Journal of Nursing最新文献

Acute illness and hospitalization, key stressors for older adults, are associated with significantly elevated risks of disability and mortality. Physical resilience is defined as the ability of an individual to resist or recover from functional decline following health stressors. Nurses working in partnership with older adults to assist their development of physical resilience can promote disease and functional recovery. However, the definition, concept, and measurement of physical resilience in older adults lack consensus in the literature. Using the conceptual analysis approach of Walker and Avant (1995), the defining characteristics of physical resilience in older adults identified in this article include: (1) experiencing a new or acute stressor, (2) having sufficient physiological reserves to address this stressor, and (3) having the capacity to resist functional decline. These characteristics are demonstrated using case examples that offer relevant empirical indicators and highlight their application in nursing research and practice. This analysis is hoped to help improve the understanding of physical resilience in older adults among nurses and suggest pathways for application in clinical practice.

Public concern over violence against women and children is growing, with citizens demanding tougher punishments for offenders and closely monitoring court proceedings. Poor evidence collection not only undermines the rights of victims but also increases the risk of unduly light sentences for perpetrators. In cases involving women, children, violence, or accidental harm, hospitals face two urgent legal duties: to swiftly preserve original evidence to clarify accountability and to act before the narrow window for evidence collection closes due to medical intervention. For unconscious patients, despite the necessity of evidence speaking in their stead, Taiwan's healthcare system lacks an integrated forensic nursing service, leading to insufficient and weak evidence. This is a chronic and systemic issue that erodes victim rights and contributes to lighter penalties for offenders. Forensic nursing offers a critical solution by uniting healthcare and evidence preservation under a model that is recognized and supported internationally. In 2023, the Taiwan Nurses Association launched a forensic nursing training initiative that has since gained strong support from nursing professionals. However, creating a fully dedicated forensic nursing system still faces policy and resource challenges. Achieving this goal requires sustained public engagement, multi-stakeholder advocacy, and data-driven policymaking to establish a virtuous cycle of public demand, professional capacity, and government support. A comprehensive forensic nursing system is essential to upholding citizen rights and ensuring justice for the vulnerable.

Background: Preterm infants require specialized hospital care and are often separated from their parents, which may impact mother-infant attachment, parenting confidence, and parental stress negatively. Moreover, the vulnerability of preterm infants leads to lower parenting confidence among parents, increasing parental stress.

Purpose: This study was designed to examine the effectiveness of early parental sensitivity interventions on mother-infant attachment, parenting confidence, and parental stress in mothers of preterm infants.

Methods: A quasi-experimental study was conducted, with the participants, all mothers of preterm infants, assigned to either the experimental (n = 34) or control (n = 34) group. The control group received standard care instructions, while the experimental group received early parental sensitivity interventions, including a virtual reality tour of the neonatal intensive care unit, behavioral cue videos for premature infants, and participation in caregiving activities. The Maternal Attachment Inventory, Maternal Confidence Questionnaire, and Parental Stressor Scale: Infant Hospitalization were used to collect study data, with differences analyzed using generalized estimating equations.

Results: The experimental group showed higher average mother-infant attachment and parenting confidence and lower average parental stress than the control group during the third through fifth days after birth. However, no significant changes in these three variables were observed between the fifth day and one month after birth in either group.

Conclusions / implications for practice: The results of this study found that early intervention programs for mothers of preterm infants may not immediately establish attachment, build parenting confidence, or alleviate parental stress in a short period. It is recommended that the importance of continuous intervention be emphasized in future research.

Background: Stigma negatively affects the recovery of and care quality received by people with mental illnesses as well as the mental health of the entire population. As part of global anti-stigma trends, the teaching strategy of introducing recovered patients into classroom settings as "recovery educators" has been increasingly accepted and adopted. This strategy is designed to improve student attitudes toward mental illness while promoting self-identity and sense of value in recovered patients.

Purpose: By training patients with mental illness to become recovery educators and incorporating core related concepts, this study was designed to develop an anti-stigmatizing mental health nursing education model appropriate to the Taiwanese culture context.

Methods: A community participatory research approach was used to conduct a two-stage research process covering curriculum development and curriculum implementation. The participants included clinical professionals, nursing students, educators, recovery educators, and researchers. By conducting an inductive analysis of observational notes, meeting minutes, and reflective journals, the curriculum development process and outcomes were documented.

