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Background: Team-Based Learning (TBL) is a potentially effective method of instruction that has been applied only infrequently in nursing education in Taiwan. Purpose: This study was developed to examine the effects of incorporating the TBL strategy into the course "Advanced Medical Nursing English". Methods: A quasi-experimental, single group, and pre-post test design was adopted. Nursing students who took the "Advanced Medical Nursing English" elective course used the TBL strategy for 8-weeks. Students were assigned to heterogenic groups of 12 students each based on their scores on an English pre-test. The collected data included the scores on individual and group readiness tests, a self-directed learning questionnaire, learning satisfaction, and an English posttest. Self-completed reflection papers and focused group interviews were used for qualitative appraisal. Results: A total of 72 students were enrolled. Nearly all (93.1%) were female and 21-22 years of age. The results of a paired samples t-test applied to examine the effects of the TBL strategy on learning outcomes showed that English posttest and self-directed learning ability scores had both improved significantly (all p < .05). The results of ANOVA tests showed that students with lower pre-test scores improved more than those with higher pre-test scores. The results of a sample t-test with a test value of 4.0 applied to examine learning satisfaction found a non-significant change (p > .05), indicating no change in perceived satisfaction. The qualitative analysis identified four themes regarding perceptions of the TBL strategy, including "friendships in learning", "harmonious atmosphere and participations", "inertial shock and adjustments", and " excessive learning load". Conclusion: TBL was shown to be an effective learning strategy for RN-BSN students in a Medical Nursing English Course, particularly those with relatively low pre-test scores. Future studies should focus attention on reading assignments to avoid overburdening students. The results of this study may serve as a reference for medical nursing English education. [ABSTRACT FROM AUTHOR]

The recent large-scale movement of people across the globe has triggered many cross-cultural opportunities that were quite rare in the past, but now occur almost every day. However, these cross-cultural opportunities have also introduced a variety of cultural tensions and visible exclusionary practices, which are of serious concern. The summation of these opportunities and phenomena has resulted in a greater demand for cross-cultural competence (CCC) of individuals living in a diversified global community. In Taiwan, within recent years, there has been a significant influx of international students and in effect, this increase has gradually transformed the university campus into a more diversified community. In order to promote cross-cultural exchange and a mutual understanding between the growing number of international students and local college students, it is important to develop their cross-cultural competence early in their college lives. Consequently, this paper details an empirical study on the mediating effects of social factors on the development of a local college student's cross-cultural competence, including the school climate, family and home, peers, personal value system, and traditions. Using a modified CCC scale developed by Chen and Ching (), a total of 933 valid responses were gathered and analyzed. Structural equation modeling (SEM) was used to analyze and develop a model of relationships among the social factors. Results show that student exposure to a cross-culturally tolerant environment has greatly enhanced their cross-cultural competence. In addition, the SEM results have also shown a significant path from student school climate, individual perspective (personal value system and traditions), and cross-cultural competence. In conclusion, in order for Taiwan college students to become better equipped with adequate cross-cultural skills, additional interventions and opportunities should be encouraged. [ABSTRACT FROM AUTHOR]

Background: research in care home settings is often negatively focused, portraying life as sterile and devoid of meaningful experiences. Care homes have the potential to influence people's lives socially, physically and psychologically. It is important to understand what factors contribute to this.Objective: to conduct a systematic qualitative review of care home life and provide practical recommendations to enhance residents' quality of life.Methods: the following databases were searched: PsycINFO, Medline, Web of Science, EMBASE, Allied and Complementary Medicine Database and Cumulative Index to Nursing and Allied Health Literature. References from appropriate journals and individual articles were checked. Papers that fitted our selection criteria were selected. Two independent reviewers assessed methodological study quality. Thematic analysis and meta-ethnographic methods were adapted to synthesise findings.Results: thirty-one studies were identified. People in care homes voiced concerns about lack of autonomy and difficulty in forming appropriate relationships with others. Four key themes were identified: (i) acceptance and adaptation, (ii) connectedness with others, (iii) a homelike environment, (iv) caring practices.Conclusion: positive experiences in care homes can occur and are important for residents' quality of life. The review supports literature highlighting the need for relationship-centred approaches to care and emphasises the importance of understanding the resident's attitude towards living in care homes. [ABSTRACT FROM AUTHOR]

