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AIMS AND OBJECTIVES: The aim of this study was to identify and describe predictors of QOL of elders who live alone in Taiwan. BACKGROUND: Despite a growing population of elders who live alone, research on their quality of life, important for policy decisions and health care provider interventions is virtually absent. METHODS: A descriptive correlational design surveyed 192 Taiwanese elders living alone, selected at random from urban and rural areas. During home visits elders completed the WHO-QOL-BREF, Social Support Scale and Center for Epidemiological Studies Depression Scale (CES-D) in addition to providing demographic data. RESULTS: Multiple linear regressions showed that six variables predicted physical health and the psychological wellbeing QOL domains, accounting for 74.5 and 60.1% of the variance, respectively. Four variables predicted 46.7 and 34.3% of the environmental and the social relationship QOL domains, respectively. CONCLUSIONS: Elders who live alone in rural areas and suffer from depression are at high risk for a low quality of life. However, elders living alone reported a better quality of life than their institutionalized counterparts. Interventional research and policy decisions focused on treatment for depression and providing social support networks, as these elders age, will be particularly important. RELEVANCE TO CLINICAL PRACTICE: By understanding variables associated with elders' quality of life, nurses can coordinate interventions to improve their quality of life. Poorly educated rural women who live alone are particularly vulnerable. Nursing assessment of quality of life indicators and implementation of strategies for increased social support are needed for high-risk elders. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Index of Nausea and Vomiting (INV), developed by Rhodes and others in 1984, measures three dimensions of upper gastrointestinal distress: nausea, vomiting and retching (NVR). While the revised version has been tested with a variety of high-risk populations, there are no data suggesting that it can be used to assess upper gastrointestinal distress among the growing numbers of ambulatory or day surgery patients. AIM: The aim of this study was to evaluate a modified version of the INV for use with ambulatory surgery patients. METHODS: A secondary analysis was conducted using data obtained from a descriptive study designed to identify risk factors for postdischarge nausea and vomiting (PDNV) among adult ambulatory surgery patients. Patients who reported PDNV (n = 190) participated via phone interview 24 hours after discharge by completing a modified Rhodes INV. FINDINGS: Reliability analysis (alpha = 0.897) indicated that the modified Rhodes INV measured upper gastrointestinal distress as a single concept in the postdischarge ambulatory surgical sample. One item of the 8-item scale was dropped. Principal component analysis extracted one factor that accounted for 67% of the variance with all items loading. CONCLUSIONS: Upper gastrointestinal distress following ambulatory surgery discharge comprises a different symptom mix than during other high-risk events such as pregnancy or chemotherapy. Further research on the differences in assessing NVR among different populations is indicated. [ABSTRACT FROM AUTHOR]

Historically, nursing has affirmed the inductive approach to professionalism gained through education at the baccalaureate level. Research has challenged the inductive approach by identifying professionalism among associate degree-prepared nurses returning for the professional degree. Two variables derived from the literature, self-actualization and work experience, were investigated as possible antecedents to the development of professional attitudes, values, and behaviors of associate degree nurses. Findings indicated that self-actualization was positively and significantly related to the degree of professionalism. The need to reevaluate the induction model of professional socialization and consider a reactive approach is considered. [ABSTRACT FROM AUTHOR]

This pilot study evaluated the effects of a healthy-lifestyle-promoting program, taught as part of an undergraduate community health nursing course, on the physical fitness and health choices of 42 Taiwanese nursing students. A convenience sample provided quantitative indexes of physical fitness and lifestyle before and after the course. Qualitative data, in the form of student diaries, were also analyzed. The findings indicated a positive change in physical fitness, exercise, and nutrition as a result of the program. Including lifestyle programs in nursing education may help promote the long-term health of future nurses who will serve as positive patient role models. [ABSTRACT FROM AUTHOR]

