A previous study (Kao 2017) used social support as the basis to develop a simulation trial version of a mobile application (App), We’ll, which helps women suffering from postpartum emotional disorders relieve depression via its function of interaction. The We’ll app for the present study is a trial simulation version. The official version of Android We’ll system hasn’t been evaluated its usability yet. The purpose of the study is for the usability evaluation of Android We’ll system. The researchers indicated users’ usability, satisfaction, and feedback regarding the interface and functional frameworks of the current app version. This study recruited 30 participants with the inclusion criteria of Taiwanese women aged 20 to 40 years who had experience in giving birth. Task testing comprised 12 items covering all functions provide by the app. All of the participants completed all tasks. The participants were asked to perform thinking aloud during the task testing period. On the basis of the feedback to the thinking aloud process during the test, interface operation issues were categorized into three types of errors, namely, navigation error, presentation error, and control error by the nature of errors and severity regarding how the errors influenced task completion. The overall average score of the SUS was 70.5, higher than the designated standard average of the SUS. Therefore, the satisfaction toward We’ll met the standard level. After the aforementioned procedure, usability task testing results were organized to determine the following problems that need to be solved. (a) Redesign the house icons of friends, family, and hospital on the home page (b) Enlarge the click area of friend and family rows (c) Improve the presentation of the EDPS test results, change the histogram into numeral score feedback, and add suggestions and reminders (d) Establish a dynamic tutorial for first-time login users.

Background Recently, empirical researchers have observed direct associations between conflict and interaction behaviors within organizational teams. However, research concerning indirect links between conflict and interaction behaviors on interdisciplinary teams in nursing school is scant, particularly in Taiwan. Objectives The aim of this study was to explore the relationships among various types of conflict and interaction behaviors on interdisciplinary nursing education teams. Design, setting, and participants This study utilized a cross-sectional, quantitative, descriptive design. The authors collected survey data from 99 nursing students who participated in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Methods Questionnaires assessed the nursing students' perceptions about their teams' conflicts (of task, process, and relationship), and interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication). The authors used descriptive statistics to compare demographics, conflict scores, and interaction behavior scores for collocated and distributed interdisciplinary teams. A Pearson's analysis identified correlations among the variables and their components, and the SPSS PROCESS macro showed moderating effects of spontaneous communication on the relationship between distributed team and conflict subscales. Results After confirming the distributed team experienced significantly more conflict than the collocated team, we found significant negative correlations between constructive controversy and both process conflict and relationship conflict on the distributed team. Another interaction behavior, spontaneous communication, had a moderating effect on the relationships between the distributed team and both task conflict and relationship conflict. Conclusion In interdisciplinary educational settings for nursing students, spontaneous communication may moderate the types of conflict that distributed teams are more likely than collocated teams to experience. Constructive controversy may be especially effective at mitigating conflict on distributed teams. Nursing educators may refer to these insights to improve outcomes for educational interdisciplinary healthcare teams.

The aim of this study is to address languages barriers and cultural barriers problems through experience-based design (EBD) approach, that may occur in healthcare settings faced by the increasing numbers of foreigners in Taiwan. This study put foreigners at the center in the service of a healthcare system, applied the modified EBD approach to understand their needs and to improve the health check service process for them. The results of this study showed that EBD approach could come out appreciate solutions to solve languages barriers and improve foreigner’s health check service quality. Because of the foreign patient joined the process and co-design to figure out the solution that has potential to reduce their negative feelings.

