Receiving Treatments. Shiow-Ching Shun, National Taiwan University College of Medicine, Taiwan .... Hsiu-Chin Chen, Chi Mei Medical Center, Taiwan. 6 ...
Concurrent Session
Index Concurrent Session 1: Utilizing Evidence to Improve Outcomes Session # CS1-001
CS1-002
Abstract # B07-007 Self-Efficacy in Coping Affect Quality of Life in Liver Cancer Patients After Receiving Treatments Shiow-Ching Shun, National Taiwan University College of Medicine, Taiwan B07-008 Association Between Muscle Strength and Fatigue in Colorectal Cancer Survivors in Taiwan Yun-Jen Chou, National Taiwan University College of Medicine, Taiwan
CS1-003
B07-010
Evaluate the Neurological Effect for Applying Hypothermia Intervention to the Traumatic Brain Injury Patients Ming-Yuan Tan, Taipei Veterans General Hospital, Taiwan
CS1-004
B07-013
Does the Words What Advanced Cancer Patients Describe Their Pain Affect Their Pain Severity, Emotional Status, and Quality of Life Lih-Mih Chen, Kaohsiung Medical University, Taiwan
CS1-005
B08-004
Cancer Patient Family Responses and Actions to Family Members With Cancer Who Use Complementary and Alternative Medicine Shou-Yu Wang, Hungkuang University, Taiwan
CS1-006
B05-007
Establish and Evaluate of Care Map in the Critical Stage for Oral Cancer Patients After Flap Reconstructive Microsurgery Shu-Fen Kao, Taipei Veterans General Hospital, Taiwan Concurrent Session 2: Perspectives on Nursing Education
CS2-001
B09-001
Program Satisfaction and Student Activation as Correlates of Academic Performance Among Senior Nursing Students Joanne Mae Evangelista Nava, San Beda College, Philippines
CS2-002
B09-010
Reliability and Validity of the Direct Observation of Procedural Skills Assessment Tool : Evaluating Nursing Clinical Practices Hui-Hsun Chiang, Tri-Service General Hospital, Taiwan
CS2-003
B09-011
A Study on the Construction of the Core Competence Indicators for Clinical Nursing Teachers Chu-Ko Fen, Jen-Teh Junior College of Medicine, Nursing and Management, Taiwan
CS2-004
B09-012
Comprehensive Strategies Building up Students' Confidence in Operation Room Within Four Weeks Clinical Curriculum Mei -Yun Yu, Fooyin University, Taiwan
1
CS2-005
B09-013
Effect of Multiple Teaching Strategies Intervention on Nursing Ethical Education Among Nurse Students Hsiao-Lu Lee, Yuhing Junior College Health Care & Management, Taiwan Concurrent Session 3: Nursing Care Issues in Families
CS3-001
B02-011
The Role of Empathy From Partner on the Relationship Between Body Image and Depression Su-Ying Fang, National Cheng Kung University, Taiwan
CS3-002
B05-002
The Confident Level of Nursing Intervention IPV Women Among ER Nurses Yung-Mei Yang, Kaohsiung Medical University, Taiwan
CS3-003
B07-005
A Clarification of the Characteristics of the Untreated Mentally Disabled Person Who Was the Target of the Neighbors' Claims Yoshioka Maeda Kyoko, Tokyo Medical University, Japan
CS3-004
B14-020
Exploring Patients Perceived Family Involvement in Elective Surgical Decision Making Mei-Ling Lin, Tsaotun Psychiatric Center of Ministry of Health and Welfare, Taiwan
CS3-005
B07-014
Home Care Needs in Liver or Renal Transplantation Recipients' Spouses Yu-Hsuan Chang, National Tainan Institute of Nursing, Taiwan
CS3-006
B11-013
The Subjective Experiences Among the Family Facing Critical Patient Receiving Palliative Sedation Therapy in ICU Szu-Yin Chen, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
Cross-Strait Session 4: Health Promotion in Acute and Chronic Conditions CS4-001
B03-001
The Effects of Early Multiple-Time PN Counseling on Newly HIV-Diagnosed Male Homosexuals Piao-Yi Chiou, MacKay Junior College of Medicine, Taiwan
CS4-002
B04-005
A Wareness on the Health Effects of Secondhand Smoke John Michael H Hernandez, Lyceum of the Philippines University-Batangas, Philippines
CS4-003
B04-010
The Prevalence, Clinical Features of Hypertention in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Its Nursing Strategy Yan Wang, Tianjin Medical University General Hospital, China
CS4-004
B07-019
Fatigue and Its Related Factors in Hemodialysis Patients Yu-Jun Zhan, National Taiwan University Hospital, Taiwan
CS4-005
B11-011
The Subjective Experiences of Maintaining Their Healthy Life Among Patients With Chronic Kidney Disease Hsiang-Chin Yu, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
2
CS4-006
B11-019
Assessing the Quality of Life Among Diabetic and Non-Diabetic Patients Undergoing Coronary Artery Bypass Grafting Surgery in Taiwan Healthcare System Ru-Yu Lien, Taipei Veterans General Hospital, Taiwan
Concurrent Session 5: Maternal Health and Baby-Friendly Care CS5-001
B02-005
Postpartum Urinary Retention: Risk Factors and Efficacy of Early Intervention Program Meei-Ling Gau, National Taipei University of Nursing and Health Sciences, Taiwan
CS5-002
B02-008
Determinants of Postpartum Weight Retention, Body Composition and Health for Taiwanese Postpartum Women Shu-Shya Heh, National Taiwan University, Taiwan
CS5-003
B02-013
Vaginal Birth After Cesarean: Risk Decision-Making Processes in Taiwanese Pregnant Women Following a Primary Cesarean Section Shu-Wen Chen, Deakin University, Australia; Chang Gung University of Science and Technology, Taiwan
CS5-004
B02-015
The Effects of Walk on Physical and Psychological Health During Postpartum Yu-Hsiang Liu, Fooyin University, Taiwan
CS5-005
B07-011
Differences Between Separate Care for New Mother and Infant Versus Rooming-In at Night in Fatigue and Quality of Sleep Mung-jung Lee, Taipei Tzu Chi Hospital, Taiwan
CS5-006
B11-017
First-Time Taiwanese Fathers' Lived Experiences at the First Meeting With Their Newborns Chien-Huei Kao, National Taipei University of Nursing and Health Sciences, Taiwan Concurrent Session 6: Special Issues in Clinical Nursing Care Effect of a Peer Support Group on Breastfeeding Continuation in Taiwan Su-Chen Kuo, National Taipei University of Nursing and Health Sciences, Taiwan
CS6-002
B04-012
CS6-003
B06-006
Rethinking Ageing in the Light of Youth: The Value of Rememberings in Challenging Loss Suzanne Goopy, University of Calgary, Australia
CS6-004
B14-018
Trajectories and Predictors of Pain and the Quality of Life Following Lung Cancer Diagnosis and Treatment: A Latent Class Growth Modeling Shiow-Luan Tsay, Dayeh University, Taiwan
CS6-005
B07-022
Developing Evidence-Based Care Standards and Guidelines for Pain Management Rung-Chuang Feng, Taipei Veterans General Hospital, Taiwan
CS6-006
B10-002
The Prevalence of Musculoskeletal Disorders in Nursing Professionals at a Regional Hospital in North Tsu-Chi Wang, Taipei City Goverment, Taiwan
3
Concurrent Session 7: Perspectives on Improving Nursing Care CS7-001
B03-002
Compare the Effectiveness of Medical Antibacterial Wipes Against Conventional Disinfectant Yin-Jhen Sun, Tri-Service General Hospital, Taiwan
CS7-002
B03-003
The Feasibility of Head of Bed Elevation for Preventing Ventilator Associated Pneumonia Shin-Shang Chou, Taipei Veterans General Hospital, Taiwan
CS7-003
B07-009
Providing an Evidence-Based Reminder Intervention to Reduce Catheter-Associated Urinary Tract Infections in Hospitalized Patients in a Medical Center in Taiwan Shir-Ling Lin, Taipei Veterans General Hospital, Taiwan
CS7-004
B07-012
Comparison of Phlebitis of Two Peripheral Intravenous Catheter Replacement Model on Adults: A Quasi-Experimental Study in Northern Taiwan Shu-Chen Kuo, Taipei Veterans General Hospital, Taiwan
CS7-005
B07-021
Evaluating the Effectiveness of Different Skin Disinfectants in Preventing Blood Culture Contamination-A Randomized Controlled Trial Wan-Tzu Sun, Taipei Veterans General Hospital, Taiwan
CS7-006
B11-008
Comparison of the Effects of Replacing Peripheral Intravenous Catheters at 96 Hours Versus 72 Hours Among Surgical Inpatients in Otorhinolaryngology Department: A Randomized Controlled Trial Wei-Na Wang, Chi Mei Medical Center, Taiwan Concurrent Session 8: Issues in Geriatric Care
CS8-001
B04-008
Effective Self-Management, A Success Route for Patients with Hypertension Pak Fong Wong, International Medical University, Malaysia
CS8-002
B04-009
Effectiveness of Influenza Vaccination in Elderly Persons: A Nationwide Population-Based Study Chun-Yu Liang, Tri-Service General Hospital; National Defense of Medical Center, Taiwan
CS8-003
B06-003
Association of Polypharmacy With Fall-Related Fractures in Older Taiwanese People: Age-And Gender-Specific Analyses Hsueh-Hsing Pan, Tri-Service General Hospital, Taiwan
CS8-004
B06-009
The Risk Factors Association With Functional Status Among Disabled Residents' Targeting Long-Term Care Facilities in Taiwan- A Cross-Sectional Study Hui-Chi Huang, MacKay Medical College, Taiwan
CS8-005
B07-015
A Need-Based Nutritional Intervention Effectively Improved Physical Functioning of Nursing Home-Living Elderly-A Randomized Controlled Study Li-Chin Lee, Asia University, Taiwan
4
Concurrent Session 9: Diverse Strategies to Enhance Competent Healthcare CS9-001
B09-003
To Explore the Embedded Meaning of Caring for Life: An Example of Nursing Experience of Senior Good Nurses Yu-Fang Tsai, Chi Mei Mdeical Center, Taiwan
CS9-002
B14-023
A Study of Competency Analysis for Aesthetic Medicine Nursing Staff Hui-Tzu Yen, Kang-Ning Junior College of Medical Care and Management, Taiwan
CS9-003
B11-016
Optimistic Bias, Prior Experience, Self-Efficacy, Knowledge, and Precautions Regarding Needlestick Injuries: A Study on Clinical Nurses From a Hospital in Middle Taiwan Tsai-Shin Lee, Jen-Teh Junior College of Medicine, Nursing and management, Taiwan
CS9-004
B12-002
Building Leadership and Management Competencies Among Nurses Jui-Chen Tsai, Taipei Medical University-Shuang Ho Hospital, Taiwan
CS9-005
B14-028
Competencies for Occupational Health Nurses in Taiwan Yun-Ping Lin, China Medical University, Taiwan
CS9-006
B14-027
Determination of Stress Factors and Strategies for Coping With Stress Used by Nurses Who Work at Intensive Care Unit Vesile Unver, Gulhane Military Medical Academy, Turkey
Concurrent Session 10: Complementary Health and Spirituality CS10-001
B04-018
The Study of Employees' Dietary Behavior and Its Related Factors Jing-Wen Jang, Sijhih Cathay General Hospital, Taiwan
CS10-003
B05-005
Fish Oil Generates Bioactive Lipid Mediators and Accelerates the Wound Healing of Cutaneous Incision Yi-Chi Peng, Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan
CS10-004
B08-001
A Spiritual Model in Nursing: Systematic Review of Ku's Sequent Spiritual Literature Ya-Lie Ku, Fooyin University, Taiwan
CS10-005
B08-005
A Review of Nurses' Knowledge, Attitudes, Complementary and Alternative Medicine Hsiao-Yun Chang, Fooyin University, Taiwan
CS10-006
B14-024
Freshwater Clam Supplementation Decrease Toxicity of Chemotherapy With Doxorubicin Chin-Chieh Tien, Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan
5
and
Communication
About
Concurrent Session 11: Perspectives on Improving Patient Outcomes CS11-001
B11-003
The Effectiveness of Nurse-Led Case Management on Quality of HIV Care Yen-Chin Chen, National Cheng Kung University, Taiwan
CS11-002
B11-010
The Effects for the Bed-Exit Alarm System for Preventions of Falls Among Elderly in Acute Care Medical Center Ya-I Hsieh, Taipei Veterans General Hospital, Taiwan
CS11-003
B11-014
Development and Validation for Chinese Language Version of Test of Functional Health Literacy in Adults Pei-Yi Sung, Taipei Veterans General Hospital- Taoyuan Branch, Taiwan
CS11-004
B14-026
Psychometric Validation of the London Chest Activity of Daily Living Scale in Taiwanese Patient With Chronic Obstructive Pulmonary Disease Su-Er Guo, Chang Gung University of Science and Technology, Taiwan
CS11-005
B14-030
Voice Assessment to Discriminate the Success Rate for the Patients With Autogenous Fat Intracordal injection Yung-An Tsou, China Medical University and Hospital, Taiwan Cross-Strait Session 12: Research in Acute Care Issues
CS12-001
B04-014
Study on Quality of Life and Influencing Factors of Patients Following Mechanical Heart Valve Replacement Ya Wen, West China Hospital, Sichuan University, China
CS12-002
B05-001
Delay in Seeking Treatment of Patient With Acute Myocardial Infarction Related Factors Yu-Hua Hsu, Far Eastern Memorial Hospital, Taiwan
CS12-003
B07-020
Health Status and Quality of Life of Extra Coporeal Membrane Oxygenation Survivors Fong-Tzu Hsieh, National Taiwan University Hospital, Taiwan
CS12-004
B11-020
The Investigation of Quality of Life Among Taiwanese Pancreas Transplantation Patients I-Wen Chang, Taipei Veterans General Hospital, Taiwan
CS12-005
B12-003
The Nursing Management From a Pain Status Survey at a Large Comprehensive Teaching Hospital Xu-Ping Xie, West China Hospital, China Cross-Strait Session 13: Mental Health Research
CS13-001
B04-007
Self-Transcendence and Depression in Taiwanese Men With Oral Cancer Hsiu-Chin Chen, Chi Mei Medical Center, Taiwan
6
CS13-002
B06-002
Influencing Factors of Caregiving Rewards for Primary Caregivers of Older Persons With Mild to Moderate Dementia-A Longitudinal Study Chun-Hui Huang, Chang Gung University of Science and Technology, Taiwan
CS13-003
B11-006
The Roles of Lifestyle Behaviors and Antipsychotics in Metabolic Syndrome Between Patients With Mental Illness and General Populations Wei-Fen Ma, China Medical University, Taiwan
CS13-004
B14-022
A Combined Quantitative and Qualitative Study of the Psychoeduation Intervention "Balancing My Swing" for Bipolar Disorder Pei-Chen Hsu, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan
CS13-005
B14-025
Elevated Healthcare Utilization Among Medical Patients With Depression or Suicide Risks: Implications for Clinical Nurses Chia-Yi Wu, National Taiwan University College of Medicine, Taiwan
CS13-006
B12-004
Nurse Satisfaction and Burnout in Neurological Ward in Shanghai Hui Jiang, Tongji University, China Cross-Strait Session 14: Disaster Nursing and Intensive Care
CS14-001
B01-002
Disaster Nursing in Post-Morakot Mental Health Intervention: An Action Research Yao-Yu Lin, Tsaotun Psychiatric Center, Taiwan
CS14-002
B01-003
Studying the Level and Factors Influencing of Disaster Nursing Competences Among WenChuan Earthquake Areas Hospitals Heng Wang, West China Hospital, Sichuan University, China
CS14-003
B01-004
Developing and Integrating Disaster Health Management for Taiwanese Nursing Education: A Pilot Study Shiu-Yun Fu, Fu-Jen Catholic University, Taiwan
CS14-004
B01-005
The Integration of Nursing Process Into the Development of Taiwan Disaster Nursing Model Fu-Chih Lai, Taipei Medical University, Taiwan
CS14-005
B04-016
Insufficient Early Detection of Peripheral Neuropathy in Rural Diabetes Residents and Associated Factors Chia-Mou Lee, Min-Hwei Junior College of Health Care Management, Taiwan
CS14-006
B11-015
Exploring Factors Influencing Nurses Providing End of Life Care in Intensive Care Units Chia-Hui Chou, National Taipei University of Nursing and Health Sciences, Taiwan Concurrent Session 15: Child and Adolescent Health Care
CS15-001
B02-006
Painful Menstruation Experience and Related Multiple Factors in Female Adolescents in Taiwan I-Chen Lu, Chung-Hwa University of Medical Technology, Taiwan
7
CS15-002
B04-001
Parents' Knowledge on Oral Rehydration Therapy Opatha Withanage Lakmali Dharmawansa, Lady Children-Colombo, Sri Lanka
Ridgeway
Hospital
for
CS15-003
B04-020
Mental Health and Quality of Life Among Family Caregivers of Disabled Children: The Influence of Health Promotion Lifestyles Jen-Kuei Ko, Kaohsiung Medical University, Taiwan
CS15-004
B07-003
Systematic Review on the Impact of Parental Cancer on Aadolescent Children Sheena Ramazanu, Khoo Teck Puat Hospital, Singapore
CS15-005
B07-018
The Uncertainty and Parental Stress in Primary Caregivers of Children With Airway Abnormalities Shin-Huei Ho, Taipei Veterans General Hospital, Taiwan
CS15-006
B11-007
Taking Care of Adolescent Patient With Cancer- the Subjective Experiences Among Pediatric Nurses Hsiang-Ling Tan, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
