Hao-Yuan Chang

Influence of personality on care quality of hospital nurses.

This study investigates the relationship between hospital nurse personality and care quality in Taiwan. Hierarchical regression analysis was applied to data for 192 pairs of nurses and patients. Analytical results are as follows: (1) nurse openness was positively correlated with patient perceptions of responsiveness and (2) nurse neuroticism was negatively correlated with patient perceptions of responsiveness, assurance, and empathy.

Pain in Long‐Term Breast Cancer Survivors: Frequency, Severity, and Impact

OBJECTIVE To better understand the severity and impact of pain in women who are breast cancer survivors. DESIGN Cross-sectional survey. SETTING Cancer wellness clinic. PATIENTS Two hundred fifty-three women with a history of early-stage breast cancer who had completed therapy and were without evidence of disease. Interventions. None. OUTCOME MEASURES A survey that included questions about cancer history, pain, sleep problems, and physical and psychological functioning. RESULTS About half of the participants (117 or 46%) reported some pain, although most rated its intensity as mild. Both average and worst pain ratings showed significant associations with physical functioning (rs, -0.48 and -0.43, respectively), severity of sleep problems (rs, 0.31 and 0.30), and psychological functioning (rs, -0.27 and -0.24). Age (with younger participants slightly more likely to report pain) and history of antiestrogen therapy showed nonsignificant trends to predict the presence of pain. CONCLUSIONS The study findings provide new and important knowledge regarding the severity and impact of pain in female breast cancer survivors. The results indicate that clinicians should assess pain regularly in breast cancer survivors and treat this pain when indicated. The findings also support the need for research to determine whether improved pain management would result in improved quality of life for women with a history of breast cancer.

The experience of and coping with lumbopelvic pain among pregnant women in Taiwan.

OBJECTIVES 1) To replicate and extend previous research on the prevalence and characteristics of pregnancy-related lumbopelvic pain, and 2) to examine the associations between pain intensity, pain interference, and pain coping strategies in a sample of women with pregnancy-related lumbopelvic pain. DESIGN Cross-sectional design. SETTING An academic public and urban medical center in Taiwan. PATIENTS Pregnant women without gestational or psychiatric diseases in the 35th to 41st gestational week. INTERVENTIONS N/A. OUTCOME MEASURES Questionnaires were used to collect data on demographics, pain intensity, pain interference, and pain coping responses. RESULTS Of 230 consecutive cases scheduled for an outpatient obstetrics-gynecology clinic appointment, 187 agreed to participate in this study. One hundred and forty (74.9%) of these reported pregnancy-related lumbopelvic pain. Most participants with pain reported it as mild to moderate in severity and that the pain interfered with a number of daily activities. The coping responses used most often for pain management included rest (94.3%), task persistence (87.9%), and asking for assistance (87.1%). CONCLUSION The results confirmed that pregnancy-related lumbopelvic pain is a common problem that interferes with important activities. Pregnant women use a number of coping strategies to manage lumbopelvic pain. A common use of passive coping responses such as rest and asking for assistance suggest the possibility of a helplessness phenomenon in response to pain among some of the study participants. Education and interventions targeting this may be warranted to minimize the chances that the lumbopelvic pain experienced during pregnancy will develop into a chronic pain problem over time.

Development of Service Quality Scale for Surgical Hospitalization

BACKGROUND/PURPOSE Findings from literature showed inconsistent results for applying service quality scale in hospitals. Moreover, hospitalization services are provided by diversified departments and a scale designed to measure the overall hospitalization quality is difficult and capturing special characteristics of different departments is also not an easy task. This study attempted to develop a service quality scale for surgical hospitalization (SQSH). METHODS Forty-two items were designed via literature review, interviews with patients, health professionals and experienced care givers. A cross-sectional survey was conducted in one hospital. A total of 271 patients in surgical wards were chosen using stratified random sampling; 57.7% of the sampled patients were aged below 55, and 52.2% were male. RESULTS The response rate was 93.4%. Twenty-nine items were retained through the scale development process and six factors were formed: needs management, assurance, sanitation, customization, convenience and quiet, and attention. Six factors explained 57.3% of total variance. Five experts assessed the content validity; content validity index was 0.964. Furthermore, all Cronbachs alpha exceeded 0.642 and all factor loadings exceeded 0.5. The concurrent validity correlation was 0.583, which had a p value below 0.01. CONCLUSION The SQSH has sufficient usefulness, reliability and validity. Future research on service quality can apply the SQSH scale to link with utilization intention and patient loyalty and attempt to develop a hospitalization quality scale for other departments.

