Lichi Huang - Academia.edu (original) (raw)
Papers by Lichi Huang
Diabetes mellitus is one of the most common chronic diseases worldwide. Eight to 26% of the diabe... more Diabetes mellitus is one of the most common chronic diseases worldwide. Eight to 26% of the diabetic population has been reported to be affected by neuropathic pain, which may exert a substantial impact on the quality of life by interfering with daily functioning and enjoyment of life. The studies revealed in general subjects (N=393), age, weight, peripheral arterial disease (PAD), and diabetes were risk factors significantly associated with neuropathic pain, while in the diabetic group, these factors were age, weight, and PAD. In study for survivors of myocardial infarction (MI) (n = 426), prevalence of neuropathic pain was even higher and the risk factors were age, waist circumference, peripheral arterial disease (PAD), and diabetes; while in the diabetic group it was waist circumference, physical activity, and PAD.
Mid-Taiwan Journal of Medicine, 2007
Purpose. The purpose of this study was to evaluate the reliability and validity of two instrument... more Purpose. The purpose of this study was to evaluate the reliability and validity of two instruments designed to measure job satisfaction among nurses. Methods. The participants comprised 360 nurses from two hospitals. The two instruments, the Nurses' Job Satisfaction Scale (NJSS) and the Nurses' Professional Commitment Scale (NPCS), were developed based on literature review and clinical experience to assess job satisfaction and professional commitment among nurses. The validity of each instrument was determined by measuring the content validity, construct validity, criterion validity and concurrent validity. Internal consistency reliability and test-retest reliability were also examined to estimate the stability of the scales. Results. The final version of the NJSS showed good internal consistency reliability (Cronbach's alpha=0.92) and test-retest reliability (Pearson's correlation=074). The construct validity of the NJSS was evaluated by factor analysis and four fac...
Heart (British Cardiac Society), Jan 15, 2014
Chronic inflammatory disease may trigger vascular atherosclerosis. This study aimed to determine ... more Chronic inflammatory disease may trigger vascular atherosclerosis. This study aimed to determine whether chronic osteomyelitis (COM) is linked to an increased risk of coronary heart disease (CHD). A national insurance claim dataset of more than 23 million enrolees was used to identify 15 054 patients with newly diagnosed COM and 60 216 randomly selected age-matched and gender-matched controls between 2001 and 2009 for comparing the risk and incidence of CHD. The study period was from the entry date to the first date of the following events: the diagnosis of CHD, death, withdrawal from the Taiwan National Health Insurance programme or the end of 2010. The analysis of the CHD risk was performed using Cox proportional hazards regression model. During a follow-up period of 67 927 person-years, the overall incidence rate of CHD in COM cohort was 1.95 times higher than non-COM cohort (16.66 vs 8.52 per 1000 person-years). After controlling age, gender and four comorbidities (hypertension,...
Hu li za zhi The journal of nursing, 2011
The effectiveness of early detection and intervention is emphasized in child development. The kno... more The effectiveness of early detection and intervention is emphasized in child development. The knowledge and attitudes of pediatric nurses related to child development is a factor critical to identifying and helping disabled children. The purpose of this study was to explore general pediatric nurse knowledge of young child development and attitudes and behavior toward child developmental care. Researchers collected data for this descriptive study using a structured questionnaire and recruited a sample of 112 pediatric nurses from hospitals in Central Taiwan. Data was analyzed by Mean, Pearson correlation, ANOVA, and Logistic regression. The study revealed pediatric nurses have a good level of knowledge related to children development. Although most participants held positive attitudes toward early intervention and child developmental care, their related behaviors were inadequately reported. Predictive factors of child developmental care behavior in nurses included attending related c...
Hu li za zhi The journal of nursing, 2010
Staff shortages present nurses with ever increasing levels of stress and working hours. This has ... more Staff shortages present nurses with ever increasing levels of stress and working hours. This has resulted in a corresponding increase in talent flight away from the nursing profession. Responding to financial constraints imposed by the Bureau of National Health Insurance (NHI), Taiwan hospitals have reduced nursing staff numbers and recruited nurses at lower levels of competencies and experience. However, few studies have explored the impact of nurse staffing on patient outcomes in Taiwan. Accordingly, we review relevant literature on nurse classifications, the current status of Taiwan nursing manpower, Taiwan and other national regulations on nursing staffing, and the impact of nursing staffing on patient outcomes in an effort to facilitate future study. Our literature review demonstrated that insufficient nursing staffing relates significantly to rates of nosocomial infections, patient mortality, patient falls, pressure ulcers, and rates of patient and family satisfaction. Insuffi...