8
Abstracts
9
CS1-001
Self-Efficacy in Coping Affect Quality of Life in Liver Cancer Patients After Receiving Treatments Shiow-Ching Shun Yeur-Hur Lai
Purpose:
Methods:
Results:
Implications
Key Words:
National Taiwan University College of Medicine, Taiwan National Taiwan University College of Medicine, Taiwan
Many patients with hepatocellular carcinoma (HCC) frequently received medical treatments because of its high recurrent rate. However, the short stay of hospitalization and unpredictability of treatment outcome, the self-efficacy in cancer care might be the important role affecting the level of quality of life after discharge. Aims: the aim of this study was to identify if the self-efficacy in coping with cancer before discharge was associated with quality of life in liver cancer patients after receiving non-surgical treatments including transcathether hepatic chemoembolization, percutaneous ethanol injection, and radiofrequency ablation. Data were collected two times including the day before discharge (T0), and eighth weeks (T1) after discharge by using a set of structured questionnaires to assess patients' care quality of life, symptom distress, fatigue, anxiety, depression, and level of self-efficacy in a teaching hospital in Northern Taiwan. Health-related quality of life and its associated factors were examined by descriptive analysis and the significant factors associated with the level of quality of life at T1 were identified by multiple regression. Patients with liver cancer (N = 114) reported that fatigue was the most distressed symptom after treatment. Self-efficacy at T0 was associated with the level of anxiety (r = -.247, p = .020) and physical and mental related quality of life at T1. However, after controlling other associated factors, the level of self-efficacy (β = .115, p < .005) before discharge was significant factor associated with mental related quality of life (QOL) at T1. for Practice: The level of self-efficacy in coping with cancer before discharge is an important factor to affect the level of mental-related QOL after 8 weeks of treatment. Therefore, health providers should closely assess the self-efficacy in coping with cancer after discharge in order to improve their mental-related QOL after discharge. liver cancer, self-efficacy, quality of life.
10
CS1-002
Association Between Muscle Strength and Fatigue in Colorectal Cancer Survivors in Taiwan Yun-Jen Chou Shiow-Ching Shun Yeur-Hur Lai Jau-Yih Tsauo
Purpose:
Methods:
Results:
Implications
Key Words:
National Taiwan University College of Medicine, Taiwan National Taiwan University, Taiwan National Taiwan University, Taiwan National Taiwan University, Taiwan
Colorectal cancer is the third most commonly diagnosed cancer in the world, and the third most common cause of cancer death in Taiwan. Evidences have shown that fatigue is the most common symptom in cancer survivors. However, measuring fatigue is lack of an objective indicator. Therefore, the aim of this study was to explore the association between fatigue and muscle strength in colorectal cancer survivors and further to examine if the muscle strength can be the objective indicator of fatigue in colorectal cancer survivors. A cross-sectional study design was used to recruit patients from a medical center in Taipei. Patients (n= 160) with colorectal cancer had completed cancer-related treatment at least three months and less than five years. The Chinese versions of questionnaire included: a form with demographic and clinical characteristics, Cancer Fatigue Scale (CFS), Symptom Distress Scale and the Hospital Anxiety and Depression Scale. The muscular strength was measured by grip strength, low extremity strength, 30-second chair stand test, and 6-minute walk test. The generalized estimating equation (GEE) was to explore the association between fatigue and muscle strength after controlling other associated factors. The mean age was 62.08 (SD= 11.59). Muscle strength was significant factors with the cognitive and mental domain of CFS. Patients with lower frequency of 30-second chair stand test (β = -.099, p = .0001), higher level of symptom distress (β = .102, p =.020), and higher level of depression (β = .172, p = .012) have higher level of cognitive domain of CFS. Moreover, patients with lower level of low extremity strength (β = -.202, p = .008) and Karnofsky performance status (KPS) (β = -.117, p = .012), and higher level of depression (β = .338, p = .002) have higher level of mental domain of CFS. for Practice: Symptom distress, depression, KPS, and muscle strength of lower limbs were the significant associated factors with fatigue in colorectal cancer survivors. Muscle strength of lower limbs could be an important factors associated with fatigue after controlling other factors. Therefore, the health care providers might develop the exercise education program, especially focusing on how to train the patients' muscle strength of lower limbs in order to maintain better level of energy and quality of life. colorectal cancer, fatigue, muscle strength.
11
CS1-003
Evaluate the Neurological Effect for Applying Hypothermia Intervention to the Traumatic Brain Injury Patients Ming-Yuan Tan Shirling Lin Mei-Kuei She Yu-Hsia Chang Chin-Lin Lai
Purpose:
Methods:
Results:
Implications
Key Words:
Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
Traumatic brain injury (TBI) is a major cause of death and long-term morbidity. This injury can result in death or a lifelong impairment of physical, cognitive, and psychosocial functioning. The purpose of this study was to establish an evidence-based hypothermia intervention care guideline for traumatic brain injury patients and to provide the comprehensive strategic contentious care plans for improving the quality of care for patients in the neurological intensive care units. This research design used three methods steps by steps: (1) to use systematic review method and search clinical guideline to investigate the major domains of hypothermia intervention care guideline in traumatic brain injury patients and the effectives of each strategy in each domain; (2) to construct the hypothermia intervention care guideline and examine the reliability and accessibility; (3) to investigate the effectiveness of this hypothermia intervention guideline to traumatic brain injury patients. A quasi-experimental study design was used. Guideline included starting low temperature 34.2~ 35.8 ℃ in 6~8 hours, maintaining low temperature for 48 hours, then rewarming in 8 hours was provided. The relative ratio of neurological outcome, Glasgow outcome scale, and mortality from two groups were computed and analyzed. The findings were the following: (1) the difference of 72-hour body temperature from two groups was different significantly (p= .000); (2) the cranial perfusion pressure increased within the 72 hours in experimental group (p= .000); (3) the 6-month neurological outcome improved better in experimental group; (4) the 6-month mortality was no significantly difference between two groups (p = .495). for Practice: The result of this study developed a hypothermia intervention care guideline for traumatic brain injury patients and to provide the implementation of an intervention to judge appropriateness of applying the hypothermia intervention. Furthermore, it would be recommended expanding this hypothermia intervention care guideline to other institution. traumatic brain injury, hypothermia intervention, evidence-based practice.
12
CS1-004
Does the Words What Advanced Cancer Patients Describe Their Pain Affect Their Pain Severity, Emotional Status, and Quality of Life. Lih-Mih Chen
Purpose:
Methods:
Results:
Implications Key Words:
Kaohsiung Medical University, Taiwan
Although the words what patients describe their pain has been regarded as a part of pain assessment, but the relationships among the words, pain severity, emotional status, and quality of life has rarely been investigated. This cross-sectional, exploratory study tried to 1) understand the frequency of using words to describe pain experience; 2) determine the relationships among pain quality, pain severity, emotional status, and quality of life. A descriptive and correlated study was designed to investigate the relationships among pain quality, pain severity, emotional status and quality of life. 120 adult advanced cancer patients who suffering from pain had been purposively recruited with the IRB approval of a medical center. Six self-report questionnaires, including MPQ-SF, BPI, CES-D and BAI, and QOL-P/CS, were filled out by the participants. Data was analyzed by descriptive statistics, Pearson's correlation coefficient, and independent t-test. Results indicated that: 1) 2 to 14 words were used to describe pain with mean of 9.09±2.65 words; the top five words that advanced cancer patients used most were nagging (91.7%), tiring (90.0%), exhausting (89.2%), unbearable (81.7%), and aching (79.2%); 2) the total number of words that advanced cancer patients used was significantly correlated with worst pain intensity (p= .000), average pain intensity during past week (p = .014), current pain intensity (p = .033), depression mood (p= .000) and quality of life (p = .000); 3) patients' anxiety status were significantly correlated with using aching, throbbing and shooting to describe pain (p< .05); using stabbing, gnawing, tender, exhausting, tiring, penetration, nagging, miserable and unbearable to describe pain were significantly correlated to depression mood (p< .05); using stabbing, gnawing, nagging, miserable, unbearable to describe pain were significantly correlated with quality of life; and patients' worst pain intensity were significantly influenced by using stabbing, nagging, miserable, unbearable, exhausting and tiring to describe pain (p< .05). for Practice: The findings from this study would indicate the importance in assessment of the words what patients describe their pain. pain quality, pain severity, depression, anxiety, quality of life.
13
CS1-005
Cancer Patient Family Responses and Actions to Family Members With Cancer Who Use Complementary and Alternative Medicine Shou-Yu Wang Ying-Ying Chang
Purpose:
Methods:
Results:
Implications
Key Words:
Hungkuang University, Taiwan Taichung Verterans General Hos, Taiwan
Complementary and alternative medicines (CAM) have long existed in human society. A Japanese cancer study reported that 32% of the patient informants were non-Western medicine users. One in Taiwan study found that 95.8% of adults in the community are using CAM. Another study in Taiwan that explored cancer patients' use of CAM found that family influences are one of the main reasons that they use or do not to use CAM. However, there are no similar studies of Taiwanese cancer patients' family responses to people with cancer on the use of CAM that are in depth. It becomes very important to explore cancer patients' family responses regarding cancer patients' use of complementary and alternative medicine. Therefore, the purpose of this study is to explore cancer patients' family responses to family members with cancer who use complementary and alternative medicine. A grounded theory approach was employed in this study. Sixteen in-depth interviews were conducted with families taking care of cancer patients who use complementary and alternative medicine. Open coding, axial coding, selective coding, and systematic comparison were used in the data analysis process. The study found four main categories that affected cancer patients' family responses regarding their family members who use CAM: use of CAM as nutrition supplements, use of traditional Eastern medicine, adjusting the patient's life styles, and seeking for religious practice. "Every treatment has its advantages and disadvantages" was identified as the core category in this study. for Practice: The results of this study show that it is important to develop health care professionals' knowledge and skills in understanding cancer patients' family perspectives in the cancer patients' use of CAM. Further, it is also essential to establish the evidence of CAM use in order to provide adequate information to the families of the cancer patients. These implications are able to benefit nursing education, improving patient safety, caring for cancer patients' needs, and enhancing cancer nursing practice. complementary and alternative medicine, cancer patients, family, grounded theory, qualitative research.
14
CS1-006
Establish and Evaluate of Care Map in the Critical Stage for Oral Cancer Patients After Flap Reconstructive Microsurgery. Shu-Fen Kao Shih-Hsin Hung Fang-Chu Lin Ya-Hui Chang Fang-Yu Chang Wan-Yun Chang
Purpose:
Methods:
Results:
Implications
Key Words:
Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
The study aims was to develop oral cancer patients receiving microsurgery flap reconstruction surgery care map, intensive care cost, medical resource utilization and patient satisfaction. Quasi-experimental research and sampling by purpose in medical center plastic surgery intensive care oral cancer patients after microsurgical flap surgery, divided into experimental group and control groups, experimental group perform intensive care map, control group provided routine care processes. The first phase was developed care map; second stage was to compared two groups length of stay in ICU, medical resource utilization analysis, patients satisfaction. The results showed experimental group ICU length of stay was 9.3 ± 3.9 days, control group was 9.6 ± 5.3 days; medical costs in the period of experimental group was NT＄380,304.5 ± 101,820.2, the control group was NT＄411,198.6 ± 164,346.9, two groups was significant difference. Patient satisfaction experimental group average score was 3.7 ± 0.5. The control group was 3.4 ± 0.6. for Practice: In this study, integrated care conceptual framework, combined with the health care team members to establish the standard of care processes, improved communication effectively, reduce health utilization, provide the guideness for clinical nursing care, improve quality of intensive care. care map, microsurgery of free flap reconstruction, oral cancer.
15
CS2-001
Program Satisfaction and Student Activation as Correlates of Academic Performance Among Senior Nursing Students Joanne Mae Evangelista Nava
Purpose:
Methods:
Results:
Implications
Key Words:
San Beda College, Philippines
The purpose of this study was to determine whether program satisfaction and student activation are related to the academic performance of senior nursing students. A descriptive correlational design was used to infer relationships among variables in this study. Utilizing the Nursing Student Satisfaction Scale (NSSS), Student Activation Measure (SAM) and Grade Point Average (GPA), a cross-sectional survey was conducted among 220 senior nursing students from selected schools in Metro Manila with Level II accreditation granted by the Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). Results of the survey revealed a very significant relationship between program satisfaction and student activation (r= .402, p< .01). The environment, which includes the school's classrooms, nursing laboratories and libraries, was found to have a significant relationship with academic performance (r= .134, p< .05). However, no significant correlation existed between academic performance and student activation (r = -.109, p = n.s.). for Practice: School administrators and faculty members must strive to increase the level of satisfaction of students as it allows them to become more activated and engaged in learning. Improvement in facilities must be prioritized as it is important in teaching the necessary competencies in nursing and helping students to excel academically. program satisfaction, student activation, academic performance, nursing students.
