Journal of Nursing最新文献

Important concepts in leadership management related to the field of medical care management include servant leadership, charismatic leadership, and transformational leadership. Since the 2020 emergence of the coronavirus pandemic, the world has faced the immediate challenges of epidemic prevention and control. Although national government and medical system officials as well as scholars have weighed in on this issue, their leadership does not appear to line up the core ideas of leadership. Daft and Lengel (2000) examined the influence of fusion leadership on individuals and organizations. The fusion of many nuclei of leadership intentions will produce great power and influence. To elucidate the concept of integrated leadership for individuals and organizations in the post-pandemic healthcare system, this paper summarizes the defining characteristics of fusion leadership based on the conceptual analysis method of Walker and Avant (2019). Concurrently, we confirm the antecedents and consequences of fusion leadership, use different cases to illustrate the analysis, and share the reference indicators and measurements of fusion leadership to provide a reference for healthcare system administrators.

Background: Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings.

Purpose: The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity.

Methods: During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated.

Results: The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89.

Conclusions / implications for practice: The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.

Teaching in English (aka English as a medium of instruction [EMI]) presents a significant challenge for many university instructors. This is particularly true for those who have never taught an EMI course before, as they may feel confused, anxious, and unsure how to start. Beyond the challenge of the language itself, the pressure of conveying specialized knowledge in a non-native language and ensuring student comprehension are major sources of stress. This article was developed to share and explore the approach and experience of a field instructor teaching his first EMI course in STEM (science, technology, engineering, and mathematics). In the article, the anxieties and worries that may arise prior to starting the course and strategies that may be used to overcome these are discussed. In addition, measures that teachers may use to effectively manage classes and ensure student understanding during the course and to continually enhance teaching quality are addressed. We hope this article can help those interested in or required to teach EMI courses successfully take the first step and continue to improve with confidence, enhancing their teaching abilities.

COVID-19 has been a global pandemic for three years. Symptoms experienced by patients with this disease include fever, cough, fatigue, muscle pain, and diarrhea as well as mental health issues. The terms "coronasomnia" and "COVID-somnia" emerged in 2021 to describe sleep disorders attributable to stress associated with the COVID-19 pandemic. In this study, the concept analysis method proposed by Walker & Avant (2019) was utilized to define the concept of coronasomnia (Walker & Avant, 2019), with three key attributes identified, including COVID-related anxiety or depression; insomnia that emerges after the pandemic; and experiencing difficulty falling asleep, interrupted sleep, or early morning awakenings accompanied by difficulty returning to sleep. Furthermore, the concept was elucidated in this study using typical, borderline, opposite, and relative cases. Lastly, evidence-based tools for validating the antecedents and consequences of coronasomnia were introduced. We hope the results of this concept analysis enhance nurses' understanding of coronasomnia and facilitate the implementation of clinical care and research in this area.

With the rise of the medical tourism industry in Taiwan and changes in the country's population structure, nurses are facing greater challenges than ever before. Both professional knowledge and English proficiency are indispensable. Various types of English for Specific Purposes (ESP) courses have emerged to assist healthcare professionals to build their English abilities and cope with the changing demands of their profession. However, related research indicates that the deficient state of English communication skills among nurses in Taiwan may hinder the country's ability to effectively promote medical internationalization and handle ongoing changes in its population structure. To effectively face this predicament, educators must re-examine the current design of ESP courses. Therefore, this article was developed to explore ESP courses from the three perspectives of language descriptions, needs analysis, and learning theories. Furthermore, the concepts and research related to these three perspectives, including the nurse-patient relationship, community of practice, situated learning, and English as a medium of instruction, were reviewed. Some insights into how these concepts may be applied to ESP courses are also proposed with the goals of better incorporating the needs of learners into course designs and placing learners at the center of language learning.

Higher education is becoming increasingly internationalized, and English as a medium of instruction (EMI) for academic content has become commonplace in countries where English is not a native language. However, concerns are growing that the fast-growing trend of EMI lacks sufficient consideration of the related challenges with regard to implementation and impact. As a complex phenomenon, EMI requires increased awareness of its positive and negative implications for teachers and students. The attitudes and perspectives of teachers and students play a significant role in influencing the promotion and effectiveness of EMI teaching. Nevertheless, internationalization is essential for the advancement of nursing education. Therefore, it is imperative to understand the perspectives and challenges faced by teachers and students with regard to EMI and their readiness to embrace it. Therefore, in this article, we first define EMI and describe the reasons for its introduction and then discuss the challenges that teachers and students involved with EMI face in order to provide a reference for nursing education policymakers and academic institutions tasked with EMI development and implementation.

Background: Individuals in the asymptomatic incubation period of COVID-19 are highly contagious. This threat of asymptomatic transmission contributes to increased stress among nursing staffs and undermines their resilience.

Purpose: This study was designed to explore the correlates and predictive factors of resilience in the contexts of work stress and job satisfaction among nursing staffs.

