Journal of Nursing最新文献

The high-pressure nature of clinical nursing work and workplace environments influence how nurses perceive fatigue and their physical and mental health. Therefore, promoting self-care-related skills and capabilities has become an important issue in nursing education. The concept of nurse self-care, the content of mindful self-compassion therapy, and how to apply this therapy in nurse self-care are introduced in this article. Based on the findings of prior empirical research, the concept of self-care in the context of nurses consists of three key abilities: mindfulness, self-compassion, and resilience. These abilities emphasize promoting the ability of nurses to be aware of their body-mind-spirit distress in the present and to respond to suffering with kindness and empathy. Furthermore, resilience may be developed even while facing adversities in life. Mindful self-compassion therapy has been increasingly applied in recent years to improve body-mind well-being in healthcare professionals. This therapy includes the concepts of mindfulness and self-compassion, self-compassion actions, how self-compassion can be applied to facing emotional difficulties, and practicing gratitude and savoring life for a life happiness. Empirical research results consistently confirm that mindful self-compassion therapy can effectively reduce both occupational and compassion fatigue. Therefore, mindfulness self-compassion skills incorporated into nurses' daily lives and work have been subsequently developed based on the concepts underlying mindful self-compassion therapy. These skills help nurses be more consciously aware of the personal impact of work stress, take ameliorative actions such as breathing exercises or body scanning to trigger a physical relaxation response, and use self-compassionate language to self-support.

Green spaces are highly valued for their aesthetic appeal and recreational functions. However, with rapid urbanization and rising workplace pressures, mental health issues such as anxiety and mood disorders are becoming increasingly prevalent. Nurses, impacted by shift work and heavy workloads, often face challenges such as fatigue, psychological stress, and insomnia that can negatively affect work efficiency and patient care quality. Contact with nature has been shown to effectively relieve stress and enhance psychological resilience, making this an important strategy for improving overall health in nurses. In light of this, integrating green spaces into the design of healthcare facilities is essential. For example, creating outdoor gardens and natural landscape areas as well as incorporating natural light with window views and greenery not only provides nurses with spaces for stress relief but also helps enhance psychological resilience, boost happiness and job satisfaction, and, ultimately, improve patient care quality while supporting the sustainable development of healthcare services. At the policy level, management should actively implement health-promotion measures such as scheduling regular outdoor breaks and designing activities that encourage interactivity with nature. These strategies not only support the physical and mental well-being of nursing staff but also contribute to a more human-centered and sustainable healthcare environment, laying a solid foundation for the long-term sustainable development of the medical system.

After brain injury, patients must adapt to their altered lives and undergo long-term rehabilitation, which is a process that imposes increasing burdens on personal health, families, and society. In facing adversities in life, having a relatively high level of self-resilience can help patients secure critical support and successfully adapt to life changes. In this article, a literature review is used to discuss the challenges faced by patients with brain injuries and resilience in these patients is systematically and objectively analyzed using concept analysis. The significant mechanisms identified include the difficulties associated with having predisposing factors, internal and external risk factors, protective factors of attributes, and disease progression of the outcome. Furthermore, commonly used assessment tools in Taiwan and elsewhere are introduced, and empirical strategies that have been deployed in recent years to enhance scholarly understanding of resilience in patients with brain injuries and its progressive improvement are discussed. The objective of this study was to help medical professionals better understand the nature of resilience in patients with brain injury, strengthen protective factors, reduce risk factors, and ultimately improve resilience and quality of life.

Mindfulness and compassion have gained increasing recognition in global healthcare and nursing fields in recent years as important strategies for enhancing the mental health of healthcare professionals, reducing their occupational burnout, and improving the quality of clinical care they provide. In this article, the historical development, mechanisms, and applications of mindfulness in healthcare settings are explored. The related literature indicates that mindfulness enhances attention regulation, emotional management, and self-awareness to effectively reduce stress and anxiety in healthcare professionals while improving their professional performance, empathy, and self-compassion. To promote mindfulness and compassion in healthcare settings in Taiwan, concrete recommendations are given in two key areas: 1) selecting certified mindfulness instructors and standardized courses and 2) implementing institutional strategies such as providing learning opportunities, fostering supportive environments, and integrating mindfulness education into healthcare training. In addition, common misconceptions regarding mindfulness are discussed to underscore that it is not a panacea. Beginners should avoid unrealistic expectations, overly rely on self-sought online resources, or view mindfulness as a quick-fix tool. In this article, the importance of long-term, consistent practice and professional guidance is underscored. In conclusion, mindfulness and compassion offer promising approaches to enhancing well-being in healthcare professionals as well as the quality of patient care they provide. It is hoped this paper encourages greater awareness and adoption of mindfulness and compassion within Taiwan's healthcare community and helps ultimately integrate these practices into clinical settings to foster a healthier, more compassionate, and more humanistic healthcare environment.

The Ministry of Health and Welfare's "Pilot Program of Home Care for Acute Symptoms", launched in 2024, and complementary measures for long-term care services are introduced in this article. The goal of the pilot program is to provide appropriate home medical care to specific emergency patients as an alternative to hospitalization, allowing the extension of emergency care from hospitals to home and residential institutions and connecting long-term care resources during and after acute care. Given that many of those targeted by the pilot program are individuals with mobility issues or who require long-term care, and thus subject to higher levels of treatment difficulty and care service demand, the Ministry has relaxed the rules initially set for this program. Now, cases that meet the conditions for long-term care benefits under the "Regulations on Application and Payment for Long-Term Care Services" are eligible to access long-term care services during the home care period within the scope of care provided by the home care team without adjusting payment limits or co-payment terms. For institutional residents, additional incentive indicators for the pilot program have been incorporated into the "Plan for Minimizing Outpatient Visits by Institutional Residents". In summary, these measures are designed to improve the efficiency and quality of home care provided to address acute symptoms while optimizing the use of long-term care resources to address future medical and caregiving challenges in Taiwan's future super-aged society.

