Chu-Yu Huang

Main Caregivers’ Experiences of Managing Pain for Children With Neuroblastoma in Taiwan

Neuroblastoma is a common malignant tumor among children. Seventy percent of children with neuroblastoma have metastatic disease when the diagnosis is established. The aim of this study was to understand the main caregivers’ lived experiences in managing pain for children with neuroblastoma. A descriptive qualitative design was used. Twelve main caregivers of children with neuroblastoma were interviewed. Two themes evolved: experiences of pain and coping with pain. Three subthemes were found under the theme “experience of pain”: pain assessment based on language expressions and behavioral observations, tendency of misdiagnosing tumor metastasis–related pain, and unique manifestations of pain at various phases. Four subthemes evolved under the theme “coping with pain”: utilization of pharmacological and nonpharmacological modalities for pain management, learning to confront pain, seeking mental and emotional support, and adjustment of family lifestyle. The results provide a description regarding the expression of pain in children with neuroblastoma and the pain management modalities used by the main caregivers. The findings serve as a reference for health care providers in Taiwan as they manage pain for children with neuroblastoma and seek to understand the needs of the main caregivers.

Concept Analysis of Pain

The purpose of this paper is to expand the understanding of tile concept of pain. The authors intent to clarify the defining attributes of pain and identify antecedents that influence the perception of pain and the possible consequences of pain by using Walker and Avants (1995) concept analysis. A model case demonstrates how pain is tied to these critical attributes. A borderline case and a contrary case are presented to differentiate the concept of pain from other concepts. Empirical referents demonstrate the current perspective of the concept of pain.

Flipping the classroom to improve self-directed learning for RN to BSN students in Taiwan

Purpose: The last two decades have witnessed a sharp increase in the global migration of nurses along with an increasingly diverse patient population, regardless of geographic location. The “Diversity and Social Justice Issues in a Global Society” course was created to prepare Doctor of Nursing Practice (DNP) students to effectively practice in line with regional, national and international health needs and professional standards.C change in the demographic profile of many societies around the globe caused by a wide range of factors, such as colonization, immigration, acculturation and the mobility of workforces, contributes to the creation of multicultural environments. Regardless of the degree of pre-existing cultural diversity, people from different cultures bring with them their own languages, values, beliefs, traditions, ethical and moral perspectives, and attitudes to illness, health and healthcare as well as their historical, political and economic circumstances. Such diversity can create difficulties for healthcare providers and patients alike due to the potential for cultural clashes, misunderstandings and discrimination, and individual power differences which eventually will impinge on the health and safety of all the parties involved. In this paper, I will argue that Almutairi’s model of critical cultural competence (CCC) is a promising approach that can address the complexities that arise from crosscultural interactions in healthcare settings, which ultimately can improve the standard of healthcare for patients, families and the community as a whole. I will close by discussing how his approach can influence organizational policy, orientation programs and continuous professional development initiatives.Background: Nursing is a profession that theoretical and practical training need to be integrated. Different education strategies have been used to improve students’ psychomotor and communication skills such as simulation, standardized patients and part-task trainers. Students can examine all other parts of each other’s bodies during the learning process; the sensitive parts of the anatomy remain areas that are not routinely appropriate. Performing a clinical procedure required integration of the acquisition of a technical skill with effective communication skills.Results: Forty three students (93.5%) completed the survey. They all agreed that the flipped classroom teaching strategies were effective in improving their abilities of clinical reasoning and problem-solving. Forty students (93%) reported that the scenario based learning augmented their self-directed learning; 88% students had increased their interesting in pediatric nursing and motivated learning. The qualitative data revealed that flipped classroom can (1) bridge the knowledge-practice gap; (2) improve the self-directed learning ability and expand the depth and breadth of learning and (3) increase reflective learning, community skills and team competency using strategy of collaboration.Older age is often connected with stresses (e.g. reduced financial capacity, aloneness, increased morbidity). Violence may be an additional strain increasing the overall burden of older persons. Re ...