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Factors related to changes in resilience and distress in women with endometrial cancer
No full text[[abstract]]The purpose of the study is to explore changes in resilience and physical and psychological distress and their related factors over time in women with endometrial cancer. This study adopted a repeated measures design using purposive sampling and was conducted in a hospital in Taiwan. Data were collected before surgery, 2 weeks after surgery, and 3 months after surgery. The measured variables consisted of demographic and disease characteristics, social support, resilience, and physical and psychological distress. A total of 48 women participated in the study, of whom 42 (mean age = 54.2 years old) completed all of the questionnaires. The results showed that resilience and physical distress in women with endometrial cancer was not statistically significantly changed over time. Rather, their psychological distress was significantly alleviated 2 weeks and 3 months after surgery as compared to before surgery. Women with less social support showed a lower level of resilience. In addition, those with a lower level of resilience experienced greater psychological distress. Compared with those who received only surgical treatment, women who had undergone surgery combined with chemotherapy and radiotherapy had more physical distress. Clinical medical staff should conduct continuing assessments of the resilience, physical distress, and psychological distress of women with endometrial cancer. Interventions related to resilience-enhancing and self-care should be implemented to avoid worsening or to improve women's resilience and distress
Effects of empowerment-based illness management on the medication adherence and recovery of persons with schizophrenia: A systematic review and mete-analysis
No full text[[abstract]]Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta-analysed the effects of empowerment-based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random-effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self-medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18–0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self-strength, connecting external forces, understanding personal needs, and overcoming self-stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10–0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self-strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery
Factors Associated with Personal Recovery among Psychiatric Nursing Home Residents
No full text[[abstract]]WHAT IS KNOWN ABOUT THE SUBJECT?: Poor recovery will cause harm to the quality of life and well-being of residents and that the scope of influence includes the self, family and society. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The factors associated with personal recovery are empowerment, social support and global functioning. This pioneer study contributes new evidence that personal recovery is mainly predicted by empowerment, social support and global function, with empowerment exhibiting the highest predictive value. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support. Mental health professionals should shift to empowerment-oriented care to improve individuals' personal recovery, such as offering more opportunities to achieve autonomy, encouraging individuals' involvement in decision-making and promoting individuals' motivation for achieving their goals. ABSTRACT: Introduction Individuals diagnosed with mental illness have a need for recovery. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. Aim The study aimed to identify the factors associated with personal recovery among psychiatric nursing home residents. Methods This was a cross-sectional study with convenience sampling. Participants were recruited from a psychiatric nursing home in Northern Taiwan between April and June 2018. Data were collected through self-reported, structured questionnaires with verified reliability and validity. Descriptive and hierarchical regression analyses were performed. The present study followed the STROBE guidelines. Results The study included 158 participants. The factors associated with recovery according to bivariate associations were religious belief, psychotic symptoms, global function, social support and empowerment. In the hierarchical regression, empowerment, social support and global function were the main predictive factors of recovery, with the explained variation reaching 40.8%. Empowerment exhibited the highest predictive value for the recovery. Implications for clinical practice Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support
Community Psychiatric Mental Health Nursing: Practice and Challenges
