Journal of Nursing最新文献

{"title":"[Project to Improve FloTrac Cognition and Skill Accuracy in Nurses Working in the Intensive Care Unit].","authors":"Chih-Ying Kuo,&nbsp;Hsin-Hua Cheng,&nbsp;Pei-Chi Cheng","doi":"10.6224/JN.202310_70(5).10","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).10","url":null,"abstract":"<p><strong>Background & problems: </strong>FloTrac is used to monitor hemodynamics in patients. Insufficient awareness of and inexperience with this machine put patients at risk.</p><p><strong>Purpose: </strong>A project was developed to increase FloTrac cognitive accuracy from 57.6% to 85% and skill accuracy from 73.3% to 91% in ICU nurses. Also, FloTrac installation time was intended to be reduced to less than 8 minutes and 38 seconds.</p><p><strong>Resolution: </strong>Create a pithy, easy-to-remember formula; make operation teaching videos, operation manuals, and reminder cards; arrange educational training; and monitor quality regularly.</p><p><strong>Results: </strong>FloTrac cognitive accuracy increased from 57.6% to 90.4%; FloTrac skill accuracy increased from 73.3% to 99.7%; and installation time was shortened from 8 minutes and 38 seconds to 5 minutes and 42 seconds.</p><p><strong>Conclusions: </strong>After implementation of the project, nurses improved their professional knowledge and were better able to help doctors obtain hemodynamic data efficiently to provide patients with accurate and rapid treatment.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"75-83"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111666","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 Health-Seeking Experience of Patients With Sjögren's Syndrome].","authors":"Chih-Yu Peng,&nbsp;Mei-Ping Liu,&nbsp;Pin-Hsuan Lee,&nbsp;Cheng-I Yang,&nbsp;Huai-Ti Hsieh,&nbsp;Meng-Chen Hsieh,&nbsp;Li-Hung Lee","doi":"10.6224/JN.202310_70(5).06","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).06","url":null,"abstract":"<p><strong>Background: </strong>The multiple symptoms of Sjögren's syndrome lead patients affected by this disease to seek medical advice from different medical disciplines and specialists. Diagnoses are often made many years after initial onset, resulting in mental and physical exhaustion and misunderstandings.</p><p><strong>Purpose: </strong>This study was designed to explore the health-seeking experiences of patients with Sjögren's syndrome.</p><p><strong>Methods: </strong>Qualitative research methods and purposive sampling were used. Fourteen patients with Sjögren's syndrome were interviewed by the first author, and the collected data were analyzed using content analysis.</p><p><strong>Results: </strong>Four themes were revealed from the data, including: (1) distressing symptoms; (2) difficulty in diagnosis; (3) concerns about drug side effects; and (4) facing the disease. The participants initially sought medical attention when they began experiencing early onset symptoms that caused discomfort or annoyance. Their doctors' failure to provide proper diagnoses during the long health-seeking process caused a great deal of suffering to the participants. Although related medications should be taken for life, the participants reported taking lower-than-prescribed dosages out of fear of side-effects. The participants explored their process of coping with the disease, which began with denial and ended with acceptance. By learning from their health-seeking process, participants realized that they needed to take proper care of themselves, adapt to life with their disease, and control related symptoms.</p><p><strong>Conclusions / implications for practice: </strong>To facilitate the early diagnosis of Sjögren's syndrome, healthcare professionals should improve their awareness of this condition and refer patients with related symptoms to rheumatologists and immunologists. Effective early diagnosis and treatment can help these patients reduce the time and effort involved in unproductive doctor's visits, allowing them to better continue as productive members of society and to maintain a good quality of life.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172378","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 Influence of Confinement Location on Maternal Psychological and Role Adaptation: A Six-Month Follow-Up Study].","authors":"Yi-Han Wang,&nbsp;Meei-Sheu Shu,&nbsp;Li-Chu Lai,&nbsp;Wang-Ting Chen,&nbsp;Ying-Fen Tseng","doi":"10.6224/JN.202310_70(5).08","DOIUrl":"10.6224/JN.202310_70(5).08","url":null,"abstract":"<p><strong>Background: </strong>Approximately 70% of postpartum women in Taiwan choose postpartum care institutions for their postpartum confinement. However, few studies have explored the follow-up relationship between confinement location and, respectively, maternal psychological and role adaptation.</p><p><strong>Purpose: </strong>To explore the differences in psychology and maternal role adaptation between postpartum women in two different confinement locations and to analyze the predictors of maternal confidence and maternal competence at six-months postpartum.