Hu li za zhi The journal of nursing, 2009
For many years assistant personnel have been an integral part of Taiwan's healthcare system, ... more For many years assistant personnel have been an integral part of Taiwan's healthcare system, assisting nurses to take care of patients and helping out with various aspects of unit work. The skill-mixed model was discussed during the period of greatest SARS risk in Taiwan, when the tradition of family accompaniment in hospitals presented a real and present risk of nosocomial cross-infection. Since 2003, health care authorities have continued to attempt to implement an appropriate nursing model to improve overall delivery of healthcare. The nursing model implementation in Taiwan is similar to the skill-mixed model deployed in Western countries. Therefore, this article introduces the origin, definition, purpose and categories of the skill-mixed model, as well as related studies on the impact of the skill-mixed model on nursing and patient care outcomes. The article will further explore the current situation and difficulties of applying the skill-mixed model in Taiwan. This article ...
Nurse Education Today, 2013
Studies have shown that education can improve the knowledge, attitudes, and beliefs of neonatal n... more Studies have shown that education can improve the knowledge, attitudes, and beliefs of neonatal nurses regarding neonatal palliative care. However, no study has investigated the need for neonatal nurse education in neonatal palliative care in Taiwan. The purpose of this study was to explore neonatal nurses' experiences in caring for dying neonates and their educational backgrounds regarding palliative care, as well as to assess their educational needs. A cross-sectional survey was used for this research. A research structural questionnaire was used to investigate the research goals. One hundred fifteen nurses participated in this survey. Few participants indicated having received neonatal palliative care education (13%), but most responded that palliative care is necessary in neonatal nursing education (97.4%). Participants also responded that they were often or always exposed to death in NICU (62.6%), but few reported providing pain management to dying neonates (8.7%) and few had experience providing symptomatic care for dying neonates (19.1%). Fifty percent ranked "pain control" as the area in which they most required training. Another high-ranked need was in discussing with parents and families the outcomes of CPR and their neonate's progress. Research indicates that the education currently provided to neonatal nurses does not meet their distinctive needs. Neonatal nurses in Taiwan expressed an urgent desire for training in pain control and communication. Research suggests that the most important topics to trainees are pain management and end-of-life communication. Additionally, non-pharmacological pain control interventions are valuable and should be included in an educational program.
Maternal and Child Health Journal, 2012
(1) To explore attitudes and beliefs of neonatal nurses toward nursing care for dying neonates; (... more (1) To explore attitudes and beliefs of neonatal nurses toward nursing care for dying neonates; (2) to estimate the influence of neonatal nurses' personal and professional characteristics on their attitudes towards end-of life care for dying infants. A cross-sectional design was used. A questionnaire was used to collect data from 80 neonatal nurses. Research setting was four level III NICUs at four medical centers around the central region of Taiwan. Research participants were neonatal nurses who had worked for at least 1 year in one of level III NICUs and had been directly involved with the care of dying infants. Research participants were 80 neonatal nurses (response rate 100 %). Research findings identified eight barriers hindering neonatal palliative care practice. These barriers were insufficient communication due to the lack of an in-service educational program; the lack of available counseling help for neonatal clinicians; inability to express personal opinions, values and beliefs towards neonatal palliative care; insufficient staffing; the lack of unit policies/guidelines for supporting palliative care; the technological imperative; parental demands and personal beliefs about death and previous experience caring for dying infants. Further studies are needed to explore each barrier and to provide in-service neonatal palliative care educational programs that are needed to decrease these barriers.
Journal of Pain and Symptom Management, 2006
The purpose of this study was to examine the effectiveness of a pediatric pain education program ... more The purpose of this study was to examine the effectiveness of a pediatric pain education program (PPEP) for student nurses. The sample consisted of 181 licensed student nurses who were enrolled in a nursing school in Taiwan. Student nurses attended a 4-hour PPEP that involved case scenario discussion, video, and lecture. Data were collected by an extensive questionnaire that assessed student nurses' knowledge of, attitudes toward, and self-efficacy in pediatric pain assessment and pharmacological and nonpharmacological pain management. The results demonstrated that student nurses gained significant knowledge of pediatric pain, expressed more appropriate attitudes, and reported greater self-efficacy in children's pain management after attending PPEP. Their knowledge of analgesic pharmacotherapy did not significantly improve. These results suggest that PPEP should be integrated into pediatric nursing curricula to enhance knowledge and skills regarding children's pain management during the early stage of a nursing career.