The present study aimed to investigate whether facial electromyography (EMG) recordings reflect the perception of effort and primary active lower limb muscle activity during incremental workload cycling. The effects of exercise intensity on EMG activity of the corrugator supercilii (CS), masseter and vastus lateralis (VL) muscles, heart rate (HR) and the rating of perceived exertion (RPE) were investigated, and the correlations among these parameters were determined. Eighteen males and 15 females performed continuous incremental workload cycling exercise until exhaustion. CS, masseter and VL muscle activities were continuously recorded using EMG during exercise. HR was also continuously monitored during the test. During the final 30 s of each stage of cycle ergometer exercise, participants were asked to report their feeling of exertion on the adult OMNI-Cycle RPE. HR and EMG activity of the facial muscles and the primary active lower limb muscle were strongly correlated with RPE; they increased with power output. Furthermore, facial muscle activity increased significantly during high-intensity exercise. Masseter muscle activity was strongly and positively correlated with HR, RPE and VL activity. The present investigation supports the view that facial EMG activity reflects the perception of effort. The jaw clenching facial expression can be considered an important factor for improving the reporting of perceived effort during high-intensity exercise in males and females.

A new pictorial rating of perceived exertion (RPE) scale that focuses on the facial expression of effort was developed for evaluating physical tasks. This study aimed to examine the concurrent validity and construct validity of the facial pictorial RPE scale. Twenty-two males and eighteen females were recruited. Concurrent validity was established by correlating the scale with respiratory rate (RR) and heart rate (HR) responses to a load-incremented cycle ergometer protocol. Construct validity was established by correlating RPE derived from the facial pictorial RPE scale with RPE derived from the Borg scale. Both concurrent and construct evidence supported the use of the facial pictorial RPE scale by males and females to estimate RPE during the incremental cycle ergometer test. This validation implies that adult participants could establish the link between the symbolic representation of pictorial faces and the sensory cues provided by HR and RR.

The purpose of this study is to determine how many of face features and their combinations could be better comprehensive for different level of physical exertion. Thirty-four healthy volunteers, including 18 males and 16 females were recruited from a university population to participate in the study. There were four types of stimuli outline faces including one holistic condition and three partial face conditions were examined. The sequence of displaying the four types of stimuli faces was from single feature to multi-feature, the order was mouth only condition, eyebrows with eyes condition, eyebrows with mouth condition, and holistic face condition. The main finding of this study is that the different combination of face feature stimuli would influence on perceiving the facial expression of effort. If the key features of facial expression were shown no matter other features were reduction, participants could still correctly understand the information.

Occupational noise still remains one of the most prevalent occupational health and safety problems. Hearing protectors are very important in providing proper protection for workers’ hearing ability in noisy working environments. The protection efficiency of wearing hearing protectors such as earplug depends heavily on whether it is fitting inner the ear. Three-dimensional (3D) surface anthropometry enables us to collect key dimensions to fit between ear canal and earplug. However, few studies explore the relationship between hearing protectors and 3D canal data. Therefore, this study employs an ear impression injection and 3D scanning of ear impression to measure the external auditory canal size of Taiwanese adult, and find the key dimensions of EAC to provides a reference for hear protecting earplug design. 220 ear canal impressions were taken from both side ears of 110 adults. The portable 3D Camera was used to collect 3D auditory canal data from the ear impression models. The results of the study show that the key dimensions of external auditory canal for hearing protection are the length, width, depth of cavum concha, the ear aperture length and width, the canal isthmus, and the length of from ear aperture to first bend and second bend. In addition, we find the differences in ear canal size between men and women. The results of this study can give references for designing and choosing earplugs, achieve the objective of hearing protection for workers.

Background: Metabolic syndrome (MetS) and hyperuricemia are important risk factors for cardiovascular disease. However, findings regarding the relationship between serum uric acid (UA) level and components of MetS have been inconsistent. This study was performed to explore the potential value of UA level as a marker of MetS among male and female Chinese of different ages.Methods: A total of 5896 subjects (2960 females and 2936 males) were recruited from the Department of Health Management at the Chang Gung Medical Center. Hyperuricemia was defined as a serum UA value >7.0 mg/dL for males or >6.0 mg/dL for females. MetS was defined according to the criteria of the Adult Treatment Panel III, as modified for Chinese subjects. Serum UA was used to differentiate MetS and to calculate epidemiological indices by means of discriminate analysis and logistic regression.Results: The sensitivity and specificity of serum UA concentration as a marker of MetS ranged from 55.2% to 61.4% and 61.9% to 68.4%, respectively. Subjects with high UA had a higher risk of MetS, with odds ratios ranging from 1.23 to 1.82 (P < 0.01). A positive correlation between serum UA and MetS was observed in both sexes. Serum UA and the occurrence of MetS rose with increasing age in females; in males, however, UA values did not vary with age.Conclusions: Serum UA is more closely associated with MetS in females than in males. High UA among middle-aged women may predict the development of MetS.

