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[[alternative]]Montessori Materials Design and Implementation for Three-to- six-year-old Children – Water & River
No full text[[abstract]]本研究探討了在臺北市卡爾維德蒙特梭利幼兒園的蒙特梭利課程中整合水 和河流主題的可能性。鑒於傳統蒙特梭利教育中缺乏這些主題，本計畫旨在透 過互動的蒙特梭利活動中，向 3-6 歲的兒童介紹河流和水循環的概念。在為期 一個月的時間裡，12 名參與者參與了為了增強他們對臺灣三大河流和水循環階 段的理解的活動。前測和後測評估顯示，孩子們的知識有提高，計畫結束時 100%的參與者能正確說出主要河流和水循環階段。研究強調了實際操作在培養 幼兒環境意識和地理理解方面的有效性，建議將科學相關內容融入學前幼兒教 育可以彌補課程差距並豐富教育體驗。[[abstract]]This study explores the integration of water and river themes into the Montessori curriculum for preschool children at Karlwitte Montessori School in Taipei, Taiwan. Recognizing the absence of these topics in traditional Montessori education, the project aimed to introduce children aged 3-6 to the concepts of rivers and the water cycle through interactive, Montessori-inspired activities. Over one month, 12 participants engaged with materials designed to enhance their understanding of Taiwan's three largest rivers and the stages of the water cycle. Pre- test and post-test assessments demonstrated improvements in the children's knowledge, with 100% of participants correctly identifying major rivers and water cycle stages by the project's end. The study highlights the effectiveness of hands-on learning in fostering environmental awareness and geographical understanding in young learners, suggesting that integrating science-related content into early childhood education can bridge curricular gaps and enrich educational experiences
[[alternative]]The Relationship between Self-Efficacy and Evidence-Based Practice (EBP) Competency among Nursing Students in Indonesia
No full text[[abstract]]背景： COVID-19 大流行擾亂了護理教育，在理論學習和實際應用之間造成了顯著的差距，導致護理學生的信心降低。解決這些差距對於讓學生為未來的臨床實踐做好準備至關重要。循證實踐 (EBP) 是提供安全、高品質病患照護所不可或缺的核心能力。護理學生的專業能力通常與他們的自我效能感相關，因此在他們進入專業實習之前評估他們的能力自我效能感和 EBP 能力非常重要。本研究旨在探討護理學生大流行後的能力自我效能與 EBP 能力之間的關係，並找出影響 EBP 能力的預測因子。方法： 於 2023 年 8 月至 9 月間進行一項描述性關聯研究，參與者包括 178 名在印尼一所私立大學完成專業課程的護理學生。參與者使用護理能力自我效能量表 (NCSES) 和學生循證實踐問卷 (SEBPQ)，完成了一項基於網路的調查，兩者均已翻譯成印尼語，並通過了內容和可靠性驗證。資料分析包括 Pearson 相關、Spearman Rank、t 檢驗、方差分析及多重迴歸，以找出預測因子。結果： 研究參與者的年齡為 21-40 歲，大部分為女性 (89.9%)。大多數學生的護理能力自我效能感呈現中等水平 (37.1%)。Pearson 分析顯示，護士學生的能力自我效能感 (r = 0.333, p < 0.001) 與其 EBP 能力之間有統計上顯著的正相關。期刊閱讀習慣也與 EBP 能力呈正相關 (r = 0.255, p < 0.001)。多重迴歸分析發現，每天閱讀期刊的時數 (B = 14.675, p = 0.011) 和 NCSE (B = 0.312, p < 0.001) 是 EBP 能力的顯著預測因子。然而，線上學習和使用的資料資源類型對 EBP 能力沒有顯著影響。總結： 本研究強調了自我效能感在提升護理學生實證為本實踐能力方面的重要性。研究結果表明，旨在提高自我效能感、促進定期閱讀期刊和優化線上學習資源的教育策略可以顯著提高 EBP 能力。通過關注這些領域，護理教育者可以讓學生更好地做好準備，以滿足循證醫療的需求，最終改善患者的治療效果。[[abstract]]Background: The COVID-19 pandemic disrupted nursing education, creating significant gaps between theoretical learning and practical application, leading to reduced confidence among nursing students. Addressing these gaps is crucial for preparing students for future clinical practice. Evidence-Based Practice (EBP) is a core competency essential for delivering safe, high-quality patient care. Nursing students' professional competence is often linked to their self-efficacy, making it important to assess their competence self-efficacy and EBP competency before they enter professional practice. This study aims to examine the relationship between post-pandemic competence self-efficacy and EBP competency in nursing students and identify the predictors influencing EBP competency.Method: A descriptive correlational study was conducted between August and September 2023, involving 178 nursing students at a private