liu c.-c., chen y.-c., yeh y.-p. & hsieh y.-s. (2011) Effects of maternal confidence and competence on maternal parenting stress in newborn care. Journal of Advanced Nursing 68(4), 908-918. Abstract Aim. This paper is a report of a correlational study of the relations of maternal confidence and maternal competence to maternal parenting stress during newborn care. Background. Maternal role development is a cognitive and social process influenced by cultural and family contexts and mother and child characteristics. Most knowledge about maternal role development comes from western society. However, perceptions of the maternal role in contemporary Taiwanese society may be affected by contextual and environmental factors. Methods. A prospective correlational design was used to recruit 372 postpartum Taiwanese women and their infants from well-child clinics at 16 health centres in central Taiwan. Inclusion criteria for mothers were gestational age >37 weeks, ≥18 years old, and healthy, with infants <4 months old. Data were collected between August 2007 and January 2008 using a self-report questionnaire on mothers' and infants' demographic variables, maternal confidence, maternal competence and self-perceived maternal parenting stress. Results. After controlling for maternal parity and infant temperament, high maternal confidence and competence were associated with low maternal parenting stress. Maternal confidence influenced maternal parenting stress both directly and indirectly via maternal competence. Conclusion. To assist postpartum women in infant care programmes achieve positive outcomes, nurses should evaluate and bolster mothers' belief in their own abilities. Likewise, nurses should not only consider mothers' infant care skills, but also mothers' parity and infant temperament. Finally, it is crucial for nurses and researchers to recognize that infant care programmes should be tailored to mothers' specific maternal characteristics. [ABSTRACT FROM AUTHOR]

Background The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. Methods A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). Results This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. Conclusion Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme. [ABSTRACT FROM AUTHOR]

