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[[alternative]]Effectiveness of Somatic Experiencing on the Psychological Entrapment among Family Caregivers
No full text[[abstract]]動彈不得（entrapment）是形容渴望逃離難以忍受情境，但感覺無路可逃的心理狀態，與家庭照顧者憂鬱、焦慮等心理問題高度相關。本研究根據Peter Levine博士開發的身體經驗創傷療法（Somatic Experiencing®）設計完整可實踐之「回到安全」身體經驗課程。研究目的在探討課程介入後，對研究參與者之：一、動彈不得感受改善成效；二、身心健康改善成效；三、內感受覺察培育成效；四、參與課程之主觀知覺經驗。本研究採準實驗研究設計，共26位自覺有動彈不得困擾之家庭照顧者參與，以非隨機方式分為實驗組與等待對照組。實驗組接受為期八週，每週一次2小時的「回到安全」身體經驗課程，並於課後接受個別訪談；等待對照組於實驗期間不介入任何措施，待實驗組課程結束後再進行課程。兩組在課程前後完成動彈不得量表（ES）、身心健康量表（GHQ）、內感受覺察量表（MAIA-2）檢測，所搜集資料數據透過SPSS統計軟體進行描述性統計、信度考驗、獨立樣本t檢定和相依樣本t檢定分析。個別訪談以內容分析法進行分析，並輔以團體觀察紀錄作為參考。綜合量化與質性研究，實驗組研究參與者參與課程後在減輕動彈不得、改善身心健康及提升內感受覺察方面均有顯著改善。本研究以培育安全感為核心目標，根據學習歷程建構出包含五個構面的「回到安全」內感受覺察歷程：「安全導向」、「自我覺察」、「循序漸進自我調節」、「鞏固安全」和「體現安全」，研究參與者更敏覺生理不安信息，能自信地採取行動確保自身的安全與舒適。根據研究結果提出建議，作為推動家庭照顧者身心健康之輔助方案及未來相關研究之參考。關鍵詞：內感受覺察、身體經驗創傷療法、家庭照顧者、動彈不得[[abstract]]Entrapment describes the psychological state of desiring to escape an unbearable situation but feeling trapped, highly associated with depression and anxiety among family caregivers. This study designed a complete and practical "Return to Safety" Somatic Experiencing Course based on Somatic Experiencing® developed by Dr. Peter Levine. The study aimed to explore the effects of the course intervention on:1) reducing the sense of entrapment; 2) improving physical and mental health; 3) cultivating interoceptive awareness; and 4) subjective experiences of course participation. This study adopts a quasi-experimental research design with 26 participants, who reported were family caregivers experiencing entrapment. The participants were divided into an experimental group and a waitlist control group in a non-random manner. The experimental group attended an 8-week "Return to Safety" Somatic Experiencing Course, with one 2-hour session per week, followed by individual interviews. The waitlist control group received no intervention during the experimental period and attended the course after the experimental group completed it. Both groups were assessed pre- and post-intervention using the Entrapment Scale (ES), the General Health Questionnaire (GHQ), and the Multidimensional Assessment of Interoceptive Awareness, Version 2(MAIA-2). The collected data were analyzed using SPSS for descriptive statistics, reliability test, independent samples t-test, and paired samples t-test. Individual interviews were analyzed using content analysis, supplemented by group observation records. The quantitative and qualitative results indicated significant improvements in reducing the sense of entrapment, enhancing physical and mental health, and increasing interoceptive awareness in the experimental group post-intervention. The study focused on cultivating a sense of safety, developing a "Return to Safety" interoception awareness process with five dimensions: "Safety Orientation," "Self-Awareness," "Gradual Self-Regulation," "Strengthening Safety," and "Embodying Safety." Participants reported became more attuned to physiological discomfort and confidently took actions to ensure their safety and comfort. Recommendations based on the findings are provided to support the mental and physical health of family caregivers and inform future research. Key words: Entrapment、Family Caregiver、Interoceptive Awareness、Somatic Experiencin
[[alternative]]The Relationship Among Leisure Involvement, Perceived Risk and Behavioral Intention of Outdoor Hot Spring Participants
No full text[[abstract]]台灣地理位置優越，蘊含許多豐富的地熱資源。惟因2020年開始之新型冠狀肺炎疫情肆虐，加以社交距離的相關限制，民眾只剩下有限的室內休閒活動可以參與。2021年後疫情時代國民旅遊風潮盛行，許多人會選擇前往海邊、山林等空曠之戶外地點進行休閒活動行為，野溪溫泉的活動也開始盛行。本研究以野溪溫泉參與者為調查對象，探討其人格特質、對野溪溫泉的休閒涉入、知覺風險，以及行為意圖之關係，並利用不同的背景分析各個構面的影響程度。本研究為量性研究，採立意取樣，以發放問卷方式，針對台灣18歲以上民眾進行資料蒐集和調查，使用SPSS軟體進行迴歸分析。本研究發現不同人格特質的參與者對於行為意圖程度上存在差異。休閒涉入較高者，行為意圖程度相對高，意謂著有顯著正影響；反之，知覺風險程度較高者，行為意圖程度相對較低，也就是說有著顯著的負影響。本研究之結果可以瞭解野溪溫泉對於參與者是否為一個可以安心前往的休閒活動，也可提供相關政府機構正視野溪活動之休閒安全問題，並加以規畫或推動野溪溫泉相關活動。