Methods: A cross-sectional study design was employed on a convenience sample of 408 nurses. The survey included a demographic datasheet, the Nurse Occupational Stressor Scale, Job Satisfaction Scale, and Resilience Scale. Inferential statistics were conducted using independent sample t test, Pearson correlation analysis, and stepwise multiple linear regression.

Results: The participants were an average 32.6 years old. The average resilience score indicated a "moderate" resilience level. Resilience was treated as the dependent variable, while the demographic variables, Nurse Occupational Stressor Scale score, and job satisfaction dimension scores were treated as independent variables. Stepwise regression analysis was used to identify the key predictors of resilience, which included professional autonomy and development (β = .468, p <.001), occupational hazards (β = .163, p <.001), interpersonal interaction and collaboration (β = .223, p < .001), self-perceived economic status (β = -.093, p < .05), supervisor's leadership style (β = -.118, p < .05), and marital status (β = .078, p < .05). The model explained 39.4% of the total variance.

Conclusions / implications for practice: The results of this study support healthcare providers promoting resilience in several specific ways. Healthcare organizations should enhance professional competence through professional education and training programs; improve workplace safety; foster an atmosphere conducive to team cooperation; provide job support through mentorship and apprenticeship systems and caring leadership from nursing supervisors; continuously conduct caring and stress-relief activities; and utilize online self-report health questionnaires to enable nursing staff facing psychological and emotional challenges to seek professional counseling and support. Enhancing resilience strategies on a long-term basis can improve the mental health of nursing staff, which may be expected to enhance the quality of patient care.

Background: The 2005 revision of the code of ethics for nurses has been in effect in Taiwan for more than 17 years. Although this code has been smoothly implemented during this time, changing social expectations and ethical perspectives, advancements in science and technology, and the evolution of the nurse-patient relationship suggest this code should be once again be updated.

Purpose: This study was conducted to suggest revisions to the Taiwan code of ethics for nurses necessary to meet current needs and address social and medical care environment trends.

Methods: A multivariate research approach was adopted. The classification of the code of ethics for nurses norms in six international nursing organizations and evidence-based ethical and philosophical thinking literature were referenced, with the main notification demands incorporated into the Ministry of Health and Welfare's Nursing Workplace Controversy Reporting Platform. After drafting the aspects and provisions of Taiwan code of ethics for nurses norms, expert review procedures such as focus groups, Delphi expert consensus, and public forums were conducted.

Results: After three expert focus group discussion rounds, a structured questionnaire was completed, and 50 Delphi experts in six fields completed the online questionnaire. After the second consensus round, the importance and clarity of the 47 ethical code provisions in the four aspects were determined with 100% and 99.8% agreement reached, indicating no significant difference in scores between the multidisciplinary expert group and the ethical code. The resulting revision proposed for the Taiwan code of ethics for nurses includes: nursing staff and care recipients (14 provisions), nursing staff and practice (13 provisions), nursing staff and the profession (10 provisions), and nursing staff and society (10 provisions).

Conclusions / implications for practice: In terms of education, the revised Taiwan code of ethics for nurses should be integrated into the nursing education curriculum of nursing colleges and used as teaching material for the continuing education of nurses. In terms of policy, these norms should be included as evaluation benchmarks and inspection items for hospitals. In addition, the attention and support of senior managers in institutions must be secured and a handling protocol for moral dilemma cases and related consultation mechanisms must be established. Nursing supervisors should be guided to develop the ability to address these dilemmas to help foster a positive workplace and a respectful team atmosphere. All professional groups should participate actively in promoting issues related to nursing ethics, organize seminars and continuing education activities, and make the revised Taiwan code of ethics for nurses and learning cases available online for reference by nursing staff nationwide.

Background & problems: Safe and efficient operational workflows in nursing care can alleviate workloads, enhance quality of care, and improve job satisfaction. A recent survey indicates that the admission process for patients with COVID-19 in nursing care is excessively lengthy due primarily to the waiting time for physicians to enter the ward, external support, and frequent reorganization of medical materials. Inadequate organization measures have resulted in requisite materials not being centralized, leading to increased travel times, interruptions in nursing records maintenance, unprofessional explanations, and time-consuming consent form signing processes.

Purpose: In this project, lean management was implemented to reduce the time spent on the nursing admission process for patients with COVID-19.

Resolutions: The nursing admission process and job responsibilities were revised. Furthermore, new policies were implemented, including introducing remote consent form signing, using intelligent digital health education assistants, revising related inventory processes, and planning admission nursing carts to streamline the admission process.

Results: The average processing time in the isolation room was reduced by 30.5% from 105 minutes to 73 minutes; the average time spent by nurses on the admission process was reduced by 34.1% from 504 minutes to 332 minutes; and nursing satisfaction levels rose from 55.4% to 82.7%.

Conclusions: In this project, lean management was used to investigate the nursing admission process for patients with COVID-19 and a value stream map was compiled to identify low-value activities within the process. Through the implementation and standardization of project measures, processing time was effectively reduced, manual labor was minimized, and job satisfaction improved.