Aim and objectives: The aim of this study was to develop a theory to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis. Background: Taiwan ranks first worldwide in end‐stage renal disease incidence and dialysis prevalence. Many patients cannot accept long‐term dialysis treatment and thus face several physical and psychological suffering. No theory has yet been developed to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis. Design: A grounded theory approach was used in this study. Methods: A theoretical sampling was performed after interviewing 25 patients who had adapted to peritoneal dialysis at a medical centre in Taiwan from January 2018 to September 2018; data saturation was achieved. Data were analysed using open, axial and selective coding and while using the constant comparison technique. COREQ reporting guidelines were utilised. Results: A substantive theory was developed to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis. The core category that emerged from the data collected was 'Confronting peritoneal dialysis to live and co‐exist with peritoneal dialysis'. Other key categories linked to and embraced in this core category were as follows: positive self‐regulation, regulation of daily life and the process of adaptation to dialysis method. Conclusion: The results could help healthcare professionals to better understand the process of end‐stage renal disease patients' adaptation to peritoneal dialysis, thereby facilitating patients' adaptation to dialysis in their daily life, enhancing their quality of life and improving the quality of medical care. Relevance to clinical practice: Healthcare professionals could use this theory as reference when providing care for peritoneal dialysis patients to assist them in adapting to life with peritoneal dialysis as soon as possible through positive self‐regulation, daily life adjustments and the process of adapting to the dialysis method. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the lived experiences of family caregivers of epidermolysis bullosa (EB) patients. Background: Patients with EB need long‐term care. Their family experiences physical and mental stress while proving that care. However, very little research has explored the family caregivers' actual lived experiences when caring for EB patients. Design: This is a qualitative research using the phenomenological approach. Methods: Data were collected with the assistance of the Taiwan Foundation for Rare Disorders (TFRD). Interviews were conducted between 2015 and 2017 with primary family caregivers (n = 10) who had cared for EB patients for at least five years. Data were analysed using Colaizzi's (1978) seven‐step phenomenological method. COREQ reporting guidelines were utilised. Results: Four themes and eleven subthemes emerged after data analysis: (a) transformation and helplessness: changing expectations and helplessness associated with the rare, unknown disease; (b) mother's responsibility: mothers loving and protecting their children, surviving through adversity and challenges and self‐experiencing a child's pain; (c) physical and mental fatigue experienced by the whole family: physical and mental exhaustion, and unbalanced lives; and (d) adjustment and social support: providing mutual assistance to mitigate adversity, hopeful search for treatments, the importance of patient associations and rare disease foundations, and social assistance requirements. Conclusion: Family caregivers experience many challenges when caring for EB patients and experience substantial stress and overwhelming burdens. Consequently, they would benefit greatly from various support systems to reduce the burden of caring for EB patients. Relevance to clinical practice: Healthcare professionals can use the findings from this study to understand the circumstances faced by family caregivers and tailor care and education specifically to support each family's financial, social and household needs, thereby helping them reduce the stress of caring for EB patients. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence shows that advance care planning is effective in improving outcomes. However, its applicability and acceptability outside Western cultures remain unknown. Examination of relevant cultural adaptations is required prior to wider adoption. Aim: To examine the feasibility and acceptability of a culturally adapted advance care planning intervention in a Taiwanese inpatient hospital for advanced cancer patients, family members and healthcare professionals. Methods: A single-group, non-controlled, mixed methods feasibility study guided by a previously developed logic model. The culturally adapted advance care planning intervention represented a one-time intervention, comprising pre-advance care planning preparation and follow-up consultation. Qualitative interviews explored participants' view on their involvement in the study. Patients' medical records were examined to assess intervention fidelity. Findings from both data sets were integrated following analysis. Results: N = 29 participants (n = 10 patients; n = 10 family members and n = 9 healthcare professionals) participated in the intervention, of who 28 completed follow-up interviews. Of the 10 advance care planning interventions delivered, most components (n = 10/13) were met. Key contextual moderators influencing the intervention feasibility included: (1) resource constraints resulting in increased workload; (2) care decisions informed by relatives' experiences of care; (3) the requirement for financial and policy support; and (4) a presumption for end-of-life care provision and surrogate decision-making. Six areas of intervention refinement were identified for future research. Conclusion: Implementing a culturally adapted advance care planning intervention in an inpatient hospital setting in Taiwan is possible. The participants reported the intervention to be acceptable. However, careful attention to the conceptual underpinning using local primary data is imperative for its success. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) affects a significant proportion of Taiwanese individuals (Weissman et al., 1996; Yang, Yeh, & Hwu, 2012). Psychotropic medications are typically the mainstay of treatment for BD, and there is an abundance of international research on biological etiology and medication options. However, there is comparatively little research on psychosocial aspects of BD, including how it is understood and managed within families. As culture provides the context in which psychiatric disease is managed, there is a need to identify distinct Chinese psychosocial perspectives that might shed light on intervention options. This research explored how Taiwanese patients and family members comprehend and cope with BD. A sample of 42 participants, including 20 Taiwanese patients diagnosed with Bipolar Disorder-I (BD-I) for at least 4 years, and 22 family members, participated in separate interviews on explanatory models of illness. Qualitative thematic analysis focused on features that were distinct from those in current Western research literature. Five themes were identified that represented Taiwanese conceptualizations of BD, notions of etiology, views regarding treatment, and the difficulties in managing the disorder. Participants used Chinese language terms and descriptions of BD that reflected greater concerns about irritability, anger, and family conflict than about other symptoms, and participants also emphasized characterological trait descriptions of the condition. Their responses reflected their acceptance of lifelong family responsibility for caretaking, clashing beliefs regarding biomedical versus traditional Chinese medical and spiritual models of etiology and cure, profound concerns about the effects of psychiatric medication on the liver and kidney systems, and a focus on stress rather than genetic or biological models of etiology. [ABSTRACT FROM AUTHOR]

The influence of the broader autism phenotype (BAP) on the adjustment of siblings of children with autism has previously been researched mainly in Western cultures. The present research evaluated a diathesis-stress model of sibling adjustment using a questionnaire study including 80 and 75 mother-typically developing sibling dyads in Taiwan and the United Kingdom (UK). UK siblings reported elevated adjustment difficulties compared to the Taiwanese sample and to normative data. Whilst higher BAP levels were generally associated with greater adjustment difficulties, differences were found across cultures and respondents. Although significant diathesis-stress interactions were found, these were in the opposite direction from those predicted by the model, and differed across cultural settings. Implications for culturally-sensitive sibling support are considered. [ABSTRACT FROM AUTHOR]

