Hui-Man Huang

Development and Psychometric Testing of the Suicide Caring Competence Scale (SCCS) for Family Caregivers in Taiwan

Suicide caring competence is important for family caregivers to care their relatives with suicidal tendencies. The purpose of this study was to develop and test the psychometric properties of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan. A 20-item SCCS was tested on 165 family caregivers. Confirmatory factor analysis indicated that five subscales with 19 items best fit the data. The Cronbachs α and test-retest reliability of the SCCS was 0.90 and 0.81, respectively. The SCCS demonstrated acceptable construct validity and reliability. Nurses can use the SCCS to assess the suicide caring competence of family caregivers.

Stigma Experienced by Caregivers of Patients with Schizophrenia: A Qualitative Study

Background: Stigmatization of patients with mental illness has been investigated in numerous studies. Little research has explored how caregivers of schizophrenia patients perceive and experience stigmatization. Aim: This study designed to explore the subjective experience of stigma from the perspectives of caregivers of patients with schizophrenia, during the process of caring schizophrenic patients. Methods: A qualitative study with in-depth interviews was used. Narrative data was obtained by 15 care givers of schizophrenia patients. A thematic analysis method was used to analyze data.Results: Four themes, including 10 sub-themes linked to the stigma experience of care givers. The four themes were: (a)symptom disturbance is the fundament to the root of calamity;(b)negative perception is a shackle strapped to you for all life; (c) illness in a family leads to a lifelong labor; (d)not knowing the path of the future.

Development and Psychometric Testing of the Suicidal Recovery Ability Scale (SRAS) for Assessing Individuals Who Have Attempted Suicide

Abstract Assessing the recovery ability of individuals who have attempted suicide is crucial for psychiatric health nurses. The purpose of this study was to develop and test a psychometric Suicidal Recovery Ability Scale (SRAS). Confirmatory factor analysis (CFA) indicated that three subscales with 15 items best fit the data. The global SRAS score showed significant negative correlation with the Beck Hopelessness Scale (BHS) score. The Cronbach’s α and test-retest reliability scores for the global SRAS and the subscales all exceeded 0.70. Nurses can use the SRAS to assess the recovery ability of individuals who have attempted suicide and provide proper care to help them.

The relationships between uncertainty and coping Behaviors of patients with liver Cirrhosis

Background: Patients tend to develop a sense of uncertainty when they lack control over the progress of the disease, and physical discomforts. The sense of uncertainty that patients develop when facing their disease or treatment may elicit physical and psychological distress which can influence the patients’ coping behaviors. Purpose: This study investigated the relationships between cirrhotic patients’ sense of uncertainty and coping behaviors. Methods: A cross-sectional, correlational research design was used. Convenience sampling was performed to select 76 cirrhotic inpatients in the division of gastroenterology at a hospital in Southern Taiwan. Three structured questionnaires (Personal Characteristics Questionnaire, Mishel Uncertainty in Illness Scale, Coping Behaviors Scale) were used for data collection. Results: (a) Cirrhotic patients perceived a moderate or increased level of uncertainty and problemoriented coping behaviors were the most frequently used coping behaviors. (b) Patients who had no religion, who had fatigue or severe disease conditions exhibited comparatively high levels of uncertainty. (c) Patients who were singled or unemployed, or fatigue often showed emotion-oriented coping behaviors. Consuming alcohol frequency, illness severity was positively correlated with emotionoriented coping behaviors. (d) Patients who were unemployed often exhibited problem-oriented coping behaviors. Educational level and consuming alcohol frequency were positively correlated with problemoriented coping behaviors. (e) Patients’ sense of uncertainty was positively correlated with emotion- and problem-oriented coping behaviors. Conclusions/ Implications for Practice: Since cirrhotic patients frequently exhibit emotion-oriented coping behaviors and have high level of uncertainty, nurses could encourage them to express their emotions and problems, and listen to them patiently. If patients were high levels of uncertainty, and exhibit problem-oriented coping behaviors, by spontaneously providing disease-related information and social support, they can readily adopt to their disease conditions.

Category 3 and 4 Controlled Drugs Users' Perceptions of Participating in Drug-Abuse-Health Prevention Lectures in Taiwan.