[[abstract]]Taiwan's advantageous geographical location harbors abundant geothermal resources. However, since the outbreak of the Covid-19 in 2020 and the subsequent implementation of social distancing measures, the populace has been limited to indoor activities. After the 2021 pandemic era, there has been a surge in domestic tourism, with many opting for outdoor leisure activities in places like beaches and forests. As a result, activities such as outdoor hot springs bathing have become increasingly popular.This study focuses on participants of outdoor hot springs activities, investigating the relationships between their personality traits, involvement in hot spring leisure activities, perceived risks, and behavioral intentions. Different backgrounds are utilized to analyze the extent of influence of each aspect. Employing a quantitative approach, the study adopts purposive sampling and questionnaire distribution to collect data from Taiwanese adults aged 18 and above. Regression analysis is conducted using SPSS software.The study reveals differences in the behavioral intentions of participants with varying personality traits. Those with higher levels of leisure involvement exhibit relatively higher behavioral intentions, indicating a significant positive influence. Conversely, participants perceiving higher levels of risk demonstrate relatively lower behavioral intentions, signifying a significant negative impact. These findings contribute to understanding whether outdoor hot springs serve as a reassuring leisure activity for participants and provide valuable insights for relevant government agencies to address leisure safety concerns associated with such activities, facilitating the planning and promotion of related activities
[[alternative]]Exploring the characteristics of health indicators and G20 efficiency by machine learning— Based on data envelopment analysis
No full text[[abstract]]自19世紀工業化以來，能源的大量使用導致了全球溫室氣體排放激增，引發氣候變遷等許多環境問題，更甚至也對各國的經濟發展和健康狀況造成多重影響。為此本研究利用資料包絡分析法和機器學習對G20國家及台灣進行分析，探討這些國家在環境、經濟和健康方面的表現，並找出預測環境發展的指標。研究主要分為兩個階段：第一階段評估整體效率，第二階段分析健康指標與整體效率之間的關係。在第一階段，我們通過衡量各國的能源消耗、勞動力人口、人均GDP和二氧化碳排放量來評估其環境健康效率。結果顯示，高收入水平國家（如加拿大、英國和法國）通常具有較高的效率；中低收入水平國家（如印度、印度尼西亞和南非）則效率較低，影響整體效率的因素包括經濟狀況、政策、技術和人口結構等。在第二階段，我們進一步分析了各國的健康指標，包括人均健康支出、五歲以下兒童死亡率、健康預期壽命、嬰兒死亡率和孕產婦死亡率，並探討這些指標與第一階段得出的整體效率之間的關係。結果表明，人均健康支出可以在環境效率的基礎下，做為各國間健康評估的分群指標，也意涵為環境對於健康的影響可以藉由健康支出減緩，因此健康支出較高的國家，通常可以由健康支出吸收環境對健康的影響，其他健康指標（如嬰兒死亡率、五歲以下兒童死亡率、健康預期壽命和孕產婦死亡率）雖然也有助於評估醫療照護體系的效率，但較無法說明環境對於健康的影響，所以無法全面反映國家的環境與健康的效率水平。[[abstract]]Since the industrialization of the 19th century, the massive use of energy has led to a surge in global greenhouse gas emissions, causing many environmental problems such as climate change, and even multiple impacts on the economic development and health status of countries. Therefore, this study analyzes the environmental, economic and health performance of the G20 countries and Taiwan by using data envelopment analysis and machine learning, and identifies indicators for predicting environmental development. The study is divided into two phases: the first phase assesses overall efficiency and the second phase analyzes the relationship between health indicators and overall efficiency. In the first stage, we assessed the energy-economic efficiency of countries by measuring their energy consumption, labor force, GDP per capita, and CO2 emissions. The results show that high-income countries (e.g., Canada, the United Kingdom, and France) are generally more efficient, while lower-middle-income countries (e.g., India, Indonesia, and South Africa) are less efficient, and that factors affecting overall efficiency include economic conditions, policies, technology, and demographics.In the second stage, we further analyze the health indicators of each country, including per capita health expenditure, under-five mortality rate, healthy life expectancy, infant mortality rate and maternal mortality rate, and explore the relationship between these indicators and the overall efficiency derived in the first stage. The results show that per capita health expenditure can be used as a subgroup indicator for health assessment across countries on the basis of environmental efficiency, which means that environmental impacts on health can be mitigated by health expenditure, so that countries with higher health expenditure can usually absorb the environmental impacts on health through health expenditure, and that the other health indicators (e.g., infant mortality rate, under-five mortality rate, healthy life expectancy, and maternal mortality rate) can also be useful for assessing the health of a country, although they can be useful for assessing the health of a country. Other health indicators (e.g., infant mortality, under-five mortality, healthy life expectancy, and maternal mortality) are also useful in assessing the efficiency of the health care system, but they are less able to account for environmental impacts on health, and therefore do not provide a full picture of the level of efficiency of a country's environment and health