I used a phenomenological method to examine the caregiving experiences of Taiwanese men with their siblings with Down syndrome (DS). Four themes emerged after drawing on stories shared by 7 men: taking responsibility for the caregiving, adjusting to an unfamiliar caregiving role, and counting on help from women and reframing. The results of the study show that the Taiwanese brother caregivers were raised according to the cultural norm, because of which they accepted the caregiving responsibility, even though they had rarely been included in the early life of their sibling with DS. These brothers thus encountered chaos in the process of transferring into the role of main caregiver. Greater attention must be paid to the promotion of earlier involvement of brothers in the life of their sibling with DS, and the special challenges surrounding a brother giving care to a sister with DS. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the changes and associated factors in decisional conflict and regret in patients with localised prostate cancer up to six months postprimary treatment. Background Various treatments of differing qualities can be used for patients with localised prostate cancer; these treatments may cause conflicts in treatment decision-making and post-treatment regret. Design A quantitative longitudinal study. Methods A total of 48 patients were recruited from a 3700-bed medical centre in northern Taiwan and assessed at pretreatment and one and six months post-treatment. Demographic characteristics, clinical information and results from the psychosocial adjustment to illness scale, decisional conflict scale and decision regret scale were collected. Data were analysed based on the generalised estimating equations models. Results The overall decisional conflict substantially improved over time. However, the feeling of being less informed was high and did not improve considerably during the study period. Education level, decision preferences and psychosocial adjustment were associated with decisional conflict and influenced decision-making. The feeling of ineffective decision-making and decisional regret was low, post-treatment. Psychosocial adjustment was associated with effective decision-making and decisional regret. Conclusion In patients with localised prostate cancer, decisional conflict reduced considerably up to six months post-treatment. Moreover, the patients were satisfied with their treatment decision-making and believed that they had made the correct choice up to six months post-treatment. However, patients may have experienced feelings of being less informed pre- and post-treatment, particularly those with lower education levels, a preference for passive roles, or inferior psychosocial adjustment. Consequently, health professionals must provide adequate medical information and psychosocial intervention to help patients in the decision-making process. Relevance to clinical practice Nurses and healthcare providers must provide localised prostate cancer patients with adequate information and psychosocial intervention to reduce decisional conflict. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Resilience embodies the personal qualities that enable one to thrive in the face of adversity and is a significant factor affecting the health of patients with mental illness. Most research on resilience has focused on patients in high-risk groups. Thus, there is lack of research exploring the resilience of psychiatric patients and related factors. Purpose: The aims of the present study were to (1) explore the relationships among demographic characteristics, psychiatric symptoms, perceived stress, medical professional-patient interaction, social support, social adaptive function, and resilience and (2) identify indicators of resilience in psychiatric patients. Methods: A total of 180 psychiatric patients were recruited from a mental hospital in eastern Taiwan. The brief psychiatric rating scale, perceived stress scale, questionnaire of medical professional-patient interaction and social support, Connor-Davidson Resilience Scale (CD-RISC), and social adaptive function scale were used to collect data. Results: Participants in the present study showed an intermediate level of resilience. Resilience scores correlated positively with medical professional-patient interaction and social support and negatively with perceived stress, social adaptive function, and psychiatric symptoms. Stepwise multiple regression analysis indicated that perceived stress, social support, education, and social adaptive function collectively accounted for 45.3% of the total variance. Conclusion / Implications for Practice: For psychiatric patients, enhancing social support and social adaptive function and decreasing perceived stress improves their resilience and decreases the frequency of their psychiatric episodes, thus increasing their chances of returning to society. [ABSTRACT FROM AUTHOR]

