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Chung-Hey Chen

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Copperbelt University

Cornell University

Medical University of Vienna

Richard Matasic

University of medicine Zagreb

University of Virginia

Dragos Simandan

Brock University

Al-Qasim Green University

Sohag University

St Cyril and Methodius, Skopje, Macedonia

Aristotle University of Thessaloniki

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Papers by Chung-Hey Chen

Effectiveness of aerobic gymnastic exercise on stress, fatigue, and sleep quality during postpartum: A pilot randomized controlled trial

International Journal of Nursing Studies, 2018

Background: Gymnastics is a preferable safe exercise for postnatal women performing regularly. Ob... more Background: Gymnastics is a preferable safe exercise for postnatal women performing regularly. Objective: The aim of this pilot randomized controlled trial was to determine whether the aerobic gymnastic exercise improves stress, fatigue, sleep quality and depression in postpartum women. Design: Single-blinded, randomized controlled trial held from December 2014 until September 2015. Setting: Postnatal clinic of a medical center in southern Taiwan. Participants: 140 eligible postnatal women were systematically assigned, with a random start to experimental (n = 70) or a control (n = 70) group. Interventions: Engage in aerobic gymnastic exercise at least three times (15 min per section) a week for three months using compact disc in the home.

A qualitative study of the experiences of Taiwanese women having their first baby after the age of 35 years

Midwifery, 2007

Objective: to explore the experiences of Taiwanese women who become pregnant for the first time a... more Objective: to explore the experiences of Taiwanese women who become pregnant for the first time after the age of 35 years. Design, setting and participants: a phenomenological method was used to collect data by interviews. This study was undertaken in a 1600-bed university hospital in southern Taiwan, with a purposive sampling of 10 first-time pregnant women aged 35-44 years. The interviews were tape-recorded and transcribed to develop data categories. Findings: participants amply demonstrated that the core experience was 'jubilant apprehension' (Yu-Shee-Zhun-Ben in Mandarin). Five subcategories were expressed among pregnant women over 35 years of age. These were 'surprise and worry about childbirth outcomes;' 'embarrassment about being outside the societal age norm for pregnancy;' 'ambivalence about impending lifestyle changes;' 'loneliness and lack of support;' and 'concern about the safety of pregnancy and childbirth'. Conclusion and implications for practice: although pregnancy was a pleasant surprise for these women, they were concerned that their childbearing was beyond the social expectation for their age. We highlight new aspects of midwifery professionalism that should address the childbearing experience of women over 35 years of age, and provide a basis for care of this group.

Effectiveness of mental health website intervention on stress and depression for women with recurrent miscarriage: A randomized controlled trial

Health Care for Women International

Body Image, Social Support and Depression in Gynecologic Cancer Patients

Effects of group qigong exercise on modifying risk factors in adults with ischemic heart disease

Outcomes of a walking exercise intervention in postpartum women with disordered sleep

Journal of Obstetrics and Gynaecology Research, 2021

Good sleep quality is essential to physical and mental‐health‐related quality of life. The purpos... more

Message from the Editor

Journal of Nursing Research, 2017

Knowledge-economy building, a national movement that is focused on improving quality of life, is ... more Knowledge-economy building, a national movement that is focused on improving quality of life, is not only grounded in data and information but also embraces knowledge innovation and effective use in practice as core values. When I was an undergraduate student in nursing, biostatistics and nursing research were not part of the curriculum, and my research work after graduation was built on the accumulated experience of exploration and self-study. My academic career began from the position of assistant instructor. I published my first case report in 1980, my first overview paper in 1981, and my first original research paper in 1982, all in the Journal of Nursing. Research at that time was a way to enhance my professional knowledge. Having the opportunity to study for a Master of Science and PhD at the University of Pittsburgh in the United States was the turning point in how I conceptualized my research career. I began to perceive research as ‘‘an ongoing reflection of the process of deduction / induction that highlights the power and limitations of science.’’ To be honest, being a scientist is hard work. Congratulations to all authors for establishing their academic legacy.

The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan

Archives of Suicide Research, 2018

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Gro... more In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.

Effects of Qigong Exercise on Biomarkers and Mental and Physical Health in Adults With at Least One Risk Factor for Coronary Artery Disease

Biological research for nursing, Jan 20, 2015

Current medical technology permits the early detection of risk factors for coronary artery diseas... more Current medical technology permits the early detection of risk factors for coronary artery disease (CAD) in adults, and interventions are available to prevent CAD-related morbidity and mortality. The goal of this study was to determine the effectiveness of a Qigong exercise intervention in improving biomarker levels and mental and physical health outcomes in community-dwelling adults diagnosed with CAD risk factors, in a southern Taiwanese city. Participants were randomly assigned to an experimental (n = 84) group that participated in a 60-min Qigong group session 3 times per week for 3 months or a control (n = 61) group that did not receive the intervention. Self-perceived mental and physical health assessed with the Chinese Health Questionnaire-12, and body fat percentage were measured at baseline and 6, 12, and 16 weeks. Blood samples were collected at baseline and 12 weeks for analysis of lipid profiles, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin (HbA1c), ...

