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Stroke is the third leading cause of death in Taiwan. Poststroke older adults are often admitted to long-term care facilities. The impacts of the two concurrent life events of stroke and relocation may increase the risk of depression in stroke survivors. Depression in elderly stroke survivor residents of long-term care facilities has not been studied.

Interventions targeting multiple risk behaviors have the potential to offer greater health benefits on public health. The purpose of this study was to evaluate the effects of a Workplace Multiple Cardiovascular Disease Risks Reduction Program (WMCVDRRP) on male participants at high risk for cardiovascular disease.

This study investigated patients' perceptions and expectations of their families' participation in the informed consent process of elective surgery.

Background and aims:The Timed up and Go Test (TUG) is recommended as a screening tool for fall risk in older people. It is assumed that this general mobility test is underpinned by physiological factors such as strength, coordination and balance. However, no studies have examined the range of physiological and psychological factors which influence performance on this test. The aim of this study was to examine the relative contributions of a range of sensorimotor, balance and psychological factors to TUG performance in a large sample of older people. Methods:280 community-dwelling people aged 65 plus years (mean age 74.9, SD=6.4) underwent the TUG test, as well as quantitative tests of vision, peripheral sensation, strength, reaction time, balance, fear of falling, pain and vitality. Results:The time required to complete the TUG was significantly related to limitations in instrumental activities of daily living and fear of falling. Many physiological and psychological factors were significantly associated with TUG performance in univariate analyses. Stepwise multiple regression analyses identified knee strength, postural sway, reaction time, edge contrast sensitivity, MMSE score, SF12 body pain and general health scores, number of medical conditions and age as significant and independent predictors of TUG performance. Of these measures, the lower limb strength measure explained most variance in TUG times. However, other sensorimotor, balance, psychological and health measures provided important independent information. The combined set of variables explained 43.5% of the variance in TUG times (multiple r=0.65). Conclusions:Findings indicate that, in community-dwelling older people, TUG performance is influenced by lower limb strength, balance, reaction time, vision and pain, in addition to cognitive function and health status.

Quality of life is an important indicator for evaluating therapeutic outcomes and mortality in patients with end-stage renal disease. Few studies have explored the impact of symptom distress and social support on quality of life in this population. A correlational study was designed to examine the influence of symptom distress, social support and demographic characteristics on quality of life in renal transplant recipients. A convenience sample of 113 renal transplant recipients was recruited from a medical center in Southern Taiwan. A structured questionnaire was used to collect data. This four-part tool included Quality of Life Index - Kidney Transplant Version III, Physical Symptom Distress Scale, Social Support Scale, and demographic characteristics. Data were analyzed by descriptive and inferential statistics SPSS 10.1 statistical package. Percentage, rank, mean and standard deviation, t-tests, chi-square, ANOVA, Pearson's correlation and multiple regression were computed. Results showed that renal transplant recipients had a moderate quality of life. Social support and symptom distress, age, employment status, and household income significantly explained 28.8 of the variance in quality of life. Findings suggest implications for interventional programming and research aimed toward improving quality of life, including individual and family-based approaches designed to enhance recipients' social support and address effective management of symptoms. Recruiting a transplant clinical nurse specialist to design and implement an intervention program also is recommended.

The purpose of this study was to examine factors affecting the development of nursing competence in the writing of N3 clinical nurse level III case reports. A cross-sectional survey was conducted in 13 hospitals in southern Taiwan from July to October, 2002. The subjects included 239 nurses who had passed N3 case report accreditation. The results show that 1 nurses rated their current competence at a fairly good level 5.57 ± 0.74. There was no significant difference between nurses' subjective self-evaluation and supervisors' objective evaluation 5.57 ± 0.74 vs 5.55 ± 0.89 t0.162, p.871. 2 The nurses' self-rating, supervisors', and colleagues' evaluation all indicated moderate progress in nursing competence after writing N3 case reports. The progress scores rated by nurses themselves, supervisors and colleagues were not significantly different 4.89 ± 1.35 vs. 4.84 ± 1.57 vs. 4.84 ± 1.26 F0.096, p.909. This finding reveals that writing N3 case reports has a positive effect on nursing competence. 3 The results also indicate that ‘Attitude toward N3 case report’, ‘Writing difficulty’, ‘Preparation for writing case report’ were the three predicting factors of progress in nursing competence, which accounted for 26.2 of the total variance. Therefore we recommend that N3 advancement education should include guidance in alleviating writing difficulty and emphasis on implementing various types of preparation for writing case reports, as effective ways to improve nursing competence.