[[alternative]]Interdisciplinary Competence Redevelopment in Information Personnel: A Case Study of Radio frequency Chip Measurement Automation System
No full text[[abstract]]隨著無線通信技術的迅速發展，射頻元件的需求急劇增加，這讓射頻晶片量測技術不僅要快速且準確。本研究目標是提升射頻晶片量測系統的自動化程度以及使用者體驗，以應對大量生產中對效率和精確度的要求，減少人工操作錯誤，提高生產效率。本研究採取的方法是整合探針台和射頻晶片量測儀器的操作系統，並讓使用者可透過遠程控制和預設的自動化指令，減少手動錯誤並提高工作效率。這種整合後的系統能夠自動完成一連串複雜的操作，並即時分析和存檔量測數據，從而實現高效的自動化量測。本研究開發的系統是基於IEEE 488.2標準（General Purpose Interface Bus，GPIB）以及SCPI（Standard Commands for Programmable Instruments，標準可程式儀器命令集），這系統提供使用者以統一的語言和命令來控制各種量測儀器，讓使用者可以讓系統像遙控器一樣，通過遠程編程自動控制射頻晶片量測的過程，包括自動捕獲數據、分析、存檔以及報表的生成。綜上所述，本研究所開發的射頻晶片量測系統將使量測更快捷、更準確，同時減少對人工的依賴。本研究結果將為未來射頻晶片量測系統的設計和整合提供一個全面的指導，有助於推動射頻晶片測試技術的進步。[[abstract]]In the fast-paced world of wireless communication, the burgeoning demand for radio frequency (RF) components has highlighted the critical need for swift and precise RF chip measurement techniques. This study focuses on advancing the automation and user experience of RF chip measurement systems. These improvements are essential to address the high demands for efficiency and precision in bulk production, ultimately reducing manual errors and boosting overall productivity. Our approach marries the technical depth of industry practices with user-friendly methodology. We've integrated the operating systems of probe stations with RF chip measurement instruments. This integration allows users to remotely control and execute preset automated commands, reducing human errors and enhancing efficiency. This integrated system can automatically perform a series of complex operations and instantly analyze and archive measurement data, thus achieving efficient automation of measurements. The core of our system is based on the IEEE 488.2 standard (General Purpose Interface Bus, GPIB) and SCPI (Standard Commands for Programmable Instruments). This foundation provides a common language and set of commands for controlling diverse measurement instruments. Imagine being able to control these sophisticated instruments as easily as changing channels on your TV remote. Users can automate the entire RF chip measurement process, including data capture, analysis, archiving, and report generation, through straightforward remote programming. In summary, the RF chip measurement system developed in this research will make measurements faster and more accurate while reducing reliance on manual labor. The results of this study will provide comprehensive guidance for the future design and integration of RF chip measurement systems, helping to advance RF chip testing technology
[[alternative]]Modeling carbon footprint system’s enterprise architecture with ArchiMate:A case study for one of Wiring Harness's products
No full text[[abstract]]隨著全球氣候變遷日益嚴重，減碳已成為各國共同目標，尤其歐美已由道德訴求轉為法規規範。歐美是台灣重要的出口地區，為因應歐美碳邊境節整機制(Carbon Border Adjustment Mechanism, CBAM)，以及清潔競爭法案（Clean Competition Act, CCA）所需提交的碳足跡資訊，企業首先必須結合生產資訊系統方能有效蒐集碳足跡資訊，了解碳排放的來源與數量。企業架構可有效校準企業流程、資訊系統與實體設備，更有可視覺化建模語言 ArchiMate，能描述企業的業務流程、組織結構、資訊流、IT 系統和技術基礎設施的建構和運作的通用語言。本研究選擇已推行綠色供應鏈的某線束廠之某線束材為案例，說明如何建構碳足跡資訊蒐集系統，並以 ArchiMate 具體規劃出涵蓋策略、業務、應用和技術層面的具體資訊架構。本研究以某線束廠之某線束材進行碳足跡數據蒐集，研究結果表明：企業架構確實可展現整體應有業務流程(業務層面)，該層面與資訊流(應用層面)之關聯，並呈現與相關資訊流串接時之應有資訊設施。然而完整碳足跡蒐集需視公司是否有完備的投入、產出資訊，以及能串接各活動數據之正確的碳排係數，以利於後續開展碳足跡核算及制定減排措施。[[abstract]]As the severity of global climate change escalates, reducing carbon emissions has emerged as a shared objective among nations worldwide. Europe and North America, significant export markets for Taiwan, are transitioning from ethical appeals to legal obligations. To comply with the carbon footprint data requirements specified by the European Union's Carbon Border Adjustment Mechanism (CBAM) and the Clean Competition Act (CCA), Taiwanese businesses must streamline their production information systems to efficiently gather carbon footprint data and identify the sources and quantities of their carbon emissions. Enterprise architecture is essential for harmonizing business processes, information systems, and physical facilities. The ArchiMate modeling language offers a standardized framework for visually representing various aspects of an enterprise, including business processes, organizational structure, information flows, IT systems, and technical infrastructure. This study focuses on a specific wire harness product from a manufacturer that has implemented a green supply chain. The research serves as a case example to demonstrate the development of a system for collecting carbon footprint information. Using