Accessible summary Learned resourcefulness and personal beliefs are significant predictors of adaptive functioning., The mediating effect of personal beliefs on the relationship between learned resourcefulness and adaptive functioning was validated in adults with depression., The findings from this study may provide the basis for developing a useful nursing intervention constituting resourcefulness skills with positive personal beliefs to help patients with depression improve their ability to function well in their daily activities., Abstract Research has shown that patients with depression have difficulty with performing daily tasks and meeting their own personal care needs. According to Beck's cognitive theory of depression, such deficits in adaptive functioning are affected by disturbances in specific personal beliefs that reflect the process of regulating cognitions. Rosenbaum's learned resourcefulness theory proposed that adaptive functioning is influenced by learned resourcefulness, while learned resourcefulness is associated with the process regulating cognitions. This study aims to test the mediating effect of personal beliefs on the relationship between resourcefulness and adaptive functioning. The study involved a cross-sectional design. Participants consisted of 187 adults with depression in southern Taiwan. The data were collected through four instruments: Cognitive Triad Inventory, Self-Control Schedule, modified Community Living Skills Scale, and a demographic questionnaire. Both resourcefulness and personal beliefs were significant predictors of adaptive functioning, and personal beliefs mediated the effect of learned resourcefulness on the adaptive functioning of the adults with depression. The results validate the role played by personal beliefs in effecting learned resourcefulness and adaptive functioning among adults with depression and provide direction for designing nursing interventions that consider personal beliefs when teaching resourcefulness skills to adults with depression. [ABSTRACT FROM AUTHOR]

Aims and objectives The specific aims of this study were as follows: (1) to describe psychosocial adjustment in adults with end-stage renal disease who underwent maintenance peritoneal dialysis; (2) to explore the influence of demographics, clinical variables, symptom distress and social support on psychosocial adjustment and (3) to determine predictive factors of psychosocial adjustment. Background Proper psychosocial adjustment is important for patients with end-stage renal disease to cope with multiple stressors of their disease and to balance their lives within the restrictions imposed by peritoneal dialysis treatment. Knowledge on psychosocial adjustment in patients receiving long-term peritoneal dialysis has been limited. Design The study was based on a predictive correlational design. Method One hundred peritoneal dialysis patients were recruited from outpatient peritoneal dialysis clinics of a general hospital in Taipei, Taiwan. Data were collected with the study questionnaires, including the Physical Symptom Distress Scale, the Social Support Scale and the Psychosocial Adjustment to Illness Scale - self-report. Results The mean score on the Psychosocial Adjustment to Illness Scale was 359·7 ( SD = 40·0), indicating that these participants were moderately struggling in adjusting to their illness. Symptom distress, family social support and financial status explained 38·3% of the variance in psychosocial adjustment ( F3,96 = 21·5, p < 0·001). Conclusions The level of psychosocial adjustment in peritoneal dialysis patients is suboptimal. Overall, the patients with high physical symptom distress, weak family social support and poor financial status reported deficient psychosocial adjustment to their illness. Implications for practice The findings of this study are relevant to the understanding of preconditions that enable peritoneal dialysis patients to successfully adjust to the disease and its diverse consequences. Patients with insufficient income, higher symptom distress and less family social support have a greater risk of psychosocial maladjustment. Medical professionals may use these variables to identify higher risk groups for early intensive intervention. [ABSTRACT FROM AUTHOR]

Aims This article is a report of a study that explored the perceptions of patients as they experienced their diabetes illness trajectory, and their initial decisions to undergo dialysis, in an effort to provide further complementary guidance for nurses and healthcare practitioners. Background Diabetes leads to higher morbidity and mortality when patients develop renal failure resulting from diabetic nephropathy. An effective self-care regimen and multidisciplinary team approach are required to avoid or delay the serious chronic complications of the disease. Patients and healthcare practitioners must be aware therefore of psycho-physiological adjustment when seeking to delay the onset of complications. Design A qualitative design was used for data collection through semi-structured interviews. Method Data were analysed using content analysis. Participants were 25 diabetes patients undergoing initial haemodialysis who were recruited from diabetes and nephrology wards at a medical centre in northern Taiwan. Data were collected from December 2010-August 2011. Findings The core theme describing the illness trajectory derived from face-to-face interviews with people undergoing hemodialysis was 'from silence to storm'. There emerged also five phases of patient experience that resulted from the development of diabetic nephropathy: (1) diabetes onset stage; (2) stable stage; (3) burden stage; (4) shock stage; and (5) coping stage. Conclusions Patients suffer with diabetic nephropathy for a long-term period. Our findings may enhance the understanding of nurses regarding the experiences of patients with diabetic nephropathy, and will help them provide diabetes care that promotes healthy life for those individuals. [ABSTRACT FROM AUTHOR]