16
CS2-002
Reliability and Validity of the Direct Observation of Procedural Skills Assessment Tool : Evaluating Nursing Clinical Practices Hui-Hsun Chiang Ya-Lin Chen Chi-Jen Tsai Ju-Wen Liao Li-Hung Huang Wen-Chii Tzeng
Purpose:
Methods:
Results:
Implications
Key Words:
Tri-Service General Hospital, Taiwan Tri-Service General Hospital, Taiwan Tri-Service General Hospital, Taiwan Tri-Service General Hospital, Taiwan Tri-Service General Hospital, Taiwan Tri-Service General Hospital, Taiwan
Tools for direct observation of medical trainees for performance-based skills are reported, but their have not been applied in nursing clinical practice. Direct Observation of Procedural Skills (DOPS) scale had good validity evidence for medical clinical performance assessment, however, less evidence for nursing clinical practice. The purpose of this study was to examine the reliability, validity of the Direct Observation of Procedural Skills among registered nurses performing clinical practices. A cross-sectional study was conducted at a medical center in Taipei, Taiwan. Register nurses enrolled from October 2012 to October 2013. A total of 170 Nurse Post Graduate Year (NPGY) register nurses who age above 20 years old completed a structural questionnaire of the Direct Observation of Procedural Skills. Internal consistency, factor structure and content validity were assessed. Exploratory factor analysis were applied to detect dimensions of the scale. Results of this study indicated that DOPS is a one-dimensional scale. Internal consistency and the content validity index of the DOPS were .99 and .93, respectively. Factor analysis revealed that only one factor, clinical practice process, explained 90.7% of the variance. for Practice: The DOPS is a one-dimensional scale with good reliability and validity, which is an effective short and comprehensive tool for evaluating register nurse with clinical practices performances. It can effectively assist nursing staff in clinical practice for nurses post graduate year. The results can also serve as a good reference to identify competence of register nurses in clinical settings. Therefore, it could further increase the efficiency of educational evaluation. clinical nursing practice, direct observation of procedural skills, nurse post graduate year.
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CS2-003
A Study on the Construction of the Core Competence Indicators for Clinical Nursing Teachers Fen Chu-Ko Shu-Yuan Chao
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Jen-Teh Junior College of Medicine, Taiwan Hungkuang University, Taiwan
This study aims to understand the contents of the core competence for clinical nursing teachers and to construct the indicators of the core competence for clinical nursing teachers. To meet the purpose of this research, by way of the literature review on the core competence for clinical nursing teachers and focus group interview with eight nursing experts, the preliminary framework of the indicators is developed from the analysis of the results. This study adapts the Modified Delphi Technique survey to construct the indicators of the core competence for clinical nursing teachers by consulting with 23 Delphi experts and integrating the different opinions to reach the agreement from these experts through two-round Q& A and revisions. According to the research result, the indicators of the core competence for clinical nursing teachers are composed of six dimensions as follows: "Teaching Competence","Clinical Nursing Competence","Leadership and Management", "Problem-solving Competence","Communication and Interpersonal Relationship", and "Academic Research and Professional Development Competence" with 14 sub-dimensions and 81 indicators. for Practice: Based on the research result, the researcher proposes the indicators of the core competence for clinical nursing teachers to self-examine their working competence. In the meantime, this framework of the indicators can be considered as a reference not only for nursing school faculties to draw up measures for recruiting and assessing the clinical nursing teachers, but also for the related educational institutions to plan future training programs for clinical nursing teachers in Taiwan. clinical nursing teacher, core competence, indicators construction.
18
CS2-004
Comprehensive Strategies Building up Students' Confidence in Operation Room Within Four Weeks Clinical Curriculum Mei -Yun Yu Wen-Jane Chang Hsiu-ju Jen Ean-Mei Chuan Yu-Chun Lin Yung-Chen Chen
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Fooyin University, Taiwan Fooyin University, Taiwan Far Eastern Memorial Hospital, Taiwan Far Eastern Memorial Hospital, Taiwan Far Eastern Memorial Hospital, Taiwan Far Eastern Memorial Hospital, Taiwan
Perioperative nursing care is a mystical zone and under-researched area of nursing practice. The stereotypical image of perioperative nursing care is considered one of task- and technically-orientated nursing practice; nurse works in a medical model and are dominated by constraints and influenced from outside factors. The communication occurs within perioperative team members is important to both team function and the socialization of students, the communicative nature of perioperative team members is complex and socially motivated from surgery, nursing, and anesthesia. Dominant themes were time, safety and sterility, resources, roles, and situation. Communicative tension arose regularly in relation to these themes. Each procedure had one to four ''higher-tension", events, which often had a ripple effect. The best strategies to enhance students' capabilities are well-prepared of knowledge, skills and psychological aspects before joining team working. Strategies enhancing technical skills: focal pointed and time limited technical skills quizzes: focal pointed out steps easily contaminated then listed to essential parts of quizzes criteria; time limited quizzes stand for students would fail the quizzes, if they don't conduct the skills in fluently. Skills include opening cover of sterile package, gowning, gowning another person, recognizing instruments, passing instruments and handling sharps. Strategies enhancing caring of perioperative patients: simulative activities make students know what patients feel and role play polish students' communicative skills with patients. Strategies enhancing knowledge of perioperative nursing care: concept mapping themes of perioperative nursing care: patient safety, sterilization and aseptic principle, preoperative anxiety, hypothermia. Strategies enhancing confidence of students: on-going encouragement from daily clinical practice and keep reflexing from daily clinical practice either. 90% students conducted first week's technical skills quizzes and wrote down what they felt when they were patients on operation bed. Each student conducted a concept map and passed quizzes. Average score of self-efficacy evaluation was 83%. Average score of teaching satisfaction was 4.75 in 5. for Practice: As the nature of operation room, conducting clinical curriculum needs to organize all strategies to build up students' confidence. I do believe all clinical curriculum practice need comprehensive strategies to empower students' capability and confidence too. strategies, perioperative nursing care, clinical curriculum.
19
CS2-005
Effect of Multiple Teaching Strategies Intervention on Nursing Ethical Education Among Nurse Students Hsiao-Lu Lee Ling-Ing Lee
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Yuhing Junior College Health Care & Management, Taiwan Yuhing junior college health care & management, Taiwan
The study explored the learning efficiency on applying multiple teaching strategies to nursing ethics for junior college nursing students. This study was the methodology of quasi-experimental research. This research surveyed 250 nursing students(NS), and the valid respondents were 242. The participants' average age was 18.45. The multiple teaching strategies conducted from 2-16 weeks included reading Nightingale biography, clinical ethical role-play, case's organ transplantation experience sharing to NS. To identifies the learning efficiency on applying multiple strategies, 3 questionnaires were adopted. First, the ethical situation of structure questionnaire was conducted (20 structural questions aboutethical situation of structure, ESS). Second, the evaluation of multiple teaching strategies about teaching for nursing ethics questionnaire was conducted (multiple strategies teaching, MST). Lastly, critical thinking intention questionnaire was conducted (critical thinking intention, CTI). Pre-test was taken in the first week of the semester, and the post-test in the 17th week. Collected data was processed and analyzed by SPSS 20.0 Nemar-Bowker. The results showed that there were 12 significant difference between pre-test and pro-test in the ESS(x2＝10.7-50.06, p＜ .5 The pro-test average score was 94.88± 11.15 (M±SD) for CTI and it was higher than the pre-test88.13±8.58 (M±SD) (pair-t ＝ -8.27, p＜ .5). MST indicated that the agreement average score between the organ transplantation experience sharing and teaching efficiency was the highest one, M＝2.28, NS clinical ethical role-play, M＝2.00, the lowest one, and NS reading Nightingale biography, M＝2.11, the medium one. (The response ranges from "0" to "3"Likert scale. "0" represents strongly disagree, "1" represents partially agree, "2" represents agree, "3" represents strongly agree.) for Practice: Reading Nightingale biography, clinical ethical role-play, case's organ transplantation experience sharing to NS, these multiple teaching strategies were effective to nursing ethics learning. multiple teaching strategies, nursing ethical education, clinical ethical role-play.
20
CS3-001
The Role of Empathy From Partner on the Relationship Between Body Image and Depression Su-Ying Fang Bih-Ching Shu
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National Cheng Kung University, Taiwan National Cheng Kung University, Taiwan
Poor body image is prone to poorer psychosocial adjustment among breast cancer survivors. Social support protects women to some degree from the risk of depression associated with the advanced cancer treatments. Partners are the most important support resource for women. We proposed that women's perceiving understanding from their partner may minimize the impact of changed body image on their mental health. Objective: 1) to understand the relationship between women's perception of empathy from their partners and their depression as well as body image; 2) to examine the moderation effect of women's perception of empathy from their partners and women's empathy for their partners on the relationship between body image and depression. Cross-sectional and correlational design with convenient sampling was used in this study. Permission to carry out the study was received from a hospital ethics committee. Women who agreed to participate signed the informed consent. Measurements including perception of partners' empathy, body image, and depression were given to breast cancer survivors. One hundred and fifty one women were recruited in this study. Results showed that significant relationship between body image and depression (p< .001), and between depression and empathy from partner (p< .001). However, there was no significant relationship between body image and empathy from partners. The moderating effect of empathy from their partners on the relationship between body image and depression was also significant (p< .01). for Practice: Intervention conducting to improve women's mental health needs to encourage their partners to participant. Content within the intervention are recommended to include the communication skill which can improve partners' empathy skill. body image, depression, empathy from partner, breast cancer survivors.
21
CS3-002
The Confident Level of Nursing Intervention IPV Women Among ER Nurses Yung-Mei Yang Hsiu-Hung Wang Fang-Hsin Lee Shu Chen Chang
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Kaohsiung Medical University, Taiwan Kaohsiung Medical University, Taiwan Kaohsiung Medical University, Taiwan Changhua Christian Hospital, Taiwan
The purpose of the study is to exam ER nurses' knowledge, attitudes and confidence in managing and taking care of IVP women in Taiwan. Cross-sectional design with a questionnaire in the internet. 224 ER nurses from 7 hospitals in Taiwan including district hospitals, regional hospitals, and medical centers. Structure questionnaires used in this study included: (a) knowledge of healthcare for IVP scale (KHIVPS), (b) attitudes on healthcare for IVP scale (AHIVPS), (c) confidence of healthcare for IVP scale (CHIVPS), and (d) demographic inventory scale (DIS). Out of 256 ER nurses participated in this internet study. 212 ER nurse completed the internet survey with a response rate of 82.8%. The age of the participants ranged from 20 to 39 years (mean = 30.8 + 4.6). Of the participating nurses, 94.6% were female, 68.36% had bachelor degree, 58% were unmarried. Clinical working experience: ≧10yrs (34.6%). ER working experience: ≧ 10yrs (20.8%). About IPV care experience, 109(48.2%) participants have provided care for battered women for more than 5 times in recent 6 month. One and a half (115, 50.9%) ER nurses without IVP related training course previously. ER Nurses who have more clinical and ER working experiences have higher level of attitudes. ER Nurses who are older, have more clinical and ER working experiences have provided care for battered women have higher level of confidence. ER nurses ’ knowledge, attitudes and confidence of managing female patients experiencing domestic violence are significantly correlated. ER Nurses who have more ER working experience have higher level of confidence level. for Practice: ER nurses' knowledge, attitudes and confidence of managing and taking care of VAW should be paid more attention. Educational training program should be established for ER nurses. The results could provide government as references in making health policies of domestic violence intervention. Forensic nurses should be developed in near future to play designated roles for providing quality care to the women who are experiencing intimate partner violence. IVP, intimate partner violence, confident level.
22
CS3-003
A Clarification of the Characteristics of the Untreated Mentally Disabled Person Who Was the Target of the Neighbors' Claims Yoshioka Maeda Kyoko
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Tokyo Medical University, Japan
In Japan, the mental health care would be promoting deinstitutionalization. However, the public have stigma about the mentally disabled person, and complain about the behavior of them. Public health nurses (PHNs) required response of this claims and supported to the mentally disabled person who lived in the community. The purpose of this study was to clarify the characteristics of the untreated mentally disabled person who was the target of the neighbors' claims. We analyzed 1593 mental health consultation records at a community health center that were written from April 2007 to July 2012 in this cross-sectional survey. To clarify the characteristics of the untreated mentally disabled person, we divided the mentally disabled person into two groups depending on whether he/she had psychiatric treatment or not: the “under treatment group” and the “untreated group”. Data were analyzed by using the chi-squared test, Fisher's exact test, and t-test. We performed a chi-squared automatic interaction detection technique (CHAID) to clarify the characteristics of the untreated mentally disabled who lived in the community. The head of the community health center and all staffs approved the conduction of this study. We found that 81 had information on neighbors' claims about the behavior of mentally disabled, 12 records were excluded from data because of having a lot of missing value. Among the 69 records, 34 were the “under treatment group” (49.3%), 35 were the “untreated group” (50.7%). In the “under treatment group”, eleven were male, the average of the age of them was 59.2 (SD=14.6), receiving welfare benefits was 48.5%. In the “untreated group”, eighteen were male, the average of the age of them was 54.1 (SD=13.1), receiving welfare benefits was 27.3%. There were no significant differences in these parameters between two groups. The CHAID showed that the mentally disabled person who (1) have refused to take medicine or (2) did not understand his/her mental disorder was untreated. If the mentally disabled person met (1), 85.7% were untreated. If the mentally disabled did not meet (1) but met (2), 31.2% were untreated. for Practice: Among the neighbors' complaints, the person who has refused to take medicine and did not understand the mentally ill had needs of psychiatric treatment. The findings would help PHNs effectively identify the mentally disabled person who needs help to take a psychiatric care for continuing their independent life in the community. neighbors' claims, mentally disabled, stigma, deinstitutionalization, community.
23
CS3-004
Exploring Patients Perceived Family Involvement in Elective Surgical Decision Making Mei-Ling Lin Ching-Huey Chen
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Tsaotun Psychiatric Center of Ministry of Health and Welfare, Taiwan National Cheng Kung University, Taiwan
Respect for autonomy is based on the idea of Western Individualism. A person owns right to make his or her own decisions. However, Asian culture emphasizes family as a whole, even if the patient has the capacity to make decision, their family may involvement in clinical medical decisions. The purpose of this study is to explored selective surgery patients' perception in surgical decision and associated factors. Constructed questionnaire was used to collect data from 62 subjects from a medical center at southern Taiwan. Questionnaire includes demographic data, clinical condition, level of involvement in surgical decision, distress conditions in surgical decision and patient perception of the reasons for their family involved in surgical decision. The results showed that patients perceived poorer health status pre-surgery reported higher threats of the surgery, patients who had more surgical experience reported less trouble in understanding the related medical message. Women reported more distress than men in the perceptions of the asymmetry between doctors and patients. While the patients perceived their family involving in surgical decision more, the patients perceived less the asymmetry between doctors and patients. Patients had more surgical experiences reported less concerns in physicians' neglect attitude. Patients over 65 years of age perceived more family involvement in surgical decision making. for Practice: The results of this study provide empirical data for the clinical health professionals in understanding the role of family in surgical decision making. respect for patient's autonomy, selective surgery, family involvement in medical decisions.
