Background: The experiences of teenagers with cancer are related to falling ill, receiving treatm... more Background: The experiences of teenagers with cancer are related to falling ill, receiving treatment, and the way they exist in the world. The understanding of the meaning of teenagers coexisting with cancer must be placed in the social context with the teenagers at the core. Objective: By using an interpretive ethnographic research method, this study applied the body perception view of Merleau-Ponty to how teenagers with cancer understand self through the body in a social and cultural context. Methods: Participant observation and individual semistructured interviews of 18 teenagers diagnosed with cancer were conducted over a 20-month period. Results: The illness experience of teenagers undergoing chemotherapy was described as self-integration. Five themes emerged: boundary ambiguity of body, medical equipment as part of the body, confined body space, from self-dissociation toward self-integration, and healing power formed by self and others. Conclusion: In the face of the adjustments of body disorder, the teenagers with cancer initiated motility of the body, self-displacement, and integration in order to regain control of the body. Implications for Practice: The provision of correct disease knowledge to strengthen teenagers' understanding and their sense of mastery of their bodies throughout the participation in their cancer treatment is essential. Discussions on making decisions, self-management, and social identification are related to the relationship between body and self as well as between healthcare and otherness. Providing culture and social sensitivity support systems and resources to teenagers and families can strengthen them to face the disease and promote positive healing. T he experience of teenagers with cancer related to falling ill, the subsequent treatment process, and the associated changes to their bodies all effect the self-image of these teenagers and the way they exist in the world. 1-4 The exploration of cultural and psychological phenomenon of the disease includes the significance of the symptoms and diseases at an individual
To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms... more To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. Background: Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non-pharmacological interventions have been suggested for use during pregnancy. Design: A systematic review of randomised controlled trials.
Qualitative translational research refers to the "bench-to-bedside" enterprise of harne... more Qualitative translational research refers to the "bench-to-bedside" enterprise of harnessing knowledge from the basic sciences to produce new treatment options or nursing interventions for patients. Three evidence-based translational problems related to qualitative translational research discussed this year address the interfaces among the nursing paradigm, the basic sciences, and clinical nursing work. This article illustrates the definition of translational science and translational blocks of evidence-based practice; discusses the qualitative research perspective in evidence synthesis, evidence translation and evidence utilization; and discusses the research questions that must be answered to solve the problems of the three translational gaps from the qualitative research perspective. Qualitative inquiry has an essential role to play in efforts to improve current healthcare-provider nursing interventions, experiences, and contexts. Thus, it is vital to introduce qualitat...
Evidence-based healthcare, the organized translation of knowledge into practice, and the implemen... more Evidence-based healthcare, the organized translation of knowledge into practice, and the implementation of evidence in practice have become vital in nursing care and health policy. Evidence translation is an essential concept that relates to the knowledge development and core competence of advanced practice nurses (APNs). The present article introduces the development and definitions of nursing evidence translation. The evidence-based nursing perspectives of Techne and Phronesis are used to illustrate the characteristics and nature of knowledge translation. The evidence translation models are introduced and the barriers that are often encountered during the three stages of evidence translation are explained. The final section discusses the future development of evidence translation.
OBJECTIVE The aim of this evidence implementation project was to identify the barriers and omissi... more OBJECTIVE The aim of this evidence implementation project was to identify the barriers and omissions affecting adequacy of hemodialysis and to develop implementable strategies to maintain hemodialysis adequacy among hemodialysis patients with end-stage renal disease. INTRODUCTION Assessing adequacy of hemodialysis and improving quality of life are important issues for patients with end-stage renal disease. However, they are often inadequately addressed, and evidence-based practices are not always followed. METHODS A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice approaches. Seven audit criteria that represent best practice recommendations for maintaining hemodialysis adequacy among hemodialysis patients were used. A baseline audit was performed, which was followed by the implementation of multiple improvement strategies over 20 weeks and the outcomes finalized using a follow-up audit to determine the change to be implemented in practice. RESULTS The baseline audit results showed that most audit criteria were less than 77% in practice. The compliance rates for nurses who had received education regarding hemodialysis, checking the prescription order for each patient at each session, and using the prescribed dialyzer for every session were determined to have reached 100% at the follow-up audit. The compliance rates for completion prehemodialysis checks, using a sterile technique when inserting an arteriovenous catheter, matching a blood flow rate with the prescription, and maintaining a blood flow rate throughout the treatment session were found to be 73-95% at the follow-up audit. The most significant finding was the proportion of hemodialysis patients with inadequate urea reduction ratio was reduced from 4.6 to 3.2% after implementation of the best practice approaches. CONCLUSION The implementation of institution-specific evidence-based resources brought about immediate improvements in hemodialysis adequacy management and practice. A variety of strategies contributed to the success of this implementation project, such as scenario simulation education, Objective Structured Clinical Examination, the interrelation response system Kahoot, the use of hemodialysis International Organization for Standardization job descriptions, regular weekly audits, and collaboration with physicians when caring for patients during clinical practice.
Review Question The specific question of this review are: What are the experience of nurses telli... more Review Question The specific question of this review are: What are the experience of nurses telling a terminal cancer patient of a diagnosis or prognosis? Inclusion criteria Phenomena of interest This review will consider studies that explore the nurse’s experiences of truth telling of a diagnosis and prognosis to the terminal cancer patient. Types of Participants This review will consider studies that include nurses involved in truth telling to terminal cancer patients, and who have worked in an oncology unit or hospice care unit for greater than one year.