university in Indonesia who had completed their professional program. Participants completed an internet-based survey using the Nursing Competence Self-Efficacy Scale (NCSES) and the Student Evidence-Based Practice Questionnaire (SEBPQ), both of which were translated into Indonesian and validated for content and reliability. Data analysis included Pearson correlation, Spearman Rank, t-tests, ANOVA, and multiple regression to identify predictors.Results: The study participants were aged 21-40 years, with the majority being female (89.9%). Most students exhibited a moderate level of nursing competence self-efficacy (37.1%). Pearson analysis revealed a statistically significant positive correlation between nursing students' competency self-efficacy (r = 0.333, p < 0.001) and their EBP competency. Journal reading habits were also positively correlated with EBP competency (r = 0.255, p < 0.001). Multiple regression analysis identified journal reading hours per day (B = 14.675, p = 0.011) and NCSE (B = 0.312, p < 0.001) as significant predictors of EBP competency. However, online learning and the type of data resources used did not significantly impact EBP competency.Conclusion: This study underscores the importance of self-efficacy in enhancing nursing students' competency in evidence-based practice. The findings suggest that educational strategies aimed at increasing self-efficacy, promoting regular journal reading, and optimizing online learning resources can significantly improve EBP competency. By focusing on these areas, nursing educators can better prepare students to meet the demands of evidence-based healthcare, ultimately leading to improved patient outcomes
[[alternative]]A study on the effects of using discharge planning LINE Bot to reduce Unplanned readmission
No full text[[abstract]]背景：病人於出院後三日內再返急診及非計劃性十四日再住院為反映住院醫療品質的指標，多國統計資料顯示每年因再入院需花費高額費用，台灣衛生福利部中央健康保險署因此將出院三日內再返急診率及非計劃性十四日再住院率納入健保總額指標，並採用住院診斷關聯群支付制度，以期提高醫療服務效率。台灣2023年出院三日內再返急診率及非計劃性十四日再住院率分別為2.6%及5.59%。北部某區域教學醫院於112年出院三日內再返急診率為2.11%；在出院三日內再返急診中以胸腔內科14.1%最高、非計畫性十四日再住院率則以腫瘤內科32.3%居首、胸腔內科17.5%次之，該院胸腔科病房112年出院準備服務共有291人，有9人(3.1%)於出院後失去聯絡、6人(2.1%)發生再住院顯示出院準備服務在病人出院過程中扮演著相當重要的角色。早期介入出院準備服務(Discharge Planning)能協助病人在住院期間獲得完整照護，出院後能銜接持續性照護，降低再入院率。台灣目前多數醫院由病房護理師協助執行出院準備服務業務，但在臨床照護的壓力之下，護理師可能無法提供完整的服務。隨著科技的進步，在COVID-19疫情期間，醫療院所嘗試運用各式行動裝置來即時解決健康照護相關議題。目的：本研究利用LINE官方帳號平台結合ChatGPT建置聊天機器人，幫助病人進行出院後的追蹤以及照護衛教。方法：研究採類實驗、立意取樣方式、單組前後測研究設計。於二十四小時內即將出院之胸腔科病人介入「出備幫手LINE Bot」，並於出院前及出院後十四天運用科技接受模式及品質滿意度問卷評值結果。結果：在60位研究對象中，介入「出備幫手LINE Bot」使用後出院後三日再返急診有二人、非計畫性十四日再住院則為一人；在介入「出備幫手LINE Bot」後認知有用性、認知易用性與使用態度及使用行為成正相關。結論：「出備幫手LINE Bot」的易用性及方便性、與ChatGPT提供及時且有用的資訊，能讓使用者獲得即時諮詢及解決方案的管道來解決照護上的問題，對病人在出院返家後的照護上令人滿意。建議未來能加入其他專門職類共同提供全方位的照護資源。[[abstract]]Background: The rate of emergency department (ED) return within three days of discharge and the rate of unplanned readmission within fourteen days are indicators of inpatient care quality. Statistics from multiple countries show that readmissions incur high annual costs. As a result, the Taiwan Ministry of Health and Welfare's National Health Insurance Administration has included the three-day ED return rate and the fourteen-day unplanned readmission rate as metrics in the national health insurance global budget system. They have also implemented the diagnosis-related group (DRG) payment system to improve the efficiency of healthcare services. In Taiwan, the rates for three-day ED returns and fourteen-day unplanned readmissions in 2023 were 