Background: Pap smear screenings effectively reduce the incidence of cervical cancer. However, the effectiveness of practical teaching strategies for this procedure is seldom discussed.

Purpose: This study was designed to evaluate the effectiveness of a Pap smear screening training approach using the two strategies of classroom simulation and practical community screening demonstrations.

Methods: Convenience sampling was used to recruit undergraduate students enrolled between 2021 and 2023 in the nursing midwifery department of a national university. Data were collected between September 2023 and June 2024 and analyzed using a pre-experimental design with a one-group pretest-posttest design. The learning outcomes considered included self-directed learning ability and practical ability performance in cervical smear procedures. Self-directed learning ability was assessed using a self-reported questionnaire, while practical ability performance was separately evaluated by two instructors using direct observation.

Results: Fifty-two students were enrolled as participants. Over time, and with the changes in teaching strategies, significant improvements were observed in self-directed learning ability in terms of mean total and subscale scores. In addition, DOPS scores showed a significant increase in practical ability performance.

Conclusions / implications for practice: Integrating clinical hands-on training into classroom-based simulation teaching can enhance autonomous learning, improve skill proficiency, and foster future self-directed learning and practical abilities in students to promote women's health.

Hypertension is a common disease both globally and in Taiwan that poses significant health risks. According to Taiwan's Health Promotion Administration, abnormal blood pressure is prevalent in up to 80% of the adult population aged 65 and above. Hypertension is associated with serious health issues such as cerebrovascular diseases, renal failure, and cardiovascular diseases, and ranks as the seventh leading cause of death in Taiwan. The diagnostic criteria for hypertension have been lowered to 130/80 mmHg. Regular and continuous blood pressure monitoring is crucial in hypertension management. Studies have demonstrated that home blood pressure monitoring (HBPM) offers significant advantages, providing accurate and long-term data on blood pressure variations, avoiding the white-coat effect, and showing a stronger correlation with cardiovascular events. HBPM not only aids in the detection and management of hypertension but also enhances patient medication adherence. Diagnosing and long-term monitoring for hypertension are recommended in 2022 Taiwan Hypertension Treatment Guidelines. The purpose of this paper is to explore the evolution of hypertension diagnostic criteria and the importance of HBPM in hypertension management, emphasizing how HBPM should be applied in diagnosis and treatment. Also, the procedures for HBPM are introduced to help healthcare professionals acquire accurate nursing guidance information. The authors hope these help nursing colleagues better understand the advantages of HBPM in hypertension management and to increase their competence in teaching patients to self-monitor their blood pressure at home to improve the overall health management of hypertensive patients through HBPM.

The increasingly severe issue of societal aging worldwide has prompted the reevaluation of elderly-care strategies and related workforce development. This paper was developed to explore new directions in elderly care workforce development from the perspective of social co-care. The current state and challenges of elderly care personnel in Taiwan are analyzed, emphasizing the importance of cross-professional collaboration to enhancing elderly care quality. Cross-professional collaboration models and training systems currently used in Japan are examined with the goal of identifying how these models and systems as well as practice experiences may benefit and help improve Taiwan's current elderly care system. The future goal is to elevate the academic qualifications and skills of care workers, foster their professional ethics and competencies, strengthen their interprofessional collaboration abilities, and improve their autonomy and professional identity. Ultimately, a clear career advancement pathway should be established to ensure care workers play a leading role within the geriatric care team.

Background & problems: Fetal heartbeat (FHB) monitoring is used to monitor the condition of a fetus in the uterus and estimate the expected time of delivery. It is crucial to accurately and comprehensively monitor fetal heart beats in high-risk pregnancies. However, invalid alarms frequently occur in clinical environments, easily promoting alarm fatigue among nurses and causing anxiety and distrust in the laboring women and their families. Health professionals may ignore valid alarms due to alarm fatigue and miss the opportunity to save a fetus' life. A survey in our hospital identified invalid alarm rates for fetal heart beats as high as 65.1%, with causes including a lack of standard operating procedures for FHB monitoring in high-risk pregnancies and incomplete health education.

Purpose: This project was developed to reduce the rate of invalid alarms in FHB monitoring in high-risk pregnancies to less than 42.8%.

Resolutions: According to patient safety references for medical equipment management, our team established FHB monitoring standards and procedures for high-risk pregnancies. We edited FHB monitoring nursing guidance leaflets and multimedia health education videos. Nurses distributed the health education leaflets and explained the purpose and precautions during labor to expectant mothers at hospital admission. We invited nurses to share the dilemmas of caring for high-risk pregnancy experiences with nurses and obstetricians. Obstetricians and nurses proposed joint solutions for monitoring to improve the feasibility of comprehensive FHB monitoring and reduce the rate of invalid alarms.

Results: The invalid alarm rate associated with FHB monitoring in high-risk pregnancies was reduced from 65.1% to 21.3%. In addition, the integrity of FHB monitoring was increased from 41.7% to 100%.

Conclusions: This project effectively reduced the invalid alarm rate for delivery room nurse FHB monitoring in high-risk pregnancies and improved the integrity of this monitoring procedure. Adopting this approach has the potential of reducing anxiety and distrust in women in labor and their families, thereby enhancing the quality of care provided to these women experiencing high-risk pregnancies.