Working Experiences of Care Aides in Long-Term Care Institutions Following the Relaxation of COVID-19 Regulations in Taiwan: A Qualitative Study.

Care aides in long-term care (LTC) institutions care for older disabled residents at high risk for COVID-19. However, they experienced many stressors during the COVID-19 pandemic. This study aims to explore the working experiences of care aides in LTC institutions following the relaxation of COVID-19 regulations in Taiwan. This qualitative descriptive study included 20 care aides who had cared for residents with COVID-19. Data were obtained via semi-structured interviews. Caring for residents with COVID-19 and the difficulties, resources and teamwork, and impact of care aides' work on their lives were discussed. Consequently, four themes were identified. First, difficulties in care, which included physical limitations by protection, workload, and impact of work schedule on the lives of the care aides. Second, psychological impact, such as worry, social isolation, and burnout. Third, interpersonal relationships with supervisors, colleagues, residents, and their families. Fourth, infection control policy from the institution and government. When infection control policies were relaxed, care aides had difficulties in caring for residents; furthermore, their family and social lives were also affected. They were required to learn knowledge of and skills for COVID-19 management. Institutions were required to provide support in materials, care processes, environment, and management.

Working dilemmas in care for breastfed newborns: An exploratory study in a single center in Taiwan.

BACKGROUND: Clinical medical staff should be aware of and examine the correlation between breastfeeding and neonatal hospitalization. Additional attention should be paid to work dilemmas experienced by the nursing staff caring for newborns to avoid exposing newborns to hospitalization risk. OBJECTIVE: The present study investigated the working dilemmas by neonatal nurses caring for breastfed newborns and risk of newborn hospitalization. METHODS: This hospital-based study in Taiwan surveyed 84 neonatal nurses using a structured questionnaire entitled "Working Dilemmas in Clinical Care for Breastfed Newborns." RESULTS: Collected data were analyzed statistically (descriptive analysis, chi-square test, and t test) using Statistical Package for the Social Sciences (SPSS) software. Neonatal intensive care unit (NICU) staff noted that breastfed newborns showed a high risk of hospitalization and nursery staff highlighted a lack of manpower and time. NICU staff experienced more working dilemmas (117.460±12.260) than nursery staff (87.410±15.820) when caring for breastfed newborns (t = 1.080, P < 0.001). NICU staff reported a higher risk of hospitalization in breastfed newborns and experienced more working dilemmas caring for these patients compared with nursery staff, who reported a lack of manpower and time. CONCLUSION: Our findings highlight the working dilemmas by neonatal nurses and can serve as a foundation for further critical studies.

Team-based learning complemented by interactive response system: Application of a strategy on the course of human growth and development for nursing students.

OBJECTIVE: Lecture-based learning (LBL) strategy cannot stimulate learners' ability to think and learn independently. Recently team-based learning (TBL), a learner-centered strategy, gained popularity in health education. An interactive response system (IRS) assists educators in providing instant feedback on classroom activities. This study was to evaluate the TBL strategy supplemented by IRS (TBL/IRS) on the learning effects of the core course, the human growth and development (HGD), in nursing education. MATERIALS AND METHODS: A quasi-experimental study design with two-group, pretests and posttests was employed with year-one students enrolled in two HGD classes in the nursing department of a university in central Taiwan. Both HGD classes employed the LBL method at the beginning of a semester. TBL/IRS strategy was introduced to the experimental class 6 weeks later. Three scales were used to measure self-directed learning, classroom engagement, and team learning. Individual and group readiness assurance tests (IRATs and GRATs) were administered. Final exams were also compared between the groups. For thematic analysis, learners' experience with TBL/IRS was collected from learner reports and a semi-structured questionnaire designed for the study. RESULTS: A total of 105 learners-48 in TBL/IRS and 55 in LBL-were recruited. Self-directed learning, classroom engagement and team learning were improved significantly in TBL/IRS whereas only self-directed learning was improved in LBL. In the TBL/IRS group, GRAT scores were significantly higher than IRAT. However, the difference in final exams between the groups was non-significant. Four themes emerged from learners' experiences with TBL/IRS: stimulate self-learning; a diverse and flexible learning method; promote high-level thinking and deepen learning results; and, cultivate teamwork and application. CONCLUSIONS: This study confirmed that TBL/IRS was effective in enhancing learners' abilities to integrate concepts and skills, thereby cultivating competence in problem-solving and teamwork. The TBL/IRS strategy was cost-effective in promoting active learning of HGD in nursing students.