There is accumulating evidence that recurring pain symptoms in children are becoming a serious he... more There is accumulating evidence that recurring pain symptoms in children are becoming a serious health concern. Children and adolescents who suffer from ongoing pain have negative outcomes not only to their physical health, but also to their emotional and spiritual health. Furthermore, recurrent pain in children may also cause a number of other negative consequences to the child, the family and society. Thus, a non-pharmacological approach to reduce the pain is vital to help children having better quality of life. The objective of this review is to determine the best available evidence on the effectiveness of non-pharmacological pain management in relieving chronic pain for children and adolescents. The search strategy aimed to find published studies, between 1956 and 2008 and limited to the English or Chinese languages. Reference lists of studies that met the inclusion criteria were searched for additional studies. This review included any systematic reviews, randomized controlled trials and quasi-experimental design that explored the effectiveness of non-pharmacological intervention for chronic pain in children and adolescents. Children and adolescents with cancer pain, Juvenile chronic arthritis, sickle cell disease, burn pain, chronic or recurrent abdominal pain, headache and aged 18 years old or less and suffering with pain for at least one month. The review considered studies that examined non-pharmacological interventions in relieving chronic pain for children and adolescents that included heat wrap therapy, massage, chiropractic spinal manipulative therapy, cognitive-behavioral therapy (distraction & guided imagery), meditation, progressive muscle relaxation, self-hypnosis, biofeedback, music therapy, and dance training. The primary outcome measures included: (1) Behavioral variables, such as pain behavior, cognitive coping and appraisal, psychiatric reaction (anxiety and depression), and social activities, (2) Quality of life scores and (3) Pain scores. The review focuses on studies that operated either at a hospital or in a community setting. Meta-analysis was used to pool the data from studies to determine the effectiveness of the intervention. The Comprehensive Meta Analysis V2 was used to manage the data. The search process identified 43,100 studies that addressed the objectives of the review protocol. Fifty-four articles were selected for critical appraisal. Finally, 31 trials were considered to be eligible for the present review and 5 articles were excluded. Data was pooled together from eight articles using meta-analysis to examine the effectiveness of relaxation training of the pre-test and post-test of headache intensity. The findings show that the effective size was 0.323 with significant difference. Two of the articles evaluate the effectiveness of relaxation training for releasing the recurrent headaches for adolescents and the post-test data were collected over the following six months. The findings show that there is a statistically significance difference. Another two articles examined the effectiveness of a relaxation training program in reducing the sum of medication used of adolescents with recurrent headaches. The findings show that there is no statistical significance. Furthermore, the findings show that biofeedback treatment could improve the outcome of children and adolescents' headache, especially at 6 and 12 months after the treatment. In terms of psychosocial treatment, five articles examined the effectiveness of behavioral treatment, relaxation training program, cognitive behavior therapy, and acupuncture/ hypnosis intervention to reduce anxiety of children and adolescent with chronic pain. The various outcomes measures among the five studies. This review has provided an evidence-based guide to future priorities for clinical practice. Relaxation programs could reduce recurrent headache and pain intensity in children and adolescents in the short term as well as lasting for three and six months. Furthermore, biofeedback treatment could reduce recurrent headache of pain intensity in children and adolescents in the short term and last for as long as six months.
This study investigated the subjective experiences of the maternal role transition during the fir... more This study investigated the subjective experiences of the maternal role transition during the first two weeks of hospitalization for premature rupture of the amniotic membranes (PROM). Thirteen pregnant couples participated in the study by completing interviews. Average gestation of the expectant mothers was 27 weeks and the women were already experiencing fetal movement during the first two weeks of hospitalization for PROM. Lincoln and Cuba's trustworthiness criteria were employed to evaluate methodological rigor. Colaizzi's phenomenological approach was used to analyze the structure of the experience. Four themes emerged: pending loss, concern about the safety of the fetus, identification of maternal roles, and the process of maternal role-making. The results provide a scientific basis for empowering nurses to assist with maternal role transition in high-risk pregnancies in a more sensitive and effective manner.
HOSPITAL MEDICINE CLINICS CHECKLIST 1. Anemia can be categorized as severe (hemoglobin [Hgb] leve... more HOSPITAL MEDICINE CLINICS CHECKLIST 1. Anemia can be categorized as severe (hemoglobin [Hgb] level <9 g/dL), moderate (Hgb 9.1-11.0 g/dL), and mild (Hgb >11.0 g/dL). 2. Hospital-acquired anemia (HAA) is prevalent in the intensive care unit as well as on the wards. 3. Every patient who is admitted to the hospital is at risk of developing HAA. Those who are anemic before admission are at risk of worsening anemia during hospitalization. 4. Causes of HAA include blood draws, erythropoietin (EPO) (Amgen Inc, Thousand Oaks, CA, USA) suppression caused by increase in inflammatory markers from acute illness, and downregulation of iron. 5. HAA recognition and treatment affect patient outcomes. 6. Prevention and management of HAA demand a team approach and a culture that supports recognition and reduction of unnecessary laboratory testing and procedures. 7. Pharmacologic treatment continues to evolve, and evidence-based use of intravenous iron and EPO may have a role in supporting erythropoiesis to help prevent transfusion.