24
CS3-005
Home Care Needs in Liver or Renal Transplantation Recipients' Spouses Yu-Hsuan Chang Shiow-Ching Shun
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National Tainan Institute of Nursing, Taiwan National Taiwan University, Taiwan
Transplantation is one of the important treatments for end-stage or acute failure of liver or renal. Although transplantation can prevent recipients from suffering with critical and fatal symptoms, patients may experience the complications with surgery and immunosuppressive drugs. Furthermore, they might have many unmet needs in daily life, especially in their spouses. The aims of this study were to explore the level of home care needs among the post-liver or renal transplant recipients' spouses, and identify the significant factors for unmet care needs. Totally, 91 spouses were recruited by purposive sampling with a cross-sectional correlated design from organ transplant outpatient departments at a medical center in northern Taiwan. Data were collected from March, 2011 to May, 2011. A set of structured questionnaires were divided into two parts: patients and spouses. The data were collected include patients' and spouses' demographic characteristics, patients' disease characteristics, the Transplant Symptom Frequency and Symptom Distress Scale, the Hospital Anxiety and Depression Scale, and the Transplant Home Care Needs Scale. Data were analyzed with descriptive statistics, Spearman's correlation and stepwise multiple regressions by SPSS 18.0 software. Through stepwise multiple regression analysis, the significant predicting variables for spouses' unmet home care needs included spouses' anxiety level, patients' unmet needs, gender and age of spouses. They could explain 50.7% of variances for spouses' unmet home care needs. for Practice: The results of this study can help clinical nurses to understand heavy burden of care in transplant recipients' spouses, and to know the high risk population with unmet needs. liver/ renal transplant, spouse, care needs, symptom, anxiety, depression.
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CS3-006
The Subjective Experiences Among the Family Facing Critical Patient Receiving Palliative Sedation Therapy in ICU Szu-Yin Chen Truey-Yeh Song Lee-Ing Tsao
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Shin Kong Wu Ho-Su Memorial Hospital, Taiwan Shin Kong Wu Ho-Su Memorial Hospital, Taiwan National Taipei University, Taiwan
To explore the subjective life experiences of family facing critical patient receiving Palliative Sedation therapy in ICU. A qualitative research design was applied. Five interviewees, aged 23 to 64 years, participated in in-depth interviews about their subjective feelings and perception for facing their loved critical patients receiving Palliative Sedation therapy in ICU. Content analysis was used by constant comparative method. There were four themes to describe the life experiences of family facing critical patient receiving Palliative sedation therapy in ICU: (1) being unfamiliar and fear during seeing the patient; (2) taking the multiple roles; (3) conflict and beyond control; (4) mood switched. for Practice: Providing Palliative Sedation therapy for critical patient is an usual medical intervention in ICU. However, this is an unique feeling and special experiences for the family when seeing their loved patients to be loss of conscious and cannot express to communicate. It is suggested: (1) to be empathy for in sighting the subjective mood and feelings of the families of critically ill patients. (2) timely and explain with the family before providing palliative sedation therapy for patients (3) establishing the caring and supporting care for the family for the initial contact with the patient. Hopefully, helping family smoothly to pass this transitional period during the patients with palliative sedation therapy. Palliative Sedation therapy, ICU family care, critical care.
26
CS4-001
The Effects of Early Multiple-Time PN Counseling on Newly HIV-Diagnosed Male Homosexuals Piao-Yi Chiou Yu-Jun Liao Li-Chan Lin Ping Chuang
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MacKay Junior College of Medicine, Taiwan Center for Disease Control, Taiwan National Yang-Ming University, Taiwan Taipei City Hospital, Taiwan
Partner notification (PN) is an important method to control the AIDS epidemic worldwide. In this study, we looked into differences in outcome between early multiple-time PN counseling and the conventional PN mode. Subjects consisted of individuals that were followed from Western blot testing until diagnosis confirmation. Random assignment was used to assign 40 subjects to the experimental group where they received early intervention consisting of two times of PN counseling. The first time lasted 60 minutes during which data were collected, information was given on PN, resources were introduced, emotional support was provided, and a communication channel with the researcher was established. The second time consisted of 90 minutes of counseling, during which information on treatment and drugs was provided, successful PN methods were introduced, an advanced PN plan was set up, emotional support was provided and resource referral was conducted. The 40 subjects in the control group received one-time 60 minutes of conventional PN counseling. All 80 subjects were single male with an average age of 28.08 (SD=4.35), most had an educational level of college or university (n=49, 61.0%), and the main route of HIV infection (79 cases; 98.75%) was homosexual intercourse. Index cases in the experimental group provided accurate contact information of 134 more partners than in the control group (t=2.17, p=.036), while there were 108 more partners that were successfully notified (t=2.56, p=.020). Compared to the control group, there were 45 more partners in the experimental group that underwent HIV testing (t=2.09, p=.041) and 31 tested positive (positive rate: 39.74%), which is 22 more than in the control group (t=2.66, p=.009) where only 9 tested positive (positive rate: 27.27%). Also, the mean number of times of resource referral was also significantly higher in the experimental than in the control group. All outcomes were better after advanced PN than after conventional PN. for Practice: The results of this study may be used in the future as a reference for the development of theories related to PN and openness of HIV-infected person, or for the improvement of policies and practices for PN and contact follow-up. HIV-infected person, early multiple times HIV partner notification, conventional HIV partner notification, index case, positive rate.
27
CS4-002
A Wareness on the Health Effects of Secondhand Smoke John Michael H Hernandez Aimee M. Amponin Mayette H. Faltado Annalynn Kaye R. Fernandez Maria Kamile A. Garcia Kristine V. Mariñas
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Lyceum of the Philippines University, Philippines Lyceum of the Philippines University, Philippines Lyceum of the Philippines University, Philippines Lyceum of the Philippines University, Philippines Lyceum of the Philippines University, Philippines Lyceum of the Philippines University, Philippines
The purpose of this study was to determine the awareness of smokers on the effects of secondhand smoke. Another aim was to find out the common health effects experienced by passive smokers and finally, to propose a comprehensive health teaching program to stop cigarette smoking. A quantitative method was applied and data were gathered with the aid of a self-made questionnaire. Five hundred smokers who puff at least a single stick per day were chosen from five municipalities of Batangas Province's District 3 and 4. Every instrument was returned totalling a hundred percent response rate. The results of the study revealed that smokers are aware that their habit put the passive smokers close to health dangers including asthma, increased phlegm production, chest discomfort, reduced lung function, cancer, heart diseases, hypertension and children's compulsion to smoking. It was found further that although the most common health effects experienced by the passive smokers are seemingly apparent to the active smokers, it doesn't motivate them to stop. for Practice: The results lead to a principal conclusion questioning the strength of the current tobacco regulation law as well as the span of control of proper authority with regards to this matter. The researchers see the need for a stronger multi-sectorial handling of smoking cessation services allowing every individual, organizations and institutions to work together in the dissemination of anti-smoking campaigns and to implement a plan of action focused on motivating smokers to end the habit-a plan which would cater a flexible approach for the public in general and for the individual needs. smoking, secondhand smoking, health effect, awareness.
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CS4-003
The Prevalence, Clinical Features of Hypertention in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Its Nursing Strategy Yan Wang Qing-Chan Yang Jing Feng Jie Cao Bao-Yuan Chen
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Tianjin Medical University General Hospital, China Tianjin Haihe Hospital, China Tianjin Medical University General Hospital, China Tianjin Medical University General Hospital, China Tianjin Medical University General Hospital, China
Investigate the prevalence, clinical features of hypertension in patients with OSAHS and explore its nursing strategy. 3,607 patients were included in this study. Subjects were classified into 4 groups based on the apnea-hypopnea index (AHI): control group (control, n = 354) with AHI < 5; mild sleep apnea (mild, n = 658) with 5 ≤ AHI < 15; moderate sleep apnea (moderate, n= 753) with 15≤ AHI 48 H. 47 patients and 298 patient days in control group were collected from Sep to Dec 2009; 54 patients and 311 patient days in experimental group; from Feb to May 2010. Both groups received standard care include change position every 2 hours. For experimental group, keeping patient's HOBE >30 degree after body position was changed. Baseline characteristics were comparable for both groups. Average degree of HOBE were 11.3 (±3.4) in control group and 22.9 (±4.8) in experimental group. Only 19.4% of the study time was achieved target HOBE of 30 degrees in experimental group. The average HOBE degree were 23.5 in day time (08:00~23:59) and 21.3 in night time (0:00~07:59). There were no significant differences between two groups in skin breakdown, ventilator day, length of stay in ICU and mortality. for Practice: The patients in the average of HOBE greater than 22.9 degree had less chance to have VAP episode. head of bed evaluation, ventilator-associated pneumonia, critical care.
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CS7-003
Providing an Evidence-Based Reminder Intervention to Reduce Catheter-Associated Urinary Tract Infections in Hospitalized Patients in a Medical Center in Taiwan Shir-Ling Lin Pey-Tsung Wang Yi-Tsun Lin Hsiang-Yu Lin
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Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
Catheter-associated urinary tract infection (CAUTIs) can result in sepsis, prolonged hospitalization, additional hospital costs, and mortality. The purpose of this study was to establish an evidence-based urinary tract care for general hospitalized patients and to provide the comprehensive strategic contentious care plans for improving the quality of care for patients with urinary catheters. This research design used two methods: (1) to use systematic review method and search clinical guideline to investigate the major domains of urinary tract standardized care and intervention in general hospitalized patients and the effectives of each strategy in each domain; (2) to investigate the effectiveness of this standardized reminder intervention for urinary tract care to general hospitalized patients. A pre-post quasi-experimental design was used. Eighty-six patients in five wards in a medical center were invited with 32 in the control group and 54 in the experimental group. General medical patients who admitted with Foley were included, but if urinary tract infection happened by admitted time was excluded. The findings were the following: (1) The success rate for Foley removing was increased from experimental group (53.7%) to control group (31.3%); (2) The absolute risk reduction of urinary tract infection from two groups was 9.8%, calculated the number need to treat was 7; (3) Estimated the saving cost of annual medical expense was NT$ 3,885,000～5,180,000; (4) The adherence rate of nurses for performing the urinary tract standardized care guideline were 90.7%. for Practice: The result of this study developed a standardized urinary tract care intervention for general hospitalized patients and provided the implementation of an intervention to judge appropriateness of indwelling urinary catheters. Furthermore, it would be recommended expanding this urinary tract care guideline to other institution. evidence-based practice, standardized reminder intervention, hospitalized patients, CAUTIs.
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CS7-004
Comparison of Phlebitis of Two Peripheral Intravenous Catheter Replacement Model on Adults: A Quasi-Experimental Study in Northern Taiwan Shu-Chen Kuo Shir-ling Lin Wei-Pin Wang Man-Shan Wang
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Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
The aim of this study was to compare the incidence of phlebitis of peripheral intravenous catheter (PIC) routine replacement and PIC clinically indicated replacement on a northern medical center in Taiwan. We used a pre-post quasi-experimental design, the inclusion criteria were the medical or surgical inpatient adults and the exclusion criteria were patients who were immunosuppressive, chemotherapy or patients under partial parenteral nutrition. There were total 999 patients were recruited; we collected the control group data from 2013/04/01 to 2013/05/31 of the routine replacement every 3 days. Then we collected the clinical indicated replacement of PICs (experimental group) from 2013/06/01 to 2013/07/31. Finally, there were 520 patients (1508 per-protocol) included in experimental group and 479 patients (1468 patient-times) within control group. The visual infusion phlebitis scale was used to differentiate if there were phlebitis. The assessors inspected the PIC puncture site every day till the end of treatment of PIC or discharge. The indicators of outcome were the morbidity of phlebitis and catheter-related bloodstream infection rate between routine replacement and clinically indicated replacement. There were no PIC-related bloodstream infections in either group. The incidence of phlebitis was analyzed by chi-square. The phlebitis rates were not different on statistics between groups. The phlebitis rates of per-protocol were not significant different on statistics (p> .05). for Practice: The incidence of phlebitis between clinically indicated replacement and routine replacement appear similar. Clinically indicated replacement was suggested over routine replacement because clinically indicated replacement would not only decrease patient discomfort, but also save equipment and staff time. peripheral intravenous catheter, clinically indicated replacement, phlebitis.
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CS7-005
Evaluating the Effectiveness of Different Skin Disinfectants in Preventing Blood Culture Contamination- A Randomized Controlled Trial Wan-Tzu Sun Wen-Wen Hsiao Yu-Jie Yang Ching-I Chang Shu-Chen Kuo Teh-Fu Hsu
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Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
The primary aim of this study was to evaluate the efficacy of venipuncture site disinfection with 2% chlorhexidine in 95% alcohol, 10% povidone iodine in 95% alcohol, and 75% alcohol in preventing blood culture contamination. The secondary aim was to evaluate the cost effectiveness of using different disinfectants in calculating cost of nursing labor and materials. A prospectively randomized investigator-blinded trial was conducted in all eligible patients in the emergency department (ED) at one medical center in Northern Taiwan from October to November, 2013. Venipuncture sites were disinfected with 2% chlorhexidine in 95% alcohol, 10% povidone iodine in 95% alcohol, or 75% alcohol. The blood cultures were taken by five trained ED nurses. Each positive blood culture was adjudicated by physicians blinded to the intervention and scored as a true positive or contaminated blood culture. The primary outcome was the rate of blood culture contamination for each disinfectants. The time of collecting blood culture was recorded and then converted to nursing labor cost. The secondary outcome was the time and total cost for each disinfectants. Of 92 blood cultures, 2 (2.2%) were contaminated with skin flora. The blood culture contamination rate with 2% alcoholic chlorhexidine was 0%, compared with a rate of 3.3% and 3.3% (non-significant) with 10% iodine tincture and 75% alcohol respectively. The drying time with 2% alcoholic chlorhexidine was 17.87±7.31 seconds, compared with 37.52±7.73 and 11.35±3.56 seconds (p< .01) with 10% iodine tincture and 75% alcohol respectively. Estimated total annual cost with 2% alcoholic chlorhexidine was 110,370 Yuan (NTD), compared with 106,101 Yuan and 47,028 Yuan with 10% iodine tincture and 75% alcohol respectively. for Practice: Choice of antiseptic agent does not impact contamination rates when blood cultures are obtained by a well-trained nurse and should, therefore, be based on costs or preference. Because of the limitation of small sample number in our study, neither disinfectant reveal lower contamination rate significantly. Further larger scale of study was needed to address this issue. Currently, the shorter time of obtaining a blood culture and the cheaper of disinfectant become preferred choices to improve nursing efficiency and to decrease labor and material costs. chlorhexidine, skin disinfectant, blood culture contamination rate.
