Journal of Nursing最新文献

Nursing information systems are becoming increasingly prevalent in our medical institutions. However, changes in the social environment and imbalances between the demands of caregivers and care recipients mean that current nursing information systems are inadequate in terms of quality and operational needs. This article was written to provide insights into opportunities to leverage technology to further promote care quality by applying a "data, information, knowledge, and wisdom" system development structure to develop intelligent technology products that equitably meet the needs of patients, caregivers, and nursing processes. Applied in clinical settings, these products should help satisfy patient needs and facilitate nursing work.

After post-coronary artery bypass surgery, patients often experience physiological issues such as pain and complications as well as psychological issues such as fatigue and depression. These issues may burden family caregivers and impact patient quality of life. Therefore, a comprehensive, multidisciplinary integrated care plan is needed to expedite postoperative recovery and reduce the social burden on patients. In recent years, government promotion of integrated healthcare, including the implementation of postoperative accelerated recovery care models, has led to the introduction of the enhanced recovery after surgery program as part of post-cardiac surgery integrated care. This program, providing combined care that is multidisciplinary and evidence-based, incorporates elements such as the provision of carbohydrate drinks, multimodal pain management, and fluid management. Reducing to a minimum the emotional and physiological stresses on patients facilitates a faster return to normal functionality. In this paper, a literature review is conducted to provide a reference for future post-coronary artery bypass surgery care by clinical teams, with the aim of offering an integrated approach to patient care.

Background: Colorectal cancer (CRC) is a primary cause of cancer-related mortality, and, after treatment, cancer survivors often worry that disease recurrence may worsen their health. Nevertheless, limited research on fear of cancer recurrence (FCR) and treatment-related symptoms has been conducted on survivors of CRC.

Purpose: This study was designed to explore (1) symptom distress severity and post-treatment FCR in CRC survivors and (2) the predictors of FCR.

Methods: A cross-sectional correlational research design and convenience sampling approach were used to recruit patients at the colorectal surgery outpatient department of a medical center in central Taiwan. Basic demographic data, the Symptom Distress Scale - Chinese Modified Form, and Fear of Progression Questionnaire - Short Form were used as monitoring tools. Pearson's product-moment correlation analysis, independent t-tests, one-way ANOVA, and stepwise linear regression analysis were used for statistical analysis.

Results: One hundred fourteen survivors of CRC with an average age of 63.44 were enrolled as participants. The top five symptoms of distress were numbness, bowel patterns, fatigue, insomnia, and dry mouth, and the average FCR score was 18.09. Gender, educational level, monthly disposable income, and symptom distress were identified as significant predictors of FCR, with an overall explanatory power of 41.4%.

Conclusions: Level of post-treatment FCR in survivors of CRC is influenced by symptom distress severity. Early intervention by healthcare providers to control or alleviate physical symptoms can help prevent the emergence of negative emotions and improve quality of life in this patient group.

Because of the critical importance to national healthcare of developing and applying smart technologies to address the needs of Taiwan's rapidly aging society, "gerontechnology" is an industry sector that must be promoted to achieve related policy goals. The scope of technologies involved in gerontechnology is broad, with the application of smart technology often the focus of industrial development. The most crucial feature of gerontechnology-related "smart" products is the collection, analysis, and feedback of target data in the application process necessary to facilitate the provision of "precision" aged care. The application of smart technology to meet the rapidly increasing life and care needs of older adults in aging societies is increasingly valued worldwide. However, the practical implementation of smart technology in aged care is still not widespread, and thus represents an urgent problem to be solved. There are many aspects to consider in the practical application of gerontechnology, among which caregivers are the key to practical application, with product suitability being the first concern of caregivers. In this article, a process is proposed to allow caregivers to assess the suitability of gerontechnology smart products in terms of "data sensing and transmission," "indicator identification and analysis," "event prediction and feedback," and "intervention measures." Based on the World Health Organization's concept of implementing research in healthcare, decision-making evaluation indicators for product selection and a product suitability questionnaire for institutional care are proposed with the goal of providing a practical tool for care institutions to assess the suitability of gerontechnology smart products.