Purpose: The impact of obesity on mortality risk in patients undergoing hemodialysis (HD) remains uncertain due to conflicting findings across obesity measurement methods. This study aimed to assess the obesity measurements influence mortality risk in HD populations., Methods: Systematic review and meta-analysis were conducted following PRISMA guidelines, registered on PROSPERO (CRD42023429943). Relevant observational studies analyzing mortality risk using obesity measurements in adult HD patients up to March 27, 2023 were included from multiple databases, including EMBASE, MEDLINE (OVID), and CINAHL (EBSCO). Pooled analyses with a random-effects model were performed using RevMan 5.4., Results: Twenty-three studies involving 381,580 subjects were reviewed. A meta-analysis of 15 studies in event-based analysis showed contrasting results between anthropometry and body composition analysis in predicting all-cause mortality. Obese patients indicated by body mass index (BMI) had a lower mortality risk than non-obese patients (RR = 0.73, 95% CI: 0.70-0.76, p < 0.001). In contrast, abdominal obesity measured by waist circumference (WC) or waist-to-hip ratio (WHR) increased mortality risk (RR = 1.35, 95% CI: 1.01-1.80, p = 0.04). Studies using bioelectrical impedance analysis (BIA) demonstrated an increased mortality risk for obese patients (RR = 1.22, 95% CI: 1.05-1.41, p = 0.009)., Conclusions: Obese patients undergoing HD exhibit different mortality risks depending on the methods of obesity measurement. The observed 'obesity paradox' in patients on HD, where lower mortality is seen with obesity measured by BMI, may reflect BMI's limitations in differentiating fat mass. More studies with other anthropometry and body composition analysis are needed to clarify this phenomenon., Competing Interests: Declarations. Conflict of interest: The authors have no competing interest to declare both of financial interest or non-financial interest. Ethical approval: An ethics statement is not applicable for this study, since it is based on published literature., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Competing Interests: Declaration of Competing Interest None to report.

Background: Cancer Worry (CW) can shape the responses and behaviors of information or support-seeking of daughters of women with breast cancer., Objective: This study aims to explore the roles of Cancer Worry (CW) as a moderator and mediator in the relationship between information needs, support needs, and psychological distress., Methods: A cross-sectional and correlational design was used in conjunction with a convenience sampling strategy. Daughters of mothers with breast cancer were requested to complete the questionnaires Impact of Event Scale Chinese version (IES-C), Cancer Worry Scale for Genetic Counseling (CWS-GC), and Information and Support Needs Questionnaire (ISNQ). Hayes' PROCESS macro using SPSS for Windows were used to examine the mediator and moderator role of CW., Results: A total of 194 daughters provided data. Cancer worry was significantly correlated with total IES (r = 0.352, P < .01), intrusion-IES (r = 0.353, P < .01), avoidance-IES (r = 0.313, P < .01), unmet support needs (r = 0.226, P < .01), and unmet information needs (r = 0.17, P < .05). Cancer worry mediated the relationship between unmet support needs and total IES (β = 0.089, 95% CI: 0.026, 0.171) and moderated the relationship between unmet information needs and total IES (β = -0.395, P = .018, 95% CI: -0.723, -0.066)., Conclusions: The role of cancer worry should be paid attention to when clinicians deliver information and provide support as well as tailoring psychological intervention for ameliorating distress in daughters of women with breast cancer., Implications for Nursing: Providing personalized information and support is essential to address the unmet needs of daughters of women with breast cancer. Healthcare professionals providing interventions to reduce distress and improve overall care should consider individual CW., Plain English Summary: This research looks at how worrying about cancer affects daughters of women who have breast cancer. It focuses on the degree of cancer worry changes the way they feel when they don't get the information and support. Researchers used surveys to gather data from these daughters, examining how their level of cancer worry influenced their needs for information and support and their psychological distress. They found that greater unmet support needs will intensify worry about cancer and then increase psychological stress. However, too much or too little worry about cancer will also heighten their psychological distress due to limited information. The findings suggest that healthcare providers, including nurses, should consider the level of worry about cancer when offering support and information to these individuals to help reduce their stress., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Su-Ying Fang reports financial support was provided by National Science and Technology Council. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: In Indonesia, the diagnosis of a serious illness is often mediated through the patient's family, reflecting the cultural importance of family involvement in the patient's care and collective decision-making., Aim: To use a case study to show the difficulty that healthcare professionals face telling the patient the truth about their condition in Indonesia., Method: The Kagawa-Singer and Blackhall ABCDE framework was used during truth-telling dilemmas to assess patients' and families' attitudes (A), beliefs (B), contexts (C), decision-making styles (D) and environments (E)., Findings: Studies have shown that family involvement in health-related communications can alleviate the stress associated with the disclosure of a serious illness. Palliative care nurses must acknowledge the importance of family in the patient's cultural context, by involving them in the disclosure of a diagnosis and disease trajectory by integrating every element of the ABCDE model in palliative care., Competing Interests: Statement of interest: None

Competing Interests: Declaration of Competing Interest None to report.