This study explores parental lived experience following admission of their child to a pediatric i... more This study explores parental lived experience following admission of their child to a pediatric intensive care unit. The interview data used were collected from 10 randomly chosen families from the Family Impact of Catastrophic Childhood Illness Project recruited during the early phase of critical care hospitalization of their child. A 3-stage contextual analysis procedure integrating interactional and contextual perspectives into Colaizzi's phenomenological approach was used to reduce text data to thematic content. The analysis uncovered a multidimensional and holistic phenomenon consisting offourorganizing concepts: initial boundaryambiguity, parents'coping patterns, family resources, andfunctioning of thefamily boundary. These results provide evidence of a collective family level perception of stress when experiencing the health crisis of a child and supportfurther use offamily stress perception as afamily levelphenomenon that represents family meaning construction during...
Objective: to explore women's experiences in interaction with their midwives during their antenat... more Objective: to explore women's experiences in interaction with their midwives during their antenatal checks and during labour. Design: a qualitative study using a phenomenological approach. Data were collected via tape-recorded interviews. All interviews were transcribed verbatim. Data were analysed using Colaizzi's method for data analysis. Setting: the homes of the study participants in the district of a Taipei (Taiwan) teaching hospital. Participants: a purposive sample of 11 Taiwanese women, one primipara, and 10 multiparae, who were one to three months post-childbirth at the time of interview. Findings: five major themes revealed the essence of women's experiences of their interaction with a midwife during pregnancy and childbirth: (1) being respected, (2) being accompanied, (3) trust, (4) being satisfied, and (5) professional competence. Key conclusions: the women recognised the service model of the midwife; they treasured their mutual relationships and the benefits that women derived from midwifery care during childbirth. In Taiwan, the government is mandated to offer midwifery models of care in hospitals, and to allow women to choose different types of care provider. Implications for practice: an awareness of women's experiences will help identify the caring behaviours as recognised by the women and may help health-care professionals provide better support and care for women during the pregnancy and childbirth periods. These findings can serve as references for future midwifery practice models and improvements in quality of care.
Infertile couples' experience of family stress while women are hospitalized for Ovarian Hyperstim... more Infertile couples' experience of family stress while women are hospitalized for Ovarian Hyperstimulation Syndrome during infertility treatment. Aims and objectives. The aim of this study was to explore the essential structure of family stress among hospitalized women receiving infertility treatment with Ovarian Hyperstimulation Syndrome. Background. When hospitalization is necessary for infertile women with Ovarian Hyperstimulation Syndrome, they face health-illness transition stress and their families are traumatized by the pressure of hospitalization. Most literature on infertility treatment has dealt with the infertile women's physio-psychological reactions, the impact on the couples' relationships and the influence of social support on infertile couples. Design. A descriptive phenomenological design consistent with Husserl's philosophy. Methods. Ten married couples from a Taipei medical centre participated in the study. All the couples were receiving infertility treatment because the female partners were suffering from moderate or severe Ovarian Hyperstimulation Syndrome and this required hospitalized. An open in-depth interview technique encouraged parents to reflect on their experience, which raised their feelings to a conscious level. Data were analysed using Colaizzi's approach. Results. This study explored infertile women's experiences from the couples' perspectives and the results identify the overall stresses that the family face. Five themes emerged from the study, namely, the stress of 'carrying on the ancestral line', the psychological reactions of the couple, a disordering of family life, reorganization of family life and external family support. Conclusions. The results demonstrate that the experience of family stress involves impacts that range across the domains of individual, marital, family and social interactions and there is a need to cope with these when the wife is hospitalized for moderate to severe Ovarian Hyperstimulation Syndrome. Relevance to clinical practice. The findings indicated that nurses should provide infertile couples with family-centred perspectives that are related to Chinese cultural
Maternal experiences making a decision about heart surgery for their young children with congenit... more Maternal experiences making a decision about heart surgery for their young children with congenital heart disease Aim. The aim of this study was to investigate the essence of the experience of mothers during the decision-making process when facing their less than three-yearold child undergoing heart surgery due to congenital heart disease (CHD). Methods. In this phenomenological study in Taiwan nine mothers were interviewed in their homes. They were invited to share their experience of family interactions and relationships while facing a decision about their child's heart surgery. The interviews were recorded and transcribed for further analysis according to Colaizzi's phenomenological methodology. Results. The essence of the maternal experience themes during the decision-making process included (i) understanding the surgery step by step, (ii) role pressure, (iii) constructing care-taking ability, (iv) endeavouring to maintain family functioning while preparing for surgery and (v) deliberate consideration to make the correct decision. Conclusions. When parents face their child having CHD and plan heart surgery, the whole family is living through a stressful decision-making process. According to the results of this study, it is obvious that the caregivers and their whole families experience psychological distress, role reorganization and remodelling of family functioning. Relevance to clinical practice. The results of this study provide evidence-based essential knowledge that will assist the management of such decision-making processes and help to prepare the child and the family to have confidence in the heart surgery.