Journal of Medical Ethics, 2012
Journal of Clinical Nursing, 2012
Aims and objectivesTo explore the effectiveness of wound care programme for emergency traumatic p... more Aims and objectivesTo explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan.BackgroundWound care is one of the most major issues for trauma patients at home. Wound infection has been alerted mostly on medical treatment. Little is known about how healthcare education impact patient care of traumatic wound after discharged from emergency department.DesignA quasi‐experimental design was used by using two groups post‐test.MethodsRandom sampling was used to recruited participants, 89 participants in each group in emergency department at a medical centre in Taiwan. A 25‐minute wound care programme was given to patients in the intervention group. A questionnaire was used to evaluate the effectiveness of the programme after 72 hours as patient followed up in out‐patient department. The data of wound infection were collected from patient's medical record by followed 2 weeks after injured.ResultsAfter wound care programme, the knowledge, skills of wou...
Journal of Child Health Care, 2013
Previous studies separately examined the effects of positioning or environmental stressors on pre... more Previous studies separately examined the effects of positioning or environmental stressors on preterm infants’ sleep and stress. Since positioning and environmental stressors occur simultaneously during infant hospitalization exploring these variables in the same study may offer new insights. A quasi-experimental study by one-group interrupted time-series design. In the current study, a total of 22 preterm infants were enrolled. Each infant was moved to either the supine or prone position for an hour at a time. Infants were videotaped and the sleep–wake states, stress behaviours and environmental conditions (light, noise and stimulation/handling) were recorded during the observation period. A total of 80 observations from 22 infants were accrued. In the supine position, preterm infants demonstrated more frequent waking states after adjusting for various environmental stressors ( p < .01). These infants demonstrated more frequent stress behaviours in the supine position after adju...
Japan Journal of Nursing Science, 2013
Aim: To explore the energy expenditure (EE) in a group of preterm infants during the periods of e... more Aim: To explore the energy expenditure (EE) in a group of preterm infants during the periods of environmental stress, and to explore the relationship between EE and physiological stress signals of preterm infants. Methods: Research design was an explorative secondary analysis of 4164 research data from 37 preterm infants which included physiological signals and environmental stressors in neonatal intensive care units. The current study investigated the data of EE calculated using heart-rate-based EE estimate. Results: A significantly positive relationship between EE and different levels of nursing intervention was found (P < 0.005). In addition, there was a significantly negative relationship between EE and oxygen saturation (P < 0.001). Conclusion: These research results confirmed that environmental stressors may impact the growth and developmental outcomes in preterm infants by increasing their EE. Neonatal clinicians should minimize excessive stimulations in order to conserve energy for the growth and developmental needs of preterm infants. Research found a significant relationship between an increase in EE and a decrease in oxygen saturation in preterm infants. The authors further hypothesized that EE of preterm infants may be predicted by estimating the oxygen saturation. Further study using different research methods and an enlarged sample size is needed.
Mid Taiwan Journal of Medicine, 2006
摘要: 目的 為發展一個具有信, 效度的護理人員組織承諾因素評量表. 方法 這個評量工具發展是依據廣泛的文獻查證和工具發展步驟, 心理計量信效度測量方法. 共有 167 位全職護理人員完成填寫此... more 摘要: 目的 為發展一個具有信, 效度的護理人員組織承諾因素評量表. 方法 這個評量工具發展是依據廣泛的文獻查證和工具發展步驟, 心理計量信效度測量方法. 共有 167 位全職護理人員完成填寫此量表. 結果 量表測試結果顯示量表的內在一致性信度 Cronbach's alpha 為 0.91. 由六 ...