ArchiMate, a detailed information architecture is designed, encompassing strategic, business, application, and technology layers. The empirical results derived from collecting carbon footprint data on the wire harness product illustrate how enterprise architecture can effectively represent the targeted business processes (business layer) and their relationships with information flows (application layer), as well as the essential information assets required for engaging with these information flows. However, a comprehensive carbon footprint data collection process necessitates the availability of complete input and output information within the company, along with the capability to link activity data with precise carbon emission factors. This linkage is crucial for facilitating subsequent carbon footprint calculations and developing strategies for reducing emissions
[[alternative]]A Preliminary Study on the Effectiveness of Scaffolding Scribbling for Emergent Writing in Preschool Children
No full text[[abstract]]本研究以鷹架式塗鴉作為書寫萌發促進手法，探討為學齡前典型發展大班兒童進行預防性介入的成效。鷹架式塗鴉以帶有意義之部件為學習目標，以筆畫作為塗鴉內容，並將鷹架策略應用於筆順學習中，運用動作學習的方式累積書寫相關的知覺經驗。此外，在引導兒童觀察漢字時，關注部件在漢字內的空間分布及位置，藉此活動流程累積基礎的字形知識。研究對象為就讀南投縣水里鄉玉峰托兒所大班兒童，總共納入33名兒童，並以隨機分配的方式分成實驗組與對照組。實驗組皆將接受為期8周，每周1次，每次35-40分鐘的鷹架式塗鴉介入課程；對照組為等待介入組。課程結束後兩組皆接受後測，並依照前後測結果分析兒童的近端仿寫與延遲抄寫的書寫表現及對於字形知識的掌握度是否有顯著進步，藉以了解該介入法作為預防手段是否有效。研究結果發現，經過八周鷹架式塗鴉活動後，實驗組兒童對於不同層次的字形知識掌握度皆達顯著差異，且實驗組兒童的仿寫表現及整體書寫表現皆較對照組兒童更為進步，且幅度達到統計意義上的顯著差異；然兩組兒童在延遲抄寫的表現皆在八周後有所進步，但兩組兒童的表現並未有顯著差距。綜上所述，鷹架式塗鴉不僅能夠解決學前兒童書寫萌發活動及相關教材不足，且學界與第一線教學人員對此沒有共識的問題，同時能夠提供大班的學前兒童一套兼顧趣味性、書寫發展及學習效果的書寫萌發活動，使學前兒童的書寫準備度更加完備。[[abstract]]This study employs scaffolded scribbling as a method to promote emergent writing, examining its effectiveness as a preventive intervention for typically developing older preschool children. Scaffolded scribbling uses meaningful components as learning targets, with strokes as the scribbling content, and applies scaffolding strategies to stroke order learning, accumulating writing-related perceptual experiences through motor learning. Additionally, when guiding children to observe Chinese characters, attention is given to the spatial distribution and position of components within characters, thereby building fundamental orthographic knowledge through the activity process.The study participants were 33 older preschool children from Yufeng kindergarten in Shuili, Nantou County. They were randomly assigned to either an experimental group or a control group. The experimental group received an eight-week intervention of scaffolded scribbling, once a week for 35-40 minutes per session, while the control group was a waitlist group. Both groups took a post-test after the intervention, and the pre- and post-test results were analyzed to determine if there were significant improvements in children's proximal copying, delayed copying performance, and orthographic knowledge mastery, assessing the effectiveness of this intervention as a preventive measure.The study found that after eight weeks of scaffolded scribbling activities, children in the experimental group showed significant improvement in their mastery of different levels of orthographic knowledge. Additionally, their copying performance and overall writing performance were significantly better than those of the control group, reaching statistical significance. Although both groups showed progress in delayed copying performance after eight weeks, there was no significant difference be-tween the two groups.In conclusion, scaffolded scribbling not only addresses the lack of emergent writing activities and related materials for preschool children and the lack of consensus between academia and frontline educators but also provides a set of engaging and effective writing activities for older preschool children. This enhances their writing readiness by balancing fun, writing development, and learning outcomes
[[alternative]]A Case Study on the Planning and Realization of Contract Management in Public–Private Partnership Non–Profit Preschools：A Case Study on Taipei City