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CS7-006
Comparison of the Effects of Replacing Peripheral Intravenous Catheters at 96 Hours Versus 72 Hours Among Surgical Inpatients in Otorhinolaryngology Department: A Randomized Controlled Trial Wei-Na Wang Chia-Chi Kuo Yu-Rung Wang
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Key Words:
Chi Mei Medical Center, Taiwan Chi Mei Medical Center, Taiwan Chi Mei Medical Center, Taiwan
This study explored the differences of associated complications of phlebitis as well as the manpower and cost involved when replacing peripheral intravenous catheters every 96 hours versus 72 hours among surgical inpatients in an otorhinolaryngology department. Data were collected between February and November 2012, two-group, pretest-posttest randomized controlled trial design was adopted. Using convenience sampling, surgical inpatients in the otorhinolaryngology department of a medical center in southern Taiwan were recruited. Block randomization was used to assign 70 participants to the 96-hour group and 71 participants to the 72-hour group. Their pretest-posttest differences of associated complications of phlebitis as well as the manpower and cost involved were compared. Data were analyzed using SPSS for Windows 17.0. Chi-square and Mann-Whitney U testing were used to compare the differences of posttest between the two groups. No significant pretest-posttest differences (p= 1.00) were found in phlebitis, local infections, and catheter tip culture of both groups. The rates of phlebitis and local infections were 0% in both groups; each group had one case with positive catheter tip culture. The 72-hour group had significantly higher material and manpower costs than the 96-hour group (p< .0001). for Practice: The evidence-based results indicated no significant differences in rates of complications of phlebitis, local infections, and catheter tip culture when replacing peripheral intravenous catheters at 96 hours versus 72 hours. However, the 96-hour group significantly reduced the cost and manpower consumption. Therefore, we suggest that if no infection signs at the intravenous injection sites are detected by nurses of three shifts, the optimal peripheral intravenous catheter replacement interval is 96 hours as compared to 72 hours. peripheral intravenous catheterization, catheter-related infection.
49
CS8-001
Effective Self-Management, A Success Route for Patients with Hypertension Pak-Fong Wong
Purpose:
Methods:
Results:
Implications
Key Words:
International Medical University, Malaysia
The study aims to develop a structured self-management guide that will assist patients with hypertension in controlling their blood pressure using minimum effort. Cross sectional experimental study is proposed for this study. Cross sectional design focuses on field study (Wood & Ross-Kerr, 2011). Experimental applies on grouping where participants are randomly assigned to a treatment group or a control group for comparison purposes. The result will be compared. After obtaining the result from both groups, the control group will be given the same intervention as treatment group. Further data collection will be obtained from both groups and comparison will be made on the result obtained. At the end of the study, all participants will receive the intervention where no participants will be disadvantaged in the study. The ethical approval will be obtained before the commencement of the study. Lahdenperä and Kyngäs (2001) highlighted that the intentional of oneself, active participation in the process of health improvement is the responsible of the individual. Even the acquiring the ability to self-monitor blood pressure is the evidence of self-management. Further to that would be recording the reading and show it to the physician during the follow up appointment as discussed in the clinical forum (Huffman, 2007). for Practice: Many report has highlighted that self-management of hypertension requires the commitment of oneself in order to achieve the desired outcomes. It is the responsibility of the patient to manage his/her illness effectively. These responsibilities include leading a healthy lifestyle, compliance to treatment prescribed and regular follow up with the physician to monitor the progress of the disease. Nurses being the advocator play an important role in ensuring the knowledge and information on leading healthy lifestyle and compliance to treatment are disseminated to the patients. The positive result obtained will be presented to hospitals and community clinics for sharing purpose. The structured self-management guide will be introduced as health promotion tools for patients with hypertension. It is believed that adequate monitoring of blood pressure can prevent patient from developing complication due to uncontrolled hypertension. hypertension, self-management, self-efficacy.
50
CS8-002
Effectiveness of Influenza Vaccination in Elderly Persons: A Nationwide Population-Based Study Chun-Yu Liang Kwua-Yun Wang Shinn-Jang Hwang Kuan-Chia Lin Chung-Yi Li
Purpose: Methods:
Results:
Implications
Key Words:
Tri-Service General Hospital; National Defense of Medical Center, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan National Taipei University, Taiwan National Cheng Kung University, Taiwan
Using a population-based observational study design with controlling for healthy seniors bias, was to evaluate the effectiveness of influenza vaccination in Taiwan. This study used anonymized data, consisting of 30% of the total elderly people aged 65 and over in 2005-2009. The study sample was randomly selected from all elderly insurers from Taiwan's National Health Insurance Research Dataset (NHIRD). To estimate the effectiveness of influenza vaccination, a conditional logistic regression with each subject's ID considered as a stratum variable, was applied to compare the risk of pneumonia hospitalization during influenza period of vaccinated and non-vaccinated years, respectively. The pre-influenza both hospitalized subjects were older, had a higher CCI than those pre-influenza never hospitalized subjects. The results revealed, of those Pre-influenza both hospitalized subjects, receipting of influenza vaccine did not alter the risk of pneumonia hospitalization. Among pre-influenza never hospitalized subjects, vaccination was associated with a slightly decreased risk of hospitalization for pneumonia during 2006-2007 influenza periods but not during 2007-2008. for Practice: Our study found influenza vaccination had better effect for healthier elderly persons, not always effect for protecting elderly in preventing pneumonia hospitalization in influenza seasons. Annual vaccination is still recommened. influenza vaccine, pneumonia, elderly.
51
CS8-003
Association of Polypharmacy With Fall-Related Fractures in Older Taiwanese People: Age-And Gender-Specific Analyses Hsueh-Hsing Pan Kwua-Yun Wang
Purpose: Methods:
Results:
Implications
Key Words:
Tri-Service General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
To elucidate the associations between polypharmacy and age-specific and gender-specific risks of admission for fall-related fractures. This is a nested case-control study. This analysis was randomly selected from all elderly beneficiaries in 2007-2008, and represents some 30% of the whole older insurers using Taiwan's National Health Insurance Research Database. We identified 5,933 cases newly admitted for fall-related fractures during 2007-2008, and 29,665 randomly controls free from fracture. Polypharmacy was defined as the use of these fall-related drugs of four or more categories of medications and prescribed related to fall within a one-year period. Logistic regression models were employed to estimate the odds ratios (ORs) and related 95% confidence intervals (CIs). The interaction of polypharmacy with age and sex was assessed separately. Compared with those who consumed no category of medication, older people consumed 1, 2, 3, and >= 4 categories of medications were all at significantly increased odds of developing fall-related fractures, with a significant dose-gradient pattern (β = .7953, p for trend< .0001). There were significant interactions between polypharmacy and age, but no significant interactions between polypharmacy and gender. The dose-gradient relationship between number of medication category and risk of fall-related fracture was more obvious in women than in men (β= .1962 vs. β = .1873). Additionally, it was most evident in older people aged 75-84 years (β = .2338). for Practice: This population-based study in Taiwan confirms the link between polypharmacy and increased the risk of fall-related fractures in older people; and highlights that elderly females and older people aged 75-84 years will be the targeted subjects for further prevention from fall-related fractures caused by polypharmacy. polypharmacy, older people, case-control study, fall-related fracture.
52
CS8-004
The Risk Factors Association With Functional Status Among Disabled Residents' Targeting Long-Term Care Facilities in Taiwan: A Cross-Sectional Study Hui-Chi Huang
Purpose: Methods:
Results:
Implications
Key Words:
MacKay Medical College, Taiwan
To identify the risk factors of functional status in long-term care facilities in Taiwan. There was a cross-sectional research design. Data were collected from July to August 2013 across four long-term care facilities (including two nursing home and two residential aged care facilities) from 408 facilities with 18,869 residential beds in four target cities of Taiwan. Four facilities were sampled using random and accreditation ranking. In all, 121 primary caregivers (47 nurses and 74 care aides) and 476 residents completed the study questionnaires and tests. A multilevel analysis approach was used to identify individual- and facility-level risk factors for functional status and assess the variation in functional status at the individual- and facility-level. Resident's questionnaires included information on: demographics, doctor diagnosis, use of PRs, fall, Mini-Mental Status Evaluation (MMSE), and function status where included Barthel Index and Modified Katz Index (transferring and mobility) which assess the physical effects of functional status. The CVI score from three experts of residents was 0.99. The questionnaires for primary caregivers included demographics, caring attitude, empowerment, and working satisfaction. The CVI scores of primary caregivers for were 0.99, 0.96, 0.98 and 0.98, respectively. The Ethical Committee of the MacKay Memorial Hospital approved the study (13MMHIS020). Permission to conduct the study was also obtained from facilities and all participants. Of 476 residents, 72% (343) were poor in transferring and mobility and the mean Barthel index was 35.1 (SD= 24.6) during the study period. The mean age of residents was 81.6 years old. The response rate of primary caregivers questionnaire were 121/150= 0.81, the mean age of nurses and care aids were 36.26 (SD= 10.59) and 48.87 (SD= 9.516) years, respectively. The mean of caring score (range 0-39) for nurses and care aids were 30.02 (SD= 5.73) and 31.32 (SD= 5.31), working satisfaction (range 0-60) were 40.87 (SD= 9.38) and 40.61 (SD= 9.124), empowerment (range 0-60) were 37.26 (SD= 9.58) and 33.76 (SD= 9.705), respectively. The main reasons for poor factional status were restraint and prevention fall. Resident level risk factors for functional status included lower Barthel Index scores (more dependent) and the use of physical restraint to avoid injury. A facility-level risk factor for factional status was younger primary caregivers. for Practice: To reduce the incidence of restraint use in facilities in Taiwan, educational programs should target primary caregivers and families in facilities. The programs including (1) when help residents left beds let resident standing on the for at least 3 second, and increased gradually the standing time, (2) encourage resident living with more independent. disabled resident, factional status, long-term care facilities.
53
CS8-005
A Need-Based Nutritional Intervention Effectively Improved Physical Functioning of Nursing Home-Living Elderly-A Randomized Controlled Study Li-Chin Lee Alan C. Tsai
Purpose:
Methods:
Results:
Implications
Key Words:
Asia University, Taiwan Asia university, Taiwan
This study examined the effectiveness of a "need-based" nutritional intervention in improving the physical functional ability of elderly persons living in nursing homes. We conducted a randomized controlled trial in elderly residents of a privately managed nursing home in Taiwan. Among 210 total residents, 96 met our inclusion criteria of being ≥65 years old, BMI ≤25 kg/m2, >1 month residence, and able to self-feed or receive oral feeding. Among the 96 who qualified, 92 agreed to participate. They were randomly assigned to either the control (n= 45) or the intervention (n= 47) group according to gender. Their weight and height were measured for computing BMI (kg/m2) and their nutritional status was rated with the Mini Nutritional Assessment at baseline and every 4 weeks thereafter. Those who were rated as malnourished or at risk of malnutrition (under-nutrition, defined as MNA score ≤24 and BMI ≤24kg/m2) in the intervention group were given an oral supplementation of 50g/day of a soy-protein-based nutritional preparation which contained 9.5 g protein, 250 kcal energy and all essential micro-nutrients. The supplementation would be suspended once either condition was not met. All subjects were rated for handgrip strength and Barthel's Index at baseline, mid-point (week-12) and end-point (week-24). Results were analyzed with Student's t-test, and the Generalized Estimating Equations (GEE), controlled for social-demographic and health-related variables. Four subjects withdrew and 2 died in the control group while 3 withdrew and 1 died in the intervention group during the trial. On the basis of Student's t-test for independent samples, the need-based intervention significantly improved handgrip strength of those who were rated as normal or at risk of malnutrition but not those who were malnourished and those who were 65-74 years old but those who were 75-85 or ≥85 years old (all p< .05). On the basis of the GEE analysis, the need-based intervention significantly improved handgrip strength at week-12 and week-24, and all-item Barthel's index and the feeding and dressing domains of the abilities of daily life at week-24, controlled for potential confounding variables (all p< .05). No adverse events or excessive weight gain were observed. for Practice: Our results suggest that the "need-based" intervention can be an effective and useful strategy for improving the physical functional ability of nursing home-living elderly without adverse events, and nutritional intervention is most effective when it is implemented in the early stage of developing malnutrition. These results highlight the importance of routine screening and timely intervention in geriatric care. Applicability of the strategy to the community-living elderly remains to be evaluated. It would be a greater challenge but will have greater public health significance. elderly, handgrip strength, nutritional intervention, physical functioning.
54
CS9-001
To Explore the Embedded Meaning of Caring for Life: An Example of Nursing Experience of Senior Good Nurses Yu-Fang Tsai Chang-Hsiung Tsai
Purpose:
Methods: Results:
Implications
Key Words:
Chi Mei Mdeical Center, Taiwan Nanhua University, Taiwan
Nursing staffs are the largest part and indispensable in the medical care system. Since 1995, health care insurance was implemented, each medical institution eliminates the number of nurses in order to reduce the cost of personnel. It has become the serious shortage of nurses in the wards. And it is difficult to provide good care without sufficient nurses and difficult to be a senior nurse with passion. A serious nursing staff can make patients and their families feel warm when they suffer from the illness. This study aims to explore the embedded meaning of caring for life: an example of nursing experience of senior nurses through five participants whom were conducted in-depth interviews and observed behaviors for data collection. Phenomenological research method was applied to interpret and understand the essence of nursing phenomena and their care experiences. Research results found that professional development of these five nurses, they had experienced many impacts and difficultities from rookie to mentor, even intend to leave, but still choose to stay and make themselves stronger. Senior nurses perform professional "good care" which is based onnursing ethics. They treat patients honestly, practice of body, mind and soul care, companionship and care for the true meaning and spirit in a whole-person care. These core skilled nursing care can give great care to be continued. Because nurses are working on the diverse medical environment, it is an important inheritance to keep the passion and power of nursing. for Practice: That will be luck for the society and country if all the nurses can stay on their profession. This research can be the references for the schools and hospitals to educate the professional nurses in the future. excellent senior nurse, excellent nursing staff, nursing experience.
55
CS9-002
A Study of Competency Analysis for Aesthetic Medicine Nursing Staff Hui-Tzu Yen Huey-Yeu Yan Chia-Ho Chan
Max Beauty Aesthetic Center, Taiwan Kang-Ning Junior College of Medical Care and Management, Taiwan Kang-Ning Junior College of Medical Care and Management, Taiwan
Purpose:
This paper evaluates the core competency of nursing staff of aesthetic medicine industry, and the criteria of competency analysis. Result of the study will be provided to organization managers or administrators as references in human resource management and cultivation. Problem statement: due to the growing and fierce competition in global aesthetic medicine market, the focus of aesthetic medicine human resources requirement has shifted from quantity to quality satisfaction. How to raise overall competency of aesthetic medicine industry has become a rather important issue.