The purpose of this her meneutic study was to investigate the essence of spirituality of terminally ill patients. In-depth unstructured interviews were used as the method for data collection. In the six-month period of data collection, the researcher was in the role of a hospice palliative care consultant who directly took care of the subject patients in a hospice ward of a teaching hospital. The six subjects were selected purposively according to various demographic backgrounds. Interview transcripts provided the data for analysis. The results were composed of four constitutive patterns and ten themes. The first constitutive pattern was “Communion with Self” which included three themes 1 Self-identity-spirituality is the discovery of the authentic self. 2 Wholeness-a human being is full of contradictions but still in whole ness. 3 Inner peace-spirituality is negotiating conflicts for self-reconciliation. The second constitutive pattern was “Communion with others” which included two themes 1 Love-spirituality is a caring relation ship but not an over-attachment to others. 2 Reconciliation-spirituality is to for give and to be for given. The third constitutive pattern was “Communion with Nature” which included two themes 1 Inspiration from the nature-spirituality is there sonance of the marvelous beauty of nature. 2 Creativity-spirituality is conceiving imaginatively. The fourth constitutive pattern was “Communion with Higher Being” which included three themes 1 Faithfulness-spirituality is keeping the trust dependably. 2 Hope-spirituality is claiming possibilities. 3 Gratitude-spirituality is giving thanks and embracing grace. The scientific rigor of this qualitative research as well as the strength and limitations of the study are reported. Implications for hospice palliative care and future research are recommended.

The purpose of this study was to compare the differences between head nurses' expectations and new graduates' perceptions of the entry-level skill competency. Subjects included 147 new graduates and 126 head nurses from four schools of nursing and their affiliated medical centers located in northern, central and southern Taiwan. The results showed that among 213 skills, 153 skills were reported by over 60 of head nurses to be performed precisely under clinical settings. In contrast to the graduates' perceptions, over 60 of the graduates had confidence to perform only 82 skills precisely. The percent age of head nurses' expectation and the perception of the graduates in skills that were reported to be performed precisely in clinical situations were significantly differenct in 145 skills 68. For seventy-six skill items there was congruence between the percentage of head nurses' expectations and new graduates' perceptions. The percentage of the head nurses' expectation were higher than the graduates' perception in 55 skills. On the other hand, for 14 skills the percentage of graduates who perceived them selves as being able to perform them precisely was significantly higher than the percentage of head nurses. The results can be applied to improve nursing skills' teaching and students' pre-job preparation.

Nurses constantly face the need to provide patient care, both physical and psychological, within the health care arena. Nursing staff must have an under standing of the concerns and experiences of hospitalization, and the sensitivity to elicit the patient's own private language of health care needs. The purpose of the study was to examine the concerns of health care needs from patients' point of view. The specific objective was to under stand the experiences of hospitalized patients. The grounded theory method was applied for this purpose with major assumptions from the symbolic inter action perspective. Twelve subjects were recruited from medical and surgical units at a teaching hospital using purposive sampling, and were inter viewed. Data were in the form of transcripts from tapes, field notes, and analytic and process memos. The constant comparative technique was utilized to discover the core themes that would explain most of the variation and integrate the data, codes and memos. Three coding processes, open coding, axial coding, and selective coding, were employed. Six aspects were generated from the results of the study to describe patients' concerns. The hospitalized experience was depicted as searching for certain aspects of health care needs including focus on the physical condition, promptness and effective ness of nursing services, health professionals' caring attitudes when giving service and their responsibility, food preparation, environment, and medical expenses.

A novel and promising approach currently available is the grafting of fetal nigra tissues into the brain of a Parkinson's patient. However, the degree of success for such treatment has mainly been evaluated by histological, radiological and physical assessments, with little or no attention paid to its effects on the patient's psychosocial status. In order to provide a more comprehensive profile, a survey was conducted using questionnaires and interviews to examine the physio-psycho-social progress of six Parkinson's patients who underwent fetal tissue grafting in Taiwan. Results indicated that the physiological effects varied among patients. Noticeably an improvement in walking was the most gratifying, but progress in dressing and writing ability seemed disappointing. From the psychological point of view, depression was commonly felt by patients. Other feelings included fear, ambivalence, and change in body image. In addition, all six patients found that their relationship with spouse became worse; they also reduced social interaction to the minimum. From the findings, we also noticed that inadequate knowledge contributed to part of the results. Therefore, some nursing suggestions especially educating the patients and family about the facts and outcome of fetal tissue transplantation are highly recommended. These may help Parkinson's patients adjust better after undergoing this novel treatment.