Journal of Nursing最新文献

{"title":"[Ethical Reflections on Preimplantation Genetic Diagnoses].","authors":"Yu-Ting Wang, Wen-Chien Hung, Wen-Pei Shih, Ya-Ting Tsai, Wei-Fang Wang","doi":"10.6224/JN.202408_71(4).12","DOIUrl":"10.6224/JN.202408_71(4).12","url":null,"abstract":"<p><p>With fertility rates at an all-time low, children have become even more the 'treasures' of their families. Progress in genetic selection technology has made preimplantation genetic diagnosis an increasingly common practice in clinics. However, the practice of purposively selecting genes for future children remains controversial. In this article, the process of preimplantation genetic diagnosis is introduced and related philosophical and social perspectives are reviewed. Finally, the ethics related to this practice are discussed in the contexts of obligation theory, utility theory, and four ethical principles. The authors hope this article sheds light on the diverse perspectives used to consider and discuss the ethical issues surrounding gene selection and, importantly, helps nurses provide care grounded in ethics and humanity in ethically uncertain circumstances.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"98-103"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New Horizons for Clinical Practice and Competence: Applying Game-Based Learning in Nursing Education].","authors":"Pei-Rong Chang, Yuan-Ping Chang","doi":"10.6224/JN.202408_71(4).02","DOIUrl":"10.6224/JN.202408_71(4).02","url":null,"abstract":"<p><p>Game-based teaching strategies enrich nursing education by enhancing the appeal and practicality of teaching activities. Different from the high-pressure and serious nature of traditional nursing education, interactive and entertaining teaching strategies that employ board games, card games, escape rooms, virtual reality, scratch cards, Kahoot quiz competitions, and other innovative methods better motivate learners to engage actively with learning content and retain nursing knowledge and practices, resulting in better learning outcomes. Game-based teaching strategies not only strengthen learners' mastery of core nursing concepts but also enhance their decision-making and critical-thinking abilities. In this article, practical applications of game-based teaching are introduced, in hopes that, by applying these instructional approaches, educators can alleviate the stress of the learning process and make learning more efficient and enjoyable for students.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revising the Taiwan Code of Ethics for Nurses].","authors":"Meei-Shiow Lu, Ching-Ching Cheng, Chiu-Fen Lin, Che-Ming Yang, Mei-Nan Liao","doi":"10.6224/JN.202408_71(4).06","DOIUrl":"10.6224/JN.202408_71(4).06","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions / implications for practice: </strong>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.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 4","pages":"32-43"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Using Lean Management to Improve the Nursing Admission Process for COVID-19 Patients in the Intensive Care Unit].","authors":"Hsin-Yi Tsao, Pao-Yu Chuang, Shu-Ing Gone, You-Ping Wang","doi":"10.6224/JN.202408_71(4).10","DOIUrl":"10.6224/JN.202408_71(4).10","url":null,"abstract":"<p><strong>Background & problems: </strong>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.</p><p><strong>Purpose: </strong>In this project, lean management was implemented to reduce the time spent on the nursing admission process for patients with COVID-19.</p><p><strong>Resolutions: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 4","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systematic Review and Meta-Analysis of Non-Invasive Acupoint Therapy as an Approach to Urinary Itching Control in Dialysis Patients].","authors":"Mei-Ling Hsieh, Hsin-Shu Huang, Yann-Fen Chao, Hsin-Li Liu","doi":"10.6224/JN.202408_71(4).09","DOIUrl":"10.6224/JN.202408_71(4).09","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Uremic pruritus, one of the most painful symptoms experienced by patients receiving dialysis, seriously affects patient quality of life and health, causes physical and mental damage, and increases hospitalization and mortality rates. Multi-modal therapies with evidence-based healthcare are needed to provide patients receiving dialysis with more convenient and feasible medical resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Relevant domestic and international research on the effectiveness and methods of non-invasive acupoint therapy in improving uremic pruritus in dialysis patients was reviewed. Discussing related knowledge can facilitate the evidence-based use of non-invasive acupoint therapy in clinical practice by clinical medical personnel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) systematic literature review and integrated analysis method, a keyword search of related articles published before September 2023 was conducted in the following databases: PubMed, Cochrane Library, Embase, Web of Science, Airiti Library, Taiwan Master and Doctoral Dissertation System, Chinese Journal Full-text Database and Wanfang Data Knowledge Service Platform. In 2019, the second version of the Risk of Bias Tool for Randomized Controlled Trials was used to evaluate research quality, after which RevMan 5.4 and Stata 14.0 suite software were used for meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine of the 112 articles selected, including 10 sets of data and 597 participants, were included in the meta-analysis. The results indicate non-invasive acupoint therapy