Annals of Surgical Oncology, 2009
Background. Approximately one-third of prostate cancer (PCa) patients show biochemical failure af... more Background. Approximately one-third of prostate cancer (PCa) patients show biochemical failure after radical prostatectomy (RP) and are prone to develop metastasis with significant mortality. Although aberrant Wnt/b-catenin (CTNNB1) signaling has been observed in numerous types of human cancers, including PCa, to our knowledge there is currently no information on the role of Wnt signaling gene polymorphisms in PCa. Methods. We comprehensively studied the contribution of genetic variations in CTNNB1 and adenomatous polyposis coli (APC), one of the key genes encoding the CTNNB1 destruction complex, to PCa risk and prognosis after RP using a hospital-based case-control study. We selected and genotyped 13 tagged single-nucleotide polymorphisms (tSNP) to predict common variants across entire APC and CTNNB1 genes in 307 patients with clinically localized PCa who received RP and 371 unaffected controls. Results. Four tSNPs (rs3846716, rs2431238, rs41115, and rs565453) and a specific haplotype (GTAAGA) in the APC tumor suppressor gene were associated with a 0.57-to 0.71-fold lower risk of localized PCa. The association of tSNPs with prostate-specific antigen (PSA) recurrence in PCa patients was then analyzed by Kaplan-Meier analysis and Cox regression model. Interestingly, we found that the APC rs3846716 GA/AA genotypes were also significantly associated with poorer PSA-free survival (log-rank test, P = 0.037) compared with the GG genotype. Conclusions. This is the first report documenting the potential prognostic role of the APC rs3846716 GA/AA genotype on PSA recurrence after RP. Patients diagnosed with localized prostate cancer (PCa) are commonly treated with radical prostatectomy (RP), but approximately 35% of patients experience biochemical failure, as manifested by prostate-specific antigen (PSA) relapse, within 10 years. 1,2 Although several clinicopathological indicators, such as PSA, Gleason score, pathologic stage, and surgical margin status, have been currently used for outcome prediction following intended curative RP of primary PCa, finding new biomarkers to improve prediction S.-P. Huang and B.-Y. Bao contributed equally to this work.
Journal of Nursing Research, 2011
Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a sk... more Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages. Conclusions: This study revealed that nurses working in skill mix model environments need more authority to delegate and educate NAs and to supervise and integrate nursing care. Study results may serve as a reference for hospital nursing practice in Taiwan.
BMC Health Services Research, 2012
Background Studies over the past decades have shown an association between nurse staffing and pat... more Background Studies over the past decades have shown an association between nurse staffing and patient outcomes, however, most of these studies were conducted in the West. Accordingly, the purpose of this study aimed to provide an overview of the research/evidence base which has clarified the relationship between nurse staffing and patient mortality of acute care hospital wards under a universal health insurance system and attempted to provide explanations for some of the phenomena that are unique in Taiwan. Methods Through stratified random sampling, a total of 108 wards selected from 32 hospitals in Taiwan were collected over a consecutive seven month period. The mixed effect logit model was used to explore the relationship between nurse staffing and patient mortality. Results The medians of direct-nursing-care-hour, and nurse manpower were 2.52 h, and 378 persons, respectively. The OR for death between the long direct-nursing-care-hour (> median) group and the short direct-nurs...
Accident Analysis & Prevention, 2013
Although accidental injury is the main factor involved in the death of young children in many cou... more Although accidental injury is the main factor involved in the death of young children in many countries, few studies have focused on parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; competence with regard to self-efficacy of first aid for their children following injuries occurring at home. The purpose of this cross-sectional study was to investigate parental self-sufficiency of first aid for home accidents in children aged 0-4 years. The study is a cross-sectional designed. Data from 445 parents recruited were collected by purposive sampling at eight metropolitan community health centers in central Taiwan. Measurements were taken from a self-developed questionnaire that included 37 questions. Logistic regression analysis was applied to explore the associations between factors and parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid at home accident. Our findings show that parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; overall rate of knowledge of first aid was 72%. The mean score for 100% certainty in parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid was 26.6%. The lowest scores for self-efficacy were with regard to choking and cardiopulmonary resuscitation (CPR). There was a significantly positive correlation between parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge and self-efficacy of first aid (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), and thus knowledge of first aid is a predictor of parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy. Knowledge of first aid is also a partly mediator between participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; attending first aid program, participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; first aid information obtained from health personnel and self-efficacy of first aid. Our findings suggest that medical services should provide first aid resources to help manage accidental injuries involving children, particularly information on how to deal with choking and CPR. With an appropriate program provided by health professionals, parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid for home accidents will be positively enhanced.
Journal of clinical …, 2009
Results. Sixty per cent of the participants used some form of folk remedies in the care of their ... more Results. Sixty per cent of the participants used some form of folk remedies in the care of their hospitalised children. The most frequently used remedies were: spirit-calling (63%); carrying a cross or incense bag (47%), praying a Buddhist mantra (36%). There was a positive ...