Background: Breast cancer is the most common diagnosis and the leading cause of cancer death among women worldwide and ranks first among Asian and Taiwanese women. Cancer-related fatigue (CRF) affects patients' functioning significantly., Aims: The aim of this study was to examine changes in cancer-related fatigue (CRF) and related factors among women with breast cancer undergoing a single chemotherapy, and to identify predictors of CRF's change over the course of the chemotherapy cycle., Methods: Four self-report questionnaires were administered to assess CRF, sleep quality, depression and anxiety, and symptom distress. Heart rate variability (HRV) was assessed to evaluate autonomic nervous system activation related to CRF. Data were collected four times: (1) before initiation of the single chemotherapy cycle (T0), (2) after completion of the single cycle (T1), (3) 1 week post-chemo (T2), and (4) 3 weeks post-chemo (T3). Repeated measurement of variance and generalized estimating equations (GEE) were conducted to estimate the trajectories and predictors., Results: One-hundred women with breast cancer (mean age 50.4 ± 9.42) participated. CRF (F = 7.46), sleep quality (F = 2.74), symptom distress (F = 9.99), anxiety (F = 5.72), and depression (F = 4.14) varied significantly over the single cycle of chemotherapy (p < .001), which the trajectories showed exacerbating at T2. HRV indicated a higher variation only on the day of injection (T0, T1). Results of the GEE revealed that anxiety, depression, and symptom distress were predictors of CRF's change over the single cycle of chemotherapy., Linking Evidence to Action: CRF worsens at 1 week after a chemotherapy injection among Taiwanese women with breast cancer. Based on the risk predictors in CRF that included anxiety, depression, and symptom distress, multistrategy CRF-alleviating interventions should be provided prior to chemotherapy and targeted at the most disturbed period, that is, 1 week after injection., (© 2022 Sigma Theta Tau International.)

Background: Sodium restriction is difficult for most individuals with hypertension. Intention to limit sodium intake predicts behavior. Information on the determinants of intention to restrict sodium intake is limited., Objectives: The aims of this study were to identify (1) determinants of intention to restrict high-sodium food intake and (2) sources of sodium consumed by patients with hypertension in Indonesia., Methods: A cross-sectional study was conducted among adult patients with hypertension (n = 206) attending cardiac clinics. A researcher-developed and tested, self-administered questionnaire that included questions about sodium restriction and a high-sodium food inventory was distributed. The quantile regression method was used to identify determinants of intention to restrict dietary sodium., Results: The mean age of the patients with hypertension was 59 ± 10 years, and more than three-fourths were obese (n = 162, 78%). The determinants of intention to limit sodium intake included gender (β = 0.737, P = .036), attitude (β = -0.141, P = .050), and subjective norm (β = -0.283, P = .005). Men reported higher sodium consumption, while attitudes and subjective norm were negatively correlated with sodium intake. These determinants predicted 13.2% of the variance in intention to restrict dietary sodium. Subjects reported frequently consuming snacks (n = 82, 39.7%) and seasoning condiments (n = 65, 31.6%)., Conclusions: High-sodium snacks and condiments added while cooking were frequently consumed among patients with hypertension in Indonesia. Understanding the factors associated with intention to follow a low-sodium diet will assist nurses to design effective interventions that promote adherence to the low-sodium diet among those with hypertension., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

This study investigated Indonesian primary health care providers' knowledge and comfort towards palliative care. A descriptive cross-sectional design was used. From August 2017 to February 2018, the research team approached 70 primary care centres in the Yogyakarta province of Indonesia and invited health care providers to complete the Palliative Care Quiz for Nursing - Indonesia and describe their comfort in caring for terminally ill patients. Data were obtained from 516 health care providers. The mean (±s.d.) score of palliative care knowledge was low (7.8±3.3 of a possible score of 20). Current comfort level in providing palliative care was also low (1.6±2.7 of a possible score of 10). Only 11.3% of palliative care knowledge was explained by respondents understanding of palliative care definition, their education levels and experience in providing palliative care in hospital. However, 82.9% of provider comfort was explained by their experiences for caring for terminally ill patients in primary healthcare centres, palliative care training and years of work experience in primary healthcare centres. Indonesian evidence-based palliative care standards and guidelines must be established with education offered to all providers.