significantly reduces the degree of uremic pruritus (synthetic effect size = -1.30, 95% confidence interval [-1.67, -0.93], p &lt; .00001). Because the heterogeneity test I² = 76%, showed a high degree of heterogeneity, a subgroup analysis was performed, showing that acupoint massage combined with traditional Chinese medicine fumigation and washing, a general simple itching assessment scale, and the Chinese region achieved better effect sizes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions / implications for practice: &lt;/strong&gt;Non-invasive acupoint therapy is easy to implement, inexpensive, non-invasive, and associated with few side effects. The authors hope these findings may increase the awareness and understanding of patients with dialysis regarding the practical operation techniques of itching acupoints. According to the results of this systematic review and meta-analysis, massage of the lung and endocrine acupoints at ST-6, SP-10, and LI-11 as well as the relevant points on the ear may be most effective in achieving urinary itching relief. Also, acupoint massage combined with traditional Chinese medicine fumigation, ST-6 far-infrared irradiation, or LI11 transcutaneous acupoint electrical stimulation can further relieve uremic pruritus in this patient population. Based on the results, acupoint massage combined with tradi","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 4","pages":"69-80"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Game Products: Innovative Pathways for Nursing Education and Clinical Training].","authors":"Mei-Fang Chen","doi":"10.6224/JN.202408_71(4).01","DOIUrl":"https://doi.org/10.6224/JN.202408_71(4).01","url":null,"abstract":"<p><p>To excel in their work, nurses must have specialized tools to support their tasks and professional development. Games, as a crucial pathway to achieving nursing education and clinical training goals, demonstrate significant potential and application value, making them an innovative product. Nursing education games come in various forms, including virtual reality, augmented reality, tabletop, and digital, and may be designed as needed for individual, two-player, or team play (Avşar et al., 2023; Bermejo et al., 2023; Tsai et al., 2024). These games, beyond their entertainment value, have clear educational objectives embedded in their design. Through levels, challenging tasks, and reward mechanisms, they stimulate learning enjoyment and promote nursing development. In this column, experts and scholars in the field of nursing engaged in game development share their experiences and achievements. Integrating games into nursing delivers a wealth of tools and resources for nursing education and clinical practice, offering immersive learning experiences, instant feedback, and individualized learning paths. For nursing students, gamified products offer safe and risk-free learning environments in which they can practice critical tasks and make decisions in simulated medical scenarios, increasing their clinical experience and confidence and enhancing their clinical judgment and decision-making skills (Wu et al., 2023). For patients, many therapeutic games have already been designed that use gameplay to improve health by facilitating user engagement in rehabilitation exercises, promoting healthy eating, and fostering social interactivity (Tsai et al., 2024). For nurses, various games are being used to promote continuous professional growth in an interactive and enjoyable learning environment, improving overall quality of care and job satisfaction (Hsieh et al., 2023). In summary, the application of game products in nursing education and clinical training has introduced new learning and training models that provide multifaceted benefits for nurses, nursing students, and patients. We hope that readers will gain a deeper understanding of related game products after reading this column and use games effectively to enhance nursing quality.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Diverse Development and Clinical Application of Game-Based Learning].","authors":"Chung-Fang Chiao, Shu-Fen Niu","doi":"10.6224/JN.202408_71(4).04","DOIUrl":"10.6224/JN.202408_71(4).04","url":null,"abstract":"<p><p>The effectiveness of game-based learning strategies lies in the ability of these strategies to engage learners and enhance their motivation to learn. This is particularly important for today's younger generations, which are known to respond better to visual rather than textual information. Gamified education provides stimulating, realistic, and enjoyable learning experiences, helping students understand complex nursing knowledge and skills. The diversity of game-based learning tools, including based board games, escape room games, digital games, simulation games, mobile serious games, and virtual reality games, not only enhances students' learning effectiveness and skills but also improves their problem-solving abilities, communication skills, and ability to cope with various challenges in clinical care. In general, game-based learning is a strategy with great potential and importance. This strategy not only has profound implications for modern nursing education and clinical practice but also, through its promotion of innovative thinking and diversified applications, can effectively promote the learning motivation of nursing professionals, improve teaching effectiveness, and enhance professional abilities and self-directed learning capabilities. In an era in which medical knowledge is constantly evolving, game-based learning should be promoted and utilized to cultivate nursing professionals' capabilities effectively.