Diabetes mellitus is one of the most common chronic diseases worldwide. Eight to 26% of the diabe... more Diabetes mellitus is one of the most common chronic diseases worldwide. Eight to 26% of the diabetic population has been reported to be affected by neuropathic pain, which may exert a substantial impact on the quality of life by interfering with daily functioning and enjoyment of life. The studies revealed in general subjects (N=393), age, weight, peripheral arterial disease (PAD), and diabetes were risk factors significantly associated with neuropathic pain, while in the diabetic group, these factors were age, weight, and PAD. In study for survivors of myocardial infarction (MI) (n = 426), prevalence of neuropathic pain was even higher and the risk factors were age, waist circumference, peripheral arterial disease (PAD), and diabetes; while in the diabetic group it was waist circumference, physical activity, and PAD.
Mid-Taiwan Journal of Medicine, 2007
Purpose. The purpose of this study was to evaluate the reliability and validity of two instrument... more Purpose. The purpose of this study was to evaluate the reliability and validity of two instruments designed to measure job satisfaction among nurses. Methods. The participants comprised 360 nurses from two hospitals. The two instruments, the Nurses' Job Satisfaction Scale (NJSS) and the Nurses' Professional Commitment Scale (NPCS), were developed based on literature review and clinical experience to assess job satisfaction and professional commitment among nurses. The validity of each instrument was determined by measuring the content validity, construct validity, criterion validity and concurrent validity. Internal consistency reliability and test-retest reliability were also examined to estimate the stability of the scales. Results. The final version of the NJSS showed good internal consistency reliability (Cronbach's alpha=0.92) and test-retest reliability (Pearson's correlation=074). The construct validity of the NJSS was evaluated by factor analysis and four fac...
Heart (British Cardiac Society), Jan 15, 2014
Chronic inflammatory disease may trigger vascular atherosclerosis. This study aimed to determine ... more Chronic inflammatory disease may trigger vascular atherosclerosis. This study aimed to determine whether chronic osteomyelitis (COM) is linked to an increased risk of coronary heart disease (CHD). A national insurance claim dataset of more than 23 million enrolees was used to identify 15 054 patients with newly diagnosed COM and 60 216 randomly selected age-matched and gender-matched controls between 2001 and 2009 for comparing the risk and incidence of CHD. The study period was from the entry date to the first date of the following events: the diagnosis of CHD, death, withdrawal from the Taiwan National Health Insurance programme or the end of 2010. The analysis of the CHD risk was performed using Cox proportional hazards regression model. During a follow-up period of 67 927 person-years, the overall incidence rate of CHD in COM cohort was 1.95 times higher than non-COM cohort (16.66 vs 8.52 per 1000 person-years). After controlling age, gender and four comorbidities (hypertension,...
Hu li za zhi The journal of nursing, 2011
The effectiveness of early detection and intervention is emphasized in child development. The kno... more The effectiveness of early detection and intervention is emphasized in child development. The knowledge and attitudes of pediatric nurses related to child development is a factor critical to identifying and helping disabled children. The purpose of this study was to explore general pediatric nurse knowledge of young child development and attitudes and behavior toward child developmental care. Researchers collected data for this descriptive study using a structured questionnaire and recruited a sample of 112 pediatric nurses from hospitals in Central Taiwan. Data was analyzed by Mean, Pearson correlation, ANOVA, and Logistic regression. The study revealed pediatric nurses have a good level of knowledge related to children development. Although most participants held positive attitudes toward early intervention and child developmental care, their related behaviors were inadequately reported. Predictive factors of child developmental care behavior in nurses included attending related c...
Hu li za zhi The journal of nursing, 2010
Staff shortages present nurses with ever increasing levels of stress and working hours. This has ... more Staff shortages present nurses with ever increasing levels of stress and working hours. This has resulted in a corresponding increase in talent flight away from the nursing profession. Responding to financial constraints imposed by the Bureau of National Health Insurance (NHI), Taiwan hospitals have reduced nursing staff numbers and recruited nurses at lower levels of competencies and experience. However, few studies have explored the impact of nurse staffing on patient outcomes in Taiwan. Accordingly, we review relevant literature on nurse classifications, the current status of Taiwan nursing manpower, Taiwan and other national regulations on nursing staffing, and the impact of nursing staffing on patient outcomes in an effort to facilitate future study. Our literature review demonstrated that insufficient nursing staffing relates significantly to rates of nosocomial infections, patient mortality, patient falls, pressure ulcers, and rates of patient and family satisfaction. Insuffi...