Exploring relationships between health-related lifestyle habits and fatigue among flight attendants and trainees.

BACKGROUND: Fatigue in flight attendants is an important issue concerning flight safety and occupational health. It is well known that work-related factors and certain lifestyle habits can cause fatigue. But very few studies have focused on the difference between having work experience flight attendants and no flight experience trainees. OBJECTIVE: The present study was performed to compare and investigate the relationships between fatigue and health-related lifestyle habits among flight attendants and trainees. METHODS: A questionnaire-based cross-sectional study with convenience sampling was conducted. A total of 107 flight attendants and 109 trainees were recruited in an international airline. The research was using a self-developed health-related lifestyle habits questionnaire and the Checklist Individual Strength (CIS) scale. The relationships between health-related lifestyle habits and fatigue were examined by Pearson's chi-square test and Fisher's exact test. Logistic regression was used to identify factors predicting fatigue among flight attendants and trainees. RESULTS: Nearly half of the participants had fatigue and poor health-related lifestyle habits. Logistic regression showed that trainees with sleeping hours less than 7 hours, had a higher probability of fatigue than those who sleep more than 7 hours. In addition, the flight attendants with an irregular sleep pattern, unbalanced diet, sedentary leisure-time, no use relaxation technique, and an exercise frequency below once a week had a higher probability of fatigue. CONCLUSION: The flight attendants' sleep patterns, diet, activity, and relaxation had a more significant impact on fatigue than trainees. Therefore, a healthy lifestyle is important in this population for good workplace performance.

Corrigendum: Pregnancy-related stress among pregnant women receiving tocolytic and non-tocolytic treatments where both used complementary medicine.

[This corrects the article DOI: 10.3389/fphar.2022.870659.].

Postoperative Lifestyle of Patients with Liver Cancer: An Exploratory Study in a Single Center in Taiwan.

Various treatments are available for patients with liver cancer; however, complications after treatment affect their quality of life (QOL). To improve the QOL of patients with liver cancer, this study investigated the postoperative lifestyle of sixty patients at the Liouying District Hospital, Taiwan. A self-reported structured questionnaire and a modified Chinese version of the Health Enhancement Lifestyle Profile (HELP-C) were used to collect the demographic data and to assess patients' overall postoperative lifestyle, respectively. Significant differences were observed between the overall postoperative lifestyle and the demographic variables of age, ethnicity, education level, marital status, chronic diseases, and postoperative complications (p < 0.05). Significant differences (p < 0.05) were observed in the HELP-C domains of diet, leisure, and activities of daily living (ADL) between the sexes. The scores for diet (9.66 ± 4.21) and leisure (4.33 ± 2.03) in women were significantly lower (p < 0.05) than those in men (13.13 ± 4.98 and 6.17 ± 2.37, respectively), indicating that women with liver cancer should be more concerned about diet and leisure after surgery. However, the score for ADL was significantly higher (p < 0.05) in women (17.90 ± 5.15) than in men (13.48 ± 2.56), indicating that men should focus on improving ADL. This research provides reference clinical data on the postoperative lifestyle of patients with liver cancer to improve their QOL.

Self-Confidence, Not Self-Awareness, Is Negatively Associated With Areca Nut Dependence.

