Journal of Nursing最新文献

Background: The National Comprehensive Cancer Network recommends qigong as an aerobic exercise for reducing cancer-related fatigue in breast cancer survivors. However, findings regarding the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in this population remain inconclusive and contradictory. Further study is warranted to better understand the impact of this exercise.

Purpose: The aim of this study was to assess the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in breast cancer survivors using a systematic literature review and meta-analysis.

Methods: The search of the literature was conducted in accordance with PRISMA 2020. The databases searched included PubMed, EMBASE, Cochrane Library, CINAHL, and Airiti Library, and relevant articles published between inception and March 2024 were retrieved systematically. The quality of the retrieved articles was assessed using the Risk of Bias 2.0 tool, and statistical analyses were performed using Comprehensive Meta-Analysis Version 2.0.

Results: Eight randomized controlled trials with a total of 469 participants were analyzed. Qigong was shown to significantly reduce cancer-related fatigue (SMD = -0.86, 95% confidence interval, 95% CI [-1.24, -0.48], p < .001) and sleep disturbance (SMD = -1.03, 95% CI [-1.36, -0.69], p < .001) and to improve overall quality of life (SMD = 0.59, 95% CI [0.27, 0.92], p < .001).

Conclusions / implications for practice: Qigong exercises that include specific "moving meditation" and "dynamic posture" components and are performed for session durations of 60 to 90 minutes with 3 to 5 sessions per week for a period of 8 to 12 weeks may reduce cancer-related fatigue and sleep disturbance in survivors of breast cancer. Furthermore, the overall effects of these improvements were shown to enhance survivor quality of life.

Background: Resilience, an increasingly important concept in the field of mental illness, refers to the active process by which individuals with mental illness positively adapt to adversity, facilitating their reintegration into society and return to the community. However, the recent pandemic has significantly impacted rehabilitation facility operations, affecting rehabilitation processes and personnel management. Thus, in the post-pandemic period, there is a need for empirical studies to revalidate the resilience of patients in halfway houses and the factors influencing it.

Purpose: The aims of the study were to explore the resilience and important factors of influence in patients with schizophrenia residing in halfway houses.

Methods: A cross-sectional survey design was employed, targeting individuals with schizophrenia residing in community rehabilitation homes in northern Taiwan. A convenience sampling method was used and 228 participants were enrolled. Research tools used in this study included measures of personal demographics, psychiatric symptoms, cognitive functions, attitudes towards medication, social support, and resilience.

Results: The average resilience score was 21.87 (SD = 8.24), with 62.7% of the participants classified with low resilience. Resilience was found to correlate significantly with age group, educational level, ability to self-administer medication, participation in computer-based rehabilitation programs, cognitive functions, attitudes towards medication, and level of social support. However, the factors identified as statistically significant were limited to attitudes toward medication, ability to self-administer medication, and participation in computer-based rehabilitation programs.

Conclusions / implications for practice: A majority of the participants, patients with schizophrenia residing in community rehabilitation homes, exhibited low resilience. This highlights the need for community mental health case managers and rehabilitation home nursing staff to work closely with these patients to enhance their resilience. Particular attention should be paid to patients' ability to self-administer medication, their attitudes toward medication, and their participation in computer-based rehabilitation programs.

Background: Foot complications, common among diabetic patients, often lead to amputation and increased dependence on daily living assistance. Effective and sustained intervention programs are important challenges that nursing staff must address.

Purpose: This study was designed to explore the effectiveness of a digital multimedia foot ulcer care program on the foot health beliefs and self-care behaviors of diabetic patients.

Methods: An experimental research design was adopted, with a total of 62 patients with type 2 diabetes in the plastic surgery ward of a regional hospital in southern Taiwan enrolled as participants. The participants were randomly assigned to either the experimental group (n = 31), which received a digital multimedia foot ulcer care program via mobile phones or tablets for eight weeks, or the control group (n = 31), which received conventional diabetic foot care education leaflets. The research instruments included a demographic questionnaire, the Diabetic Foot Ulcer Health Belief Scale, and the Diabetic Foot Care Behavior Scale. Data were collected at baseline, four weeks, and eight weeks, and were analyzed using SPSS 22.0.

Results: The study was completed with 30 participants in both groups. The experimental group showed significantly greater improvements in health beliefs at the fourth and eighth weeks post-assessment than the control group, with increases of 3.77 and 5.13, respectively (p = .03, p = .02). These improvements were statistically significant and exceeded baseline values significantly (p < .05). In terms of self-care behaviors, improvements in the experimental group exceeded those in the control group by 2.27 and 1.83, respectively, at four and eight weeks (p = .03, p = .05). Furthermore, the experimental group exhibited superior changes in scores compared to the control group.

Conclusions / implications for practice: The digital multimedia foot ulcer care program implemented in this study significantly enhanced health beliefs and self-care behaviors in patients with diabetic foot ulcers. This program may be employed during hospitalization and post-discharge to improve foot ulcer care techniques and reduce diabetic foot ulcer deterioration.

