Experiences of Female Nurses' Parental Leave in Taiwan: A Qualitative Study.

(1) Background: To counteract the recent severe decline in birthrates in Taiwan, a number of child welfare policies are being promoted. Parental leave is among the most discussed policies in recent years. Nurses are healthcare providers, but their own right to healthcare has not been well investigated and should receive more attention. (2) Aim: This study aimed to understand the experience journey of nurses in Taiwan from considering applying for parental leave to returning to work. (3) Methods: Qualitative design with in-depth interviews was conducted with 13 female nurses from three hospitals in northern Taiwan. (4) Results: Content analysis of the interviews revealed five themes, i.e., considerations for taking parental leave, support received from other parties, life experience during parental leave, concerns regarding the return to the workplace, and preparations for the return to the workplace. Participants were motivated to apply for parental leave due to the lack of help with childcare, the desire to care for their own child, or if their financial situation allowed it. They received support and help during the application process. Participants were happy that they could participate in important developmental stages of their child, but were concerned about disconnect from society. Participants were concerned about not being able to resume work. They successfully returned to the workplace through arranging childcare services, self-adapting and learning. (5) Conclusions: This study can serve as a reference for female nurses considering parental leave and provides insights to management teams for building a friendly nursing workplace and creating mutually beneficial situations.

Psychosocial Adjustment Changes and Related Factors in Postoperative Oral Cancer Patients: A Longitudinal Study.

Disease and treatment-related symptoms and dysfunctions can interfere with the psychosocial adjustment of patients with oral cancer. Identifying factors influencing psychosocial maladjustment is important because at-risk individuals can be targeted for early intervention. This prospective longitudinal study investigated psychosocial adjustment changes and associated factors in postoperative oral cancer patients. Data on psychosocial adjustment, facial disfigurement, symptoms, and social support were collected before surgery (T1) at one month (T2), three months (T3), and five months after discharge (T4). Fifty subjects completed the study, and their data were included in the analysis. Psychosocial maladjustment was reported in 50%, 59.2%, 66%, and 62% of subjects at T1, T2, T3, and T4, respectively. The subjects' psychosocial adjustment deteriorated after surgery. Results from generalized estimating equations indicated that financial status, cancer stage, pain, speech problems, social eating problems, and less sexuality were significant predictors of changes in psychosocial adjustment. Patients with insufficient income, stage III/IV cancer, severe pain, speech problems, social eating problems, and less sexuality were at higher risk for postoperative psychosocial maladjustment. Continued psychosocial assessment and appropriate supportive measures are needed to strengthen the psychosocial adjustment of these high-risk groups.

Effect of Oral Exercise on Trismus after Oral Cancer Radiotherapy: A Quasi-Experimental Study.

Trismus is a severe complication of oral cancer treatment. Oral exercise is a potentially helpful approach for preventing or improving trismus. The study aimed to test the efficacy of an oral exercise for enhancing the maximum inter-incisal opening (MIO) in patients undergoing surgery and radiotherapy for oral cancer. This is a quasi-experimental study. A sample of 69 oral cancer patients completed the study, with 35 in the control group and 34 in the intervention group. Intervention subjects were asked to perform three 20-min oral exercise sessions per day for six months. Data on oral exercise practicing time, MIO, and mandibular function impairment were collected at the last radiotherapy exposure (T1), three months (T2), and six months (T3) after the radiotherapy. At T3, the intervention group exercised 217.1 min (95%CI: 107.4~326.7) more than the control group. The generalized estimation equations showed a statistically significant group-by-time interaction in MIO. The change in MIO score from T1 to T3, as indicated by the regression slope, was 2.5 mm (95%CI: 0.4~4.6) greater in the intervention group than in the control group. The results support the efficacy of the study intervention for improving patient exercise adherence and MIO.

Nutritional Status and Related Factors in Patients with Gastric Cancer after Gastrectomy: A Cross-Sectional Study.

Patients after gastrectomy for gastric cancer are at risk of malnutrition, and poor nutritional status negatively affects patients' clinical outcomes. Knowledge of the factors influencing patients' nutritional status can inform interventions for improving patients' nutrition. A cross-sectional study was conducted to describe nutritional status and related factors in gastric cancer patients after gastrectomy. A convenience sample of gastric cancer patients with gastrectomy was recruited from general surgery or oncology clinics of a medical center in northern Taiwan. Data were collected with self-reported questionnaires, including the Functional Assessment Cancer Therapy­Gastric Module version 4, the Concerns in Meal Preparation scale, the Center for Epidemiologic Studies Depression Scale, and the Mini Nutrition Assessment. One hundred and one gastric cancer patients participated in the study. There were 81 cases of subtotal gastrectomy and 20 cases of total gastrectomy. Most patients (52.5%) were malnourished or at risk. Linear regression showed that symptom severity (ß = −0.43), employment status (ß = 0.19), and difficulty in diet preparation (ß = −0.21) were significant predictors of nutritional status. Together, these three variables explained 35.8% of the variance in patient nutritional status (F = 20.3, p < 0.001). More than 50% of our participants were malnourished or at risk for malnutrition, indicating a need for continued monitoring and support after discharge from hospitals. Special attention should be given to patients with severe symptoms, unemployment, and difficulties in diet preparation.

Degrees of Shortage and Uncovered Ratios for Long-Term Care in Taiwan's Regions: Evidence from Dynamic DEA.

The government is facing the country's aging population and low birth rate have led to a severe shortage of its healthcare workforce in Taiwan after 2003. In order to explore the status of the country's degree of long-term care shortage and uncovered ratio, this research uses the Push-Pull-Mooring (PPM) theory to explain long-term care efficiency during 2010-2019 in each city and county. We collect longitudinal-sectional data for 2010-2019 from the Ministry of Health and Welfare's Department of Statistics for 22 administrative regions in Taiwan in each year and employ dynamic data envelopment analysis (DEA) to evaluate the overall technical efficiency and the disaggregate output insufficiency to explain the research results. The main findings are as follows: (1) Cities near the capital Taipei have the highest degree of shortages in long-term caregivers and high uncovered ratios of people who need long-term care. (2) Presently, there is no demand to increase the number of long-term care institutions in Taiwan. (3) The government should introduce new long-term care certificates through national examinations in order to develop a stronger professional workforce in this field.