2.6% and 5.59%, respectively. In a regional teaching hospital in northern Taiwan in 2023, the three-day ED return rate was 2.11%. Among these cases, the thoracic medicine department had the highest three-day ED return rate at 14.1%. The oncology department had the highest fourteen-day unplanned readmission rate at 32.3%, followed by the thoracic medicine department at 17.5%. The hospital's chest department had 291 patients receiving discharge preparation services in 2023. Of these, 9 patients (3.1%) lost contact after discharge, and 6 patients (2.1%) were readmitted, highlighting the critical role of discharge preparation services in the patient discharge process.Early intervention through Discharge Planning(DP) helps ensure comprehensive inpatient care and continuity of care post-discharge, reducing readmission rates. Currently, in Taiwan, most hospitals delegate DP-related tasks to ward nurses. However, due to clinical care pressures, nurses might not provide complete services. During the COVID-19 pandemic, healthcare institutions have attempted to use various mobile devices to address healthcare-related issues in real time.Purpose: To utilize the LINE Official Account combined with ChatGPT to create a LINE bot that assists patients with post-discharge follow-up and healthcare education.Method:The study adopts a quasi-experimental design with purposive sampling and a single-group pretest-posttest design. Patients from the Department of Chest who are about to be discharged within 24 hours are introduced to the "Discharge Assistant LINE Bot." The Technology Acceptance Model (TAM) and Quality Satisfaction Questionnaire are used to evaluate the results before discharge and 14 days after discharge.Results:Among the 60 study participants, after the intervention with the "Discharge Assistant LINE Bot," two patients returned to the emergency department within three days of discharge, and one patient had an unplanned readmission within fourteen days. Following the intervention, perceived usefulness, perceived ease of use, and attitude toward use were positively correlated with behavioral intention to use.Conclusion: The ease of use and convenience of the "Discharge Assistant LINE Bot," combined with ChatGPT's ability to provide timely and useful information, offer users an immediate consultation and solution channel to address healthcare issues. This has proven satisfactory for patient care post-discharge. It is recommended that in the future, other specialized professionals be included to provide comprehensive care resources
[[alternative]]The Experience of Chinese and Western Treatment of Patients with Facial Nerve Palsy
No full text[[abstract]]研究背景與動機：身體的感覺會促成自我照護與形成病痛經驗，在已發表接受中西醫治療顏面神經麻痺病人的研究結果指出，病人身體感覺被忽略。臺灣民眾在生病時，往往接受西醫診療之餘，同時使用中醫醫療。研究目的：探討使用中西醫治療顏面神經麻痺病人的病痛經驗。研究方法:採立意取樣，以臺北某醫學中心的神經內科門診、傳統醫學門診及臺北某中醫診所為研究場所，招募使用西醫和中醫治療顏面神經麻痺之病人參與研究。以個別訪談收集從生病開始的身體感覺/受，就醫後的感受，到因應自我照顧的一連串經驗。研究結果：自111年2月到112年5月，共訪談6位同時使用中西醫治療顏面神經麻痺病人在生病過程中產生的身體感覺。他的生病經驗包含兩大部分:第一部分是關於身體的感覺。研究結果呈現受訪者對身體的感覺是不由自主的身體。這樣的感覺來自於三個方面的感覺:1.臉部的異常（如流口水、臉歪嘴斜、無法閉眼），2.醫生對這個疾病的無能為力，3.身體的感覺在就醫過程沒被注意到。第二部分是關於生病行為。由研究結果顯示:1.積極去找及使用正規醫療(急診、神內、復健、中醫)，2.面對臉部外觀異常改善緩慢或殘餘症狀，全部或部分停止西醫的神內及復健，因為疫情才停止中醫。3.察覺到身體容易受冷及風影響，認為身體變脆弱，選擇可以保護自己，提升體力的自我照顧方法。結論：這個不會影響生命，也不會影響大部分生活功能的病，實際上會影響病人對自己身體的看法。在這過程當中，因為臉部外觀功能異常，認為自己是鐘樓怪人，研究對象把查詢到的資料跟自己情況做比較，認為自己的身體是脆弱。這些不同階段的身體感受，產生不同的生病行為。所以研究對象的生病經驗是以身體感覺為核心，需要被專業人員從生病的人身體感覺角度，去關心病人。