Artificial intelligence (AI) is driving global change, and the implementation of generative AI in higher education is inevitable. AI language models such as the chat generative pre-trained transformer (ChatGPT) hold the potential to revolutionize the delivery of nursing education in the future. Nurse educators play a crucial role in preparing nursing students for a future technology-integrated healthcare system. While the technology has limitations and potential biases, the emergence of ChatGPT presents both opportunities and challenges. It is critical for faculty to be familiar with the capabilities and limitations of this model to foster effective, ethical, and responsible utilization of AI technology while preparing students in advance for the dynamic and rapidly advancing landscape of nursing and healthcare. Therefore, this article was written to present a strengths, weaknesses, opportunities, and threats (SWOT) analysis of integrating ChatGPT into nursing education, providing a guide for implementing ChatGPT in nursing education and offering a well-rounded assessment to help nurse educators make informed decisions.

The current uses, potential risks, and practical recommendations for using chat generative pre-trained transformers (ChatGPT) in systematic reviews (SRs) and meta-analyses (MAs) are reviewed in this article. The findings of prior research suggest that, for tasks such as literature screening and information extraction, ChatGPT can match or exceed the performance of human experts. However, for complex tasks such as risk of bias assessment, its performance remains significantly limited, underscoring the critical role of human expertise. The use of ChatGPT as an adjunct tool in SRs and MAs requires careful planning and the implementation of strict quality control and validation mechanisms to mitigate potential errors such as those arising from artificial intelligence (AI) 'hallucinations'. This paper also provides specific recommendations for optimizing human-AI collaboration in SRs and MAs. Assessing the specific context of each task and implementing the most appropriate strategies are critical when using ChatGPT in support of research goals. Furthermore, transparency regarding the use of ChatGPT in research reports is essential to maintaining research integrity. Close attention to ethical norms, including issues of privacy, bias, and fairness, is also imperative. Finally, from a human-centered perspective, this paper emphasizes the importance of researchers cultivating continuous self-iteration, prompt engineering skills, critical thinking, cross-disciplinary collaboration, and ethical awareness skills with the goals of: continuously optimizing human-AI collaboration models within reasonable and compliant norms, enhancing the complex-task performance of AI tools such as ChatGPT, and, ultimately, achieving greater efficiency through technological innovative while upholding scientific rigor.

This case report addresses the author's experience providing nursing care to a 37-year-old patient diagnosed with multiple myeloma requiring regular renal dialysis due to disease progression who received autologous stem cell transplantation. The patient was diagnosed with cancer in young adulthood and, as a father figure, faced various psychological issues associated with the unexpected challenges encountered during their treatment phase. Psychosocial health, which is closely associated with quality of life in patients with cancer, has gained increasing attention in recent years. The limited research published on the subject of fathers diagnosed with cancer encouraged the author to detail her experience with this case. The care period was from August 5th to August 19th, 2022. During the care period, the Gordons's 11 functional health assessment was applied, with potentially severe infections, coping disorders, anxiety, potential risk of injury existing or potential nutritional deficiencies, oral mucosal changes, and diarrhea identified as the primary health problems of concern. Nursing interventions applied included providing protective isolation measures to prevent post-transplant infection, helping the patient learn effective ways to cope with emotional distress, and providing comprehensive follow-up care information and health education to alleviate the anxiety associated with hospital discharge and life after discharge. The challenges of providing nursing care to adolescent and young adult patients differ significantly from those faced in the care of either elderly or pediatric patients. Furthermore, although extensive research has been conducted on mothers diagnosed with cancer, little research has addressed the impact on the paternal role when fathers are diagnosed with cancer, with limited information available regarding their psychological concerns and issues or the impact on family dynamics. The author hopes this case care experience offers an insightful reference and guide for nursing practice that contributes to a better understanding of the psychological aspects of young adult fathers diagnosed with cancer and facilitates more appropriate care in clinical settings.

Background: After enactment of the Patient Right to Autonomy Act in Taiwan, most of the individuals participating in advance care planning (ACP) and signing advance decisions (AD) have been healthy adults. This demographic is inadequately covered in the literature, in which related studies focus primarily on individuals with major illnesses.

Purpose: This study was implemented to understand the experiences of healthy adults participating in ACP.

Methods: A qualitative approach was taken and participants were recruited from ACP outpatient clinics in three hospitals in northern, central, and southern Taiwan. All of the participants were healthy adults who had completed the ACP process, did not have a major illness, had no psychiatric diagnoses, and could express themselves clearly. Data were collected via semi-structured interviews and analyzed using content analysis.

Results: A total of 15 participants were interviewed, generating three major themes: "Establishing the foundations of ACP", "Preserving dignity in end-of-life care", and "Key elements for successful ACP". Their motivation to engage in ACP and sign the AD form was influenced by past experiences and a desire to maintain dignity and physical autonomy through the aging process. Their decision-making processes were influenced by family opinions, sociocultural factors, and systemic dynamics.