Paternal reactions to a child with epilepsy: uncertainty, coping strategies, and depression Aim. ... more Paternal reactions to a child with epilepsy: uncertainty, coping strategies, and depression Aim. This paper reports a study examining the stress that fathers experience when caring for a child with epilepsy. Background. A seizure, which is frightening and potentially damaging, creates uncertainty about its possible effects and threatens the integrity of family systems. In the Chinese social context, epilepsy is stereotyped 'sudden craziness' of people and affected family feel shamed by the diagnosis. When a child has epilepsy, the stereotype of epilepsy affects the family experience in terms of stress and their coping process. Few studies have focused on how a father with an ill child adapts to family stress. Methods. This study was based on the resiliency model of family stress, adjustment, and adaptation, and was designed to examine the relationships among fathers' uncertainty, coping strategies, and depression. From three teaching hospitals in Taiwan, 210 fathers were recruited. A pilot study was conducted to establish the reliability and face validity of the Chinese language version of the Coping Health Inventory for Parents. Findings. Results showed that paternal uncertainty was negatively associated with the total Coping Health Inventory for Parents score for family coping patterns for factors I, II, and III. Uncertainty and coping strategies for factors II and III were indicators of paternal depression and accounted for 10AE3% of the total variance. Conclusions. The results give insight into the unique family stress that fathers experience as a result of the interaction between the social context of a child with epilepsy and the family's coping patterns. They also suggest ways to improve familycentred nursing interventions to help parents establish effective caring patterns to manage the family stress.
By using the contextual model of family stress, this study examined fathers&amp;amp;amp;amp;#... more By using the contextual model of family stress, this study examined fathers&amp;amp;amp;amp;#39; family stress experience when caring for a child receiving cancer treatments. A descriptive correlational study was designed to examine the relationships between fathers&amp;amp;amp;amp;#39; uncertainty, sense of mastery, and anxiety. Eighty fathers were recruited from two teaching hospitals in Taiwan. A pilot study was conducted to establish the reliability and validity of the Chinese language version of the above instruments. These instruments showed an acceptable internal consistency and satisfactory construct validity. Results showed that fathers&amp;amp;amp;amp;#39; level of education had a significant effect on paternal anxiety. Uncertainty and fathers&amp;amp;amp;amp;#39; education level equal to or higher than university are good predictors of paternal anxiety, which explain 25% of the variance. The results provide insight into the paternal experience of family stress and suggest ways to improve family-centered nursing interventions and thereby establish better family well-being.
Background: Binge eating (BE) is considered a marker of obesity and overweight and a significant ... more Background: Binge eating (BE) is considered a marker of obesity and overweight and a significant characteristic of feeding and eating disorders. Despite the high prevalence of obesity on college campuses, the issue of BE among college students in Taiwan has received little attention. The aim of this study was to investigate BE behavior among overweight college students in Taiwan and associated factors. Methods: This study utilized a cross-sectional survey. A total of 300 overweight college students were recruited through convenience sampling. Data were collected using a self-administered Binge Eating Scale (BES) and a body weight composition monitor (Model No. OMRON, HBF-126) and analyzed using descriptive statistics, correlation analysis, and regression analysis. Results: The average BES score was 10.67 (SD = 6.66, 0–34). With a BES score of 17 as the cut-off point, 17.3% (n = 52) of the participants were found to have moderate or severe BE behavior. Analysis of the demographic and...
The Journal of Continuing Education in Nursing, 2021
Background: This study formulated clinical guidelines for assessing nasogastric tube placement an... more Background: This study formulated clinical guidelines for assessing nasogastric tube placement and for health education guidance according to evidence-based recommendations. Method: This study used a single group, pre- and postintervention design. Purposive sampling was used to recruit participants from nursing institutions in Taiwan. Results: Sixty-two individuals in charge of nursing institutions were recruited to participate in the in-service training program. Statistically significant differences were observed in the four major items in the self-directed learning readiness scale ( t = 3.85, p < .00; t = 3.99, p < .00; t = 2.94, p < .01; t = 4.13, p < .00). With regard to program satisfaction, the mean score was 4.88 to 4.9 points. The mean score for teaching satisfaction was 4.94 to 4.9 points. Furthermore, the participants scored more than 80 points in the online course test and the nasogastric tube placement skill. Conclusion: The individuals in-charge are expected...
Eligibility criteria: (i) Randomized control trial; (ii) Include the diagnosis of muscle wasting ... more Eligibility criteria: (i) Randomized control trial; (ii) Include the diagnosis of muscle wasting disorder with an mean or median age ≥60 years, including: muscle wasting, according to the EWGSOP and AWGS or Other definitions of sarcopenia, disuse atrophy, cachexia caused by cancer or heart failure, and chronic obstructive pulmonary disease (COPD). In studies where exercise interventions were delivered to patients with cancer and at risk of cachexia, domains for the syndrome including weight loss, nutritional stores and intake, and muscle mass or function were seldom reported. To this end, it was not possible to determine the proportion of patients meeting pre-cachexia or cachexia criteria; (iii) All types of exercises, resistance exercises, aerobic exercises, vibration exercises, and multi-component regime; (iv) Full text articles in Chinese and English; and (v) Outcomes of the studies included at least one of the following data results: muscle mass, muscle strength or physical function. INPLASY registration number: This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 30 April 2021 and was last u p d a t e d o n 3 0 A p r i l 2 0 2 1 (r e g i s t r a t i o n n u m b e r INPLASY202140146).