</p><p><strong>Methods: </strong>A comparative and follow-up research design was adopted. We recruited a convenience sample of two groups of women confined, respectively, at postpartum nursing centers and at home. One hundred fifty-seven mothers recruited after G-power estimation were enrolled as participants and completed demographic data and six scales at one-week, one-month, and six-months postpartum. The statistical analysis was performed mainly using generalized estimating equations.</p><p><strong>Results: </strong>For all participants, maternal confidence was positively associated with time, being multipara, having religious beliefs, and having better mother-infant bonding (p < .05). In addition, being confined at home, being unemployed, having religious beliefs, perceiving lower levels of stress and depression, having better sleep quality, and having better mother-infant bonding were associated with higher maternal competence (p < .05).</p><p><strong>Conclusions / implications for practice: </strong>Based on the findings of this study, postpartum nursing institutions should actively promote strategies to improve maternal competence to help mothers staying in postpartum nursing centers strike an optimal balance between recuperation and parenting preparation. Furthermore, obstetric health professionals should implement policies related to mother-infant bonding to increase maternal confidence and competence and, subsequently, facilitate maternal role adjustment.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"54-65"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131405","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":"[A Nurse's Experience Providing Care to a Mother of a Toddler With Cohen's Syndrome Facing Tracheostomy Decision-Making Conflict Using Watson's Caring Theory].","authors":"Ya-Han Lin,&nbsp;Chia-Hui Chien,&nbsp;Shu-Ru Uen,&nbsp;Shao-Yu Tsai","doi":"10.6224/JN.202310_70(5).13","DOIUrl":"10.6224/JN.202310_70(5).13","url":null,"abstract":"<p><p>This case involved a 17-month-old toddler with Cohen's syndrome and cerebral palsy who had experienced multiple hospitalizations and operations since birth. During hospitalization, the patient suffered from tracheomalacia and poor swallowing and coughing abilities and had experienced two cardiopulmonary resuscitation events, after which a tracheotomy was suggested. Decision-making regarding the tracheotomy placed the mother under tremendous pressure, who was facing both the life-threatening disease of her son and her burden of care. During the nursing care period from 19th September to 6th December 2022, the author identified the main nursing problem as \"decision-conflict: decision-making in relation to tracheotomy procedure\" and distinguished the nursing process into (1) escape period, (2) conflict period, and (3) coping period after decision-making. Adopting the ten carative factors in Watson's Caring Theory as the core of her care approach, the author was able to establish a mutually trusting relationship with the mother and to understand her needs by means of listening, consistency, and empathy. This involved providing sufficient information and holding family meetings to facilitate communication in combination with palliative medical resources to provide follow-up care support as well as helping the family find meaning in their lives.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"98-107"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41138736","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":"[Enhancing Understanding Among Intensive Care Unit Nurses of Lower Back Musculoskeletal Disorders and Associated Risks].","authors":"Chi-Hsuan Fan,&nbsp;Yu-Ning Lin,&nbsp;Pei-Tzu Wu,&nbsp;Shu-Ping Shih,&nbsp;Ya-Shiu Lo","doi":"10.6224/JN.202310_70(5).09","DOIUrl":"10.6224/JN.202310_70(5).09","url":null,"abstract":"<p><strong>Background & problems: </strong>Work-related musculoskeletal disorders (WMSDs) have received the most attention worldwide of the various diseases addressed by the field of occupational medicine. In intensive care units (ICUs), patients with critical illness typically rely heavily on assistance provided by nurses to engage in daily life and rehabilitation activities. This dependence increases the risk of nurses experiencing WMSDs. An injury screening revealed that 56.4% of the nurses working in the ICU of the case hospital faced a mild risk of lower back musculoskeletal disorders and that the main contributor to this risk was lack of understanding among these nurses of lower-back-related WMSDs.</p><p><strong>Purpose: </strong>This project was designed to enhance understanding of lower back WMSDs among the ICU nurses and to reduce the percentage of nurses facing a mild risk of contracting WMSDs.