Methods:
This study incorporates well-known literatures and expert interview in five domains to determine the research framework. Analytic hierarchy process (AHP) data mining research is used in analyzing twenty-four (24) copies of questionnaire to get five (5) first-level criteria of competency analysis, seventeen (17) second-level criteria and seventy-one (71) third-level criteria. The study also refers to factor analysis statistics table KMO to assign any factor that gets weighing score totaling more than 0.8 into competency analysis of nursing staff to simplify the level structure of analysis. Among their professional competency, the study shows that nursing staff stresses expertise and skills the most, behavioral traits and motives the next, and personality traits the least stressed. Organization management could ease working pressure of nursing staff by changing their exterior orientations of competency through on-job training, aesthetic knowledge sets collection and operating room training. As to the underlying and rather invisible orientations of competency, organization management may satisfy achievement needs of nursing staff via deploying stimulus theory in work place, so as to promote their working accomplishment and ultimately to raise the industry competence of aesthetic medicine. for Practice: Study suggests aesthetic medicine industry to cooperate with academic institutes to establish courses of aesthetic medicine knowledge and skills to strengthen the competency of nursing staff, as well as to enhance mutual co-op programs to increase practical experiences of nursing students, so as to raise their competence in job market. aesthetic medicine, nursing staff, analytic hierarchy process, competency analysis, expert interview.
Results:
Implications
Key Words:
56
CS9-003
Optimistic Bias, Prior Experience, Self-Efficacy, Knowledge, and Precautions Regarding Needlestick Injuries: A Study on Clinical Nurses From a Hospital in Middle Taiwan Tsai-Shin Lee Mei-Chih Hsieh
Purpose:
Methods:
Results:
Implications
Key Words:
Jen-Teh Junior College of Medicine, Taiwan Tung's Taichung Metro Harbor Hospital, Taiwan
Needlestick injuries are common and have long represented a salient occupational risk among clinical nurses in Taiwan. This study, therefore, attempted to investigate factors influencing performance of precautionary behaviors among clinical nurses. 869 respondents were recruited from a hospital in middle Taiwan to participate in this cross-sectional study from June 17 to September 1, and 845 finally completed the questionnaire. The valid respond rate was 97.24%. The findings of this study showed that respondents were more likely to s perceive themselves less likely than others to suffer from needlestick injuries, but optimistic bias had no significant influence on the performance of precautionary behaviors regarding needlstick injuries. Self-efficacy was positively predictive of precautionary behavior performance in relation to needlestick injuries while prior experiences were significantly and negatively predictive of precautions. Knowledge, however, had no significant influence on such performance. for Practice: The results of this study implied that "to know is one thing and to do is another" even though knowledge is power. Prevention programs in relation to needlestick injuries among nurses should be explicitly focus on educating nurses not believing "it won't happen to me" and reinforcing their self-efficacy of prevention in relation to needlestick injuries through cognitive, motivational, affective, and decisional processes. needlestick injury, optimistic bias, prior experiences, self-efficacy, knowledge.
57
CS9-004
Building Leadership and Management Competencies Among Nurses Jui-Chen Tsai Meei-Ling Shyu
Purpose:
Methods:
Results: Implications
Key Words:
Taipei Medical University-Shuang Ho Hospital, Taiwan Taipei Medical University, Taiwan
The purposes of this study are: 1) to explore the current competencies of nursing managers in leadership and management; 2) to assess nurses' needs in building leadership and management skills; 3) to design continuing education courses for nurses in developing leadership and management competencies. The study methods include systemic review of literature, cross-sectional survey, and expert focus group discussion. The targeted population is nursing managers who work at medical centers or area hospitals for at least 6 months in Taiwan. Stratified randomization is used to select study subjects. This study will employ two self-constructed questionnaires, "nursing manager's self-awareness of leadership and management competencies" and "needs assessment of nurses in building nursing leadership and management skills", with adequate expert content validity, internal consistencies, and test-retest reliability. Data analyses include descriptive statistics (frequency, percentage, mean, and standard deviations), t test, univariate analysis of variance, Scheffe's posteriori comparison, and Pearson's correlation. Nursing managers experience their leadership and management skills was insufficient, especially for man. They think that need to be trained. for Practice: Results from the systemic review of literature and the cross-sectional survey, as well as continuing education courses related to nursing leadership and management in Taiwan and abroad will be provided to experts before conducting focus group meeting, in order to design a set of continuing education courses that meet nurses' needs in developing leadership and management competencies. leadership, management, competencies.
58
CS9-005
Competencies for Occupational Health Nurses in Taiwan Yun-Ping Lin Meei-Maan Chen
Purpose: Methods:
Results:
Implications
Key Words:
China Medical University, Taiwan National Taipei Universertiv of Nursing and Health Sciences, Taiwan
The purpose of this study was to establish competencies for occupational health nurses in Taiwan. The development of occupational health nursing (OHN) competencies was guided by the 2007 American Association of Occupational Health Nurses' (AAOHN) competencies in occupational and environmental health nursing. This document was initially translated into Chinese by the principal investigator. However, it has been modified and refined in several ways. First, we identified ten OHN core competencies based on the scope of practice for occupational health nurses in Taiwan. Next, performance criteria for each core competency have been modified several times based on the input of the expert panel and senior occupational health nurses on different occasions. We also referenced OHN competencies from other countries (e.g., Canada, the United Kingdom). Finally, six OHN core competencies were further modified from the ten OHN core competencies based on current occupational health and safety regulations/legislation. We have identified six OHN core competencies and established competency criteria for each core competency, delineated by three competency levels (competent, proficient, and expert). The six OHN core competencies are: (1) professionalism, ethics, and regulations/legislation; (2) assessment of interaction among workers, workplace, and the environment; (3) primary health care and communicable disease prevention and control; (4) health surveillance; (5) health management; and (6) health promotion and disease prevention. for Practice: The competencies for occupational health nurses in Taiwan can be used by: (1) the occupational health nurse to evaluate their achievement of practice competencies, (2) the employer as guidelines for occupational health nurse appraisal and selection criteria, (3) the faculty to design the areas of the core curriculum for occupational health nursing, (4) Ministry of Examination to design the content of national nursing licensing examinations, and (5) the training institutions to develop content areas of OHN education and training programs. core competencies, competency criteria, competency levels, occupational health nurses, Taiwan.
59
CS9-006
Determination of Stress Factors and Strategies for Coping With Stress Used by Nurses Who Work at Intensive Care Unit Vesile Unver Ayse Fener
Purpose:
Methods:
Results:
Implications
Key Words:
Gulhane Military Medical Academy, Turkey Gulhane Military Medical Academy, Turkey
Research has shown that Intensive Care Units (ICUs) are stressful environments. The aim of the study was to investigate the stress factors and strategies for coping with stress used by nurses who work at Intensive Care Unit. The data were collected through the use of a data collection form involving questions on nurses such as specific characteristics, "Perceived Stress Scale", and "Coping with Stress Scale". It was carried out between November 2011 and January 2012. Nurses were included if they were employed in ICUs and voluntarily participated. Nurses were excluded if they were employed for less than a year in the ICUs. The study was performed after obtaining written approval from the ethical committee of the military education and research hospital and approval of our application for permission from the school management. Descriptive statistics are shown by numbers (n) and percentages (%), and by mean (standard deviation) ( ± SD). Mann Whitney U test and Kruskal Wallis was also used to analyze the relationship between Perceived Stress Score and some variables. The mean age of the nurses was 27.39±5.12 (min: 22; max: 42). The average duration of years the experienced nurses worked were 5.69±5.91 (min: 1; max: 23) and average duration of years the experienced intensive care units were 3.19±3.06 (min: 1: max: 17) Nurses identified the following as being the most important stressors: "low salary", "sleeplessness" and "be exposed to infection". Perceived Stress Scores were found to be 27.61±4.75. We look over the Coping with Stress Scores who were experienced from intensive care nurses were shown self-confident styles. Nurse's self-confident scores were found to be 13.13±3.94. for Practice: The findings indicate that intensive care nurses experience some difficulty and stress. Also intensive care nurses perceived stress scores were pretty high. This stress factors were analyzed by administrator nurses. intensive care nurse, perceived stress, coping with stress.
60
CS10-001
The Study of Employees' Dietary Behavior and Its Related Factors Jing-Wen Jang Pei-Ti Hsu
Purpose:
Methods:
Results:
Implications
Key Words:
Sijhih Cathay General Hospital, Taiwan Ching Kuo Institute of Management and Health, Taiwan
Learn the current dietary behavior of employees'. Investigate the relationship between dietary behaviors and factors including personal background, dietary and environmental effects. We use cross-sectional study and stratified cluster random sampling. We deliver 245 questionnaires, targeting on the employees of a certain limited company. The questionnaire includes some inquiries about personal background, dietary factors, environmental effects and dietary behavior. Then we use descriptive statistics, t-test, one-way ANOVA, Pearson's correlation and multiple regression to analyze the statistics. 1. In general, the dietary behavior of the research subjects is regular. 2. Personal background: factors like female, department and self-conscious type show positive correlation to the dietary behavior. Women have better dietary behavior than men do. employees in administration department have better dietary behavior than employees in manufacture department. Employees who think themselves slightly thin have better dietary behavior than those who think themselves in standard shape, slightly fat or obese. 3. Dietary factors: employees who enjoy food have better dietary behaviors, however, they lack dietary knowledge on self-efficacy and dietary. 4. Environmental effects: employees have sufficient nutrition on vegetables and fruits; however, they have insufficient nutrition on milk and internal organs. The main resources of informations about food are from TVs, broadcasts, internet, news, magazines and books. Supports from important ones and family members are more important than that from co-workers and friends. 5. In summary, gender, industry, self-conscious type, fondness of food, dietary knowledge, self-efficacy on dietary, availability of food, informations about food and social effects have significant effects on the dietary behavior. They explained 34.1% of variance (Adj. , F-value, ). Self-efficacy on dietary is the factor having the most significant effects on the dietary behavior. for Practice: We found that the self-efficacy on dietary plays the most important role in the dietary behavior. Consequently, we suggest that not only correcting the dietary knowledge among employees but also educating them to refuse inappropriate dietary behavior, at any time and everywhere (ex: low-fat diet) so as to enhance positive self-efficacy on diet. Through the scenario practice and brain-storming, the employees will reflect on the decisions on their dietary behavior individually and actively. The staff members will put their learnings in practice and then build healthy dietary behavior. employees, dietary behavior, self-efficacy.
61
CS10-003
Fish Oil Generates Bioactive Lipid Mediators and Accelerates the Wound Healing of Cutaneous Incision Yi-Chi Peng Fwu-Lin Yang Yi-Maun Subeq Nien-Tsung Lin Chin-Chieh Tien Ru-Ping Lee
Purpose:
Methods:
Results:
Implications
Key Words:
Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan Tzu Chi University, Taiwan Tzu Chi University, Taiwan Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan Tzu Chi University, Taiwan
An excessive inflammatory response results in increased tissue injury and poor wound healing. Several treatments are currently in use to accelerate healing and more efficient formulations are still needed for specific injuries. PUFA (polyunsaturated fatty acids) could modulate immune responses and alter pro-inflammatory cytokine production. The Omega-3 PUFA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish oils generate bioactive lipid mediators that reduce inflammation and leukocyte recruitment in numerous inflammatory disease. We aimed to evaluate their fish oils generate bioactive lipid mediators effects on wound healing. Eighteen rats were used and divided into 2 groups, the SMOF(15% fish oil, 30% of a mixture of medium chain triglycerides, 30% of soybean oil and 25% olive oil) and NS(Normal saline) groups. The full thickness skin wounds were created (2 × 1cm2) on the dorsal surface of the rats. SMOF 1gm/kg (dissolved in 3 ml normal saline) or 3 ml NS (normal saline) was supplemented for 72 hours after incision wound was performed. The blood biochemical substances were measured at several time points during the first day after incision, than measured at day 5, 7, 10, 11 and 14. On the day14, cutaneous wound tissues were collected for pathological examination. There is no significant difference in the levels of WBC between SMOF and NS group after incision(p> .05). In lymphocytes level at 6, 24, 36 and 48 hours NS group was higher than SMOF group and significant differences between the two groups (p< .05). Pro-inflammatory cytokine TNF-α in NS group was significantly higher than that in SMOF group at 72 hours (p = .046). Inhibition of inflammatory cytokine IL-10 in SMOF group was higher than in NS group at 48 hours (p= .034). Providing SMOF after 48 hours, of the levels of GOT and GPT are relatively lower than those in the NS group (p< .05). In the SMOF group, BUN( at 12 hours) and CRE (at 9,12,18 and 24 hours) were lower than NS group (p< .05). The area of wound in SMOF group was smaller than NS group at day14 (3.6% vs. 5.5% ). Histology of repaired incision wounds showed that SMOF group had more fibroblast distribution and collagen fiber organization than NS group. The NS group had a greater accumulation of inflammatory cells in granulation tissue. for Practice: These results suggest that fish oil generates bioactive lipid mediators may inhibitof the inflammatory cytokine production at wound sites. These data showed a therapeutic potential to cutaneous wound healing. fish oil, wound healing, PUFA, cytokine.
62
CS10-004
A Spiritual Model in Nursing: Systematic Review of Ku's Sequent Spiritual Literature Ya-Lie Ku
Purpose: Methods: Results:
Implications
Key Words:
Fooyin University, Taiwan
The purpose of this study was to build a spiritual model in nursing. The systematically retrospective study was to review Ku's sequent studies and published papers regarding spirituality. During 2003-2004, a spiritual framework involving the relationship of the patient with himself, others, faith, and facing death through a qualitative study of 20 cancer patients was constructed. A spiritual distress scale with 30 items developed based on the 4 domains was tested on 85 cancer patients during 2004-2005. The scale had a content validity index of .83, with the 4 domains comprising 64.8% of the explanation of total variance; all the item-total correlations of the 4 sub-scales were over .30, with significant levels of p< .001. During 2006-2007, a spiritual care model, interventions, and activities that incorporated the 4 domains were developed, and integrated into the content of a spiritual nursing course. Following the empirical study's results, the author wrote a book, spirituality in nursing: theory, practice, education & research. Five stages included the development of a spiritual framework, a scale of spiritual distress, a spiritual care model, a spiritual nursing course, and a spiritual care book in nursing. for Practice: The spiritual model could apply into the nursing clinics and education, with the aim of substantially upgrading the spiritual atmosphere both for the nurses and nursing students. spirituality, nursing, model.
63
CS10-005
A Review of Nurses' Knowledge, Attitudes, and Communication About Complementary and Alternative Medicine Hsiao-Yun Chang Edward Chang
Purpose:
Methods:
Results:
Implications
Key Words:
Fooyin University, Taiwan H & L Cooperation, Taiwan
The aim of this study was to review literature regarding the prevalence of complementary and alternative medicine in the clinical practice of nurses and assess their knowledge of and attitudes towards complementary and alternative medicine as well as their ability to communicate with patients. This study used a scoping review method to map and synthesize the existing literature. Both electronic and manual searches were undertaken to identify all published studies between Jan 2007 and Aug 2013. The five stages of review methods were conducted: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing and reporting the results. A total of 14 papers met the inclusion criteria for this review. The average number of studies that included references to the practice rate was 56.9%. The number of nurses with positive attitudes toward complementary and alternative medicine was 62.5% and those reporting insufficient knowledge on this topic accounted for 66.6% of the study sample. Nearly half of the respondents (47.3%-67.7%) reported feeling uncomfortable taking part in discussion. for Practice: The current knowledge deficit among nurses regarding complementary and alternative medicine can no longer be tolerated due to the practice rate within the scope of healthcare practice. Establishing an evidence-based educational program for nurses could help to mitigate barriers to the implementation of complementary and alternative medicine. complementary and alternative medicine (CAM), nurses, knowledge, attitudes, communication.