No full text[[abstract]]為因應少子女化問題，近年教育部極力推動公共化教保服務，將原以委託民間經營的公辦民營委外模式改為公私協力模式在全國辦理非營利幼兒園，截至112學年設置數量以臺北市居冠。本研究透過蒐集學術文獻、法規、政策及官方文件進行分析並以立意取樣方式，訪問臺北市政府履約管理執行者，探討臺北市如何規劃與落實非營利幼兒園之履約管理。本研究發現，臺北市以「政府關心」、「法人用心」、「家長放心」及「幼兒開心」為推廣政府與法人共同辦理非營利幼兒園之核心價值，履約管理上首重源頭規劃並落實目標管理。與公益法人之互動除了契約關係之外，亦存在夥伴關係，並以管理者、輔導陪伴者多元角色進行履約管理，藉由落實檢核的審查、凝聚共識的到園檢查及績效考評發現問題，並以定期會議的協商討論、積極提供輔導資源支持等履約管理作為，邁向優質教保服務的具體實現；此外，本研究亦發現在公共化教保服務急速擴增下，臺北市合作的公益法人逐漸趨向多樣性，其面對法人承辦量能不足，新法人越來越多，經驗不足下，臺北市建立危機管理意識，挹注資源提供園務管理工具及辦理共識營、知能研習等協助公益法人增加園方管理知能，持續確保非營利幼兒園之辦理品質。[[abstract]]In response to the issue of declining birth rates, the Ministry of Education has actively promoted the public provision of childcare services in recent years, transitioning from a public-private partnership model that delegated operations to the private sector to a collaborative governance model for nonprofit Preschools nationwide. As of the 112th academic year, Taipei City has the highest number of such establishments. This study analyzes academic literature, regulations, policies, and official documents and employs purposive sampling to interview planning and realization of contract executors from the Taipei City Government, exploring how the city plans and implements planning and realization of contract for nonprofit Preschools.The findings indicate that Taipei City promotes the core values of "government concern," "corporation dedication," "parental trust," and "children's happiness" in the joint management of nonprofit Preschools. Planning and realization of contract emphasizes source planning and the implementation of target management. Interactions with public benefit corporations transcend contractual relationships, embodying a partnership dynamic. Planning and realization of contract is conducted through diverse roles of managers and facilitators, addressing challenges through meticulously executed evaluations, consensus-building site inspections, and performance assessments.Regular meetings for negotiation and active provision of supportive resources further constitute the planning and realization of contract practices aimed at realizing high-quality childcare services. Additionally, this study reveals that the rapid expansion of public childcare services has led to increasing diversity among the public benefit corporations partnering with Taipei City. Facing insufficient operational capacity among these corporations, the emergence of numerous new entities lacking experience has prompted the city to establish a crisis management awareness. Resources are allocated to provide management tools for kindergartens and organize consensus-building camps and competency training to augment the management capabilities of public benefit corporations, thereby ensuring the quality of operations in nonprofit Preschools
[[alternative]]The relationships of Nurses' Self-Efficacy, Knowledge, Attitudes, and Practice of Managing Pain in Indonesia
No full text[[abstract]]Pain is a global healthcare issue, which can cause many negative consequences on the patients and may prolong the patient's hospitalization if not resolved. Thus, the quality of nursing care, including pain management, is pivotal for hospitalized patients. According to the knowledge-attitude-practice (KAP) model, nurses acquire knowledge in school and hospital training, cultivate positive attitudes, and adopt effective practices to improve pain management behaviors. Previous studies also found that self-efficacy, which refers to individuals' belief in their ability, affects their ability to achieve their goals in pain management to control and manage pain successfully. However, no adequate scale in Indonesia measured pain management self-efficacy and knowledge and attitude regarding pain among nurses and nursing students. Therefore, this study aimed to 1) assess the psychometric properties of the Indonesian version of the Pain Management Self-Efficacy Questionnaire (PMSEQ-IDN) and Knowledge and Attitude Survey Regarding Pain (KASRP-IDN) and 2) evaluate the role of the self-efficacy in pain management on the relationships between the knowledge, attitude, and practice on pain management.This study used a cross-sectional design. The respondents for psychometric testing were 489 participants, which consisted of 245 Registered Nurses (RNs) and 244 Graduate Nurses (GNs). For mediation analysis, the total respondents were 500 RNs and GNs. Due to the pandemic, the data collection was conducted through online surveys, including demographic profiles, PMSEQ-IDN, KASRP-IDN, Nurse Behavior Questionnaire (NBQ-P), and General Self-Efficacy-12 (GSE-12). Data analysis included face and content validity, construct validity by conducting Confirmatory Factor Analysis (CFA), concurrent and known group validity, internal consistency, test-retest reliability, Rasch model analysis, and mediation analysis. The PMSEQ-IDN had I-CVI values ranging from 0.95 to 1.00 and an S-CVI of 0.99. The psychometric evaluation