[[abstract]]Background and Motivations:Previous studies on patients with facial palsy indicate that patients’ bodily sensations are overlooked during the treatments. Taiwanese people often use both traditional Chinese and Western medicine when they are ill.Objectives:To explore the illness experiences of patients with facial palsy in the treatment using traditional Chinese and Western medicine.Methods:Purposive sampling was adopted. The neurology outpatient department (OPD) and the traditional Chinese medicine OPD in a medical center in Taipei, and a traditional Chinese medicine clinic in Taipei were the research sites. Individual interviews were used to collect a series of illness experiences.Results:From February 2022 to May 2023, a total of 6 patients using traditional Chinese and Western medicine to treat facial palsy were interviewed. Their illness experiences consist of two themes. The first theme is about bodily sensations. They described their bodies as an “Involuntary Body,” and this bodily sensation stems from three aspects: 1. Facial Abnormalities 2. Doctors’ powerlessness to treat the disease 3. Neglect of Patients’ bodily sensations. The second theme is about illness-related behaviors. Includes: 1. Actively seeking and using regular medical treatment 2. Stopping parts of the treatments when there’s only little improvement 3. Choose self-care methods on noticing how weak one’s body is.Conclusions：Though facial palsy isn’t life-threatening, it still influences the way patients perceive their bodies. For instance, due to the deviation of eyes and mouth, patients describe themselves as a “Quasimodo.” The bodily sensations at different phases lead to different illness-related behaviors. Patients’ illness experiences take bodily sensations as the core, and patients require professionals’ care and attention from the view of their bodily sensations
Experiences of family caregivers taking care getting lost of persons with dementia: a qualitative study
No full text[[abstract]]Background: Getting lost with family members who have dementia is a significant source of stress for family caregivers. In Taiwan, family caregivers develop strategies to deal with dementia persons who may get lost. This study aimed to explore the experiences of family caregivers caring for persons with dementia who have been lost outside the home.
Methods: A descriptive phenomenological method was used. The COREQ checklist was used to ensure the explicit reporting of data. A total of 20 family caregivers caring for persons with dementia who were lost outside their homes were selected from hospital outpatient clinics and a day care center in northern Taiwan using purposive sampling. Data were analyzed using the Giorgi analysis method.
Results: Five main themes emerged: (i) surprised persons with dementia lost outside, (ii) using strategies to prevent persons with dementia from getting lost, (iii) using strategies to find lost persons with dementia, (iv) exhaustion in long-term care persons with dementia, and (v) coping with the care load. It was found that family caregivers were surprised, nervous, and worried about persons with dementia being lost outside. They used the first strategy to supervise persons with dementia to prevent external losses. In addition, long-term supervision of persons with dementia led to mental exhaustion in the family caregivers. Finally, the family caregivers learned about loss prevention strategies and obtained family support and care replacement workers to reduce the care burden.