</p><p><strong>Resolutions: </strong>1. Organize integrated courses to introduce human-induced hazards and enhance nurses' understanding and prevention of WMSDs. 2. Design slogans, posters, and teaching videos to promote awareness of patient turning tips and procedures to prevent nurses from experiencing WMSDs due to incorrect force application. 3. Design illustrations highlighting risky postures commonly performed by nurses in ICUs that may cause lower back WMSDs to prevent the occurrence of human-induced injuries.</p><p><strong>Results: </strong>The rate of correct understanding of lower back WMSDs in the target nurse population improved from 73.8% to 96.2%. In addition, the percentage of those assessed with a mild risk of contracting lower back musculoskeletal injuries decreased from 56.4% to 25.5%.</p><p><strong>Conclusions: </strong>This project promoted multifaceted improvement measures based on the WMSD screening and risk classification and management processes stipulated by Taiwan's Ministry of Labor to increase understanding of lower back WMSDs among ICU nurses and reduce the percentage of those facing a mild risk of contracting WMSDs.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"66-74"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131404","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":"[Reflections on the Design of English-Medium Instruction Courses in Nursing].","authors":"Nai-Ying Ko,&nbsp;Yen-Chin Chen","doi":"10.6224/JN.202310_70(5).05","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).05","url":null,"abstract":"In line with the Taiwan government's 2030 bilingual national policy, nursing education must emphasize the importance of enhancing English proficiency, developing international competitiveness, and fostering global literacy. English is used as the medium of instruction (EMI) in nursing education with the main goal of conveying professional knowledge and skills through effective communication and linguistic awareness. The achievement of this goal may be enhanced by the use of artificial intelligence (AI) technology and software to assist teachers and students improve their linguistic awareness. EMI curricula provide to students of different nationalities opportunities to learn and appreciate multicultural perspectives, allowing them to practice respect for different cultural perspectives, cooperate in international learning environments, and build global competence.","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168495","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":"[An Inconvenient Fact: Impact of EMI on Nursing Education].","authors":"Shu-Ling Chen","doi":"10.6224/JN.202310_70(5).01","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).01","url":null,"abstract":"<p><p>With the internationalization of higher education, English as a Medium of Instruction (EMI) has become one of the most significant global educational trends in the 21st century (Aizawa et al., 2023). Medium of instruction refers to the language used when teaching non-language academic/content subjects such as science (Lo & Lo, 2014). The aims of EMI include developing students' English professional expertise, expanding their knowledge of different academic disciplines, and preparing them to participate in the international community. EMI is used in many countries, including Taiwan, as an internationalization strategy in higher education (HE). In 2018, Taiwan's National Development Council proposed a blueprint for developing Taiwan into a bilingual nation by 2030, with related policies promoting the widespread use of English in HE. In 2021, Taiwan's Ministry of Education announced a new program on bilingual education for students to promote EMI courses in HE. However, in addition to English language proficiency, internationalization is essential to nursing education. Thus, it is also necessary to actively strengthen the international outlook and global village citizenship of Taiwan's nursing students. In both university and vocational nursing education, English education focuses mostly on English for Specific Purpose (ESP)-oriented English courses designed to help learners do well in their academic and professional preparations for their future careers (Saragih, 2014), while English for Academic Purposes (EAP) focuses on enabling learners to use English in their study and research activities (Flowerdew & Peacock, 2001; Hyland & Hamp-Lyons, 2002). EAP is concerned with using English in academic domains (Walkinshaw et al., 2017). In contrast to ESP and EAP, EMI, although also using English as a teaching tool and conveying academic knowledge in English, does not include improving English proficiency and abilities as a primary goal (Dearden & Macaro, 2016). The current global explosion of EMI in higher education is unprecedented (Aizawa et al., 2023), leading to EMI being described as an 'unstoppable train' from which EMI educators must safely ensure their students alight at their destination (Macaro, 2018). To reduce