Background: The experiences of teenagers with cancer are related to falling ill, receiving treatm... more Background: The experiences of teenagers with cancer are related to falling ill, receiving treatment, and the way they exist in the world. The understanding of the meaning of teenagers coexisting with cancer must be placed in the social context with the teenagers at the core. Objective: By using an interpretive ethnographic research method, this study applied the body perception view of Merleau-Ponty to how teenagers with cancer understand self through the body in a social and cultural context. Methods: Participant observation and individual semistructured interviews of 18 teenagers diagnosed with cancer were conducted over a 20-month period. Results: The illness experience of teenagers undergoing chemotherapy was described as self-integration. Five themes emerged: boundary ambiguity of body, medical equipment as part of the body, confined body space, from self-dissociation toward self-integration, and healing power formed by self and others. Conclusion: In the face of the adjustments of body disorder, the teenagers with cancer initiated motility of the body, self-displacement, and integration in order to regain control of the body. Implications for Practice: The provision of correct disease knowledge to strengthen teenagers' understanding and their sense of mastery of their bodies throughout the participation in their cancer treatment is essential. Discussions on making decisions, self-management, and social identification are related to the relationship between body and self as well as between healthcare and otherness. Providing culture and social sensitivity support systems and resources to teenagers and families can strengthen them to face the disease and promote positive healing. T he experience of teenagers with cancer related to falling ill, the subsequent treatment process, and the associated changes to their bodies all effect the self-image of these teenagers and the way they exist in the world. 1-4 The exploration of cultural and psychological phenomenon of the disease includes the significance of the symptoms and diseases at an individual
To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms... more To assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. Background: Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non-pharmacological interventions have been suggested for use during pregnancy. Design: A systematic review of randomised controlled trials.
Qualitative translational research refers to the "bench-to-bedside" enterprise of harne... more Qualitative translational research refers to the "bench-to-bedside" enterprise of harnessing knowledge from the basic sciences to produce new treatment options or nursing interventions for patients. Three evidence-based translational problems related to qualitative translational research discussed this year address the interfaces among the nursing paradigm, the basic sciences, and clinical nursing work. This article illustrates the definition of translational science and translational blocks of evidence-based practice; discusses the qualitative research perspective in evidence synthesis, evidence translation and evidence utilization; and discusses the research questions that must be answered to solve the problems of the three translational gaps from the qualitative research perspective. Qualitative inquiry has an essential role to play in efforts to improve current healthcare-provider nursing interventions, experiences, and contexts. Thus, it is vital to introduce qualitat...
Evidence-based healthcare, the organized translation of knowledge into practice, and the implemen... more Evidence-based healthcare, the organized translation of knowledge into practice, and the implementation of evidence in practice have become vital in nursing care and health policy. Evidence translation is an essential concept that relates to the knowledge development and core competence of advanced practice nurses (APNs). The present article introduces the development and definitions of nursing evidence translation. The evidence-based nursing perspectives of Techne and Phronesis are used to illustrate the characteristics and nature of knowledge translation. The evidence translation models are introduced and the barriers that are often encountered during the three stages of evidence translation are explained. The final section discusses the future development of evidence translation.
OBJECTIVE The aim of this evidence implementation project was to identify the barriers and omissi... more OBJECTIVE The aim of this evidence implementation project was to identify the barriers and omissions affecting adequacy of hemodialysis and to develop implementable strategies to maintain hemodialysis adequacy among hemodialysis patients with end-stage renal disease. INTRODUCTION Assessing adequacy of hemodialysis and improving quality of life are important issues for patients with end-stage renal disease. However, they are often inadequately addressed, and evidence-based practices are not always followed. METHODS A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice approaches. Seven audit criteria that represent best practice recommendations for maintaining hemodialysis adequacy among hemodialysis patients were used. A baseline audit was performed, which was followed by the implementation of multiple improvement strategies over 20 weeks and the outcomes finalized using a follow-up audit to determine the change to be implemented in practice. RESULTS The baseline audit results showed that most audit criteria were less than 77% in practice. The compliance rates for nurses who had received education regarding hemodialysis, checking the prescription order for each patient at each session, and using the prescribed dialyzer for every session were determined to have reached 100% at the follow-up audit. The compliance rates for completion prehemodialysis checks, using a sterile technique when inserting an arteriovenous catheter, matching a blood flow rate with the prescription, and maintaining a blood flow rate throughout the treatment session were found to be 73-95% at the follow-up audit. The most significant finding was the proportion of hemodialysis patients with inadequate urea reduction ratio was reduced from 4.6 to 3.2% after implementation of the best practice approaches. CONCLUSION The implementation of institution-specific evidence-based resources brought about immediate improvements in hemodialysis adequacy management and practice. A variety of strategies contributed to the success of this implementation project, such as scenario simulation education, Objective Structured Clinical Examination, the interrelation response system Kahoot, the use of hemodialysis International Organization for Standardization job descriptions, regular weekly audits, and collaboration with physicians when caring for patients during clinical practice.
Review Question The specific question of this review are: What are the experience of nurses telli... more Review Question The specific question of this review are: What are the experience of nurses telling a terminal cancer patient of a diagnosis or prognosis? Inclusion criteria Phenomena of interest This review will consider studies that explore the nurse’s experiences of truth telling of a diagnosis and prognosis to the terminal cancer patient. Types of Participants This review will consider studies that include nurses involved in truth telling to terminal cancer patients, and who have worked in an oncology unit or hospice care unit for greater than one year.