Conclusions: It is essential to teach family caregivers early to prevent persons with dementia from losing external strategies. Nurses also provide long-term care services to reduce the care burden on family caregivers
The Behavioral Adaptations and Barriers of Patients Employing Non-Pharmacological Strategies for Cancer Pain Management-A Qualitative Study
No full text[[abstract]]The use of non-pharmacological strategies to complement pharmacological approaches can enhance cancer pain management by promoting patient autonomy and increasing management effectiveness. This study aimed to explore the required behavioral adaptations and situational barriers that cancer patients encounter when utilizing non-pharmacological strategies to manage pain. We adopted an exploratory-descriptive qualitative research approach, purposive sampling, and semi-structured interview guidelines to conduct face-to-face interviews with 18 cancer patients experiencing moderate or severe levels of worst pain. Data were analyzed using inductive content analysis to explore patients' experiences. Five themes described the behavioral adaptations of patients using non-pharmacological strategies to deal with cancer pain: finding complementary therapies, utilizing assistive skills, adapting to assistive skills, diverting attention, and seeking help. Situational barriers faced by patients include being in the workplace or in a climate-affected environment. Behavioral adaptation is necessary for non-pharmacological strategies to coping with cancer pain. The behavioral skills can help the patients to overcome situational barriers to engagement with these strategies. Thus, health professionals are expected to help the patients acquire adequate behavioral adaptation and skills for self-pain management, and assess the effectiveness of the strategies
Early Childhood Teachers’ Professional Development in Practical Knowledge of Assessment: Integration between Teachers and the Preschool
No full text[[abstract]]本研究目的是從學習評量實踐知識的觀點，提出幼兒教師專業發展的一條路徑：如何交互考量「幼兒教師主體」及「幼兒園願景」，以貼近幼兒教師評量專業精進需求。幼兒教師的學習評量之輔導的目的，在於幫助幼兒教師清楚得知幼兒學習狀況，得到佐證以評估學習的成效，並回饋課程與教學對幼兒學習的影響。筆者彙整國內實施學習評量文獻，發現存在兩個議題：（一）評量行動與評量目的落差：知道「做什麼」不知「為何做」；（二）評量信念與實踐的落差：知道「如何做」但無法「做得好」；此二問題往往導致無法有效評估學習成效、無法做出最佳評量決定、偏離原有評量信念、及易受外力左右評量行動的後果。學習評量專業發展即為改善評量實踐，幫助幼兒教師達成「知行合一」的目標。筆者針對幼兒教師評量專業發展提出兩個策略：（一）教師主體性與幼兒園願景鑲嵌互融：個人與幼兒園建立評量共識共創願景，勇於發聲進行社群專業對話，覺察並修正自己的評量實踐知識。（二）透過解決現場的實踐問題，教師協同合作提升評量知能：瞭解幼兒教師已有的經驗與知識，藉由協同解決問題產生成功經驗，關注問題解決中的幼兒園整體脈絡。期望藉由上述二策略，幼兒教師與幼兒園全體共同面對評量現況，在建構評量實踐知識的過程中提升個人專業，共謀園所願景，最終促進幼兒的學習成長。
This study proposed a point of view on the practical knowledge of assessment for learning to develop the teacher’s profession which considers both the subjectivity of the preschool teacher and the vision of preschool. The objective of mentoring the preschool teachers in assessment for learning was to recognize evidences in children’s learning, evaluate learning results, and give feedback to curriculum and instruction. Reviewing literature, the researchers found two issues in assessment practice: Firstly, there were gaps between “why” and “how” to action of assessment. Secondly, there were gaps in “what to do” and “what should do” in assessment practices. To improve teachers’ practical knowledge in assessment, the researchers recommended to integrate both teacher-based and preschool-based needs into
professional development, including building vision through teachers, reaching a consensus in assessment practice, and resolving field problems coordinately to
promote knowledge of assessment
Acute Effects of 160-Degree V-Shape Whole-Body Periodic Acceleration (WBPA) on Blood Pressure and Cardiovascular Hemodynamics
No full text[[abstract]]Whole-Body Periodic Acceleration (WBPA) has been reported to induce endothelial nitric oxide and cause vasodilation. However, the effects of WBPA on blood pressure and cardiovascular hemodynamics are still unclear and controversial. The objective of this study was to determine whether a single session of 160-degree V-shape Whole-Body Periodic Acceleration (WBPA-V-160), i.e., periodic motion of the supine body headward to footward, improved blood pressure and cardiovascular parameters. A pre-evaluation and post-evaluation of blood pressure and cardiovascular hemodynamics via DynaPulse Noninvasive and Quantitative Hemodynamic Profile Analysis were performed after a single 30 min trial of WBPA-V-160 with a moving distance, headward to footward, of 2 mm, at a constant frequency of 4 Hz. Systolic BP, diastolic BP, heart rate, end systolic pressure, end diastolic pressure, mean arterial BP, and pulse pressure at post-evaluation were significantly lower than at pre-evaluation after WBPA-V-160, whereas systemic vascular compliance and brachial artery distensibility at post-evaluation were significantly higher than at pre-evaluation. The WBPA-V-160, performed for 30 min, did improve blood pressure and cardiovascular hemodynamics by lowing the BP parameters and enhancing systemic vascular compliance
Angiotensin II Receptor Blocker Irbesartan Enhanced SIRT1 longevity Signaling Replaces the Mitochondrial Biogenetic Survival Pathway to Attenuate Hypertension-Induced Heart Apoptosis
No full text[[abstract]]Background: The present study investigated whether angiotensin II type 1 receptor blocker irbesartan (ARB) and partial agonist of PPAR-γ prevents heart apoptosis by suppressing cardiac Fas/FasL-mediated to mitochondria-mediated apoptosis in the hearts of hypertensive rat model.