of the PMSEQ-IDN showed strong construct validity in assessments with 20 items. Regarding concurrent validity, a strong correlation between the PMSEQ-IDN and the GSES-12 was r = 0.917 (p < .001). For known-group validity, the mean PMSEQ-IDN score for GNs was 3.76 higher than that for RNs (t = -3.408, p = .001). The measure's internal consistency (Cronbach's alpha = 0.949, Composite Reliability = 0.72 to 0.93) and test-retest reliability (ICC = 0.873) confirmed its reliability. The Rasch analysis for KASRP-IDN showed that the data met the model's criteria with item reliability exceeding 0.8 and sufficient item separation, but it lacked person reliability and separation. All items satisfied the statistical requirements for outfit mean square, but some items did not meet the criteria for outfit ZSTD and point-measure correlation. All rating scales found the scale functioning properly, and differential item functioning (DIF) by respondent status was detected. The mediation analysis showed significant positive relationships among KASRP-IDN, PMSEQ-IDN, and Pain Management Practice. However, the mediation analysis showed that self-efficacy partially mediated between KASRP and pain management practice.In conclusion, the PMSEQ-IDN and KASRP-IDN demonstrate robust psychometric properties, affirming their reliability and validity for assessing pain management self-efficacy and knowledge among healthcare professionals in Indonesia. These tools effectively distinguish competency levels across different professional groups and highlight the importance of self-efficacy in enhancing pain management practices. Identifying DIF also provides crucial insights for further refinement and targeted application of these scales. The mediation analysis reveals that self-efficacy plays a modest but significant mediating role between knowledge-attitude about pain management and pain management practices. This indicates that while increasing knowledge about pain management is crucial, enhancing self-efficacy is also important to translate this knowledge into practice effectively. The results suggest that interventions aiming to improve pain management should focus on enhancing knowledge and boosting self-efficacy to achieve better practical outcomes
[[alternative]]Effects of the self-management on anxiety, depression, quality of life and self-management of patients with acute coronary syndromes: a randomized controlled trial
No full text[[abstract]]背景：急性冠狀動脈症侯群是沉默的殺手，也是全世界死亡的主要原因，並給個人的經濟和社會帶來巨大負擔，而心絞痛及心肌梗塞也是為最常見的急性冠狀動脈疾病，通常為造成猝死的最主要原因，一旦發生常造成病人焦慮憂鬱及生活品質下降，因此期藉由自我管理方案能夠幫助病人做好自我管理，以提升生活品質。目的：探討施行自我管理方案對急性冠狀動脈症候群病人之焦慮、憂鬱生活品質及自我管理之追蹤成效。方法：本研究為二個階段的計畫，第一階段：建構與發展急性冠狀動脈症候群病人之自我管理之介入措施並進行前驅性研究，依文獻查證後設計介入措施。並進行前驅測試，經由此檢討改善。第二階段：採隨機對照控制試驗，以1：1隨機取樣研究設計，探討急性冠狀動脈症候群病人接受自我管理方案後，其焦慮、憂鬱、生活品質及自我管理之成效。於北部某醫學中心心臟內科病房進行，診斷為急性冠狀動脈症候群病人，符合條件，同意加入研究，並填妥同意書者。第一階段前驅性研究預計受試者為10人，進行單組前後測試，於2星期及1個月再收集成效指標。第二階段受試者共104人，實驗組及對照組各52位。資料收集包含人口學疾病特性、憂鬱、焦慮、生活品質及自我管理等變項。測量工具包含醫院焦慮憂鬱量表、SF-36臺灣版生活品質問卷及自我管理量表。介入後1個月及3個月後再收集其成效指標，介入成效將以GEE進行統計分析。 研究結果：第一階段：發展「急性冠狀動脈症候群自我管理」手冊及「護心新生活-急性冠狀動脈症候群之自我照顧」影片等，邀請臨床專家進行手冊內容效度測試平均CVI為.97。接著招募10位個案單組進行前驅測試，以測試自我管理方案介入後2星期及1個月後其焦慮憂鬱、生活品質及自我管理之成效。第二階段：本研究採隨機控制試驗，分別以1：1分派實驗組及對照組各52位，研究過程中兩組皆未有中途退出的個案，共104位全數納入資料分析。平均年齡為62.1歲。在焦慮之成效，隨著時間遞變，實驗組及對照組於1個月後及3個月焦慮平均分數都有顯著下降趨勢，實驗組1個月及3個月平均分數下降趨勢較對照組高，且達統計顯性差異(t=2.059,p=.042、t=5.758,p<.001)，因此實驗組較對照組成效佳。在憂鬱之成效：隨著時間遞變，實驗組及對照組於1個月後及3個月憂鬱平均分數都有逐漸下降趨勢，但是兩組於1個月(t=1.956,p=.053)，無顯著差異，於3個月(t=4.697,p<.001)兩組平均分數有逐漸下降趨勢，有顯著差異。在生活品質之成效：隨著時間遞變，生理構面，其兩組於1個月(t=-3.21,p=.002)及3個月(t=-7.83, p<.001)平均分數都有逐漸提升趨勢，但以實驗組生活品質成效較對照組更為顯著；心理構面，其兩組於1個月(t=-3.094,p=.003)及3個月(t=-6.83, p<.001)平均分數也是都有逐漸提升趨勢，但都以實驗組生活品質成效較對照組更為顯著。在自我管理成效：隨著時間遞變，兩組於1個月(t=-4.70, p<.001)及3個月(t=-9.03, p<.001)自我管理平均分數都有逐漸提升趨勢，但實驗組自我管理成效較對照組更為顯著。結論：本研究結果發現自我管理方案對急性冠狀動脈症候群病人可以降低其焦慮、憂鬱及增進生活品質及自我管理。臨床實務應用：對於急性冠狀動脈疾病病人之自我管理照護，目前鮮少有系統性且有成效的自我管理方案介入可引用，本研究結果支持並將提供臨床實務參考及推廣。