Abstract This study was designed to explore Category 3 and 4 controlled drug users’ perceptions of participating in health‐prevention lectures. A phenomenological approach was used. Twelve participants were interviewed after completing the lectures. Findings revealed five themes (1) mixed emotions; (2) self‐development; (3) finding the lectures lacked practicality and relevance; (4) highlighting three stages for discontinuing drug‐usage; and, (5) suggesting tips for the advancement of lectures. These findings could be used as a map to help health professionals understand drug users’ perceptions of attending health prevention lectures and provide insight into how young people might stop using drugs. HighlightsCategory 3 and 4 controlled drugs users experienced fear and helplessness before attending the lectures.Category 3 and 4 controlled drugs users experienced positive growth after attending the lectures.Self‐awareness helps controlled drugs users realize drugs are unhealthy and living in a drug‐free environment is better.It is important for controlled drugs users to find help from diverse sources and support systems.Interactive teaching and learning processes could improve controlled drugs users’ motivation during the lectures.

The Psychological Process of Breast Cancer Patients Receiving Initial Chemotherapy: Rising From the Ashes.

Background: In Taiwan, breast cancer is the most common cancer in women. Most breast cancer patients are willing to receive chemotherapy and experience adverse effects and suffering during the process of chemotherapy. Objectives: The aim of this study was to explore patients’ psychological process when receiving initial chemotherapy for breast cancer. Methods: A qualitative grounded theory approach was used. Data were collected through semistructured interviews of 20 patients who were from 1 district teaching hospital during 2012 to 2013. Results: A substantive theory was generated to describe the psychological process experienced by breast cancer patients in their initial treatment. The core category was “rising from the ashes.” Four categories emerged and represented 4 stages of the psychological process experienced by breast cancer patients. They were (1) fear stage: patients are frightened about permanent separation from family, chemotherapy, and the disease getting worse; (2) hardship stage: patients experience physical suffering and mental torment; (3) adjustment stage: patients fight against the disease, find methods for adjustment, and get assistance from supporting systems; (4) relaxation stage: patients were released from both the physical and mental sufferings, and patients accepted the disease-related change in their lives. Conclusion: Each stage is closely related to the other stages, and each is likely to occur repeatedly. It is important to help patients achieve the relaxation stage. Implications for Practice: The results of this study may enhance nurses’ understanding of the psychological process of patients receiving initial chemotherapy for breast cancer, thereby helping nurses to provide appropriate assistance to improve the quality of patient care.

A Comparison of the Quality of Life of Patients with Schizophrenia in Daycare and Homecare Settings

Background: Deinstitutionalization has been a social movement in Taiwan since 1984. This practice emphasizes quality of life as an important outcome in the treatment of patients with chronic mental illness. Purpose: This study compares the quality of life of patients with schizophrenia between daycare and homecare settings in Taiwan. Methods: A cross-sectional comparison design was used. A convenience sample of 70 participants was drawn from daycare (n = 45) and homecare (n = 25) settings. Three structured questionnaires, a personal characteristics questionnaire, the Quality of Life Scale for Psychiatric Patients, and the Positive and Negative Syndromes Scale, were used to collect personal characteristics, quality of life, and psychopathological status information on participants. Results: Compared with homecare participants, daycare participants had higher quality of life in several domains, more work opportunities, and less severe positive symptoms. Conclusions/Implications for Practice: Providing work opportunities and proper psychopathology care to patients with schizophrenia may further enhance their quality of life. Practitioners should encourage people with chronic schizophrenia to receive regular care in either a daycare setting or a homecare setting.

Post-Stroke Depression: The Associated Factors and Effective Intervention

Stroke is a major health problem in the elderly population in Taiwan. Patients who have had strokes are at significant risk for various neuropsychiatric illnesses. The most common and important neuropsychiatric illnesses is poststroke depression (PSD). PSD affects the speed of recovery, functional outcome, and has an important impact on the quality of life of patients with stroke. PSD also increase institutional length of stays and health care cost. Therefore, PSD is an important public health issue and has received the most attention in stroke research. In clinical practice, only minority of PSD patients are diagnosed and even fewer are treated. This paper reviews the current literature on PSD and offers an integrated approach to PSD concepts, prevalence of PSD, associated factors, and practical pharmacologic and nonpharmacologic intervention for PSD. Effective pharmacologic treatment includes anti-depressants: SSRI, TCA; Chinese pharmacy (tonic to the heart and spleen & smooth depression decoction) etc. Nonpharmacologic treatment includes ECT, Psychotherapy, and educational counselling. Drug therapy is the first choice intervention for PSD. This paper highlights the importance of early recognition and emphasis on clinical support and therapy in the care of patients with depression following stroke. Research to prevent and reduce depression after stroke might be a worthy project for the future.