Predictors of Antenatal Psychosocial Stress in Taiwanese Women

The journal of nursing research : JNR, Jan 18, 2015

Antenatal stress has been associated with adverse outcomes in mothers and their children. However... more Antenatal stress has been associated with adverse outcomes in mothers and their children. However, little research has been conducted to identify the factors associated with psychosocial stress in pregnant women. This study explored the predictors of psychosocial stress during pregnancy. A convenience sample of 136 second-trimester and 164 third-trimester pregnant women were recruited from a medical center in southern Taiwan. Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Edinburgh Prenatal Depression Scale, Pittsburgh Sleep Quality Index, Maternal-Fetal Attachment Scale, and Interpersonal Support Evaluation List. The results of this study found positive correlations between PSRS and both Edinburgh Prenatal Depression Scale (r = .368, p < .01) and Maternal-Fetal Attachment Scale (r = .168, p < .01) and negative correlations between PSRS and both gravidity (r = -.137, p < .05) and Interpersonal Support Evaluation List (r = -.266, p < ....

The effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy

Complementary Therapies in Medicine, 2015

Objective: While music listening has been studied as an intervention to help reduce anxiety in pr... more Objective: While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancyspecific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. Design: A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n = 145) and a control group (n = 151). Interventions: The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. Main outcome measures: Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS). Results: The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups.

Revision and validation of a scale to assess pregnancy stress

The journal of nursing research : JNR, 2015

Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune ... more Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune systems, has been implicated in the etiology of prenatal complications or postnatal psychiatric disorders, and may adversely affect fetal health. The 30-item Pregnancy Stress Rating Scale (PSRS), initially developed in 1983 by Chen and colleagues, is the only measure to date designed specifically to evaluate prenatal stress. The purpose of this study was to reconsider and revise the 30-item PSRS and validate the new PSRS. A cross-sectional design was used. Adding new items of pregnancy stress generated from clinical experience and expert recommendations resulted in a 40-item revised PSRS that was more reflective of current social conditions. Three hundred pregnant women, recruited from the antenatal clinic of a medical center in southern Taiwan, completed the revised PSRS to assess its internal consistency, test-retest reliability, construct validity, and convergent and discriminate vali...

[The affect of gender on caregiving: a study of male nurses]

Hu li za zhi The journal of nursing, 2010

Caring, the essence of nursing, is widely viewed as a feminine activity. Therefore, determining t... more Caring, the essence of nursing, is widely viewed as a feminine activity. Therefore, determining the existence and extent of differences in caring shown by male nurses in comparison with their female counterparts is a matter that requires further discussion. This article discusses the effects of gender differences on nursing care provided by male nurses according to analyzing the essential elements of caring. Findings indicate that certain caring behaviors performed by male nurses differ from their female colleagues due to extant internal conflicts between masculine and caring concepts. This article proposes two suggestions to nursing educators: 1. When training male nurses, in addition to emphasizing the value of caring, instructors should also emphasize teaching caring competence; 2. Based on an acceptance of diversity, instructors should accept the existence of differences between male and female nurse caring behaviors due to fundamental gender differences.

[Nursing knowledge: the evolution of scientific philosophies and paradigm trends]

Hu li za zhi The journal of nursing, 2010

Different aspects of philosophy are derived from different paradigms that contain various main po... more Different aspects of philosophy are derived from different paradigms that contain various main points, some of which are repeated or overlap. Belief and practice are two components of a paradigm that provide perspective and framework and lead to nursing research. Changes in healthcare have popularized empirical and evidence-based research in the field of nursing research. However, the evidence-base study approach has given rise to a certain level of debate. Until now, no standard paradigm has been established for the nursing field, as different professionals use different paradigms in their studies. Such provides certain limitations as well as advantages. The quantitative aspects of a nursing paradigm were developed by Peplau and Henderson (1950) and Orem (1980). Such remained the standard until 1990, when Guba and Parse proposed qualitative viewpoints in contextual features. Therefore, the nursing paradigm has made great contributions to the development of knowledge in nursing care...

[Applying the transtheoretical model to tobacco prevention education in adolescence: a literature review]

Hu li za zhi The journal of nursing, 2009

The Transtheoretical Model (TTM) is a contemporary psychological model of behavioral change emplo... more The Transtheoretical Model (TTM) is a contemporary psychological model of behavioral change employed to develop efficient interventions to promote healthy behavioral changes. Interventions can be individualized to the needs of individuals in order to achieve optimal results. No integrated plan currently exists in Taiwan for reducing cigarette use among children. This article presents a systematic review of TTM, with the goal of constructing a model for protecting teenagers against tobacco-related health risks. Analysis results are hoped to be useful as a reference for developing systematic interventions aimed at reducing the health risks posed to teenagers by cigarette smoking.