[[abstract]]Background: Acute coronary syndromes (ACS) are a silent killer and a leading cause of death globally, posing significant economic and social burdens on individuals. Angina and myocardial infarction, the most prevalent forms of coronary heart disease, are typically the primary causes of sudden death. Once they occur, they often lead to patient anxiety, depression, and reduced quality of life. Thus, self-management programs are essential in helping patients effectively manage their conditions and enhance their quality of life.Objective: This study explores the effectiveness of a self-management program in enhancing the quality of life and the self-management of anxiety and depression among patients with acute coronary syndrome.Method：This study was structured in two stages. The first stage involves constructing and developing self-management intervention measures for patients with acute coronary syndrome (ACS). Following a review of the literature, these measures were initially tested in a pilot study to allow for further refinements. The second stage consists of a randomized controlled trial using a 1：1 random sampling design to assess the effectiveness of the self-management program on anxiety, depression, quality of life, and self-management in patients with ACS. The research is carried out in the cardiology ward of a northern medical center. Patients diagnosed with ACS who met the inclusion criteria, agreed to participate, and completed the consent forms were enrolled. The pilot study aims to include 10 subjects and involves a single-group pre-test and post-test design, with effectiveness indicators collected at 2 weeks and 1 month. The second phase includes a total of 104 subjects, divided equally between the experimental group and the control group. Data collection encompasses demographic and disease characteristics, levels of depression, anxiety, quality of life, and self-management. Measurement tools include the Hospital Anxiety and Depression Scale, the SF-36 Taiwan Version Quality of Life Questionnaire, and a Self-Management Scale. Effectiveness indicators were collected 1 month and 3 months post-intervention, and the effectiveness of the intervention is statistically analyzed using Generalized Estimating Equations (GEE).Results:Phase 1: Development of an "Acute Coronary Syndrome Self-Management" manual and an "Acute Coronary Syndrome Self-Care" multimedia video was completed. Clinical experts were invited to conduct validity testing of the manual's content, achieving a Content Validity Index (CVI) of .97. Subsequently, a single-group pilot study with 10 participants was conducted to test the effects of the self-management program on anxiety, depression, quality of life, and self-management 2 weeks and 1 month post-intervention.Phase 2: A randomized controlled trial was conducted with 104 participants, 1：1 divided equally into an experimental group and a control group with 52 participants each. Throughout the study, no participants dropped out, resulting in a 0% attrition rate. The average age of participants was 62.1 years. Effectiveness on anxiety: Over time, the average anxiety scores of both the experimental and control groups showed a significant downward trend at 1 and 3 months. The experimental group's scores decreased more significantly than those of the control group, with statistically significant differences (t=2.059, p=.042 at 1 month; t=5.758, p<.001 at 3 months), indicating better outcomes for the experimental group. Effect on depression: The average depression scores for both groups gradually decreased over time, showing no significant difference at 1 month (t=1.956, p=.053). However, at 3 months (t=4.697, p<.001), the scores showed a significant downward trend and a significant difference. Effect on quality of life: In terms of physiological aspects, both groups experienced improvements over time, with significant improvements in average scores at 1 month (t=-3.21, p=.002) and 3 months (t=-7.83, p<.001). The experimental group showed more significant improvements than the control group. In psychological aspects, both groups showed improvements at 1 month (t=-3.094, p=.003) and 3 months (t=-6.83, p<.001), with the experimental group again showing more significant effects. Self-management effectiveness: Over time, the average scores of both groups improved significantly at 1 month (t=-4.70, p<.001) and 3 months (t=-9.03, p<.001), with the experimental group showing more substantial improvements compared to the control group.Conclusion: The findings suggest that the self-management program effectively reduces anxiety and depression while enhancing the quality of life and self-management skills of patients with acute coronary syndrome.Clinical Practice Implications: Current self-management educational materials for acute coronary diseases often lack systematic, effective interventions. Therefore, the results of this study will provide a valuable reference for clinical practice and its promotion
[[alternative]]The quality of life of parents of surviving children with brain tumors and solid tumors.