Conclusions / implications for practice: During the ACP and AD signing process, the consulting team not only helps healthy adults successfully provide informed consent but also, by fostering a supportive communication environment, ensures medical preferences and expectations are accurately reflected, thus promoting mutual care, support, and understanding among all parties.

Background: Job satisfaction in nurse practitioners is influenced by the level of autonomy and empowerment they perceive within their practice environment. Little in-depth research has been done to explore the relationship among organizational climate, leadership style, and job satisfaction in the context of nurse practitioners.

Purpose: This study was developed to explore the relationship among organizational climate, leadership style, and job satisfaction in nurse practitioners with the goal of enhancing their job satisfaction.

Methods: A cross-sectional correlational approach and snowball sampling method were employed to recruit 400 qualified nurse practitioners to complete an online survey. This survey was a structured questionnaire consisting of the Practice Organizational Climate Scale, Leadership Style Scale, and Job Satisfaction Scale. Statistical analyses used included the independent t test, one-way ANOVA, Pearson's correlation, and multiple linear regression analysis.

Results: Most of the participants were 31 to 50 years old. A significant and positive correlation was identified among overall organizational climate, leadership style, and job satisfaction. In terms of organizational climate components, only professional visibility was not found to significantly correlate with job satisfaction. Transformational leadership, servant leadership, independent work, and relationships with support and management departments collectively explained nearly 72.4% of overall job satisfaction.

Conclusions / implications for practice: The findings demonstrate job satisfaction in nurse practitioners to be significantly influenced by organizational climate and leadership style. Thus, fostering a positive organizational climate and enhancing transformational and servant leadership styles may be expected to improve job satisfaction in this group substantively. Therefore, it is recommended healthcare institutions focus on improving the organizational climate, providing more autonomy and support, and enhancing leadership training for supervisors with the goal of increasing overall job satisfaction and retention rates among nurse practitioners.

Background: End-of-life care in long-term care institutions is increasingly important. Nursing assistants are the primary care workforce, and their end-of-life care capabilities affect the quality of care provided to residents as well as residents' physical and mental health.

Purpose: This study was designed to explore the life attitudes, fear of death status, end-of-life care abilities and experience, and coping styles of nursing assistants in long-term care institutions in the eastern region and the effects of these variables on care.

Methods: A cross-sectional, mixed-methods research design was used. The study included 165 nursing assistants working in long-term care facilities in Taitung and Hualien counties. The study questionnaire included items covering life attitudes, fear of death, and dying care abilities. In addition, in-depth interviews were conducted with 12 of the participants.

Results: Most of the participants held positive attitudes toward life and reported having a low to moderate fear of death. A significant and positive correlation between life attitude and dying care ability was identified (r = .426, p < .001). Although average ability to provide physical care to residents at end of life was found to be relatively good, ability to provide emotional support and allow residents to express their emotions was generally poor. The scales of fear of death, life attitude toward love and care, ideals, and high school education were identified as significant predictors of dying care ability, together explaining 22.8% of the variance. The interview results were summarized into five major themes that also echoed the quantitative results.

Conclusions / implications for practice: Attitudes toward life and fear of death partially were shown to influence the dying care ability of the nursing assistants in this study. Dying care skills should be strengthened in nursing assistants, and they should be encouraged to explore the meanings of life and death through on-the-job education. Also, long-term care institutions should show concern for and support their nursing assistants by sponsoring case discussions, care experience sharing sessions, and support groups.

Background & problems: Joint replacement wound stitches are typically not removed until two weeks after the operation. Therefore, patients with joint replacement must be able to execute proper wound care after discharge from the hospital to reduce the risk of wound infection. Prior data from Chang Gung Memorial Hospital's orthopedics ward indicate only 69% of joint-replacement patients are able to perform wound care properly at home. Potential causes for this noted by patients include age-related forgetfulness, being unable to discern redness or swelling in the wound, and language comprehension difficulties (i.e., Taiwanese vs. Mandarin). Poor rates of wound care may also be attributable to incomplete wound care education by nursing staff and wound care education being provided without adequate practice on the day of patient discharge.

Purpose: This project was implemented to improve the accuracy of wound self-care performed by patients after joint replacement surgery and to enhance their related knowledge and wound-care technical correctness.

Resolution: A wound care education checklist, wound care cue cards, wound care video clips, wound condition red flag cue cards, and customized wound care pack were proposed and implemented.

Results: The rate of accuracy of wound self-care performance increased from 69% pretest to 98% posttest, showing the intervention to have effectively improved post-discharge wound care quality.

Conclusions: To effectively improve the post-discharge accuracy of wound self-care in patients with joint replacement, the consistency of post-surgery wound care education given by nursing staff to patients should be improved, patients should be reminded of wound assessment and care steps, and patients should be aware that wound abnormalities require an immediate return to the hospital for follow-up treatment.