Areca nut is the fourth most commonly used addictive substance globally. Therefore, this study aimed to examine correlations among areca nut self-awareness, areca nut cessation self-confidence, and areca nut dependence in the Taiwanese population. This was a descriptive study in which 120 areca nut chewers who sought medical attention at a regional hospital and were residents of the Yunlin-Chiayi area, were recruited as study subjects. A structured questionnaire was used for data collection, which included demographic data, an areca nut self-awareness scale, an areca nut cessation self-confidence scale, and an areca nut dependence scale. A Pearson correlation analysis revealed that areca nut self-awareness and areca nut cessation self-confidence were not significantly correlated (r = 0.16, p = 0.069). Areca nut self-awareness and areca nut dependence also did not have a significant correlation (r = -0.06, p = 0.511). However, we found that areca nut cessation self-confidence and areca nut dependence were significantly negatively correlated (r = -0.37, p < 0.001), that is, the higher the areca nut cessation self-confidence, the lower the areca nut dependence. In addition, areca nut self-awareness showed significant correlations by age (r = 4.54, p = 0.005), occupation (r = 2.91, p = 0.02), and family support (r = 3.83, p = 0.03). Scheffe's post-hoc test revealed significant differences that subjects whose family members were extremely supportive of areca nut cessation had higher areca nut self-awareness. In conclusion, areca nut cessation self-confidence and areca nut dependence showed a significant negative correlation. Areca nut self-awareness revealed significant correlations by age, occupation, and family support. The results of this study can be used to provide a reference for implementing areca nut cessation policies in the future.

Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine.

Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women's health studies.

Together through the valley of death: Lived experience of case managers to meet the informational needs of gynecologic cancer survivors.

OBJECTIVES: Case managers are crucial providers of health education and consultation for patients with gynecologic cancer to satisfy their informational needs. The purpose of this study is to understand the experience of case managers working to meet the needs of these patients in order to further improve their overall quality of care. MATERIALS AND METHODS: A qualitative study employed. Twenty case managers recruited from Taiwanese healthcare institutes using purposive sampling. Participants were interviewed in semi-structure fashion. All interviews were verbatim transcribed. The steps of Giorgi's phenomenological method were used to analyze the transcripts. RESULTS: Three major themes and twelve subthemes emerged. Major themes were associated with cancer development: (1) during diagnosis, build a communication bridge and provide appropriate treatment early on, become consultants; (2) during treatment, provide comprehensive medical care for cancer, become the patient's manager; (3) during follow-ups, assist patients to comprehend and adapt to living with cancer, return to society and the original pace of life. CONCLUSION: Case managers accompany patients with gynecologic cancer and address their problems to other medical professional. The informational needs of patients with gynecologic cancer differ along the course of the disease. It is important for cancer care manager to deliver the information of individualized health care in timely manner to ensure the overall quality of care for patients with gynecologic cancer.

Food Away From Home and Self-Perceived Gastrointestinal Health.

Dietary behavior is a critical lifestyle factor affecting health. This study aimed to investigate food away from home (FAFH) and its effect on gastrointestinal (GI) health. A questionnaire-based survey was conducted with 300 participants at a hospital in Liouying, Taiwan. The survey collected demographic information and data on FAFH and GI health. The association of GI health with FAFH consumption behavior was significant (t-test, p < 0.05). Bodyweight status was associated with age (F = 5.01, p = 0.01), dietary situation (F = 1.96, p = 0.04), number of meals (F = 1.85, p = 0.03), dietary preferences (F = 2.84, p = 0), reasons for FAFH (F = 1.86, p = 0.02), FAFH types (F = 2.01, p = 0), and outcomes associated with FAFH (F = 2.51, p = 0). Gastrointestinal condition was associated with the number of meals (F = 2.55, p = 0), the level of activity after meals (F = 2.16, p = 0.02), and FAFH type (F = 1.48, p = 0.04). The results indicated that the participants aged 20-40 years had more problems related to their self-perceived body weight status than those aged 41-50 years. The results of this study clarify the FAFH among people in Taiwan and the effects on GI health and may serve as a reference for relevant behavioral research in food and health studies.

Translation and validation of Taiwan Chinese version of the self-regulation questionnaire for gynecologic cancer survivors.