Purposes: The study aimed to translate the Exercise Self-Efficacy Scale (ESES) into Indonesian and test the cultural equivalence, reliability, and validity of the new version for university students., Methods: The cross-sectional study recruited 379 Indonesian university students using convenience sampling. Phase 1, a culturally appropriate version of the ESES was developed in the Indonesian language. Phase 2, the psychometric properties were determined through exploratory factor analysis, bootstrap factor analysis, and confirmatory factor analysis. The internal consistency reliability was tested using Cronbach's α, whereas the stability using intraclass correlation coefficient to assess., Results: The students' ages ranged from 17 to 39 years, and 65.0% were women. For translation equivalence, the mean item content validity indexes ranged from 3.5 to 4, and all items were understandable. The 16-item scale exhibited cross-cultural appropriateness and readability, with a three-factor model explaining 62.3% of the variance in exercise self-efficacy. A bootstrap analysis using 100 resamples further confirmed the three-factor model. The indices of the good-fit model that used the three-factor by two-stage least squares method were satisfactory, with χ 2 /df = 3.3, goodness of fit index = .88, and root mean-square error of approximation = .05 (p < .001). The Cronbach's α was .78, .80, and .92 for factors 1, 2, and 3, respectively. The test--retest reliability was demonstrated with an intraclass correlation coefficient of .91, indicating adequate measurement stability., Conclusion: The 16-item ESES-I has acceptable validity and reliability; however, a broader application of the scale requires further testing in different populations to confirm its external validity., Competing Interests: Conflict of interest All authors declare no conflicts of interest in this study., (Copyright © 2020. Published by Elsevier B.V.)

Background: Patients with heart failure rarely engage in adequate self-care. Greater emphasis on self-care discharge readiness is needed., Purpose: This study examined the effects of a predischarge educational program combined with 1 year of postdischarge follow-up on self-care behaviors, readmission, sleep quality, and depression in patients with heart failure., Methods: A longitudinal, nonequivalent two-group pretest-posttest design was used. The intervention group received tailored education and follow-ups, whereas the control group received routine predischarge heart-failure education from direct care nurses only. Measurements included the self-care maintenance and self-care management subscales of the Self-Care of Heart Failure Index, Pittsburg Sleep Quality Index, Patient Health Questionnaire-9, and readmission rate. Data obtained at baseline and at 1, 3, 6, and 12 months postdischarge were analyzed using linear mixed models with both intention-to-treat and per-protocol approaches. The propensity score was used to adjust for the confounding effects of the New York Heart Association functional class and left ventricular ejection fraction., Results: Of the 62 patients with heart failure (28 in the intervention group and 34 in the control group) who were sampled at baseline, 47 (n = 25 vs. n = 22) provided data over the entire course of this 1-year study (76% retention rate). The per-protocol analysis did not find significant differences for any variables. However, the intention-to-treat analysis showed that the intervention group significantly improved in self-care maintenance at 6 months and self-care management at 12 months after hospital discharge, with fewer, albeit not significantly fewer, first and subsequent hospital readmissions than the control group., Conclusions/implications for Practice: The effect of this intervention was not found to be substantial, indicating a need to design more efficacious and powerful interventions. Hospitalized patients must receive patient education before discharge to foster their self-care knowledge and skills regarding self-care at home. Strategies are needed to help nurses provide patient education in a time-efficient manner.