Background: Critically ill neonates receive care in the neonatal intensive care unit (NICU). Unfortunately, some neonates pass away in the NICU. Providing comprehensive neonatal palliative care and hospice services is crucial in supporting parents through the loss of their offspring. In our NICU, we identified that only 74.5% of nurses are able to properly recognize the need for palliative care and only 55% are able to implement the necessary procedures.

Purpose: A project was designed and implemented to enhance the ability of nursing staff to recognize the need for and properly implement palliative care to improve the quality of this care in the NICU.

Resolutions: We organized an on-the-job education and training program within our NICU with the goals of heightening awareness among nursing staff. In addition, a specialist palliative care operation flow chart, process preparation checklist, and palliative-care-related tools were created to facilitate the care process.

Results: After program implementation, among nursing staff in our NICU, the palliative care recognition accuracy rate rose to 100% (from 74.5%) and the implementation rate rose to 94.8% (from 55%). The quality of provided neonatal palliative care and hospice services was significantly improved.

Conclusions: The developed program was shown to significantly improve nursing staff recognition and implementation of neonatal palliative care in our NICU. This experience provides a reference for improving palliative care quality and for helping families effectively manage end-of-life challenges.

The rapid development of technology in recent years has not only transformed everyday life but also profoundly impacted the fields of healthcare and caregiving. Approaches to care that are technology-based and human-centered may be used to provide care services that are more efficient, accurate, and personalized and that, ultimately, improve our quality of life and overall health. First, intelligent health monitoring systems can generate customized health management plans based on individual health conditions and needs, allowing chronic diseases to be managed more effectively and helping prevent disease onset. Examples of these systems include smart medication dispensers (Gargioni et al., 2024) and fall prevention exercise apps for older adult patients (Czuber et al., 2024). Also, in clinical settings, especially in the context of monitoring patients in operating rooms and intensive care units, visualization technologies are using psychology and cognitive neuroscience principles to leverage human sensory perception to improve caregiver understanding of information. Patient data are presented using different shapes, colors, and animation frequencies, which are more effectively perceived, integrated, and interpreted than other formats (e.g., numbers). This helps healthcare professionals effectively perceive and identify potential medical issues, enhancing their situational awareness, helping them make better decisions, and improving patient safety (Gasciauskaite et al., 2023). In the field of rehabilitation, Krishnan et al. (2024) developed a wearable rehabilitation device to facilitate gait rehabilitation in post-stroke patients that exhibits better durability, modularity, and usability than previous technologies. In addition, for patients with upper limb impairments who experience varying degrees of ability loss in performing activities of daily living, robotic platforms have been introduced to facilitate intensive and repetitive exercises that strengthen motor skills and neuroplasticity (Bucchieri et al., 2023). In conclusion, human-centered technology care is a field ripe with potential that combines the power of technology with human-centered care to improve support and service capabilities. Articles in this issue explore the application of social robots in nursing practice, the applicability of smart technology in cardiac and elderly care, and the opportunities for next-generation smart care. We look forward to seeing more human-centered technology care solutions in the future that further promote health, well-being, and comprehensive social development.

Recent, rapid advancements in technology have enabled the introduction and integration of robots into everyday life. Different from the traditional image of robots as cold and mechanical, social robots are designed to emulate human interaction patterns, improving the user experience and facilitating social interactivity. Thus, social robots represent a promising new care intervention. In this article, after defining social robots and explaining the factors influencing "human-robot interaction", the authors discuss the effectiveness of social robots in the context of providing care to patients with dementia and autism as well as to pediatric patients. Finally, current cases in which PARO, a social robot, has been used in nursing are described, and key challenges and suggestions for future social robot applications are given. Current evidence indicates social robots must be developed and designed to adhere to a people-centered approach to achieve better robot-assisted care outcomes, be better accepted by patients, and better enable patients to open up emotionally and maintain good physical, mental, and social well-being.