the challenges students face on their EMI journeys, educators must first understand the common challenges experienced by students. In this EMI educational scenario, educators experience how the change in the language of instruction impacts their teaching and their students' learning effect. From a pedagogical perspective, studies have confirmed that, in addition to teacher training support (Lauridsen, 2017; Sánchez-Pérez, 2020), HE should focus on providing more solid and diverse training courses that teach strategies for pronunciation and discourse, accommodate diversity in the classroom, and teach multicultural competencies (Orduna-Nocito & Sánchez-García, 2022). Therefore, for this column, we have invited authors with background","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137046","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":"[Concept Analysis of Fusion Leadership].","authors":"Wen-Ling Chen,&nbsp;Hsiu-Hung Wang,&nbsp;Kuei-Min Chen","doi":"10.6224/JN.202310_70(5).12","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).12","url":null,"abstract":"<p><p>Important concepts in leadership management related to the field of medical care management include servant leadership, charismatic leadership, and transformational leadership. Since the 2020 emergence of the coronavirus pandemic, the world has faced the immediate challenges of epidemic prevention and control. Although national government and medical system officials as well as scholars have weighed in on this issue, their leadership does not appear to line up the core ideas of leadership. Daft and Lengel (2000) examined the influence of fusion leadership on individuals and organizations. The fusion of many nuclei of leadership intentions will produce great power and influence. To elucidate the concept of integrated leadership for individuals and organizations in the post-pandemic healthcare system, this paper summarizes the defining characteristics of fusion leadership based on the conceptual analysis method of Walker and Avant (2019). Concurrently, we confirm the antecedents and consequences of fusion leadership, use different cases to illustrate the analysis, and share the reference indicators and measurements of fusion leadership to provide a reference for healthcare system administrators.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"91-97"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111489","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":"[Development and Validation of the Outpatient Nurses Communication Behavior Inventory].","authors":"Shan-Wei Lu,&nbsp;Li-Chen Hung,&nbsp;Chieh-Yu Liu,&nbsp;Chu-Yu Huang,&nbsp;Su-Fen Cheng","doi":"10.6224/JN.202310_70(5).07","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).07","url":null,"abstract":"<p><strong>Background: </strong>Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings.</p><p><strong>Purpose: </strong>The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity.</p><p><strong>Methods: </strong>During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated.</p><p><strong>Results: </strong>The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89.</p><p><strong>Conclusions / implications for practice: </strong>The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"44-53"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150921","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":"[From 0 to 1: Taking the First Step in English-Medium Instruction].","authors":"Tong-Yu Hsieh","doi":"10.6224/JN.202310_70(5).04","DOIUrl":"https://doi.org/10.6224/JN.202310_70(5).04","url":null,"abstract":"<p><p>Teaching in English (aka English as a medium of instruction [EMI]) presents a significant challenge for many university instructors. This is particularly true for those who have never taught an EMI course before, as they may feel confused, anxious, and unsure how to start. Beyond the challenge of the language itself, the pressure of conveying specialized knowledge in a non-native language and ensuring student comprehension are major sources of stress. This article was developed to share and explore the approach and experience of a field instructor teaching his first EMI course in STEM (science, technology, engineering, and mathematics). In the article, the anxieties and worries that may arise prior to starting the course and strategies that may be used to overcome these are discussed. In addition, measures that teachers may use to effectively manage classes and ensure student understanding during the course and to continually enhance teaching quality are addressed. We hope this article can help those interested in or required to teach EMI courses successfully take the first step and continue to improve with confidence, enhancing their teaching abilities.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"70 5","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180140","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}