There is accumulating evidence that recurring pain symptoms in children are becoming a serious he... more There is accumulating evidence that recurring pain symptoms in children are becoming a serious health concern. Children and adolescents who suffer from ongoing pain have negative outcomes not only to their physical health, but also to their emotional and spiritual health. Furthermore, recurrent pain in children may also cause a number of other negative consequences to the child, the family and society. Thus, a non-pharmacological approach to reduce the pain is vital to help children having better quality of life. The objective of this review is to determine the best available evidence on the effectiveness of non-pharmacological pain management in relieving chronic pain for children and adolescents. The search strategy aimed to find published studies, between 1956 and 2008 and limited to the English or Chinese languages. Reference lists of studies that met the inclusion criteria were searched for additional studies. This review included any systematic reviews, randomized controlled trials and quasi-experimental design that explored the effectiveness of non-pharmacological intervention for chronic pain in children and adolescents. Children and adolescents with cancer pain, Juvenile chronic arthritis, sickle cell disease, burn pain, chronic or recurrent abdominal pain, headache and aged 18 years old or less and suffering with pain for at least one month. The review considered studies that examined non-pharmacological interventions in relieving chronic pain for children and adolescents that included heat wrap therapy, massage, chiropractic spinal manipulative therapy, cognitive-behavioral therapy (distraction &amp;amp;amp; guided imagery), meditation, progressive muscle relaxation, self-hypnosis, biofeedback, music therapy, and dance training. The primary outcome measures included: (1) Behavioral variables, such as pain behavior, cognitive coping and appraisal, psychiatric reaction (anxiety and depression), and social activities, (2) Quality of life scores and (3) Pain scores. The review focuses on studies that operated either at a hospital or in a community setting. Meta-analysis was used to pool the data from studies to determine the effectiveness of the intervention. The Comprehensive Meta Analysis V2 was used to manage the data. The search process identified 43,100 studies that addressed the objectives of the review protocol. Fifty-four articles were selected for critical appraisal. Finally, 31 trials were considered to be eligible for the present review and 5 articles were excluded. Data was pooled together from eight articles using meta-analysis to examine the effectiveness of relaxation training of the pre-test and post-test of headache intensity. The findings show that the effective size was 0.323 with significant difference. Two of the articles evaluate the effectiveness of relaxation training for releasing the recurrent headaches for adolescents and the post-test data were collected over the following six months. The findings show that there is a statistically significance difference. Another two articles examined the effectiveness of a relaxation training program in reducing the sum of medication used of adolescents with recurrent headaches. The findings show that there is no statistical significance. Furthermore, the findings show that biofeedback treatment could improve the outcome of children and adolescents&amp;amp;#39; headache, especially at 6 and 12 months after the treatment. In terms of psychosocial treatment, five articles examined the effectiveness of behavioral treatment, relaxation training program, cognitive behavior therapy, and acupuncture/ hypnosis intervention to reduce anxiety of children and adolescent with chronic pain. The various outcomes measures among the five studies. This review has provided an evidence-based guide to future priorities for clinical practice. Relaxation programs could reduce recurrent headache and pain intensity in children and adolescents in the short term as well as lasting for three and six months. Furthermore, biofeedback treatment could reduce recurrent headache of pain intensity in children and adolescents in the short term and last for as long as six months.
This study investigated the subjective experiences of the maternal role transition during the fir... more This study investigated the subjective experiences of the maternal role transition during the first two weeks of hospitalization for premature rupture of the amniotic membranes (PROM). Thirteen pregnant couples participated in the study by completing interviews. Average gestation of the expectant mothers was 27 weeks and the women were already experiencing fetal movement during the first two weeks of hospitalization for PROM. Lincoln and Cuba's trustworthiness criteria were employed to evaluate methodological rigor. Colaizzi's phenomenological approach was used to analyze the structure of the experience. Four themes emerged: pending loss, concern about the safety of the fetus, identification of maternal roles, and the process of maternal role-making. The results provide a scientific basis for empowering nurses to assist with maternal role transition in high-risk pregnancies in a more sensitive and effective manner.
HOSPITAL MEDICINE CLINICS CHECKLIST 1. Anemia can be categorized as severe (hemoglobin [Hgb] leve... more HOSPITAL MEDICINE CLINICS CHECKLIST 1. Anemia can be categorized as severe (hemoglobin [Hgb] level <9 g/dL), moderate (Hgb 9.1-11.0 g/dL), and mild (Hgb >11.0 g/dL). 2. Hospital-acquired anemia (HAA) is prevalent in the intensive care unit as well as on the wards. 3. Every patient who is admitted to the hospital is at risk of developing HAA. Those who are anemic before admission are at risk of worsening anemia during hospitalization. 4. Causes of HAA include blood draws, erythropoietin (EPO) (Amgen Inc, Thousand Oaks, CA, USA) suppression caused by increase in inflammatory markers from acute illness, and downregulation of iron. 5. HAA recognition and treatment affect patient outcomes. 6. Prevention and management of HAA demand a team approach and a culture that supports recognition and reduction of unnecessary laboratory testing and procedures. 7. Pharmacologic treatment continues to evolve, and evidence-based use of intravenous iron and EPO may have a role in supporting erythropoiesis to help prevent transfusion.