Information concerning the association of serum UA levels and the development of MS in the Chinese aging population is limited. The aims of this study were to investigate age-related metabolic disorders and analyze the relationship between serum UA levels and the components of MS in the elderly. This cross-sectional observational study was performed in subjects from the Department of Health Examination, including 1182 subjects aged ≧65 years; among these subjects, 528 were women (mean age, 70.7 ± 4.8 years) and 654 were men (mean age, 71.4 ± 5.3 years). All the subjects underwent three-dimensional (3-D) whole-body scanning for accurate anthropometric measurements. Data analyses were performed using SPSS software. Results: MS, hyperuricemia, hypertension, and diabetes mellitus (DM) were present in 53.9%, 40.6%, 33.1%, and 30.1% of the subjects, respectively. Univariate statistical analysis showed that age, blood pressure, blood sugar levels, high-density lipoprotein levels, triglyceride levels, WBC count, and related anthropometric indices differed significantly in subjects categorized according to serum UA levels. In conclusion, our study showed that a high percentage of elderly subjects had hyperuricemia. The results showed an association between serum UA levels and cardiovascular risk factors, and this finding warrants concern with regard to the aging population.

Visual information such as pictures, drawings or dynamic videos is often designed to facilitate learning and instruction. Many studies have explored the effectiveness of presenting procedural learning information through comparing different media and combinations of media; however the mapping of a task and its specific media is still not clear. Therefore, the purpose of this study is to determine the effect of using different kinds of visual information aids on learning a procedural task performance for larger scale equipment. The comparison between the three factors (dynamic, planned, and abstract) of the five learning media indicated the significant effect of different kinds of visual information. The findings show that for this specific learning purpose, the alternative media types for visual information instruction should be utilized. The second and also most important finding in this research is that well-designed and planned pictures were much better than unplanned ones. The third finding is that the abstract drawing is also very important in specific learning situations.

Clothes fitting simulation is of great importance in assisting online fashion shopping. Recently, human mannequin and clothes simulations have improved to the point that they can generate realistic animation of clothes in real-time. However, under the constraints of online technologies, e.g. server calculation and download speed, this function is only available with larger online retailers. With the consideration of a low cost system installation and limited Internet download speeds, an experimental online toolkit development was undertaken. It consisted of creating and adjusting the digital human model, digitalising clothes data and virtually fitting clothes. Finally, the whole process was integrated into an online fashion shop.

Many health indices have a relationship with anthropometric indices. This research attempts to provide a new measurement: a chronic disease risk factor score built into the regression model. This new model will help people visualize their health status and get multiple information during the process of the healthy examination.Data from 8,034 subjects were collected from the data bank of the Health Examination Center in Chang Gung Memorial Hospital. Related anthropometric indices and biochemical factors were selected and used to construct a regression model. The anthropometric indices used were body mass index, waist hip ratio, waist hip area ratio, health index, waist leg ratio and trunk leg ratio. Biochemical data included blood pressure, glucose, triglyceride, cholesterol and uric acid, combined to form an anthropometric chronic disease risk factor score.Subjects under 45 years of age had the highest chronic disease risk factor score, and were selected to construct a regression model. The R-square of this model is 0.355; its predictive error is near 12%. After verification with a testing group, the regression model could be used to predict health status.The purpose of this study was to develop a new anthropometric chronic disease risk factor score by combining anthropometric indices and biochemical data. A multiple regression model was used to illustrate health status via anthropometric chronic disease risk factor scores for the subjects participating in the health examination. The results show that the chronic disease risk factor score is useful for prescribing relevant medical treatment as well as for other research.