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

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

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

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

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

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