Background: Poor disease control in patients with chronic obstructive pulmonary disease (COPD) is associated with suboptimal inhaler use.

Purpose: This study was designed to explore the accuracy of inhaler use and related factors in elderly patients with COPD.

Methods: A cross-sectional survey design was used to recruit patients with COPD from a medical centre in southern Taiwan who were over 65 years old and used inhalers regularly. All of the data as well as information on inhaler use accuracy were collected using a self-designed questionnaire and inhaler operation checklist. Multivariable logistic regression was used to analyse significant correlates of correct inhaler operation.

Results: The average age of the 150 participants was 75.0 years (SD = 7.5) years. Most used one type of inhaler only (86.0%). The rate of accurate inhaler operation was 40.7% (n = 61) for the sample, with dry powder inhalers associated with the highest accuracy (64%) and pressurized metered-dose inhalers associated with the lowest accuracy (1.6%). Multivariate logistic regression analysis showed that using a soft mist inhaler (adjusted odds ratio, AOR = 23.29; 95% confidence interval, 95% CI [2.84, 191.07]), using a dry powder inhaler (AOR =15.60, 95% CI [1.99, 122.26]), and higher satisfaction with the inhaler were positively and independently associated with accurate inhaler use (AOR = 1.94, 95% CI [1.09, 3.44]).

Conclusions / implications for practice: Important factors related to inhaler use accuracy include inhaler type and level of patient satisfaction with their inhaler. Healthcare professionals should regularly confirm that older patients are able to use their inhalers correctly and are satisfied with their inhalers.

The COVID-19 pandemic led to significant burnout among nurses, resulting in a shortage of nursing staff. Issues related to nursing work have received significant attention recently, and only healthy nurses are capable of providing good quality patient care. The authors employed Bronfenbrenner's Ecological System Theory to analyze the impact of the COVID-19 pandemic on nurses and proposed specific strategies and recommendations to enhance the nursing workplace. Under the Ecological System Theory, several factors, including inadequate preparedness, dangerous working environment, work-family conflicts, discrimination due to public panic, and health damage, contribute to nurse burnout. Whether during or after the COVID-19 pandemic, it is necessary to provide education programs to enhance the professional abilities of nurses, foster policies that promote a positive practice work environment, implement a triage system based on the severity of patients, elevate the image of the nursing profession, monitor the health of nurses, and advocate for transformational leadership. The nursing workplace should help nurses gain greater confidence and improve their ability to handle various workplace challenges. In the future, medical institutions should provide a better work environment for nurses and expect the public to pay more attention to the development of the nursing profession.

The most direct challenge to the healthcare system in Taiwan associated with population aging is the chronic and growing shortfall in medical and nursing practitioners. The integration of artificial intelligence, Internet of Things, and advanced 5G communication technologies is making healthcare more streamlined and intuitive to improve healthcare service efficiency, encourage cross-disciplinary cooperation to improve patient health management, and introduce and mainstream innovative service models such as telecare. To this end, the wearable smart cardiac care system 'Vipasyana', jointly developed by the interdisciplinary research team of the Departments of Electrical Engineering and Computer Science at National Yang Ming Chiao Tung University, not only has an innovative fully functional wireless wearable electrocardiograph but also uses machine learning-based detection/prediction methods to detect and monitor for emergencies such as myocardial infarction, ventricular tachycardia/ventricular fibrillation, and heart failure. To handle the real-time streaming sensing data generated during clinical trials, a big data real-time streaming framework based on Apache Storm and microservices has also been integrated. In addition, a mobile phone app and virtual reality 3D ward round system providing a user-friendly management and monitoring tool for medical staffs were developed and integrated into the system. The 'Vipasyana' system is capable of providing precision medical services to individual patients.