Results: The Recovery Educator Training Camp and Anti-Stigma Curriculum Including Recovery Educators were developed based on the findings. The course development and implementation process may be summarized under the following three themes: (1) The vision, hopes, and concerns associated with community partner recruitment, (2) Viewing recovery from different perspectives and promoting health equity, and (3) Innovating and developing anti-stigmatization elements into the course.

Conclusions: A community participatory research approach was used to develop "recovery patients as educators" as an anti-stigma mental health nursing education model. By allowing recovery educators to showcase their process of recovery and nursing students to interact directly with recovery educators, the developed model successfully facilitates recognition of recovery and promotes anti-stigmatization attitudes in both recovery educators and students.

The impact of gratitude on mental health and job stability in nurses is explored in this article, with a focus on relevant challenges and potential interventions. Based on a review of the literature, gratitude is a positive psychological resource that may effectively reduce stress, enhance psychological resilience and well-being, improve the workplace atmosphere, and reduce turnover intention. Gratitude, which encapsulates the recognition and response of an individual to the goodwill of others, may be cultivated through practice in nurses to further enhance job satisfaction and professional identity. Gratitude-related interventions such as keeping gratitude journals, writing letters, engaging in team activities, and practicing meditation have been shown to significantly reduce occupational burnout and stress. For example, recording three things one is grateful for each day or participating regularly in gratitude gatherings can improve interpersonal relationships and strengthen team cohesion. However, challenges such as high drop-out rates, limited intervention formats, and significant resource demands hinder organizations from fully implementing these interventions. Various measures to overcome these challenges, including taking regular gratitude walks and establishing gratitude walls, should be implemented while also ensuring that intervention designs are adequately adapted both culturally and contextually. In summary, gratitude interventions have the potential to significantly enhance the mental health of nursing staff while promoting their job satisfaction and retention. Future efforts should concentrate on advancing gratitude education and practices, optimizing intervention methods, and helping healthcare institutions address workforce shortages.

In this paper, meta-ethnographic synthesis is introduced as a qualitative systematic review method to provide researchers with a comprehensive theoretical foundation of this method and an understanding of its analytical steps. Grounded in interpretivism, this method incorporates Geertz's concept of "thick description" and Turner's concept of "translation" and emphasizes the exploration of meaning within cultural contexts. By continuously comparing and synthesizing similar and divergent concepts and metaphors across multiple qualitative studies, this approach highlights the cultural context and interpretive significance of integrated phenomena, thereby constructing higher-order interpretive frameworks. Moreover, comprehensive explanations are given of the seven phases proposed by Noblit and Hare (1988), i.e., getting started, determining relevant content for the initial inquiry, reading the studies, establishing how the studies are related, translating the studies into each other, synthesizing the translations, and presenting the final synthesis. Furthermore, potential applications of meta-ethnographic synthesis in the field of healthcare are described, including synthesizing multicultural caregiving experiences to elucidate the lived worlds of patients and caregivers. Meta-ethnographic synthesis not only fosters deeper cultural insights but also provides concrete qualitative evidence to inform policy-making and facilitates the translation and exchange of knowledge between academia and clinical practice. The insights provided in this paper highlight that meta-ethnographic synthesis, through its comparison and interpretation, offers unique insights into human experience and cultural diversity, enriching qualitative research with new perspectives and theoretical contributions.

Background: Taxanes are essential chemotherapy agents for breast cancer treatment. However, patients frequently experience chemotherapy-induced peripheral neuropathy (CIPN) during their course of treatment. Cryotherapy is a non-pharmacological approach that has been explored for its potential effects on preventing or improving CIPN. However, although several studies have reported on the effects of cryotherapy, no comprehensive review has been conducted to confirm its benefits.

Purpose: This study was designed to investigate the potential benefits of cryotherapy in terms of alleviating CIPN in patients with breast cancer undergoing taxane-containing chemotherapy.

Methods: This systematic review was conducted using databases including PubMed, Embase, Cochrane, CINAHL, Medline, and Airiti Library, focusing on female patients over 18 years old with breast cancer treated using taxane-containing regimen. Key words searched were based on the PICO (patient/problem, intervention, comparison, outcome) framework, and cover articles in the literature published up to December 2023. In this study, the Jadad Quality Scale was employed to evaluate the randomized controlled trials (RCTs), while methodological index for non-randomized studies was utilized for non-RCTs.