Aims and objectives. To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background. The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. Design. We adopted a phenomenological design using focus group interviews. Methods. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of 'being new'. Interview data were analysed according to Sloan's (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. Results. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of 'struggling to be an insider'. This phenomenon was characterised by four themes, including (1) 'being new as being weak', (2) 'masking myself', (3) 'internalising the unreasonable' and (4) 'transforming myself to get a position'. Conclusions. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self-oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Relevance to clinical practice. Recognition of the journey of 'struggling to be an insider' helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in-service training programmes and (4) retain future nurses. [ABSTRACT FROM AUTHOR]

Teacher quality has been a perennial issue in the field of education. In addition to academic ability, psychological and motivational characteristics are regarded as increasingly important dimensions of teacher quality. This study has established a multidimensional framework of teacher quality including social competency, adaptive ability and career commitment and used it to examine the qualities of pre-service college students in teacher education programs based on a national survey in Taiwan. It is found that in this country where ‘those who are academically able, teach’ has been a tradition, pre-service students further possess better adaptive and motivational qualities than their non-teaching counterparts. The underlying policy and socio-cultural contexts of such a positive phenomenon of ‘those who are adaptive and motivated, teach’ are further explained and implications for teacher educators and policy makers are discussed. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to test a relationship model of self-esteem and job adjustment affecting the service attitude of male nurses in Taiwan. Service attitude of nurses may affect their intention to leave and the quality of health care for their patients. Self-esteem is an important predictor of service attitude. Very few researchers have assessed job adjustment and service attitude in male nurses. Reducing job stress and burnout would help to increase job satisfaction. A cross-sectional research design was used in this study. In 2009, 338 male nurses were invited to participate in this study. Finally, 284 participants completed the questionnaire, and the response rate was 84·0%. The results revealed that the postulated model fits the data from this study well. Self-esteem did not significantly correlate to service attitude. Job adjustment was a significantly influencing factor on service attitude. We conclude that job adjustment was indeed important in explaining the service attitude of male nurses. Nurse managers must help male nurses adjust their job as soon as possible to improve their service attitude. In clinical practice and management, our findings provide concrete directions for nursing management and professionals in helping male nurses adjust to their job to improve male nurses' service attitude. More clinical situation must be provided and practiced before male nursing students graduate from school. We suggest future study is needed to generalise this model to different populations. [ABSTRACT FROM AUTHOR]

The study was designed to validate a model for a successful aging process and examine the gender differences in the aging process. Three hundred twelve participants who were 65 or older completed a Taiwan Social Change Survey that measures four factors that define successful aging process: including physical, psychological, social support, and leisure activity. Structural equation modeling analysis shows in addition to the three supporting variables, leisure activities is a significant factor related to successful aging process. The findings of the study verified that the proposed model is well supported by the data and fits well for both female and male populations. The findings of the study also suggest that, for gerontological researchers, leisure activities of old people deserve their attention when helping the old generation age well. [ABSTRACT FROM AUTHOR]