Background : The application of external abdominal pressure by endoscopy nurses has long been recognized to facilitate passage of the endoscope during colonoscopy. Applying sustained abdominal pressure during a colonoscopy for an obese patient is especially challenging and may result in musculoskeletal injury for the endoscopy nurse. Methods : Four experienced endoscopy nurses cared for 100 obese adult patients scheduled for colonoscopy who had a body mass index (BMI) greater than 25 kg/m 2 . Duration of applied pressure, as well as nurse pain and fatigue were examined after they cared for 50 patients with and 50 patients without a positioning wedge. Findings : No difference in the mean fatigue score between nurses providing standard care versus those using the positing wedge was observed (mean score: 2.6 vs. 2.0, respectively); however, self-reported pain was higher for those providing standard care relative to those using the positioning wedge (mean score: 2.9 vs. 1.3, p = .0143). In 18 patients who required both the wedge and pressure, these nurses still reported lower pain scores relative to nurses who provided care without a wedge ( M = 1.3 vs. 2.9, respectively). Conclusion/Application to practice : A positioning wedge for obese patients undergoing a colonoscopy can reduce the need for external abdominal pressure applied by endoscopy nurses. Occupational health nurses should endorse the use of a gel wedge to promote safe patient handling and reduce the potential for musculoskeletal injury among endoscopy nurses.

INTRODUCTION: The application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care to assure patient safety and expedite release at the earliest opportunity. While current Centers for Medicare & Medicaid Services regulations require trained staff to continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. The experience of an acute psychiatric hospital demonstrates that more frequent registered nurse assessments can decrease duration of mechanical restraint episodes. AIMS: The aim of this three-part quality improvement project was to decrease duration of mechanical restraint episodes by increasing the frequency of registered nurse assessment and surveillance. METHODS: First, the requirement for frequency of face-to-face registered nurse assessment during episodes of mechanical restraint was increased from once every hour to once every 30 minutes. Second, the frequency of assessment was increased on half the hospital's units, from every 30 minutes to continuous registered nurse presence during restraint. Finally, the remaining units adopted 1:1 registered nurses during restraint. Mean hours of restraint per episode were measured and compared before and after each practice change. RESULTS: Mean duration of restraint episodes decreased 23% in the first change cycle, 12% in the second, and 44% in the third. Overall, there was a statistically significant 30% decrease in mean duration of restraint episodes. CONCLUSIONS: Increased frequency of registered nurse assessment and surveillance can significantly decrease duration of mechanical restraint episodes. Nurses are encouraged to adopt mechanical restraint practice standards that provide continuous psychiatric intensive care by a registered nurse.

Objective: The purpose of this study was to evaluate the effect of a web-based survivorship care plan (SCP) computerized application (APP): (SCP-A) on women's unmet needs, fear of recurrence, symptom distress, anxiety, depression, and quality of life (QoL)., Methods: Women diagnosed with breast cancer, who had completed their primary treatment but less than 5 years without a sign of recurrence (N = 165) were randomized to a SCP-A or a control group. Self-reported questionnaires were completed by the both groups at baseline (T0), 5 weeks (T1), 3 months (T2), 6 months (T3), and 12 months (T4)., Results: Controlling for relevant covariates, mixed effect model analyses revealed a significant decrease in women in the SCP-A group compared to the control group for total unmet needs since T3 (p < .004) and fear of recurrence since T4 (p = .02). Women in the SCP-A group also reported significant improvements in QoL at T4 (p < .001) relative to those in the control group., Conclusion: Providing SCP using an information website application for women with breast cancer can decrease unmet needs, fear of recurrence, and improve quality of life during short-term and long-term use., Practice Implications: Web-based information that provides survivorship care plans for breast cancer survivors are beneficial., Competing Interests: Declaration of Competing Interest The authors declared that they have no conflict of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose: The purpose of this study was to understand the influence of demographic and psychological factors on self-management behaviors and interdialytic weight gain (IDWG) as a fluid adherence marker among patients undergoing hemodialysis in Indonesia., Design: A quantitative correlational study., Method: A convenience sample of 145 patients undergoing hemodialysis was recruited from the dialysis units in two hospitals in Jakarta from September to December 2015. Questionnaires were used to examine self-management behaviors, depression, anxiety, and stress. Data for IDWG were obtained by subtracting the individual's predialysis weight from his or her postdialysis weight from the previous session. Hierarchical multiple linear regression identified the predictors of IDWG., Results: Self-advocacy was ranked the least performed self-management behavior, while medication adherence was ranked the most likely to be performed. Among the subscales of the Self-Management Behavior Indices, positive correlations were found between the communication dimension with all psychological factors (depression, anxiety, and stress), while self-advocacy had positive correlation with anxiety. Subjects gained a mean of 4.5% of their postdialysis weight, with over 50% exceeding the recommended 4% IDWG. Overall, 53.6% of the IDWG was explained by the weekly duration of hemodialysis, level of depression, communication, partnership in care, and self-advocacy., Conclusions: Self-management behaviors are potential predictors that can be modified by nephrology nurses in order to enhance clinical outcomes, with the specific outcome being IDWG. Self-management behaviors contribute to the promotion of appropriate IDWG. Depressed patients are less likely to adhere to weight gain restrictions., Clinical Relevance: Education combined with training in self-management behaviors-particularly communication, becoming a partner in care, and advocating for care-may improve adherence to IDWG guidelines among Indonesian hemodialysis patients. Interventions targeting depressed patients are needed., (© 2019 Sigma Theta Tau International.)