64
CS10-006
Freshwater Clam Supplementation Decrease Toxicity of Chemotherapy With Doxorubicin Chin-Chieh Tien Fwu-Lin Yang Yi-Maun Subeq Nien-Tsung Lin Yi-Chi Peng Ru-Ping Lee
Purpose:
Methods:
Results:
Implications
Key Words:
Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan Taipei Tzu Chi General Hospital, Taiwan Tzu Chi University, Taiwan Tzu Chi University, Taiwan Tzu Chi University; Hsin Sheng College of Medical Care and Management, Taiwan Tzu Chi University, Taiwan
Many cancer patients ask oncology nurses about their food choices when they have cancer and are undergoing treatment may be very different from what they are used to eating. Because is very important to maintain proper nutrition before, during, and after chemotherapy treatment. Doxorubicin is one of the most widely used anticancer drugs. Many studies showed taking some supplements (vitamins, herbs, and foods) may help reduce the severity of a potential side effect caused by the Doxorubicin. The freshwater clam (FC) extracts is a widely-consumed shellfish and is beneficial for anti-inflammatory. New data regarding the safety of taking freshwater clam pretreatment and undergoing of doxorubicin also will be examined. We investigated whether or not freshwater clam pretreatment reduce of a potential side effect caused by doxorubicin., Eighteen male Wistar-Kyoto rats were randomly divided into 3 groups (n = 6 per group). Before a single injection of Doxorubicin (8.3mg/kg i.v.), in freshwater clam-treated (70 mg/kg/day, p.o.) and steroid-treated (0.4 mg/kg/day, p.o.). Saline-treated p.o. (Dox) as control group. Blood samples were taken from femoral artery at 0, 1, 3, 6, 9, 12, 18 and 24 hours for blood biochemistry analysis. According to our results, the freshwater clam extracts have ability to reduce the organs injured and inflammation by Dox treatment. There are significant difference in the levels of GOT, GPT, CK, CK-MB and LDH, between FC and saline group. These finding were similar to steroid-treated group, there are also significant difference in liver and heart markers (p< .05). Pro- inflammatory cytokine TNF-α with saline-treated (Dox) group was higher t at 18 hours and significant differences between the two groups (p< .05). Inhibition of inflammatory cytokine IL-10 with FC was higher than saline group and steroid groups at 1, 3, 9 and 24 hours (p< .05). for Practice: These results suggest that taking freshwater clam extracts may help reduce the potential organs injury and inflammation caused by doxorubicin in early stage. freshwater clam, doxorubicin , anti-inflammatory.
65
CS11-001
The Effectiveness of Nurse-Led Case Management on Quality of HIV Care Yen-Chin Chen Nai-Ying Ko
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National Cheng Kung University, Taiwan National Cheng Kung University, Taiwan
Monitoring the quality of HIV care and evaluation the effectiveness of HIV case management program (CMP) on retention in HIV care and viral suppression after initiation of highly active antiretroviral therapy (HAART) has become a global focus. The study was to portrait the trends and to evaluate the impact of CMP in retention in care and viral suppression among HIV-infected person from 2008 to 2010. A retrospective study was conducted among 1,302 HIV-positive individuals who had at least one visited in outpatient clinics between 2008 and 2012. Of them, 715 (54.9%) were enrolled in HIV CMP. Trend analyses and logistic regression were applied to investigate longitudinal trend and the impact of CMP on quality of HIV care. Retention in care was significantly improved from 44.5% in 2008 to 57.3% in 2012 and the percentage of viral suppression within 12 months after initiation of HAART was increased from 88.4% in 2008 to 93.5% in 2012. Of patient who received HIV CMP, 73.6% were retained in care, which is significantly higher than 31.7% in those without CMP (p< .001). Among patients received HAART more than 180 days, achieved viral suppression within 12 months were significantly more likely to be retained in care (adjusted odds ratio (AOR)= 5.36, 95% CI [2.6, 10.9], p< .001). for Practice: Nurse-led case management programs play a role in improving HIV related health outcomes. HIV CMP is beneficial to HIV-infected persons by improving retention in care and indirect related to successful viral suppression. HIV/AIDS, case management, retention in care, viral suppression.
66
CS11-002
The Effects for the Bed-Exit Alarm System for Preventions of Falls Among Elderly in Acute Care Medical Center Ya-I Hsieh Shir-Ling Lin
Purpose:
Methods:
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Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospit, Taiwan
Most falls in acute care setting occur in the patients' room, especially during attempts to get in or out of bed. bed-exit alarms, designed to detect patients, movement out of bed, increase staff surveillance of cognitively and/or physically impaired patients at risk for bed related falls. However, the overall reliability of bed exit alarms in detecting patient movements out of bed has not been well established. The purpose of this study is to establish an evidence-based bed-exit alarms care guideline for elderly patients in acute care setting and to provide the comprehensive strategic care plans for fall prevention for elderly patients in the medical units. This research design used two-group 6-month cohort perspective study to investigate the effectiveness of this bed-exit alarm to prevent fall for elderly patients in the medical units. The relative ratio of fall, injury related fall and fall rate from two groups were computed and analyzed. The accuracy for bed-exit alarms was calculated. The main findings were as follows: (1) The fall rate of regularly performed bed-exit alarm cohort group was 0.121%, the fall rate of not regularly performed bed-exit alarm cohort group was 0.163%; (2) The sensitivity, specificity and likelihood ratio were 94.1%, 72.8% and 3.44, respectively, for detecting high fall risk patients of exiting the bed, based on using the bed-exit alarm; (3) The adherence rate of nurses for performing the evidence-based bed-exit alarms care guideline were 97.3%. for Practice: The result of this study is to develop a bed-exit alarms care guideline for elderly patients and to provide the implementation of an intervention to judge appropriateness of applying the bed-exit alarms system. Furthermore, it would be recommended expanding this bed-exit alarms care guideline to other institution. bed-exit alarms, fall, elderly, acute care setting, diagnostic test.
67
CS11-003
Development and Validation for Chinese Language Version of Test of Functional Health Literacy in Adults Pei-Yi Sung Kwua-Yun Wang
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Methods:
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Taipei Veterans General Hospital- Taoyuan Branch, Taiwan Taipei Veterans General Hospital, Taiwan
Health literacy presents a personal reading and writing abilities. It also includes individual operation within the medical system and the ability to make medical decision. Serveral researches prove that health literacy is far more accurate than socioeconomic status, age, and race in predicting a person. The TOFHLA was translated using a back-translation procedure. A purposive sample of 224 adult were recruited from Nai-Hu district, Taipei. In terms of whether suffering from chronic diseases, the paticipants was divided into normal group(n=138) and disease group(n=86). The questionnaires used in this study were demographic characteristics, Wechsler adult intelligence scale-third edition(MAISⅢ): Arithmetic, Comprehension and TOFHLA. Percentage, mean, score index, pearson correlation and t-test were used for data analysis. p< .05 was considered as the statistical significance. The results revealed that the TOFHLA was internally consistent, and had good content validity(CVI=0.985). The Cronbach's α for total and subgroups was between 0.825and 0.873 and Test-retest reliability was between 0.917 and 0.920 (p< .05). The TOFHLA total score was significantly correlation with the MAIS-Ⅲ. The TOFHLA discriminated adult with regard to cor- morbidity (with or without) (p< .000) , age (p< .000) and educational level (p< .000). for Practice: In conclusion, the Chinese version of TOFHLA has internal consistency and strong evidence of content, concurrent, and discriminating validity for Taiwanese adult. These findings suggest that it is a useful instrument and can be used in patient health education. health literacy, TOFHLA, reliability, validity, patient education tool.
68
CS11-004
Psychometric Validation of the London Chest Activity of Daily Living Scale in Taiwanese Patient With Chronic Obstructive Pulmonary Disease Su-Er Guo
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Methods:
Results: Implications
Key Words:
Chang Gung University of Science and Technology, Taiwan
Aims of the present study are: (1) to create a Chinese instrument with cultural and linguistic equivalence to the English version of the London Chest Activity of Daily Living Scale, and (2) to test the psychometric properties of the Chinese version of LCADL. To achieve the first purpose, the research team used a 5-step modified translation and back translation procedure to develop the Chinese LCADL. Four bilingual, 2 monolingual experts plus 2 bilingual pulmonary physicians involved in the process of providing extra reassurance of cultural and linguistic equivalence between the English and Chinese version of LCADL. A sample of 206 Taiwanese patients with COPD in a central-southern Taiwan completed Chinese version of LCADL (c-LCADL). Hierarchical confirmatory factor analysis was used to test construct validity, and structural equation modeling provided criterion-related validity. In addition, Cronbach's alpha was investigated to test the reliability of the LCADL in Taiwanese COPD outpatients. Results of the analyses show that c-LCADL demonstrated high reliability and good construct validity. for Practice: The c-LCADL appears to be a valid measure for the assessment of dyspnea in Taiwanese COPD outpatients. Further evaluation of the scale is recommended to assess its validity in other diseases, and to assess its predictive validity for physiotherapy outcome. reliability, structural equation modeling, back translation, cross-cultural validation.
69
CS11-005
Voice Assessment to Discriminate the Success Rate for the Patients With Autogenous Fat Intracordal injection Yung-An Tsou Hsin-Jung Yang Wen-Dien Chang
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China Medical University and Hospital, Taiwan China Medical University and Hospital, Taiwan China Medical University and Hospital, Taiwan
Vocal cord paralysis (VCP) is a pathological voice condition, which is often caused by the thyroid cancer, neck tumor, and viral infection. Dysfunction of vocal folds makes the voice, swallowing, and breathing problems for the VCP patients. The vocal fold augmented by autogenous fat intracordal injection (AFII) has been shown to improve vocal outcomes in the clinical practice. However, previous study which used the vocal assessment to evaluate the surgical outcomes of AFII is sparse. Thus, we compared the variables of vocal assessment of VCP patients with success and failed AFII. The patients with VCP were included in the study, and evaluated with videostroboscopy and voice assessment before the autogenous fat intracordal injection. The voice assessment including vocal frequency range, intensity range, acoustics and aerodynamics were measured with computer speech analysis system (Computerized Speech Lab, KayPentax 4500). The jitter, shimmer, maximum phonation time (MPT), dysphonia severity index (DSI), noise to harmonic ratio (NHR), voice turbulence index (VTI), and soft phonation index (SPI) were calculated to analyze. Success rate of AFII, that VCP patient do not need surgery again, was assessed by an ENT physician. The differences with successful and failed surgery of VCP patients in all assessment variables were calculated to analyze. We plotted the sensitivity against 1-specificity at different HRV variables to create receiver operating characteristic curves, and the areas under the curve with 95% CI for each of the variables of vocal assessments determined the accuracy. Seventeen VCP patients underwent AFII (successful surgery, n= 8; failed surgery, n=9), and receiver operating characteristic curve analysis showed that the jitter, shimmer and NHR can be used to discriminate between successful and failed surgery. The area under the receiver operating characteristic curves for jitter (0.87, 95% CI〔0.64, 0.98〕), shimmer (0.82, 95% CI〔0.58, 0.95〕) and NHR (0.83, 95% CI〔0.59, 0.96〕) were significantly greater than that of MPT, DSI, VTI and SPI (p < .05). for Practice: The variables of vocal assessment, such as jitter, shimmer and NHR, can help ENT physician to discriminate the success rate after AFII. We also found that jitter is better than shimmer and NHR at distinguishing AFII success rate. We suggested that it is useful and necessary to assess the vocal assessment for VCP patients before AFII. vocal cord paralysis, autogenous fat intracordal injection, vocal assessment.
70
CS12-001
Study on Quality of Life and Influencing Factors of Patients Following Mechanical Heart Valve Replacement Ya Wen Xiao-Lian Jiang Ren-Rong Gong Gui-Ying You
Purpose: Methods:
Results:
Implications
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Sichuan University, China Sichuan University, China Sichuan University, China Sichuan University, China
To describe the status of QOL and identify the influential factors of QOL of patients following mechanical heart valve replacement. Convenient sampling was used to recruit 352 patients following mechanical heart valve replacement; general information, the SF-36 scales, self-management behavior questionnaire, Social Support Rating Scale were used to collect data. (1) Compared with general people, patients within one year after surgery showed a significantly worse score on all subscales of the SF-36 scales (p< .01) except for the subscale of social function, patients out of a year surviving showed a worse score in physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), social function (SF) subscale (p< .05); but the vitality (VT), role-emotional (RE), mental health (MH) score do not have a significant difference (p> .05 ). (2) Multiple regression indicated the influential factors of QOL of these patients were as followed. PF: chronic incision pain, exercise behavior, preoperative heart function, type of surgery, gender, age; RP: return to work, chronic incision pain, valve noise, subjective support, routine health behavior; BP: chronic incision pain, gender, postoperative time; GH: objective support, atrial fibrillation before surgery, chronic incision pain; VT: routine health behavior, subjective support, chronic incision pain, seeking health service, return to work; SF: routine health behavior, subjective support, chronic incision pain, return to work, anticoagulant-related complications, exercise behavior; RE: exercise behavior, objective support, chronic incision pain, routine health behavior, valve noise; MH: routine health behavior, objective support, chronic incision pain, subjective support, postoperative time, anticoagulation-related complications. for Practice: (1) Patients within one year after heart valve replacement, aspects of QOL were lower than general people except for mental health; but after one year of surgery, their vitality, role emotional, mental health can restored to normal levels. (2) The major positive impact factors of QOL were postoperative time, return to work, self-management behavior, social support; major negative impact factors were chronic incision pain, valve noise, anticoagulation- related complications. mechanical heart valve replacement, quality of life, influential factors.
71
CS12-002
Delay in Seeking Treatment of Patient With Acute Myocardial Infarction Related Factors Yu-Hua Hsu Tsuey-Yuan Huang Shiow-Li Hwang
Purpose:
Methods: Results:
Implications Key Words:
Far Eastern Memorial Hospital, Taiwan Chang Gung University of Science and Technology, Taiwan Meiho University, Taiwan
Delay treatment for acute myocardial infarction (AMI) can result in server complications even death. To determine the phenomenon and its associated factors is helpful to prevent the secondary injury for AMI patients in Taiwan. Data were collected with the response to symptoms questionnaire by patients when they arrived at emergency department and within 48 hours. One hundred and eleven AMI patients (65.8% male, 66.35±13.33 years old, 70.3 % married) were recruited in the current study. Mean time of delay treatment was 37.35 hours, and 69.4% patients arrived at the hospital within 12 hours. Most patients in the study live in the urban areas; 71.2% patients at home when the onset of symptoms; 30.6% patients did not inform others when symptoms attacked; 32.4% patients tried to relax and used self-management strategies before calling the ambulance. Patients with delay treatment had atypical and intermittent symptoms, such as breathlessness, abdomen discomfort, and sweating. In the final models, "atypical symptoms, including abdominal discomfort, sweating, breathlessness", "do not want to bother others", and "wait for symptoms gone" explained a significant proportion of the variance, ultimately accounting for 29.2% of the total variance for the delay treatment. for Practice: The results of the study provided an evidence for patient education for the public to reduce delay treatment when heart attack. acute myocardial infarction, delay in seeking treatment, symptom response.