No full text[[abstract]]近年社會風險事件頻傳，精神衛生法已修正落實精神疾病病人之社區治療及社區支持，將社區心理衛生中心新增精神病人追蹤照護之公部門角色，以個案管理為整合性服務模式。在此修法契機下，應定位並發展社區精神衛生護理的獨特角色及任務。國家衛生研究院論壇提倡應以復元導向個案管理為整合照護之精神衛生政策。為銜接此政策，筆者國科會計畫發展護理師執行之需求裁量式復元照護方案，執行後對病人復元有顯著成效。隨後亦發展輔助之行動照護平台評估社區精神病人之照護需求、執行復元照護措施及評量成效，可作為具實證基礎之社區精神衛生護理指引。為協助社區精神衛生護理之實踐，本文將闡述主要社區護理情境：精神居家治療護理及社區心理衛生中心、需求裁量式復元導向個案管理模式、社區精神衛生護理師之能力與認證，描繪精神衛生護理學會規劃之社區精神衛生護理師認證；最後提出未來的挑戰及對策，具以促進社區精神衛生照護品質並協助病人邁向復元
Current Status and Prospects of Community Psychiatric Home Care
No full text[[abstract]]社區精神居家護理為針對無法到精神醫療機構持續就醫或復健的社區精神病人，由護理師至其居住所提供行動照護服務，是有效治療或預防疾病復發、減少再住院並促進復元之社區照護模式。本文描繪臺灣精神居家護理的三種模式：精神醫療為主之精神居家治療、公衛預防疾病復發之居家關懷訪視及延緩並預防失能之長期照顧居家護理，繼而推估精神居家護理需求，最後闡述精神居家護理問題困境及未來展望，藉由推展居家個案管理實證實務及精神個案管理護理師專業認證，建置可近、完整的精神居家照護網絡，以提升社區精神病人照護品質
Current Status and Prospects for Information Communication Technology (ICT) in Allied Health Education
No full text[[abstract]]本文整理近年來運用於醫護教育領域的相關科技，從中梳理並介紹深具影響力的醫護教育科技。本文依據教育內容和教育方式，將其分為三部分：線上線下數位教育，如大型開放線上課程（massive open online courses）或是使用CD-ROM形式；行動學習（mobile learning or mobile digital education），如使用手機、平板電腦或是其他各式連結物聯網的感測器設備；數位模擬教育，如虛擬實境（virtual reality）、虛擬病人模擬（virtual patient simulation）、遊戲化學習（serious gaming and gamification），已有一些研究應用上述教育科技有正向的成果。為了理解新科技能帶來何種影響，建議相關醫護教育工作者，應該持續導入實務課程，以評估其對於學習的影響。然而，現今仍有二項威脅需克服：財政預算有限與少子高齡化問題
Effects of Living Adaptation Group in a Psychiatric Day Care Ward
No full text[[abstract]]本研究主要目的在探討精神科日間留院病房生活適應團體之成效，採「準實驗法」以立意取樣方式於北部某兩所醫學中心的精神科日間留院病房進行研究。研究者指定實驗組與對照組之醫院組別，由各院取樣符合條件的病友，全程參與且資料完整者各計7人，研究過程實驗組接受每週一次（每次50分鐘）之生活適應團體，團體進行的內容以精神病患者在疾病的認知、藥物的認知、服藥的態度及遵從醫囑服藥的護理指導與居家人際溝通和求職考量的單元主題為主，團體治療成效於活動前、後，以結構式問卷針對精神患者在疾病、藥物的認知、服藥的態度及遵從醫囑服藥意願測量之。資料以描述性、百分比、無母數Mann-Whitney等統計方法進行測試，其結果顯示：參加生活適應團體者對精神病患在疾病的認知、服藥的態度無統計顯著差異，但病患在藥物認知及對藥物副作用的認識則有統計上顯著的差異，且藉由團體活動的討論，能加強病患自我覺察其人際溝通的形式，進而應用較佳的溝通技巧和家人相處，避免衝突的產生，本結果可提供精神復健護理未來推廣活動之參考
To Explore the Nursing Function and Management Phenomenon of Psychiatric Nursing Home
No full text[[abstract]]本研究目的是探討精神護理之家護理人員的功能，及瞭解其經營的現況與困境，並提出政策性的建議。採用質性的內容分析方法，分別收集四所精神護理之家的資料及進行深入訪談。經內容分析結果呈現精神護理之家的護理人員功能有七項，分別為營造尊重住民需求的環境、強化自我生活照顧的訓練、支持情緒穩定、提供專業衛教、維繫與家屬互動、連結社會資源以及探討實務問題。精神護理之家目前經營面對四大困境，分別為（一）功能定位與收案標準的不明確，（二）督導評鑑標準的不恰當，（三）醫療給付未盡合理，和（四）空間設備皆為醫院附設機構。本研究結果提出具體建議，可作為機構服務者和中央醫療政策制訂者在制訂有關精神護理之家作業規範、評量標準以及培訓規劃的參考
The Effect of the Laughing Qigong Program on Junior High Students
No full text[[abstract]]Purpose: This study was based on the perspective that promoting health and preventative measures is better than curing disease. The purpose was to evaluate the effectiveness of the Laughing Qigong Program (LQP) among junior high school students in Taiwan. Methods: We used a nonequivalent pre-test post-test design, and selected participants (N=76, age range: 12-14) from a junior high school in Taipei County. The instruments used to collect data included self-report scales of self-esteem, sense of humor, physical condition, the feeling of pressure, and attitudes toward laughter. Also we used the Face Scale to measure current mood status. Statistical analysis was performed with SPSS 15.0. Results: Results supported the effectiveness of the LQP for all participants. The activity resulted in an increased sense of humor (F(subscript (1,41))=5.62, p＜.05), decreased physical discomfort (F(subscript (1,4))=9.14, p＜.01), and produced more positive attitudes toward laughter (F(subscript (1,51))=12.41, p＜.05). Although no statistical significance was found in the variables of self-esteem (p=.86) or stress coping (p=.77), the participants had a positive attitude toward and supported the laughter intervention according to the score of measuring by the faces scale. Furthermore, in the follow-up study, the participants in the experimental group reported the highest item scores in ”most life change” and ”Ⅰ will talk with other people with a smiling face.” Over 90% of the participants in the follow-up group felt that the LQP promoted a positive attitude toward the future. Conclusions: Laughter intervention has positive effects on the physical and mental health status of young adolescents. These findings have important implications for positive psychotherapy. We suggest that future studies be designed for biomedical evidence-based validation of the effectiveness of LQP intervention
優質護理職場醫院策略方案分析研究
No full text[[abstract]]背景：台灣有許多醫院因護理人力不足關病房，但也有些醫院不缺護理人力，它們如何做到，是引發本研究的動機。目的：透過優質護理職場選拔得獎醫院書面資料，探討優質護理職場醫院的策略方案。方法：採多元研究法透過三階段進行，第一階段確認優質護理職場醫院評審項目；第二階段為辦理優質護理職場醫院選拔；第三階段就得獎醫院書面資料進行歸納性內容分析。結果：針對18 家獲獎醫院書面資料分析，找出五大構面策略方案，分別為（一）「領導與管理」構面：「護理主管採用參與式管理」、「傾聽基層人員意見」、「重視申訴管道」、「院方重視護理部」。（二）「人事政策及薪資福利」構面：實施「工作績效獎金」、「建立護理臨床教師制度」。（三）「結構性賦權」構面：「護理部主管參與院內重要會議」。（四）「專業照護」構面：「明訂各職級護理人員之工作職責」、「專人協助新進護理師適應工作與生活」。（五）「創新與改善」構面為「電子化護理行動車提供各項相關資訊連結」。結論／實務應用：本研究結果發現得獎醫院都有不同的策略方案，建議醫院和政府在發展優質護理職場環境時，應積極參考優質護理職場醫院的策略方案，將有助護理人力招募與留任，讓病人獲得更優質、安全的照護品質