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Gamification and Game-Based Learning in Nursing Education].","authors":"Li-Fen Chao, Mei-Ling Wu, Ping-Ru Hsiao","doi":"10.6224/JN.202408_71(4).03","DOIUrl":"10.6224/JN.202408_71(4).03","url":null,"abstract":"<p><p>With the recent rapid changes in the medical environment and technology, traditional teaching methods are no longer sufficient to meet current professional needs. There is an increasing demand for emerging technologies in higher education, necessitating more interactive and personalized educational approaches. Hence, educators are exploring innovative teaching interventions, including digital simulations and gamified learning, to enhance motivation and engagement in learning. In this article, the concept and core elements of gamified learning are introduced and related methods applicable to nursing education such as digital simulations, virtual reality, tabletop games, and escape rooms are described. In addition, gamification teaching techniques that enhance student learning motivation as well as improve learning outcomes in theory and practice are discussed. Gamified learning enables nursing students to practice in rich and diverse interactive simulated environments. Using appropriate teaching strategies, the gamified approach to learning can strengthen critical thinking, problem-solving abilities, and communication confidence in students. Designing game mechanisms and methods that align with educational objectives and mastering the key principles of gamified teaching is an effective approach to diversifying and enhancing the effectiveness of learning activities in the classroom.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Efficacy of Joyful Learning on Exercise in Older Adults: The GAME Strategy].","authors":"Chia-Shan Wu, Chun-Chin Tsai, Ming-Hsin Chen, Mei-Fang Chen","doi":"10.6224/JN.202408_71(4).05","DOIUrl":"10.6224/JN.202408_71(4).05","url":null,"abstract":"<p><p>Exercise can effectively slow aging and prevent the onset and reduce the complications of chronic diseases in the elderly. However, roughly one-third of older adults are inactive. Joyful learning is an effective method for promoting physical activity, while using games is a feasible strategy for achieving joyful learning that enables individuals to fully immerse themselves in and enjoy an activity. Therefore, exploring gaming strategies to enhance physical activity among the elderly is worthwhile. In this paper, a set of gaming strategies based on the literature and practical experience is proposed. The name of this strategy, GAME, is an acronym of the following: goal setting and educational content development (G), activity design and game content creation (A), mechanics and dynamics implementation (M), and evaluation of qualitative and quantitative health outcomes (E). This systematic descriptive approach helps clearly demonstrate how gamification strategies can promote physical activity and health in older adults. The aim of this paper is to provide a reference and guide for education, research, and clinical practice in health promotion programs targeting older adults.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 4","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Using Multiple Strategies to Improve Medication Cognition in Patients After Liver Transplantation].","authors":"Yi-Jing Tsai, Jie-Yu Huang, Hsin-Huei Lin, Shu-Chien Liu, Chiu-Yi Chiang, Mei-Wen Wang","doi":"10.6224/JN.202408_71(4).11","DOIUrl":"10.6224/JN.202408_71(4).11","url":null,"abstract":"<p><strong>Background & problems: </strong>Patients with liver transplantation must take lifelong immunosuppressant medication to maintain the function of their hepatic graft. Based on clinical experience, we found that these patients were affected by both insufficient and remaining medication when they returned for outpatient service visits. After investigating the current situation, It was found that post-transplantation perceptions regarding medication were low in this patient group. After analysis, the identified causes of this included: (1) poor learning effect due to the interference from the multiple therapeutic catheter placement postoperatively; (2) delayed timing of assessing the awareness of information or perception of medication and lack of a post-operative follow-up mechanism; and (3) insufficient educational tools and materials for patients.</p><p><strong>Purpose: </strong>This study was designed to increase medication awareness from the current average of 68.3% to >91% and to increase patient satisfaction with medication guidance from the current 63.0% to >85% in patients who had received liver transplantation.</p><p><strong>Resolutions: </strong>The improvement strategy included: designing a health education sheet including related medication information and a daily medication record; designing a mnemonic, interactive video, or test to improve medication perception; creating measures associated with a monitor mechanism to assess medication knowledge.</p><p><strong>Results: </strong>After strategy implementation, medication awareness increased from 68.3% to 92.5% and satisfaction with medication guidance increased from 63.0% to 87.2%.</p><p><strong>Conclusions: </strong>The implementation of several strategies concurrently can enhance medication awareness in patients after liver transplantation and increase patient satisfaction with medication guidance.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 4","pages":"89-97"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}