Promoting Holistic Well-Being in Chronic Stroke Patients Through Leisure Art-Based Creative Engagement.

PURPOSE: To examine the potential value of a creative art-based activity as a caring modality for promoting holistic well-being among chronic stroke patients, and to explore the feelings and meanings that stroke patients derived from their experience in leisure art-based creative engagement (LACE). DESIGN: Qualitative design. METHOD: Participants were recruited through purposive and snowball sampling. Individual semi-structured interviews were conducted. Qualitative content analysis was performed. The design and implementation of LACE was guided by Watson's theory of caring. FINDINGS: Twenty-four participants completed the study. Four themes emerged from participants' account of experiences with the LACE: (1) appreciation of opportunities, (2) appreciation of self, (3) appreciation of others, and (4) appreciation of life. CONCLUSION: From the perspective of the participants, engaging in LACE enhances their sense of enjoyment and self-expression. Furthermore, they perceived LACE as an affirmation of life and an empowering process strengthening their connection and appreciation with the self and others. CLINICAL RELEVANCE: This study adds evidence to existing literature on Watson's theory-guided design and implementation of caring initiatives for community rehabilitation and has laid the groundwork for developing further evidencebased research in leisure art-based caring occasions for promoting holistic well-being in stroke rehabilitation.

Quality of life in head and neck cancer survivors at 1 year after treatment: the mediating role of unmet supportive care needs.

PURPOSE: The aim of the study was to test a hypothesised model that supportive care needs (SCNs) have a mediating effect on the relationship between characteristics of (Chinese) head and neck cancer (HNC) survivors and their quality of life (QoL). METHODS: A total of 285 Chinese HNC survivors who had finished cancer treatment 1 year earlier completed a self-reported survey covering demographic and clinical characteristics, the Chinese version of the Short-Form Supportive Care Needs Questionnaire (SCNS-SF34-C), the supplementary module of access to healthcare and ancillary support services and the Functional Assessment of Cancer Therapy for Head and Neck Cancer (FACT-H&N). RESULTS: The final path model showed that optimism, educational level, any coexisting disease, number of somatic symptoms, household income, eating ability, support from others, whether the cancer is under control or not and travelling time from home to hospital have direct or indirect effects, or both, on the QoL of HNC survivors, by way of unmet SCNs in the psychological, physical and/or health system information domains, which account for 64 % of the variance in the total FACT-H&N score. CONCLUSIONS: Our study demonstrated the mediating effects of SCNs in the association between HNC survivors and their QoL. Early needs assessment may help healthcare professionals to identify the actual needs of these survivors, and providing the information that HNC survivors want is a significant factor in meeting their psychological needs and thereby improving their overall QoL.

Development and evaluation of an undergraduate training course for developing International Council of Nurses disaster nursing competencies in China.

BACKGROUND: Nurses are often called upon to play the role of first responder when disaster occurs. Yet the lack of accepted competencies and gaps in education make it difficult to recruit nurses prepared to respond to a disaster and provide assistance in an effective manner. DESIGN: Based on the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies and Global Standards for the Initial Education of Professional Nurses and Midwives, a training course titled "Introduction to Disaster Nursing" was designed and implemented with 150 students. A pre-post survey design was used to assess changes in participants' self-rated disaster nursing competencies. The impact of the training course on participants' attitudes toward disaster nursing and their learning experience were also assessed. FINDINGS: All participants passed the assessments and examination with an average score of 70%. Pre- and posttraining self-ratings of the disaster nursing competencies increased from 2.09 to 3.71 (p < .001) on a Likert scale of 1 to 5, and the effect size was large, with Cohen's d higher than 0.8. No significant difference in both examination results (60% group assignments; 40% written examination) and self-rated competencies was noted between the senior year students and graduate nurse participants by Mann-Whitney U test (p value = .90). The majority of participants indicated their willingness to participate as a helper in disaster relief and saw themselves competent to work under supervision. CONCLUSIONS: The ICN Framework of Disaster Nursing Competencies was instrumental to guide the training curriculum development. This introductory training course could be incorporated into undergraduate nursing education programs as well as serve as a continuing education program for graduate nurses. CLINICAL RELEVANCE: The training program can be used for preparing generalist nurses of their nursing competencies in disaster preparedness, response and post-disaster recovery and rehabilitation.

Disaster preparedness among Hong Kong nurses.

AIM: This paper is a report of a survey to explore Hong Kong nurses' disaster preparedness. BACKGROUND: Increasingly frequent global disasters are posing threats to human health and life. The World Health Organization has called for countries to have detailed plans at all levels in order to be prepared for disasters that may arise. METHOD: A questionnaire was distributed to convenience samples of practising Registered Nurses studying in Master's degree programmes at a Hong Kong university in 2007. Results. Of a possible 174, 164 questionnaires were returned (Response rate 94%). Almost all nurses (97.6%) considered the government health department to be the organization most involved in disastrous situations. The majority (84.8%) were aware of the existence of a protocol on disaster management at their workplace. About one-third would respond in accordance with protocol (38.4%) or rely on directions from their immediate supervisors (34.8%) if a disaster occurred. Almost all the nurses (97%) considered themselves not adequately prepared for disasters. They recognized that a protocol for disaster management (85.4%) and training and drills for disasters (both 84.1%) are useful tools. CONCLUSION: Nurses in Hong Kong are not adequately prepared for disasters, but are aware of the need for such preparation. Disaster management training should be included in the basic education of nurses.