OBJECTIVE: To culturally adapt the self-regulation questionnaire to the Taiwan Chinese version (TC-SRQ) and to evaluate its psychometric properties for gynecologic cancer survivors. MATERIALS AND METHODS: A cross-sectional study was employed with a purposive sample of 287 gynecologic cancer survivors. The TC-SRQ was adapted from a Germany version through back-translation to ensure its quality. For construct validity, confirmatory factor analysis (CFA) was used to assess the TC-SRQ measurement model with fit indexes including the χ2 test, the root mean square error of approximation (RMSEA), and the normed fit index (NFI), the comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Taiwanese version of the European Organization for Research and Treatment of Cancer's 30-item core quality of life (EORTC QLQ-C30) questionnaire was used as a criterion measure for quality of life (QOL). Reliability was evaluated by internal consistency and test-retest reliability. RESULTS: For a modified measurement model of TC-SRQ, the model fit (χ2 = 311.23, P = .0; RMSEA = .088; NFI = .97, CFI = .98, NNFI = .97) was acceptable. The evidence of construct validity of TC-SRQ scale was confirmed by the model estimates. TC-SRQ correlated positively with the global QOL, physical, cognitive, emotional, and social functioning domains, and negatively with fatigue and pain domains of EORTC QLQ-C30. For known groups validity, TC-SRQ was correlated with groups attributed by age, family support, health status, and sleep quality. A Cronbach's α of .91 indicated good internal consistency; the test-retest reliability was .82. CONCLUSIONS: TC-SRQ is a valid and reliable instrument for assessing self-regulation in gynecologic cancer survivors.

Seated T'ai Chi in Older Taiwanese People Using Wheelchairs: A Randomized Controlled Trial Investigating Mood States and Self-Efficacy.

OBJECTIVE: There is growing interest in t'ai chi, but little research has addressed whether t'ai chi is effective in older people using wheelchairs for mobilization. The aim of this study was to compare the effects of seated t'ai chi exercise and usual standard activities on mood states and self-efficacy in older people living in a long-term care facility and using wheelchairs for mobilization. DESIGN: Randomized controlled trial (trial registration no. ACTRN12613000029796). SETTING: One long-term-care facility in Taiwan. PARTICIPANTS: Sixty participants were randomly assigned by a computer-generated random sequence to a t'ai chi group (n = 30) or a usual exercise and entertainment activities group (n = 30). INTERVENTION: Seated t'ai chi exercise for 40 minutes three times a week for 26 weeks was provided. MAIN OUTCOME MEASURES: Mood states (Profile of Mood States Short Form [POMS-SF]) and self-efficacy (Self-Efficacy for Exercise [SEE]). RESULTS: At week 26, participants in the t'ai chi group reported significantly lower mood states on the fatigue-inertia dimension of the POMS-SF (mean score ± standard deviation, 3.56 ± 3.71) than did the control group (mean score, 7.16 ± 6.36) (F [1, 58] = 7.15; p < 0.05). The t'ai chi group recorded significantly higher SEE levels (mean, 35.66 ± 36.83) than did those in the control group (mean, 15.30 ± 26.43) (F [1, 58] = 6.05; p < 0.05). CONCLUSION: The findings highlight the importance of t'ai chi for a reduction in the fatigue-inertia mood state and an increase in self-efficacy for older people using wheelchairs.

Seated Tai Chi versus usual activities in older people using wheelchairs: A randomized controlled trial.

OBJECTIVE: Compare the effect of seated Tai Chi exercise (intervention) to usual activities on quality of life and depression symptoms in older people using wheelchairs. DESIGN: Randomized controlled trial. SETTING: One long-term care facility in Taiwan. PARTICIPANTS: 86 long-term care residents were screened; 60 were eligible and randomized to Tai Chi group (n=30), or usual activity (n=30). INTERVENTION: One certified trainer provided the intervention group with 40min of seated Tai Chi exercise, three times a week for 26 weeks. Trial registration ACTRN12613000029796. MAIN OUTCOME MEASURES: Quality of Life (WHOQOL (BREF)); depression symptoms (GDS-SF) RESULTS: Participants in the Tai Chi group (M=3.76, SD=3.65) recorded significantly lower GDS-SF scores than participants in the control (M=7.76, SD=5.15) and the Tai Chi group registered significantly higher scores across overall QOL [p=0.03], general health [p=0.04], and the associated domains: physical health [p=0.00], psychological health [p=0.02], social relations [p=0.00], and environment [p=0.00]. CONCLUSIONS: The findings highlight the importance of Tai Chi in improving QOL and depression in this population.

Triphenylene-based tris-N-heterocyclic stannylenes.

Two planar tridentate N-heterocyclic stannylenes are synthesized from the corresponding 2,3,6,7,10,11-hexaamino-triphenylene and Sn[N(TMS)2]2. Multinuclear NMR and absorption spectra of these tris-stannylenes are reported. Molecular structure of the N-benzhydryl-substituted tris-stannylene is also realized.