No full text[[abstract]]研究背景:隨著兒童癌症治療技術進步，兒童腦瘤及固態性腫瘤的5年存活率增加。治療的相關合併症可能會影響其父母的生活。因此治療完成後的腦瘤及固態性腫瘤兒童及青少年之父母的生活品質，是我們需要持續關注的議題。研究目的:探討治療完成後腦瘤及固態性腫瘤兒童之父母親的生活品質。研究方法:本研究為橫斷面研究設計，以方便取樣，在北部某醫學中心兒童血液腫瘤門診選取治療結束後 7年內6-18歲腦瘤和固態性腫瘤兒童之父母親為研究對象。腦瘤及固態性腫瘤兒童的父母親代填兒童生活品質量表(PedsQL™ 4.0)、長處及困難量表(SDQ)及兒童行為量表(CBCL)，腫瘤及固態性腫瘤兒童的父母親則須填寫基本資料及臺灣世界衛生組織生活品質(WHOQOL-BREF)量表。研究結果:本研究參與人數共93位腦瘤和固態性腫瘤兒童之父母親，其中父親45位，平均年齡46.6±5.3歲；母親48位、平均年齡44.2 ± 4.9歲。以獨立樣本t檢定比較父母親生活品質，父親生活品質平均得分為56.27 ±7.27分，母親平均得分為57.61 ±6.20分，p =.346，兩者間無顯著相關。以單因子變異數分析父母生活品質與社經地位相關性，父親(F=.16，p=.845)，母親(F=.28，p=.756)，皆無顯著差異。最後以多元逐步迴歸分析父母社經地位、病童治療完成時間、疾病分類、治療方式、兒童行為量表、內化量尺及外化量尺、長處與困難量表與父母親生活品質皆無顯著差異。影響治療完成後腦瘤及固態性腫瘤父親生活品質之預測因子為腦瘤及固態性腫瘤兒童生活品質整體分數 ( β＝.15，p＝.024 )，母親生活品質之預測因子為腦瘤及固態性腫瘤兒童生活品質整體分數 ( β＝.14，p＝.007 )。結論:建議未來護理人員在臨床工作時除了照護兒童本身之外，也應注意父母親的生活品質，提供更多支持與資源，協助並促進更好的生活品質。[[abstract]]Background: With the advancement of childhood cancer treatment technology, the 5-year survival rate of childhood brain tumors and solid tumors has increased. Treatment-related comorbidities may impact the parents' lives. Therefore, the quality of life of parents of children and adolescents with brain tumors and solid tumors after treatment is an issue that we need to continue to pay attention to.Purpose: To explore the quality of life of parents of children with brain tumors and solid tumors after completion of treatment.Method: This study is a cross-sectional study designed to facilitate sampling. Parents of children aged 6-18 years old with brain tumors and solid tumors within 7 years after treatment were selected as the research subjects in the pediatric hematology tumor clinic of a northern medical center. Parents of children with brain tumors and solid tumors must fill in the Children's Quality of Life Questionnaire (PedsQL™ 4.0), Strengths and Difficulties Scale (SDQ), and Child Behavior Checklist (CBCL) on their behalf. Parents of children with brain tumors and solid tumors must Fill in the basic information and Taiwan World Health Organization Quality of Life (WHOQOL-BREF) scale.Result: A total of 93 parents of children with brain tumors and solid tumors participated in this study, including 45 fathers with an average age of 46.6±5.3 years and 48 mothers with an average age of 44.2 ± 4.9 years. The independent sample t test was used to compare the parents' quality of life. The average score of the father's quality of life was 56.27 ± 7.27 points, and the average score of the mother was 57.61 ± 6.20 points, p =.346. There was no significant correlation between the two. Using single factor variation to analyze the correlation between parents' quality of life and socioeconomic status, there was no significant difference between father (F=.16, p=.845) and mother (F=.28, p=.756). Finally, multiple stepwise regression was used to analyze the socioeconomic status of parents, time to complete treatment of sick children, disease classification, treatment methods, child behavior scale, internalizing scale and externalizing scale, strengths and difficulties scale, and parents' quality of life. significant difference. The predictor of father's quality of life after completion of treatment is brain tumor and solid tumor children's overall quality of life score (β=.15, p=.024), and the predictor of mother's quality of life is brain tumor and solid tumor. Overall score of quality of life in children with sexual tumors (β=.14, p=.007).Conclusion: It is recommended that future nursing staff should not only take care of the children themselves during clinical work, but also pay attention to the quality of life of parents, provide more support and resources, and assist and promote a better quality of life