Effects of internet-based digital health interventions on the physical activity and quality of life of colorectal cancer survivors: a systematic review and meta-analysis.

PURPOSE: The recent trend of Internet-based digital health interventions has driven researchers to implement them to promote physical activity (PA) and improve patients' health outcomes. This systematic review and meta-analysis aim to evaluate the effects of Internet-based digital health interventions on PA and quality of life (QoL) in colorectal cancer (CRC) survivors. METHODS: We searched for relevant studies investigating the effects of internet-based digital health interventions published until Dec. 2022 in electronic databases (PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and CEPS) according to PRISMA guidelines. The Joanna Briggs Institute critical appraisal checklist was used to examine the quality of the included studies. We performed the fixed and random effects model for meta-analysis. RESULTS: Among 746 identified studies, eight published between 2018 and 2022 were included. These covered 991 internet-based digital health interventions and 875 controls. After 6 months of internet-based digital health interventions, CRC survivors' performance in PA (standardized mean difference (SMD) = 0.23, 95% confidence interval [CI] = 0.09-0.38) and QoL (SMD = 0.11, 95% CI = 0.01-0.22) indicators improved significantly. CONCLUSIONS: Internet-based digital health improved the PA behaviour and QoL of patients with CRC. Because of differences in intervention outcomes, additional randomized controlled trials are warranted to provide suggestions for clinical practice. Internet-based digital health interventions are promising for promoting PA in CRC survivors.

An Exploration of Psychological Resilience among Undergraduate Nursing Students Undertaking an Adult Nursing Virtual Practicum during the Coronavirus Pandemic in Taiwan: A Qualitative Study.

This qualitative study aimed to explore the psychological resilience of undergraduate nursing students partaking in a virtual practicum during the coronavirus pandemic (COVID-19) in Taiwan. The virtual practicum, a form of online learning, creates challenges compared to the traditional teaching-learning experience of an actual clinical placement. Exploring how students overcome learning difficulties and build resilience is necessary for a new learning environment or for future online learning. Constructivist grounded theory and the Standards for Reporting Qualitative Research checklist were followed. Purposive and theoretical sampling were used to recruit 18 student nurses for data saturation. Semi-structured, face-to-face interviews were conducted individually to collect data. Initial, focused, and theoretical coding and constant comparative data analysis were performed. Credibility, originality, resonance, and usefulness guided the assessment of the study's quality. The core category of psychological resilience in the virtual practicum was constructed to reflect Taiwanese nursing students' progress and experiences of learning during the virtual practicum. This core category consisted of three subcategories: (i) learning difficulties within one's inner self; (ii) staying positive and confident; and (iii) knowing what is possible. The findings identified psychological resilience as an important factor for students to adjust to the adverse experiences of a rapidly changing learning environment, such as the virtual practicum. The substantive theory of psychological resilience provided a frame of reference for coping with possible future difficulties. Correspondingly, psychological resilience reflected individuals' potential characteristics and may help students to enter and remain in the nursing profession.

Exploring the experience of reflective writing among Taiwanese undergraduate nursing students: A qualitative study.

BACKGROUND: Reflective learning plays an important role in students' professional and personal development. However, some nursing curricula provide insufficient opportunity for students to understand how to reflect and what reflection is. PURPOSE: The study aimed to explore baccalaureate nursing students' experiences of reflective writing. DESIGN: The study used a hermeneutic phenomenological approach. METHODS: Through purposive sampling, 15 participants were recruited for individual in-depth face-to-face interviews which were conducted after they had completed the course 'Application of Emergency Nursing'. Interviews were semi-structured and audio-recorded. Additional data were obtained from 20 documents on consulting faculty for reflective writing. Data analysis was undertaken through a hermeneutic phenomenological framework based on van Manen's approach. RESULTS: Participants reported that reflective writing had helped them to optimise their personal and professional development. Four themes emerged from the analysis: recording a personal story, presenting a process of events, confronting challenges, and strengthening personal characteristics. CONCLUSIONS: Students were satisfied with their learning achievements and growth and felt they had become better through reflective writing. The results demonstrated that: reflective writing needs to be elaborated objectively and carefully; continuing self-dialogue can reveal the true meaning of an incident; students learned strategies to apply in future situations.

Effectiveness of the use of concept maps and simulated cases as a teaching-learning strategy in enhancing the learning confidence of baccalaureate nursing students: A qualitative approach.