chao h.-l., tsai t.-y., livneh h., lee h.-c. & hsieh p.-c. (2010) Patients with colorectal cancer: relationship between demographic and disease characteristics and acceptance of disability. Journal of Advanced Nursing 66(10), 2278–2286. Aim. This article is a report of a study conducted to examine acceptance of disability among patients with colorectal cancer and its relationships to other disease-related factors. Background. Colorectal cancer had become the third leading cause of cancer death worldwide. Recently, the topic of acceptance of disability in patients with chronic disease, especially cancer, has attracted enormous attention because the higher acceptance, the better coping with disease and the better quality of life after therapy. Method. A cross-sectional study was carried out with 110 patients with colorectal cancer recruited from a medical centre in northern Taiwan in 2008. Data were collected using the Acceptance of Disability Scale. Descriptive statistics, Pearson correlations and multiple linear regression analysis were used for analysis. Findings. Participants reported moderate levels of acceptance of disability. The regression model showed that those with shorter disease duration, stoma, lower educational level (below 9th grade), or in Duke C1 stage or above reported lower levels of acceptance, and these variables accounted for 25% of the total variance. Conclusion. The results suggest that acceptance of disability (i) is a useful construct to examine in future studies on psychosocial adaptation to cancer, and (ii) can be integrated into a clinical intervention programme of providing holistic care to patients with colorectal cancer. [ABSTRACT FROM AUTHOR]

Purpose — The purpose of this study is to evaluate the influences of expatriate characteristics, complexity of task assignment and perceived cross-cultural differences on needs for expatriate training, and expatriate training effectiveness and to evaluate the influences of the fit between the expatriate's learning style and instructor's teaching modes on! training effectiveness. Design/methodology/approach — Survey methodology was adopted to obtain data from the opinions of expatriates in foreign companies within Taiwan and China. Quantitative data were used to answer the research questions. A total of 400 foreign companies, with 200 in Taiwan and 200 in China, were selected as the survey sample. Hierarchical regression analyses were adopted to test the five research questions as developed in this study. Findings — The study results revealed that expatriates' perceived needs for training were negatively influenced by competence and adaptability to work in the overseas assignment. Expatriates' perceived needs for expatriation training were also influenced by the complexity of the task assignment, capability of host country managers, and the perceived cross-culture differences between the home country and host country. Furthermore, the levels of fit between expatriate learning preferences and the instructor's teaching methods did moderate the relationship between the need for expatriate training and the effectiveness of such training. Research limitations/implications — First, since this study adopts cross-sectional research design and examines the opinions of expatriates at one point in time, directional relationships may not be clear. It is recommended that future research conduct longitudinal studies to confirm the findings of this study. Second, due to the constraints of time and resources, the samples of this study are limited to expatriates working for foreign firms in Taiwan and in China. The generalization of the study results should thus be interpreted with appropriate caution. It is recommended that the same questionnaire, or an abbreviated form, could be used for expatriates in other countries, such as expatriates of multinational subsidiaries with US, Japanese, and European investment origins. Additional research will further confirm the validity and generalizability of the findings. Originality/value — The training of expatriates has been recognized as one of the key elements for the success of business globalization. However, the evaluation of the effectiveness of training and development for overseas expatriates has remained largely unclear. The results of this study enabled one to understand how relevant contingency factors influence expatriate training needs and effectiveness. These findings could provide importance references for academics and practitioners when deciding on business practices. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe healthcare providers' views on depression and its prevention in older people. Background. There is an urgent need to develop public health approaches to depression prevention in older adults because of the growing older population and the high rate of depression among community-dwelling older adults in Taiwan. Prior studies have focused on the prevalence of and risk factors for depression in Taiwanese community-dwelling older adults. Research from the viewpoints of prevention and healthcare providers is needed to guide these approaches. Design. A qualitative study involving semi-structured interviews. Methods. A purposive sample of 25 healthcare providers was recruited from a city in northern Taiwan. Data were collected through in-depth individual interviews and analysed using thematic analysis. Results. Results were embedded within four major themes: lack of children's support, maladaptation to distressing life circumstances in late life, innate vulnerability in the individuals and being unaware of or reluctant to accept an illness. Conclusions. Participants' accounts of depression and its prevention were conceptualised within the family and socio-cultural contexts older adults lived in. Lack of children's support was reported as a main contributor to depression in older adults. Society was reported as the main context in which depression prevention intervention should take place. Communal activities were described as important for mental wellness and depression prevention. Relevance to clinical practice. Study findings show how family, Chinese culture and socio-economic circumstances influence accounts of depression and its prevention in older adults. Attention to the cultural construction of meanings may help extend our vision beyond a focus on the biomedical discourse and promote innovative ways of tackling depression that match the policy goals with the needs of older adults and community. [ABSTRACT FROM AUTHOR]