Methods: Cardiac function using echocardiography, H&E staining, TUNEL assay, and Western blotting were measured in the excised hearts from three groups, i.e., an untreated hypertensive group (SHR), an ARB-treated hypertensive group (50 mg/kg/day, S.C., SHR-ARB), and untreated normotensive Wistar-Kyoto rats (WKY).
Results: Fas Ligand, Fas death receptors, FADD, active caspase-8, active caspase-3 (Fas/FasL-mediated apoptotic pathway), as well as Bax, cytochrome c, active caspase-9 and -3 (mitochondria-mediated apoptotic pathway), IGF-II, and p-JNK were decreased in SHR-ARB group when compared with the SHR group. SIRT1, PGC-1α, Bcl2, and Bcl-xL (SIRT1/PGC-1α pro-survival pathway) were increased in the SHR-ARB group when compared with the SHR group.
Conclusions: Our findings suggested that the ARB might prevent cardiac Fas/FasL-mediated to mitochondria-mediated apoptosis pathway in the hypertensive model associated with IGF-II, p-JNK deactivation, and SIRT1/PGC-1α pro-survival pathway upregulation. ARB prevents hypertension-enhanced cardiac apoptosis via enhancing SIRT1 longevity signaling and enhances the mitochondrial biogenetic survival pathway
Predictive Model for Oral Status in Elderly People in a Taiwanese Nursing Home Using a High-Protein Black Soybean Koji Food
No full text[[abstract]]With increased age, the appetite, chewing, swallowing, and digestive ability gradually decrease. Previous studies have shown that poor oral health is associated with an inadequate intake of macro and micronutrients and malnutrition. Therefore, improving the diet of elderly people and promoting nutrient absorption will help to improve the quality of life for elderly people. However, few studies have predicted their oral ability based on different food textures and other factors. The purpose of this study was to explore the correlation between oral assessment and texture parameters of high-protein black soybean koji products in elderly people in a nursing home. We used cross-sectional study design for seventy-nine residents aged 65 years and older were recruited. Three different texture of cookies, including normal cookie hardness (1.4 × 105 N/m2), minced cookie hardness (4.4 × 104 N/m2), and pureed cookie hardness (1.4 × 104 N/m2) were provided to participants to test the oral status. An oral assessment scale was used by a dentist to evaluate the oral status of the elderly participants. Different cookie textures showed a significant positive correlation with pronunciation (r = 0.237, p < 0.05), face (r = 0.371, p < 0.01), tongue (r = 0.362, p < 0.01), pharynx (r = 0.256, p < 0.05), swallowing (r = 0.272, p < 0.05), breathing (r = 0.315, p < 0.01), and the total oral score (r = 0.339, p < 0.01). We also used the high-protein black soybean koji products combined with elderly people's comprehensions in a predictive model that had a moderately high correlation to predict the oral status in the elderly group (r = 0.612). We concluded that the high-protein black soybean koji product was associated with the oral ability of elderly people in a nursing home in Taiwan. Our findings indicated that elderly people could immediately understand the correct food texture