BACKGROUND: Didactic lectures and exam-oriented learning can lead to students becoming passive learners who rely on rote memory. This learning style negatively impacts their ability to cultivate the core nursing values and critical thinking. OBJECTIVES: This study aimed to investigate the impact of a concept mapping teaching-learning strategy on undergraduate nursing students' ability to integrate theoretical biosciences knowledge into care practice and on their skills in critical thinking and teamwork. METHODS: A qualitative research design was adopted. A course entitled Evaluation and Analysis of Adult Nursing Cases was developed based on a concept mapping strategy involving 24 simulated cases relevant to medical and surgical nursing. The participants were students from the two-year undergraduate nursing programme at a university in Taiwan. Data were collected from September 2020 to February 2021. Qualitative data were collected from semi-structured face-to-face interviews with 20 students and from 100 reflective reports on students' learning journeys. The data were analysed using qualitative content analysis. RESULTS: Two major themes were identified: (1) changes in learning style and thinking and (2) rewards from learning. The participants reported that their learning style had changed from reliance on rote learning to image memory, and their thinking process from linear (cause-effect) to multifaceted thinking at different levels. The teaching and learning strategies contributed to feelings of ability advancement and psychological safety, which led to learning achievement and confidence. CONCLUSION: The use of a concept mapping strategy and simulated cases enhanced students' learning by enabling them to integrate theoretical knowledge and improve their thinking abilities. The teaching and learning strategies helped participants in learning about psychological safety and increased their learning confidence.

Role transition of newly graduated nurses: a qualitative study.

BACKGROUND: Newly Graduated Nurses in different socio-cultural contexts confront dissimilar situations and influences on role transfer. It is important to understand how newly graduated nurses reconstruct their own professional concept of clinical nurses. OBJECTIVES: This study aimed to explore how Taiwanese newly graduated nurses perceived their new role and the process through which they transition into the professional role. METHODS: Charmaz's constructivist grounded theory guided the study's design and implementation. Purposive and theoretical sampling and the snowball technique were used to recruit 30 participants from 3 tertiary and 2 community hospitals in Taiwan. Interviews were audio-recorded and transcribed verbatim into a readable format. Initial, focused and theoretical coding was utilized for data analysis. The criteria of credibility, originality, resonance and usefulness guided assessment of the study's quality and ensured the trustworthiness of the study process. RESULTS: The process of role transition to become a nurse comprised four stages: hesitation, psychological preparation, development and appreciation. The hesitation stage was interpreted as a phase of passive learning. In the psychological preparation, newly graduate nurses began to take full work responsibility. The development stage saw them gain work confidence and, in the appreciation stage, they acquired a full picture of their roles. CONCLUSION: To bridge the gap between theoretical learning and practice and reduce the time new graduate nurses need for role adjustment contributes to an early stage of Hesitation rather than the Appreciation stage of role transition. The findings suggest the need for further research to explore newly graduated nurses' needs during the process of role transition.

Circadian rhythm mediates the relationship between physical activity and quality of life in younger and older cancer survivors.

Increasing evidence suggests that physical activity (PA) improves the quality of life (QoL) of cancer survivors. However, the biological mechanisms underlying the relationship between PA and QoL are unclear. The purpose of this study was to determine whether the relationship between PA and QoL differs in younger and older cancer survivors and whether circadian rhythm (CR) mediates this relationship. We also explored the effect of the CR on QoL. The participants were 235 cancer survivors, comprising 143 younger and 92 older patients. Data were collected using the Taiwanese versions of the Physical Activity Scale for the Elderly and Short Form-36. The robustness and stability of the CR were measured using an actigraph. Mediation was tested using multiple mediation analyses. The CR mediated the relationship between PA and the physical domain of QoL in younger and older cancer survivors (23% and 59% mediating effects, respectively). The CR partially mediated the effect of PA on the mental dimension of QoL in older cancer survivors (36% mediating effect), but not in younger cancer survivors. Cancer survivors with a more robust CR had a significantly higher QoL, particularly in the physical functioning domain (d = 0.43, p < 0.001). The results provided evidence that the CR mediated the relationship between PA and QoL. Moreover, this mediating effect differed in younger and older cancer survivors. These results can serve as a reference for designing individualized PA programs for cancer survivors.

Measurement of physical activity in cancer survivors: a validity study.

