[Virtual Reality Skills Training Trends in Nurse Practitioner Education].

Technology developments change education strategies. Incorporating virtual reality into lesson plans allows education to focus not only on learning knowledge but also on knowledge and skills integration. In simulation education, learning environments are designed to approximate actual clinical situations, allowing students to practice skills in virtual clinical situations continuously. In addition, clinical lecturers may observe the students' practice process and provide feedback. Furthermore, through experiencing and practicing clinical procedures, students gain critical clinical judgment, skills, and teamwork operation competences, which may be applied in the real world. In Taiwan, the majority of nurse practitioner training is implemented in hospitals, and clinical training is done using hands-on and face-to-face teaching strategies within a mentorship framework. Because of the ongoing COVID-19 pandemic, this hospital-based training model has been significantly challenged. However, this represents an opportunity to migrate the nurse practitioner training model toward technology-based simulation education. Developing more virtual-reality-based lesson plans centered on clinical situations may help students complete training that is normally conducted in hospital teaching environments. Through repetitive practice in virtual reality settings, students may obtain comprehensive knowledge and clinical skills that will help relieve the subsequent stress of clinical practicum work and promote care quality and patient safety.

Depression and young age impact on hip fracture subsequent to stroke: A population-based cohort study.

AIMS: The purpose of this study is to identify whether depression and other associated factors in stroke are related to subsequent hip fracture. BACKGROUND: There are very few studies that focus on depression and demographic impact on subsequent hip fracture after a stroke. DESIGN: This a retrospective cohort study design. METHODS: The Taiwan Longitudinal Health Insurance Database between 1997 and 2010 was used. Two stroke patient cohorts were analysed: (1) depression within 1 year after newly diagnosed strokes; (2) without depression within 1 year after newly diagnosed strokes. Demographic characteristics, comorbidities, and hip fracture were compared using the Fine and Gray regression model for subdistribution hazard ratios. RESULTS/FINDINGS: Patients with depression showed a higher risk of hip fracture (95% CI, 0.99-1.66). Depression was associated with increased risk of hip fracture for patients below 50 years old (95% CI, 1.45-7.34). Comorbidities and gender showed no significant correlation with hip fracture risk in the depressed or nondepressed groups. CONCLUSION: Poststroke depression was a significant contributor to hip fracture in patients who suffered strokes and had more negative impact on the younger population, regardless of the gender and presence of comorbidities.

[An experience nursing an uncertain patient with complications after bariatric surgery].

This article describes a nursing care case in which a 33-year-old housewife received laparoscopic bariatric surgery and developed complications requiring multiple subsequent hospital admissions. Throughout the course of treatment from June to September 2010, the patient repeatedly experienced anxiety, helplessness, and depression due to recurrent complications that resulted in her loss of confidence in the treatment provided by the surgical team. During her fourth hospitalization, the Mishel Uncertainty in Illness Theory (MUIT) was applied to assess and establish the cause of her feelings of uncertainty toward her illness. Through a combination of reinforced emotional support, encouragement, disease consultation, individualized care measures, and improved doctor-patient communication, the patient's ability to care for herself improved and she regained confidence in control of her own physical condition. In addition, the active involvement of the patient's family throughout the course of treatment enabled her to persevere through the uncertain treatment period and successfully return to a normal life.

[Using complementary therapy with a hemodialysis patient with colon cancer and a sense of hopelessness].

Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.