Hu li za zhi The journal of nursing, 2009
For many years assistant personnel have been an integral part of Taiwan's healthcare system, ... more For many years assistant personnel have been an integral part of Taiwan's healthcare system, assisting nurses to take care of patients and helping out with various aspects of unit work. The skill-mixed model was discussed during the period of greatest SARS risk in Taiwan, when the tradition of family accompaniment in hospitals presented a real and present risk of nosocomial cross-infection. Since 2003, health care authorities have continued to attempt to implement an appropriate nursing model to improve overall delivery of healthcare. The nursing model implementation in Taiwan is similar to the skill-mixed model deployed in Western countries. Therefore, this article introduces the origin, definition, purpose and categories of the skill-mixed model, as well as related studies on the impact of the skill-mixed model on nursing and patient care outcomes. The article will further explore the current situation and difficulties of applying the skill-mixed model in Taiwan. This article ...
Nurse Education Today, 2013
Studies have shown that education can improve the knowledge, attitudes, and beliefs of neonatal n... more Studies have shown that education can improve the knowledge, attitudes, and beliefs of neonatal nurses regarding neonatal palliative care. However, no study has investigated the need for neonatal nurse education in neonatal palliative care in Taiwan. The purpose of this study was to explore neonatal nurses&amp;amp;amp;amp;amp;#39; experiences in caring for dying neonates and their educational backgrounds regarding palliative care, as well as to assess their educational needs. A cross-sectional survey was used for this research. A research structural questionnaire was used to investigate the research goals. One hundred fifteen nurses participated in this survey. Few participants indicated having received neonatal palliative care education (13%), but most responded that palliative care is necessary in neonatal nursing education (97.4%). Participants also responded that they were often or always exposed to death in NICU (62.6%), but few reported providing pain management to dying neonates (8.7%) and few had experience providing symptomatic care for dying neonates (19.1%). Fifty percent ranked &amp;amp;amp;amp;amp;quot;pain control&amp;amp;amp;amp;amp;quot; as the area in which they most required training. Another high-ranked need was in discussing with parents and families the outcomes of CPR and their neonate&amp;amp;amp;amp;amp;#39;s progress. Research indicates that the education currently provided to neonatal nurses does not meet their distinctive needs. Neonatal nurses in Taiwan expressed an urgent desire for training in pain control and communication. Research suggests that the most important topics to trainees are pain management and end-of-life communication. Additionally, non-pharmacological pain control interventions are valuable and should be included in an educational program.
Maternal and Child Health Journal, 2012
(1) To explore attitudes and beliefs of neonatal nurses toward nursing care for dying neonates; (... more (1) To explore attitudes and beliefs of neonatal nurses toward nursing care for dying neonates; (2) to estimate the influence of neonatal nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; personal and professional characteristics on their attitudes towards end-of life care for dying infants. A cross-sectional design was used. A questionnaire was used to collect data from 80 neonatal nurses. Research setting was four level III NICUs at four medical centers around the central region of Taiwan. Research participants were neonatal nurses who had worked for at least 1 year in one of level III NICUs and had been directly involved with the care of dying infants. Research participants were 80 neonatal nurses (response rate 100 %). Research findings identified eight barriers hindering neonatal palliative care practice. These barriers were insufficient communication due to the lack of an in-service educational program; the lack of available counseling help for neonatal clinicians; inability to express personal opinions, values and beliefs towards neonatal palliative care; insufficient staffing; the lack of unit policies/guidelines for supporting palliative care; the technological imperative; parental demands and personal beliefs about death and previous experience caring for dying infants. Further studies are needed to explore each barrier and to provide in-service neonatal palliative care educational programs that are needed to decrease these barriers.
Journal of Pain and Symptom Management, 2006
The purpose of this study was to examine the effectiveness of a pediatric pain education program ... more The purpose of this study was to examine the effectiveness of a pediatric pain education program (PPEP) for student nurses. The sample consisted of 181 licensed student nurses who were enrolled in a nursing school in Taiwan. Student nurses attended a 4-hour PPEP that involved case scenario discussion, video, and lecture. Data were collected by an extensive questionnaire that assessed student nurses' knowledge of, attitudes toward, and self-efficacy in pediatric pain assessment and pharmacological and nonpharmacological pain management. The results demonstrated that student nurses gained significant knowledge of pediatric pain, expressed more appropriate attitudes, and reported greater self-efficacy in children's pain management after attending PPEP. Their knowledge of analgesic pharmacotherapy did not significantly improve. These results suggest that PPEP should be integrated into pediatric nursing curricula to enhance knowledge and skills regarding children's pain management during the early stage of a nursing career.