Results: The 11 studies used in this analysis included five RCTs comprising 198 patients and six non-RCTs comprising 1,930 patients. Five of the studies reported cryotherapy may help prevent CIPN, five reported cryotherapy may alleviate CIPN symptoms, and one study reported no significant prevention or alleviation effect.

Conclusions / implications for practice: Cryotherapy shows promise as a practical and safe method the prevention / alleviation of CIPN symptoms during chemotherapy treatment. However, the related evidence is inadequate, indicating a need for more rigorous studies to establish stronger evidence.

Background & problems: In recent years, awareness of the need to facilitate death with dignity has advanced significantly in Taiwan. Critically ill patients admitted to intensive care units (ICUs) often endure the pain of medical interventions. Therefore, providing comprehensive end-of-life care that respects patient dignity is crucial. A situational analysis revealed that the ICUs in our hospital lacked standardized care procedures, that ICU staff were unclear about the role of the palliative care team, and that related educational training was deficient. Further investigation showed the completeness rate of ICU nurse implementation of end-of-life care to be 46.3%.

Purpose: This project was developed and executed to increase the end-of-life care completeness rate to 85.0%.

Resolutions: Establish end-of-life care standard operating procedures; design a small portable reminder card featuring the slogan "Physical, Mental, and Spiritual Care" to help prompt nurses while on duty; and plan educational training and cross-team workshops that utilize a simple tabletop game to support course teaching and increase engagement and interactivity.

Results: Result: After full project implementation, the rate of end-of-life care completion was 88.4%.

Conclusions: The developed project effectively improved the integrity of end-of-life care provided by ICU nurses, alleviating the suffering of terminally ill patients and enhancing their dignity. The project also helped families face the grieving process with greater composure, improving the overall quality of end-of-life care provided in our ICUs.

Background & problem: A case of mishandled sexual assault forensic evidence in our unit during February 2022 potentially harmed the rights of the victim, the integrity of the legal procedure, and increased legal risks for our hospital.

Purpose: This incident led to a project aimed at improving emergency nurse accuracy in handling forensic evidence related to sexual assault.

Resolution: Strategies implemented included developing creative mnemonics, establishing diverse digital learning materials, producing instructional videos on sexual assault forensic evidence handling procedures, refining training for newly recruited personnel, organizing regular in-service education sessions, and conducting scenario-based simulations.

Results: Result: The accuracy rate of emergency nurses in handling sexual assault forensic evidence rose from 65.7% before project implementation to 94.5% after project implementation.

Conclusions: The project significantly improved sexual assault forensic evidence handling among emergency nurses in our hospital using phased and gamified learning methods to enhance motivation and improve professional competence.

Background: Pingtung is a county in Taiwan that covers a large area and a population marked by significant cultural diversity. Healthcare programs in the county must take geographical and cultural needs into consideration to create a person-centered, friendly-care model for the county's older adult residents.

Purpose: This study was designed to explore the experiences of community nurses in Pingtung County caring for adults in the community and identify related core competency needs.

Methods: A focus group research method was used, and community nurses were recruited to participate in focus group discussions. Each focus group included 10 to 12 nurses, and each session lasted about 120 minutes. The interview data were recorded, transcribed, content analyzed, and rigorously controlled.

Results: The two discussion sessions organized for this study were both held on August 9, 2012, with a total of 12 head nurses and 13 registered nurses participating. The researchers identified the following six themes: 1. Training of cross-cultural community care and systemic care capabilities; 2. Cultivation and improvement of professional capabilities; 3. Improving capabilities of evidence implementation and innovative ideas; 4. Promoting evidence implementation and self-identity; 5. Leadership management transformation and organizational reengineering; 6. Optimizing dementia care and creating a more patient-friendly atmosphere.

Conclusions: Community nurses play an important role in maintaining and improving public health. Special needs such as aging, multiculturalism, geographical characteristics, and dementia requires that systematic care provided be sensitive to cultural characteristics, work to improve evidence-based application capabilities, and strengthen leadership and management.