Purpose: Postoperative ureteroscopy patients can develop bladder spasms, complaints of pain, and the urgent need to void during emergence from anesthesia. Discomfort leads to patient agitation, resulting in a risk to patient safety. The purpose of this study was to determine the effectiveness of a preemptive preoperative belladonna and opium (B + O) suppository on postoperative bladder comfort, narcotic requirements, and length of stay of ureteroscopy patients., Design: A prospective double-blind study was conducted., Methods: Fifty adult outpatients scheduled for ureteroscopy were assigned to routine care or a B + O suppository immediately after anesthesia induction. Urinary urgency and pain were assessed every 15 minutes., Findings: Urgency significantly decreased in the B+O group, with less than half reporting urgency at discharge., Conclusions: Pre-emptive preoperative administration of a B + O suppository before ureteroscopy results in decreased urinary urgency during the postoperative recovery. Pre-emptive preoperative interventions can result in positive outcomes before discharge., (Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to examine the psychosocial adjustment trajectory, focusing on psychological distress, sexual relationships and healthcare information, and factors which have an impact on adjustment on receiving a positive diagnosis of human papillomavirus infection., Background: Human papillomavirus is a common sexually transmitted infection in females. To date, knowledge of the longitudinal psychosocial response to the diagnosis of human papillomavirus is limited., Design: A prospective longitudinal design was conducted with a convenience sample., Methods: Women aged 20-65 years old were followed at one, 6 and 12 months after a diagnosis of HPV. Participants completed measures of initial emotional distress and followed up psychosocial adjustment. A mixed-effects model was applied to analyse the longitudinal changes in psychosocial adjustment., Results: Seventy human papillomavirus positive women participated in the study with nearly 20% of the women reporting emotional distress during their first visit. Mixed-effects model analyses showed that a trajectory of psychosocial adjustment in healthcare orientation, sexual relationship and psychosocial distress occur from one to 6 months after HPV diagnosis. However, a declining trend from 6 to 12 months was significant in healthcare orientation. Initial emotional distress was associated with changes in psychological adjustment., Conclusions: Psychosocial adjustment to human papillomavirus was worse at 1 month compared with 6 and 12 months after diagnosis. Healthcare providers should offer health information and psychosocial support to women according to their disease progression., (© 2018 John Wiley & Sons Ltd.)

This cross-sectional study was conducted to examine 256 Muslim nurses' perception of spirituality and spiritual care in Indonesia. The Spirituality and Spiritual Care Rating Scale (SSCRS) was translated and culturally adapted. Moderately high degrees in five domains and total SSCRS were found. Specialty, education level, clinical seniority, having spiritual training, and previous spiritual caring experience could impact on the SSCRS. Most nurses have cared for patients with spiritual needs, but denied having any formal training in providing spiritual care. Providing adequate curriculum and on-job training to equip nurses' knowledge and competence of spiritual care is urgent in Muslim healthcare environment.