How do pregnant women manage lumbopelvic pain? Pain management and their perceived effectiveness

AIMS AND OBJECTIVES This study aims to (1) investigate the pain management treatments used by pregnant women with lumbopelvic pain and their perceived effectiveness and (2) identify the predictors of pain treatment use. BACKGROUND A variety of treatments have been shown to be effective for reducing pregnancy-related lumbopelvic pain. However, the frequency of use of pain treatments and their perceived efficacy in pregnant women is still unknown. Knowledge regarding the use and perceived efficacy of these treatments would help guide clinical practice and inform future research. DESIGN A cross-sectional design with consecutive sampling. METHODS Participants were pregnant women in the 35th to 40th gestational week who reported lumbopelvic pain in an antenatal clinic of a medical centre in Taiwan. Questionnaires were administered assessing pain treatment use, pain relief associated with each treatment (e.g. perceived effectiveness), pain intensity, pain interference, pain endurance beliefs and demographic variables. RESULTS Among 295 participants with lumbopelvic pain, only 34 (12%) sought pain treatment. The pain management treatments used included mechanical treatments (80% = 27/34), herbal medicine (9% = 3/34), exercise (6% = 2/34) and medications (6% = 2/34). Average perceived effectiveness associated with the treatments was 55%. Use of pain management strategies was negatively associated with pain endurance beliefs, but not with pain intensity or pain interference. CONCLUSIONS Pregnant women with lumbopelvic pain are unlikely to seek or use pain management treatments for pain, suggesting a greater need for adopting effective pain treatment in clinical settings. RELEVANCE TO CLINICAL PRACTICE The study contributes new knowledge regarding how pregnant women cope with lumbopelvic pain and reveals very low rates in the use of pain treatments. Health professionals should assess pregnant womens pain beliefs about pain endurance and emphasise the safety and effectiveness of interventions that have empirical support, to help minimise unnecessary pain during pregnancy.

Trend Analysis of Nursing Intervention Studies Published by Taiwan Nurses Association between 1954 and 2006

This study reviewed historical nursing intervention studies in Taiwan and analyzed results based on sample characteristics, methodology characteristics, and content characteristics. Historical studies were split into four groups, G1970, G1980, G1990, and G2000, based on the decade in which they were published. A comparison was then made to identify significant differences between G2000 and other groups. A total of 103 nursing intervention studies were analyzed in this study. Results included sample characteristics of studies conducted primarily by single-disciplinary research teams, although multidisciplinary studies showed a growth trend across decades, with the number of multidisciplinary studies significantly greater in G2000 than in other decades. Nursing practice was the main area of research, clients were the major participants studied, and hospitals provided the principal research setting. No statistical difference was noted in the above mentioned variables. In terms of methodology characteristics, questionnaires were used most frequently to collect data. A quasi-experimental design was the primary research design employed. Although the number of experimental designs has increased significantly in recent years, most studies specified their inclusion criteria. Reliability and validity of instruments were more clearly specified in recent decade groups than in earlier decade groups. Methodology rigor has improved in recent years, achieving a statistically significant difference between G2000 and other groups in all categories, with the exception of instrument validity. In terms of content characteristics, health education was the leading intervention type. Most interventions were categorized as tertiary prevention, with perceptual outcome used most often as the outcome indicator. However, no statistical differences in content dimension variables were identified between G2000 and other groups. In summary, the number of nursing intervention research cases has risen, and research methodology rigor has improved in recent decades. However, no statistically significant differences in sample characteristics and content characteristics between the most recent and earlier decade groups were found. Suggestions for future domestic nursing intervention studies based on study findings are made at the conclusion of this article.

Application of a fluorescent marker with quantitative bioburden methods to assess cleanliness

BACKGROUND Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain. OBJECTIVE To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning. DESIGN A prospective survey study. SETTING An academic medical center. METHODS The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison. RESULTS According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2). CONCLUSIONS The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.

Professional Practice Environment Scale-Chinese Version: Development and Psychometric Testing.

Background: The Professional Practice Environment (PPE) scale is widely used to assess the quality of the healthcare environment around the world. No validated Chinese-language scale that is designed to address this issue currently exists. Purpose: The present study evaluates the construct validity of the Chinese-version PPE on a sample of 290 healthcare workers in Taiwan. Methods: Forward and backward translations of the PPE scale of Halcomb et al. were used to ensure semantic equivalence. Further, multiple psychometric properties were examined. Results: The developed scale showed sufficient equivalence. The results of a survey of 290 healthcare providers demonstrated that the developed Chinese-version PPE scale had high reliability (Cronbach’s alpha = .88) and validity. Conclusions/Implications for Practice: The findings of the present study support the effectiveness and efficiency of the Chinese-version 30-item Halcomb’s PPE in assessing the professional practice environment in Taiwan.