PURPOSE: The purpose of the study was to validate the Taiwanese version of the Physical Activity Scale for the Elderly (PASE-T) and to assess physical activity in Taiwanese cancer survivors. METHODS: One hundred twenty-seven cancer survivors participated in this study. Instruments consisted of the PASE-T, the Taiwanese version of the MD Anderson Symptom Inventory (MDASI-T), Karnofsky performance status (KPS), and actigraph. Reliability was assessed by calculating the test-retest reliability. The validity was assessed by the content validity, criterion-related validity, convergent validity, and known-group validity. RESULTS: The test-retest reliability of PASE-T was 0.90 over a 2-week interval, based on a sample of 30 patients. The content validity index was very acceptable at 0.91. Convergent validity was demonstrated by its significant association with MDASI-T scores (symptom severity: r = -0.23, p = 0.001; symptom interference: r = -0.21, p = 0.001) and KPS scores (r = 0.59, p < 0.001). Criterion-related validity was established by a significant relationship to the actigraph total counts per minute (r = 0.64, p < 0.001). Known-group validity was established by its ability to detect significant differences according to a patient's performance status. Moreover, KPS (ß = 0.37), fatigue (ß = -0.32), and age (ß = -0.20) were significant predictors of physical activity (R(2) = 0.46). CONCLUSIONS: The PASE-T is a reliable and valid instrument for measurement of physical activity among cancer survivors in Taiwan. IMPLICATION FOR CANCER SURVIVORS: This scale could be a useful measure of physical activity in cancer survivors and subsequently facilitate the quality of oncology care.

Care needs of older patients in the intensive care units.

AIMS: To explore the care needs of older patients in the intensive care units. Background. As the numbers of older patients admitted to the intensive care units are growing, care quality of critically ill older patients has become an important issue. However, there are few studies directly investigating perceived care needs of hospitalised older patients and the studies on care needs of older patients in the intensive care units are even fewer. The identification of care needs from older patients' perspective will help develop qualified nursing practice. DESIGN: A qualitative exploratory design. METHODS: Purposive sampling was performed to recruit 35 older patients from three hospitals in Taiwan. The interview transcripts were analysed by qualitative content analysis. RESULTS: The results revealed that care needs of older patients in the intensive care units are multidimensional, including physical, informational and psychosocial dimensions. Older patients' needs of the physical dimension included relieving pain and discomfort, starting oral intake as soon as possible and having continuous sleep. Informational needs included adequate explanations about their disease progression and prognosis and information on recovery-promoting activity. Psychosocial needs included caring behaviour of intensive care units staff, flexible visiting hours, increase in control ability and maintenance of good communication with intensive care units staff. CONCLUSION: The findings can assist nurses in understanding the interventions necessary to meet care needs of critically ill older patients. The critically ill older adults need more than medical-technical care. They need more holistic care. The psychosocial and informational needs must be considered commensurate with the presenting physical needs. RELEVANCE TO CLINICAL PRACTICE: Nurses have an important role in meeting intensive care units older patients' care needs. Intensive care units nurses should conduct comprehensive assessment regarding older patients' needs at the beginning and at various points in their intensive care units stay and match these needs with appropriate nursing interventions.

Development and psychometric testing of the Cancer Knowledge Scale for Elders.

AIM: To develop the Cancer Knowledge Scale for Elders and test its validity and reliability. BACKGROUND: The number of elders suffering from cancer is increasing. To facilitate cancer prevention behaviours among elders, they shall be educated about cancer-related knowledge. Prior to designing a programme that would respond to the special needs of elders, understanding the cancer-related knowledge within this population was necessary. However, extensive review of the literature revealed a lack of appropriate instruments for measuring cancer-related knowledge. A valid and reliable cancer knowledge scale for elders is necessary. DESIGN: A non-experimental methodological design was used to test the psychometric properties of the Cancer Knowledge Scale for Elders. METHODS: Item analysis was first performed to screen out items that had low corrected item-total correlation coefficients. Construct validity was examined with a principle component method of exploratory factor analysis. Cancer-related health behaviour was used as the criterion variable to evaluate criterion-related validity. Internal consistency reliability was assessed by the KR-20. Stability was determined by two-week test-retest reliability. RESULTS: The factor analysis yielded a four-factor solution accounting for 49.5% of the variance. For criterion-related validity, cancer knowledge was positively correlated with cancer-related health behaviour (r = 0.78, p < 0.001). The KR-20 coefficients of each factor were 0.85, 0.76, 0.79 and 0.67 and 0.87 for the total scale. Test-retest reliability over a two-week period was 0.83 (p < 0.001). CONCLUSION: This study provides evidence for content validity, construct validity, criterion-related validity, internal consistency and stability of the Cancer Knowledge Scale for Elders. The results show that this scale is an easy-to-use instrument for elders and has adequate validity and reliability. RELEVANCE TO CLINICAL PRACTICE: The scale can be used as an assessment instrument when implementing cancer education programmes for elders. It can also be used to evaluate the effects of education programmes.