This study explores parental lived experience following admission of their child to a pediatric i... more This study explores parental lived experience following admission of their child to a pediatric intensive care unit. The interview data used were collected from 10 randomly chosen families from the Family Impact of Catastrophic Childhood Illness Project recruited during the early phase of critical care hospitalization of their child. A 3-stage contextual analysis procedure integrating interactional and contextual perspectives into Colaizzi's phenomenological approach was used to reduce text data to thematic content. The analysis uncovered a multidimensional and holistic phenomenon consisting offourorganizing concepts: initial boundaryambiguity, parents'coping patterns, family resources, andfunctioning of thefamily boundary. These results provide evidence of a collective family level perception of stress when experiencing the health crisis of a child and supportfurther use offamily stress perception as afamily levelphenomenon that represents family meaning construction during...
Objective: to explore women's experiences in interaction with their midwives during their antenat... more Objective: to explore women's experiences in interaction with their midwives during their antenatal checks and during labour. Design: a qualitative study using a phenomenological approach. Data were collected via tape-recorded interviews. All interviews were transcribed verbatim. Data were analysed using Colaizzi's method for data analysis. Setting: the homes of the study participants in the district of a Taipei (Taiwan) teaching hospital. Participants: a purposive sample of 11 Taiwanese women, one primipara, and 10 multiparae, who were one to three months post-childbirth at the time of interview. Findings: five major themes revealed the essence of women's experiences of their interaction with a midwife during pregnancy and childbirth: (1) being respected, (2) being accompanied, (3) trust, (4) being satisfied, and (5) professional competence. Key conclusions: the women recognised the service model of the midwife; they treasured their mutual relationships and the benefits that women derived from midwifery care during childbirth. In Taiwan, the government is mandated to offer midwifery models of care in hospitals, and to allow women to choose different types of care provider. Implications for practice: an awareness of women's experiences will help identify the caring behaviours as recognised by the women and may help health-care professionals provide better support and care for women during the pregnancy and childbirth periods. These findings can serve as references for future midwifery practice models and improvements in quality of care.
Infertile couples' experience of family stress while women are hospitalized for Ovarian Hyperstim... more Infertile couples' experience of family stress while women are hospitalized for Ovarian Hyperstimulation Syndrome during infertility treatment. Aims and objectives. The aim of this study was to explore the essential structure of family stress among hospitalized women receiving infertility treatment with Ovarian Hyperstimulation Syndrome. Background. When hospitalization is necessary for infertile women with Ovarian Hyperstimulation Syndrome, they face health-illness transition stress and their families are traumatized by the pressure of hospitalization. Most literature on infertility treatment has dealt with the infertile women's physio-psychological reactions, the impact on the couples' relationships and the influence of social support on infertile couples. Design. A descriptive phenomenological design consistent with Husserl's philosophy. Methods. Ten married couples from a Taipei medical centre participated in the study. All the couples were receiving infertility treatment because the female partners were suffering from moderate or severe Ovarian Hyperstimulation Syndrome and this required hospitalized. An open in-depth interview technique encouraged parents to reflect on their experience, which raised their feelings to a conscious level. Data were analysed using Colaizzi's approach. Results. This study explored infertile women's experiences from the couples' perspectives and the results identify the overall stresses that the family face. Five themes emerged from the study, namely, the stress of 'carrying on the ancestral line', the psychological reactions of the couple, a disordering of family life, reorganization of family life and external family support. Conclusions. The results demonstrate that the experience of family stress involves impacts that range across the domains of individual, marital, family and social interactions and there is a need to cope with these when the wife is hospitalized for moderate to severe Ovarian Hyperstimulation Syndrome. Relevance to clinical practice. The findings indicated that nurses should provide infertile couples with family-centred perspectives that are related to Chinese cultural
Maternal experiences making a decision about heart surgery for their young children with congenit... more Maternal experiences making a decision about heart surgery for their young children with congenital heart disease Aim. The aim of this study was to investigate the essence of the experience of mothers during the decision-making process when facing their less than three-yearold child undergoing heart surgery due to congenital heart disease (CHD). Methods. In this phenomenological study in Taiwan nine mothers were interviewed in their homes. They were invited to share their experience of family interactions and relationships while facing a decision about their child's heart surgery. The interviews were recorded and transcribed for further analysis according to Colaizzi's phenomenological methodology. Results. The essence of the maternal experience themes during the decision-making process included (i) understanding the surgery step by step, (ii) role pressure, (iii) constructing care-taking ability, (iv) endeavouring to maintain family functioning while preparing for surgery and (v) deliberate consideration to make the correct decision. Conclusions. When parents face their child having CHD and plan heart surgery, the whole family is living through a stressful decision-making process. According to the results of this study, it is obvious that the caregivers and their whole families experience psychological distress, role reorganization and remodelling of family functioning. Relevance to clinical practice. The results of this study provide evidence-based essential knowledge that will assist the management of such decision-making processes and help to prepare the child and the family to have confidence in the heart surgery.