Journal of Medical Ethics, 2012
Journal of Clinical Nursing, 2012
Aims and objectivesTo explore the effectiveness of wound care programme for emergency traumatic p... more Aims and objectivesTo explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan.BackgroundWound care is one of the most major issues for trauma patients at home. Wound infection has been alerted mostly on medical treatment. Little is known about how healthcare education impact patient care of traumatic wound after discharged from emergency department.DesignA quasi‐experimental design was used by using two groups post‐test.MethodsRandom sampling was used to recruited participants, 89 participants in each group in emergency department at a medical centre in Taiwan. A 25‐minute wound care programme was given to patients in the intervention group. A questionnaire was used to evaluate the effectiveness of the programme after 72 hours as patient followed up in out‐patient department. The data of wound infection were collected from patient's medical record by followed 2 weeks after injured.ResultsAfter wound care programme, the knowledge, skills of wou...
Journal of Child Health Care, 2013
Previous studies separately examined the effects of positioning or environmental stressors on pre... more Previous studies separately examined the effects of positioning or environmental stressors on preterm infants’ sleep and stress. Since positioning and environmental stressors occur simultaneously during infant hospitalization exploring these variables in the same study may offer new insights. A quasi-experimental study by one-group interrupted time-series design. In the current study, a total of 22 preterm infants were enrolled. Each infant was moved to either the supine or prone position for an hour at a time. Infants were videotaped and the sleep–wake states, stress behaviours and environmental conditions (light, noise and stimulation/handling) were recorded during the observation period. A total of 80 observations from 22 infants were accrued. In the supine position, preterm infants demonstrated more frequent waking states after adjusting for various environmental stressors ( p < .01). These infants demonstrated more frequent stress behaviours in the supine position after adju...
Japan Journal of Nursing Science, 2013
Aim: To explore the energy expenditure (EE) in a group of preterm infants during the periods of e... more Aim: To explore the energy expenditure (EE) in a group of preterm infants during the periods of environmental stress, and to explore the relationship between EE and physiological stress signals of preterm infants. Methods: Research design was an explorative secondary analysis of 4164 research data from 37 preterm infants which included physiological signals and environmental stressors in neonatal intensive care units. The current study investigated the data of EE calculated using heart-rate-based EE estimate. Results: A significantly positive relationship between EE and different levels of nursing intervention was found (P < 0.005). In addition, there was a significantly negative relationship between EE and oxygen saturation (P < 0.001). Conclusion: These research results confirmed that environmental stressors may impact the growth and developmental outcomes in preterm infants by increasing their EE. Neonatal clinicians should minimize excessive stimulations in order to conserve energy for the growth and developmental needs of preterm infants. Research found a significant relationship between an increase in EE and a decrease in oxygen saturation in preterm infants. The authors further hypothesized that EE of preterm infants may be predicted by estimating the oxygen saturation. Further study using different research methods and an enlarged sample size is needed.
Mid Taiwan Journal of Medicine, 2006
摘要: 目的 為發展一個具有信, 效度的護理人員組織承諾因素評量表. 方法 這個評量工具發展是依據廣泛的文獻查證和工具發展步驟, 心理計量信效度測量方法. 共有 167 位全職護理人員完成填寫此... more 摘要: 目的 為發展一個具有信, 效度的護理人員組織承諾因素評量表. 方法 這個評量工具發展是依據廣泛的文獻查證和工具發展步驟, 心理計量信效度測量方法. 共有 167 位全職護理人員完成填寫此量表. 結果 量表測試結果顯示量表的內在一致性信度 Cronbach's alpha 為 0.91. 由六 ...