72
CS12-003
Health Status and Quality of Life of Extra Coporeal Membrane Oxygenation Survivors Fong-Tzu Hsieh Meei-Fang Lou
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National Taiwan University Hospital, Taiwan National Taiwan University, Taiwan
Extra corporeal membrane oxygenation (ECMO) is a common invasive treatment for critically ill patients. Most ECMO research has focused on survival outcomes and scant studies have evaluated quality of life (QOL). This study investigated critically ill adults treated using ECMO regarding the following: (1) QOL after hospital discharge; (2) the differences or correlations among demographic data, disease-related information, health status, and QOL; (3) the factors that influence QOL. A cross-sectional survey was conducted using structured questionnaires and a convenient sampling method was adopted. The research participants comprised recovered adult patients who were treated with ECMO at a medical center between 2009 and 2011. The research tools comprised the patient demographic data and disease-related information, Barthel Index, instrumental activities of daily living (IADL), Notthingham health profile (NHP) part II, Short-Form 36-item questionnaire (SF-36). The 100 participants averaged 48.95±14.75 years of age. Of these patients, 10 patients were diagnosed with ECMO-related complications. The average scores for the Charlson comorbidity index (CCI), Barthel index, and IADL were 2.39±2.45, 96.15±13.16, and 7.12±1.99, respectively. The average number of currently affected items in the NHP part II was 2.27±2.85. The average scores for the physical component summary (PCS) and mental component summary (MCS) were 49.25±9.51 and 48.13±10.46, respectively. Body structure and function (CCI, r = -.33, p < .01), activity (Barthel Index, r = .57, p < .01; IADL, r = .64, p < .01), and social participation (currently affected items in the NHP part II, r = -.76, p < .01) correlated with QOL (SF-36), The factors that influenced QOL in the PCS were the number of currently affected items in the NHP part II (β= -.62, adjusted R2 = 57.9%, p = .00), Barthel Index (β = .24, adjusted R2 = 5.2%, p = .00), and work status (β = .14, adjusted R2 = 1.6%, p = .02); the factors that influenced QOL in the MCS were the number of currently affected items in the NHP part II (β = -.33, adjusted R2 = 10.2%, p = .00) and gender (β = -.19, adjusted R2 = 2.7%, p = .05). for Practice: (1) The results of this study support the theoretical framework of the international classification of functioning, disability, and health (ICF): body structure and function, activity, and social participation are intercorrelated and affect QOL. (2) Compared with other critically ill patients, patients in this study exhibited a similar QOL as patients who underwent cardiac surgery. Regarding QOL, the patients in this study attained higher scores compared with other critical groups, but lower than normal norms. extra corporeal membrane oxygenation (ECMO), health status, quality of life (QOL), short-form 36-item questionnaire (SF-36).
73
CS12-004
The Investigation of Quality of Life Among Taiwanese Pancreas Transplantation Patients I-Wen Chang Yi-Ming Shyr Shin-E Wang
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Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan Taipei Veterans General Hospital, Taiwan
The world's first successful pancreas transplantation in conjunction with a simultaneous kidney transplantation was performed in 1966 by Dr. Lillehei and associates from the University of Minnesota. In Taipei Veterans General Hospital, the first pancreas transplantation (simultaneously coupled with kidney transplantation) was successfully performed on September 19, 2003, and we were qualified to harvest and transplant pancreas graft by the Taiwan Department of Health on August 31, 2007. Currently, pancreas transplantation remains the most effective method of establishing physiological and durable normoglycemia for patients with diabetes mellitus. Improving quality of life is one major indication for receiving pancreas transplant. However, no studies have been done among Taiwanese population. Quantatitive method will employ to explore quality of life for patients received pancreas/pancreas and kidney transplantations. This is a cross-sectional research design. Purposive sample was used. SF-36 was implanted as the measurement to understand the quality of life among Taiwanese pancreas transplantation population regarding physical and mental aspects. A total of 84 patients were interviewed, with 44 of them recived simultaneously pancreas and kidney transplantation (SPK) and 40 patients received pancreas transplantation alone (PTA). Overall quality of life did not very from SPK to PAK. SPK group demostrated higher physical qualityof life than PTA group. Age is not a factor influencing qulaity of life on both physical and mental aspect. The time after transplantation was one factor influcing quality of life. for Practice: Understanding quality of life improved the communitation between health care providers and transplatation candidates. It is a good fundation to set up a reasonable expecataion for pancreas transplantation candidates among Taiwanese population. simultaneously pancreas and kidney transplantation, SPK, pancreas transplantation alone, PTA, quality of life, Taiwan.
74
CS12-005
The Nursing Management From a Pain Status Survey at a Large Comprehensive Teaching Hospital Xu-Ping Xie
Sichuan University, China
Purpose:
To understand the nursing management in a large clinical status survey, through the practice of a pain status survey at a large comprehensive teaching hospital.
Methods:
Used a self-designed questionnaire on pain condition to survey the 3,248 hospitalized patients of West China Hospital of Sichuan University between the period of December 2011 to March 2012. Out of 3,248 patients, there are 1,642 males and 1,606 females. The average age is 47.34 ± 18.33 years old. 2,916 patients are of Han ethnicity, 145 patients are of other ethnicities, and 187 cases are missing information. The patients are married in 2,557 cases, single in 442 cases, divorced in 49 cases, remarried in 9 cases, widowed in 87 cases, and missing information in 104 cases. 1,219 patients are living with their spouses and children (or parents) , 628 are living with children (or parents), 1,091 are living with their spouses, 158 are living alone, 46 in other living arrangements, and 106 cases are missing information. Of all the patients, 1,195 are in the department of internal medicine, 1,041 are in the surgical department, 465 are in the department of oncology , 217 are in the department of obstetrics, gynecology, and pediatrics,112 are in the comprehensive ward, and 218 are in other wards. The pain prevalence rate for hospitalized patients at west china hospital was 63.08%. for Practice: Pain prevalence rate of hospitalized patients is quite high, and the patients' pain management situation is not optimistic. In both the pain management process at the hospital and the implementation of this survey project, effective nursing management, pain specialist knowledge training, and quality control in the survey process play a very important role in the successful completion of the project with high quality. pain, hospitalized patients, present situation investigation, nursing management.
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Implications
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75
CS13-001
Self-Transcendence and Depression in Taiwanese Men With Oral Cancer Hsiu-Chin Chen
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Chi Mei Medical Center, Taiwan
The purpose of this study is to examine the role of the self-transcendence in Taiwanese men with oral cancer, and explore the mediating effect of self-transcendence on the relationship between illness perception and depression, to determine if self-transcendence alleviates depressive symptoms. The study employed a cross-sectional correlational design in a convenience sample (N= 99) of Taiwanese men with oral cancer. After receiving institutional review board approved, the investigator planned to recruit the patient participants from a department of Otolaryngology, oral and maxillofacial surgery, and oncology at two medical centers in southern Taiwan. The inclusion criteria are male, ages 18 or older, ability to communicate in mandarin or Taiwanese, and agreeing to participate this study. The findings indicated that 41 (41.5%) of the participants were moderately or severely depressed. The mean of self-transcendence scale (STS) score was 42.98 (SD= 9.25). Participants with higher STS scores were less likely to see their depression (p< .01). The results showed that self-transcendence mediates the influences of negative illness perceptions on the health outcome of depression. for Practice: The results of this study provide some insights for health care provides caring for men with oral cancer with depressive moods in terms of acknowledging their potential for self-transcendence and its effects in diminishing level of depression, and also understanding the importance of the patient's perceptions of his illness. Assessment of oral cancer patients' self-transcendence, illness perceptions, as well as level of depression may provide useful data for patient interactions. Health care providers may consider providing interventions for facilitating self-transcendence as a method for diminishing oral cancer patients' depressive moods. self-transcendence, depression, oral cancer.
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CS13-002
Influencing Factors of Caregiving Rewards for Primary Caregivers of Older Persons With Mild to Moderate Dementia-A Longitudinal Study Chun-Hui Huang Yea-Ing Shyu
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Chang Gung University of Science and Technology, Taiwan Chang Gung University, Taiwan
The number of patients with dementia is increasing rapidly as the number of older population increased dramatically in recent years. The burden of care for these patients often falls on their family caregivers. Positive caregiving experiences, such as caregiving reward are able to decrease the caregiver burden and prolong the family care for patients with dementia. However, a lack of related studies on caregiving reward, especially the longitudinal changes of caregiving reward was found. The main purpose of this study was to explore the longitudinal changes and predictors for caregiving reward of family caregivers of patients with dementia. Secondary analysis using generalized estimating equations (GEE) to analyze a sub-sample of a 4-year, with each wave 1 year apart, longitudinal study on family caregivers of patients with mild and moderate dementia (N= 152) from a medical center in Northern Taiwan was conducted. After controlling for time and demographic variables, better mutuality between caregiver and patients, and preparedness of the family caregiver predicted better overall caregiving reward, better rewards of caregiver learning, rewards of being there and rewards of meaning for oneself. After controlling for time and demographic variables, caregivers with better spiritual life had better overall caregiving rewards, rewards of caregiver learning, rewards of being there and rewards of meaning for oneself. In addition, the older the patient with dementia, the better the overall rewards, better rewards of caregiver learning, rewards of being there and rewards of meaning for oneself was found. At the same time, the older the family caregiver, the better the rewards of meaning and rewards of being there was found. In terms of the longitudinal changes, rewards of learning had highest score at the fourth time point than the other time points. for Practice: The results of this study can increase our understanding of positive caregiving experiences and provide a reference for further development of related interventions. dementia, elderly, family caregivers, rewards.
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CS13-003
The Roles of Lifestyle Behaviors and Antipsychotics in Metabolic Syndrome Between Patients With Mental Illness and General Populations Wei-Fen Ma
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China Medical University, Taiwan
Metabolic symptom (MS) is a health problem comprising abnormalities in obesity, blood pressure, lipid, and glucose metabolism. The incidence of MS causes up to five-fold greater risk of mortality in patients with severe mental illness and may reflect a reason of 30 life years lost. The reasons of high prevalence of MS due to the environment or the pharmacological treatments for diseases in psychiatric patients are questionable. This study aimed to investigate the roles of lifestyle behaviors and antipsychotics in the risk of MS among patients with mental illness. A cross-sectional design with convenient sampling was used for this study. After IRB approval, study subjects in group one was collected from psychiatric clinics and group two from family medicine clinics at a university medical center in Taiwan. Subjects in group one had been diagnosed as schizophrenia, mood disorders, major depression, or anxiety disorders by clinical psychiatrists. Three instruments are involved to measure variables, including personal profiles, Chinese version of health promoting lifestyle profile-short, and physical health assessments for metabolic indicators. Differences of variables were examined by t-test and ANOVA to examine the roles of lifestyle behavior and atypical antipsychotic medications related to MS in study populations. The 304 research subjects were categorized into two groups (n= 150 in G1, n= 154 in G2). No different rate of MS was found in gender and two groups, but three criteria of MS (higher systolic pressure and diastolic pressure and lower HDL level) were found significant differences in patients with mental illness than them in general populations. Meanwhile, body fat, BMI, neck and hip circumferences, waist/ hip ratio, and five lifestyles (exercise, nutrition, social support, stress management and self-actualization) were also found significant differences between two groups. In addition, no different percentage of MS was found between patients with and without taking atypical antipsychotic medications. However, body fat, BMI, waist circumferences, neck circumferences, hip circumferences, diastolic pressure, waist/hip ratio, self-actualization and exercise were significantly different in patients with taking different medicines taking. for Practice: The lifestyles play important in MS status, especially exercise and self-actualization. Some differences were also found for patients with different medicines. Mental health nursing providers may use the results to develop intervention program and nursing strategies to prevent early-stage metabolic syndromes. antipsychotics, lifestyle, nursing, metabolic syndrome, risk.
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CS13-004
A Combined Quantitative and Qualitative Study of the Psychoeduation Intervention "Balancing My Swing" for Bipolar Disorder Pei-Chen Hsu Esther Ching-Lan Lin
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Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan National Cheng Kung University Hospital, Taiwan
This study aimed to explore the process and to test the preliminary effectiveness of the psychoeduation (PE) intervention, called as "balancing my swing", integrating with the interpersonal and social rhythm therapy (IPSRT), for patients with bipolar disorder in southern Taiwan. By using the qualitative and quantitative methodological triangulation, the process and effectiveness of the10-sessions weekly PE intervention in a group format for bipolar disorder were explored. Ten patients with a DSM-IV-TR diagnosis of bipolar disorder from a southern medical center in Taiwan were purposively recruited and sequentially separated into two groups for treatment feasibility. For qualitative part, each group session was videotaped and transcribed into verbatim in a week. Content analysis was used to analyze patients' concerns, treatment agendas and strategies, as well as group dynamics, structures, and issues. For quantitative part, the pre- and post-treatment assessments were conducted with 4 outcome indicators, including 17-item Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Drug Attitude Inventory (DAI), and Kemp's Compliance Scale (KCS). The essential treatment elements of the PE with IPSRT were reported as the follows: identifying the prodromal signs, saying goodbye to grief in the past, managing and living with mood symptoms, and keeping the normal daily rhythm. Several therapists' strategies and challenges were discussed. All outcome indicators showed significant improvements (p< .05) after treatment completed, except for the DAI scores. for Practice: The nurses-led PE with IPSRT is a promising intervention for bipolar disorder. Future studies are needed to confirm the treatment effectiveness. Clinical adaptations and cultural modifications for IPSRT modality also need to be considered. bipolar disorder, psychoeduation, interpersonal and social rhythm therapy, methodological triangulation.
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CS13-005
Elevated Healthcare Utilization Among Medical Patients Depression or Suicide Risks: Implications for Clinical Nurses Chia-Yi Wu Hsiu-Ying Chang
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With
National Taiwan University College of Medicine, Taiwan National Taiwan University College of Medicine, Taiwan
The nursing role in patients' health service utilization for comorbidities of physical and mental illnesses is an important yet less researched issue. The study aims to investigate prevalence of moderate-to-severe depressive symptoms and suicide risk in medical patients and service use in people with comorbidities. We investigated consecutive emergency medical patients who admitted to a hospitalist ward of a 2000-beded medical center in northern Taiwan during 2012-2013. Deyo's age-weighted Charlson Comorbidity Index (DCCI) was applied to indicate the severity of physical illness, with DCCI