Paternal reactions to a child with epilepsy: uncertainty, coping strategies, and depression Aim. ... more Paternal reactions to a child with epilepsy: uncertainty, coping strategies, and depression Aim. This paper reports a study examining the stress that fathers experience when caring for a child with epilepsy. Background. A seizure, which is frightening and potentially damaging, creates uncertainty about its possible effects and threatens the integrity of family systems. In the Chinese social context, epilepsy is stereotyped 'sudden craziness' of people and affected family feel shamed by the diagnosis. When a child has epilepsy, the stereotype of epilepsy affects the family experience in terms of stress and their coping process. Few studies have focused on how a father with an ill child adapts to family stress. Methods. This study was based on the resiliency model of family stress, adjustment, and adaptation, and was designed to examine the relationships among fathers' uncertainty, coping strategies, and depression. From three teaching hospitals in Taiwan, 210 fathers were recruited. A pilot study was conducted to establish the reliability and face validity of the Chinese language version of the Coping Health Inventory for Parents. Findings. Results showed that paternal uncertainty was negatively associated with the total Coping Health Inventory for Parents score for family coping patterns for factors I, II, and III. Uncertainty and coping strategies for factors II and III were indicators of paternal depression and accounted for 10AE3% of the total variance. Conclusions. The results give insight into the unique family stress that fathers experience as a result of the interaction between the social context of a child with epilepsy and the family's coping patterns. They also suggest ways to improve familycentred nursing interventions to help parents establish effective caring patterns to manage the family stress.
By using the contextual model of family stress, this study examined fathers&amp;amp;amp;amp;#... more By using the contextual model of family stress, this study examined fathers&amp;amp;amp;amp;#39; family stress experience when caring for a child receiving cancer treatments. A descriptive correlational study was designed to examine the relationships between fathers&amp;amp;amp;amp;#39; uncertainty, sense of mastery, and anxiety. Eighty fathers were recruited from two teaching hospitals in Taiwan. A pilot study was conducted to establish the reliability and validity of the Chinese language version of the above instruments. These instruments showed an acceptable internal consistency and satisfactory construct validity. Results showed that fathers&amp;amp;amp;amp;#39; level of education had a significant effect on paternal anxiety. Uncertainty and fathers&amp;amp;amp;amp;#39; education level equal to or higher than university are good predictors of paternal anxiety, which explain 25% of the variance. The results provide insight into the paternal experience of family stress and suggest ways to improve family-centered nursing interventions and thereby establish better family well-being.
Background: Binge eating (BE) is considered a marker of obesity and overweight and a significant ... more Background: Binge eating (BE) is considered a marker of obesity and overweight and a significant characteristic of feeding and eating disorders. Despite the high prevalence of obesity on college campuses, the issue of BE among college students in Taiwan has received little attention. The aim of this study was to investigate BE behavior among overweight college students in Taiwan and associated factors. Methods: This study utilized a cross-sectional survey. A total of 300 overweight college students were recruited through convenience sampling. Data were collected using a self-administered Binge Eating Scale (BES) and a body weight composition monitor (Model No. OMRON, HBF-126) and analyzed using descriptive statistics, correlation analysis, and regression analysis. Results: The average BES score was 10.67 (SD = 6.66, 0–34). With a BES score of 17 as the cut-off point, 17.3% (n = 52) of the participants were found to have moderate or severe BE behavior. Analysis of the demographic and...
The Journal of Continuing Education in Nursing, 2021
Background: This study formulated clinical guidelines for assessing nasogastric tube placement an... more Background: This study formulated clinical guidelines for assessing nasogastric tube placement and for health education guidance according to evidence-based recommendations. Method: This study used a single group, pre- and postintervention design. Purposive sampling was used to recruit participants from nursing institutions in Taiwan. Results: Sixty-two individuals in charge of nursing institutions were recruited to participate in the in-service training program. Statistically significant differences were observed in the four major items in the self-directed learning readiness scale ( t = 3.85, p < .00; t = 3.99, p < .00; t = 2.94, p < .01; t = 4.13, p < .00). With regard to program satisfaction, the mean score was 4.88 to 4.9 points. The mean score for teaching satisfaction was 4.94 to 4.9 points. Furthermore, the participants scored more than 80 points in the online course test and the nasogastric tube placement skill. Conclusion: The individuals in-charge are expected...
Eligibility criteria: (i) Randomized control trial; (ii) Include the diagnosis of muscle wasting ... more Eligibility criteria: (i) Randomized control trial; (ii) Include the diagnosis of muscle wasting disorder with an mean or median age ≥60 years, including: muscle wasting, according to the EWGSOP and AWGS or Other definitions of sarcopenia, disuse atrophy, cachexia caused by cancer or heart failure, and chronic obstructive pulmonary disease (COPD). In studies where exercise interventions were delivered to patients with cancer and at risk of cachexia, domains for the syndrome including weight loss, nutritional stores and intake, and muscle mass or function were seldom reported. To this end, it was not possible to determine the proportion of patients meeting pre-cachexia or cachexia criteria; (iii) All types of exercises, resistance exercises, aerobic exercises, vibration exercises, and multi-component regime; (iv) Full text articles in Chinese and English; and (v) Outcomes of the studies included at least one of the following data results: muscle mass, muscle strength or physical function. INPLASY registration number: This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 30 April 2021 and was last u p d a t e d o n 3 0 A p r i l 2 0 2 1 (r e g i s t r a t i o n n u m b e r INPLASY202140146).
Uploads
Papers by Pei-Fan Mu