Background: The improved survival rate for breast cancer has increased the number of women living with the diagnosis for more than 5 years. Limited studies have focused on the care needs for long-term healthy survivors of breast cancer., Objective: The aims of this study were to understand the care needs of long-term breast cancer survivors and identify related factors that influence these needs., Methods: A convenience sampling with a correlational study design was used. Women at least 20 years old, who were given a diagnosis of breast cancer at least 5 years, were recruited from 2 hospital clinics in southern Taiwan. A self-administered questionnaire measuring cancer survivors' unmet needs was administered after obtaining informed consent. Binary logistic regression was used to examine variables associated with unmet care needs., Results: Of the 192 women participating, the highest unmet needs related to existential survivorship. The most frequently endorsed unmet need was for an ongoing case manager. Fear of recurrence was associated with 3 aspects including existential survivorship, comprehensive cancer, and quality-of-life unmet needs (odds ratio, 1.14-1.21)., Conclusions: Even 5 years after the diagnosis and completion of therapy, women continue to report unmet needs. Evaluating women's fear of recurrence to identify high-risk women with unmet needs is critical to providing quality care., Implication for Practice: Developing appropriate survivorship care programs combined with managing concerns regarding recurrence by a nursing case manager is needed.

Problem Identification: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting chemotherapy toxicity, which has a long-lasting effect and decreases quality of life. Although several tools have been developed to detect CIPN, the study quality, psychometric properties, and practicality of CIPN assessment tools have not been systematically reviewed.
., Literature Search: Electronic searches using keywords were conducted in Medline, PubMed, CINAHL®, and Cochrane Library for articles published from 1980-2015. Eligible studies were included if they involved patients with cancer receiving chemotherapy, provided CIPN assessment tools with psychometric properties, and were published in English.
., Data Evaluation: Data were extracted, and study quality was assessed. CIPN tools were evaluated in terms of psychometric properties and practicality.
., Synthesis: A total of 19 studies describing 20 tools were reviewed. The quality of studies varied from strong to weak. The validity ranged from low to high, and the reliability with internal consistency ranged from 0.56-0.96. Poor inter-rater agreement was found. Not all of the tools were deemed practical.
., Conclusions: Considering the psychometric properties and practicality, two tools (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity [FACT/GOG-Ntx] and Total Neuropathy Score [TNS]) are recommended for assessing CIPN.
., Implications for Nursing: Routine assessment of CIPN and choosing appropriate assessment tools are imperative. The FACT/GOG-Ntx and TNS are recommended for clinical use.

Background and Purpose: At least one-third of ambulatory surgery patients will experience nausea or vomiting during the recovery period. The purpose of this study was to examine the psychometric properties of the Ambulatory Surgery Index of Nausea, Vomiting, and Retching (AS-INVR)., Methods: Secondary analysis of longitudinal data from a study of 203 adult ambulatory surgery patients was conducted., Results: Based on the results of factor analysis, the retching item was eliminated and the 6-item, 2-dimensional AS-INV was formed. Cronbach's alphas for the AS-INV ranged from .83 to .87 across the 5 days postsurgery. Higher AS-INV scores were associated with self-reported presence of nausea and lower quality of life., Conclusions: The shortened AS-INV provides a reliable and valid measure of the amount and distress because of nausea and vomiting in adult patients after ambulatory surgery and should be considered for use in future studies.

Aims and Objectives: To evaluate the validity of the Chinese version of the CogState battery, a computerised cognitive testing among patients with heart failure in Taiwan., Background: Cognitive deficits are common in patients with heart failure and a validated Chinese measurement is required for assessing cognitive change for this population. The CogState computerised battery is a measurement of cognitive function and has been validated in many languages, but not Chinese., Design: A cross-sectional study., Methods: A convenience sample consisted of 76 women with heart failure and 64 healthy women in northern Taiwan. Women completed the Chinese version of the CogState battery and the Montreal Cognitive Assessment. Construct validity of the Chinese version of the battery was evaluated by exploratory factor analysis and known-group comparisons. Convergent validity of the CogState tasks was examined by Pearson correlation coefficients., Results: Principal components factor analysis with promax rotation showed two factors reflecting the speed and memory dimensions of the tests. Scores for CogState battery tasks showed significant differences between the heart failure and healthy control group. Examination of convergent validity of the CogState found a significant association with the Montreal Cognitive Assessment., Conclusion: The Chinese CogState Battery has satisfactory construct and convergent validity to measure cognitive deficits in patients with heart failure in Taiwan., Relevance to Clinical Practice: The Chinese CogState battery is a valid instrument for detecting cognitive deficits that may be subtle in the early stages, and identifying changes that provide insights into patients' abilities to implement treatment accurately and consistently. Better interventions tailored to the needs of the cognitive impaired population can be developed., (© 2015 John Wiley & Sons Ltd.)