Annals of Surgical Oncology, 2009
Background. Approximately one-third of prostate cancer (PCa) patients show biochemical failure af... more Background. Approximately one-third of prostate cancer (PCa) patients show biochemical failure after radical prostatectomy (RP) and are prone to develop metastasis with significant mortality. Although aberrant Wnt/b-catenin (CTNNB1) signaling has been observed in numerous types of human cancers, including PCa, to our knowledge there is currently no information on the role of Wnt signaling gene polymorphisms in PCa. Methods. We comprehensively studied the contribution of genetic variations in CTNNB1 and adenomatous polyposis coli (APC), one of the key genes encoding the CTNNB1 destruction complex, to PCa risk and prognosis after RP using a hospital-based case-control study. We selected and genotyped 13 tagged single-nucleotide polymorphisms (tSNP) to predict common variants across entire APC and CTNNB1 genes in 307 patients with clinically localized PCa who received RP and 371 unaffected controls. Results. Four tSNPs (rs3846716, rs2431238, rs41115, and rs565453) and a specific haplotype (GTAAGA) in the APC tumor suppressor gene were associated with a 0.57-to 0.71-fold lower risk of localized PCa. The association of tSNPs with prostate-specific antigen (PSA) recurrence in PCa patients was then analyzed by Kaplan-Meier analysis and Cox regression model. Interestingly, we found that the APC rs3846716 GA/AA genotypes were also significantly associated with poorer PSA-free survival (log-rank test, P = 0.037) compared with the GG genotype. Conclusions. This is the first report documenting the potential prognostic role of the APC rs3846716 GA/AA genotype on PSA recurrence after RP. Patients diagnosed with localized prostate cancer (PCa) are commonly treated with radical prostatectomy (RP), but approximately 35% of patients experience biochemical failure, as manifested by prostate-specific antigen (PSA) relapse, within 10 years. 1,2 Although several clinicopathological indicators, such as PSA, Gleason score, pathologic stage, and surgical margin status, have been currently used for outcome prediction following intended curative RP of primary PCa, finding new biomarkers to improve prediction S.-P. Huang and B.-Y. Bao contributed equally to this work.
Journal of Nursing Research, 2011
Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a sk... more Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages. Conclusions: This study revealed that nurses working in skill mix model environments need more authority to delegate and educate NAs and to supervise and integrate nursing care. Study results may serve as a reference for hospital nursing practice in Taiwan.
BMC Health Services Research, 2012
Background Studies over the past decades have shown an association between nurse staffing and pat... more Background Studies over the past decades have shown an association between nurse staffing and patient outcomes, however, most of these studies were conducted in the West. Accordingly, the purpose of this study aimed to provide an overview of the research/evidence base which has clarified the relationship between nurse staffing and patient mortality of acute care hospital wards under a universal health insurance system and attempted to provide explanations for some of the phenomena that are unique in Taiwan. Methods Through stratified random sampling, a total of 108 wards selected from 32 hospitals in Taiwan were collected over a consecutive seven month period. The mixed effect logit model was used to explore the relationship between nurse staffing and patient mortality. Results The medians of direct-nursing-care-hour, and nurse manpower were 2.52 h, and 378 persons, respectively. The OR for death between the long direct-nursing-care-hour (> median) group and the short direct-nurs...
Accident Analysis & Prevention, 2013
Although accidental injury is the main factor involved in the death of young children in many cou... more Although accidental injury is the main factor involved in the death of young children in many countries, few studies have focused on parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; competence with regard to self-efficacy of first aid for their children following injuries occurring at home. The purpose of this cross-sectional study was to investigate parental self-sufficiency of first aid for home accidents in children aged 0-4 years. The study is a cross-sectional designed. Data from 445 parents recruited were collected by purposive sampling at eight metropolitan community health centers in central Taiwan. Measurements were taken from a self-developed questionnaire that included 37 questions. Logistic regression analysis was applied to explore the associations between factors and parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid at home accident. Our findings show that parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; overall rate of knowledge of first aid was 72%. The mean score for 100% certainty in parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid was 26.6%. The lowest scores for self-efficacy were with regard to choking and cardiopulmonary resuscitation (CPR). There was a significantly positive correlation between parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge and self-efficacy of first aid (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), and thus knowledge of first aid is a predictor of parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy. Knowledge of first aid is also a partly mediator between participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; attending first aid program, participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; first aid information obtained from health personnel and self-efficacy of first aid. Our findings suggest that medical services should provide first aid resources to help manage accidental injuries involving children, particularly information on how to deal with choking and CPR. With an appropriate program provided by health professionals, parents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-efficacy of first aid for home accidents will be positively enhanced.
Journal of clinical …, 2009
Results. Sixty per cent of the participants used some form of folk remedies in the care of their ... more Results. Sixty per cent of the participants used some form of folk remedies in the care of their hospitalised children. The most frequently used remedies were: spirit-calling (63%); carrying a cross or incense bag (47%), praying a Buddhist mantra (36%). There was a positive ...