[A phenomenological study of the shift change experiences of clinical nurses in Taiwan].

BACKGROUND: The process of changing shifts requires that clinical nurses engage in critical communication and interaction activities. Little research has examined the shift-change phenomenon. How Taiwanese nurses interpret their lived shift-change experiences deserves further exploration. PURPOSE: This study explores the meaning of the shift-change experiences of nurses in Taiwan. METHODS: A hermeneutic phenomenological design was used. Data from interviews, participant observations, and field notes were analyzed. Twenty-six nurses with shift-change experience volunteered in a snowball sampling process. Data were collected using in-depth interviews. Hermeneutical analysis was used to explain the meaning of the nursing shift-change experience. RESULTS: The shift-change experiences of participants revealed their existential meaning and struggles toward self-transformation, adaptation, and self-settlement for survival. The meaning of the shift-change experience of clinical nurses in Taiwan are characterized by three themes: (a) 'A relay for accomplishing collective nursing goals', (b) 'An associated duties to be carried out jointly', and (c) 'An experience transmission as well as power practice'. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Our study highlights the cultural implications and existential meaning of the clinical shift change experience to nurses in hospitals in Taiwan. These findings provide a better understanding of the nursing shift-change experience in terms of both practical issues and nurses' perceptions. Findings may be used to improve in-service training programs and to suggest solutions to problems encountered during the shift-change period.

Population-based study of birth prevalence and factors associated with cleft lip and/or palate in Taiwan 2002-2009.

BACKGROUND: Facial cleft deformities, including cleft lip with or without cleft palate (CL/P) and cleft palate (CP), are common congenital birth anomalies, especially in Asia. This study aimed to analyze the prevalence of CL/P and CP and to identify associated factors in Taiwan. METHODS: This population-based epidemiological study retrospectively analyzed birth data obtained from the Department of Health in Taiwan for years 2002-2009. Frequency distribution, percentages and related predictors were investigated, and findings were presented by types of cleft deformities. Logistic regression analysis was performed to identify factors associated with cleft deformities. RESULTS: Overall prevalence of cleft deformities among 1,705,192 births was 0.1% for CL/P and 0.04% for CP over the 8-year study period. Higher prevalence of CL/P or CP was observed with multiple pregnancies, being male for CL/P, being female for CP, gestational age ≤37 weeks and lower birth weight (<1.5 kg). Both CL/P and CP were significantly associated with gestational age <37 weeks and birth weight<1.5 kg (all P <0.0001). CL/P was significantly associated with multiple parities (P = 0.0004-0.002). Male newborns and female newborns were significantly associated with CL/P and CP, respectively (both P<0.0001). CONCLUSIONS: Overall prevalence for congenital cleft deformities in study subjects was 0.1%, in keeping with high rates in Asia. Results suggest the need for awareness and early identification of those at high risk for cleft deformities, including newborns with gestational age <37 weeks, weighing <1.5 kg at birth and women with multiple parities, as a potential strategy to counter long-term adverse effects on speech and language in this population.

'Struggling to be an insider': a phenomenological design of new nurses' transition.

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.