[Behavioral responses of an older woman receiving tocolysis after repeated failed pregnancies]

Hu li za zhi The journal of nursing, 2007

The purpose of this study was to explore the behavioral responses to tocolysis of an older woman ... more The purpose of this study was to explore the behavioral responses to tocolysis of an older woman who has experienced two failed pregnancies. As a participant observer the primary researcher simultaneously provided care and recorded the woman's verbal and nonverbal behaviors. After repeated data analysis, it was found that the woman's stress mainly resulted from her un certainty about a safe passage through pregnancy and about the health of her fetus. In her effort to ensure a successful pregnancy and good fetal health, she exhibited the following behaviors: worrying about the status of her pregnancy, adopting effective strategies to ensure the success of the tocolysis, complying with medical procedures and nursing instructions, establishing the time marks of the pregnancy for the purpose of self-encouragement, and attaching importance to oral intake for the sake of good fetal health. The article concludes that medical personnel should actively identify the needs of pregnant ...

[Application of empowerment in the organization]

Hu li za zhi The journal of nursing, 2006

Rapid changes in modern society require organizations to innovate and reform to keep up with and ... more Rapid changes in modern society require organizations to innovate and reform to keep up with and adequately address needs. A competitive organization must retain employees who are devoted to and satisfied with their work. Empowerment of employees by organizational managers is one way by which to motivate employees and thereby increase their productivity and effectiveness within the organization. This article presents meanings, contents, structures and models related to the concept of empowerment and the process of its application. An extensive literature review was conducted. Study results are hoped to provide to nursing leaders a reference in order to execute empowerment concepts effectively within their organizations.

The effectiveness of a relaxation training program for women with preterm labour on pregnancy outcomes: a controlled clinical trial

International journal of nursing studies, 2012

Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been publish... more Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been published on the effectiveness of relaxation techniques focusing on women with preterm labour. The object of this study was to examine the effectiveness of a relaxation training program on pregnancy outcomes in women experiencing preterm labour. A single-blinded, controlled clinical trial was used. The study was conducted in two hospitals. Both of the study hospitals located in northern Taiwan are also large teaching hospitals and share the same treatment protocols of preterm labour. Inclusion criteria were being pregnant and diagnosed with preterm labour, singleton, hospitalized at time of entry into the study, at gestation between 20 and 34 weeks, and having a cervical dilatation of less than 3 cm. Exclusion criteria were if they had one or any combination of the following: antepartum hemorrhage, infection, hypertension, gestational diabetes mellitus, or immunologic disease. The experimental ...

Taiwanese Women's Process of Recovery From Stillbirth: A Qualitative Descriptive Study

Research in Nursing & Health, 2014

The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanes... more The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth.

Evaluation of a caring education program for Taiwanese nursing students: A quasi-experiment with before and after comparison

Nurse Education Today, 2009

Background: Caring is an essential component in nursing curricula. However, how caring can be acc... more Background: Caring is an essential component in nursing curricula. However, how caring can be accomplished effectively has rarely been taught to nursing students. Objectives: To examine acceptability and preliminary efficacy of a caring education program for nursing students in Taiwan. Methods: Students were recruited to participate in a pre-post-test quasi-experimental study. Students self-selected into a control group (n = 33) or an experimental group (n = 35). The experimental group registered for a 13-week caring education program based on Watson's 10 creative factors through multiple teaching strategies. The Caring Behaviors Assessment (CBA) was used to collect data at weeks 1 and 13. Content analysis was used to reach the main descriptions of caring education from an experimental group of nursing students. Results: The experimental group reported a significantly higher score of caring behaviors after participating in the education program (t = 3.4, p = .00). The score of each CBA subscale in the experimental group was significantly enhanced from week 1 to week 13, except in the existential/phenomenological/spiritual dimension. Qualitative results supported that a caring education could help nursing students by building caring behaviors which could be adapted to clinical situations. Conclusions: The findings support the credibility of caring-focused teaching strategies and such focused caring programs are acceptable and show efficacy for nursing students.

Effectiveness of aerobic gymnastic exercise on stress, fatigue, and sleep quality during postpartum: A pilot randomized controlled trial

International Journal of Nursing Studies, 2018

Background: Gymnastics is a preferable safe exercise for postnatal women performing regularly. Ob... more Background: Gymnastics is a preferable safe exercise for postnatal women performing regularly. Objective: The aim of this pilot randomized controlled trial was to determine whether the aerobic gymnastic exercise improves stress, fatigue, sleep quality and depression in postpartum women. Design: Single-blinded, randomized controlled trial held from December 2014 until September 2015. Setting: Postnatal clinic of a medical center in southern Taiwan. Participants: 140 eligible postnatal women were systematically assigned, with a random start to experimental (n = 70) or a control (n = 70) group. Interventions: Engage in aerobic gymnastic exercise at least three times (15 min per section) a week for three months using compact disc in the home.

A qualitative study of the experiences of Taiwanese women having their first baby after the age of 35 years

Midwifery, 2007

Objective: to explore the experiences of Taiwanese women who become pregnant for the first time a... more Objective: to explore the experiences of Taiwanese women who become pregnant for the first time after the age of 35 years. Design, setting and participants: a phenomenological method was used to collect data by interviews. This study was undertaken in a 1600-bed university hospital in southern Taiwan, with a purposive sampling of 10 first-time pregnant women aged 35-44 years. The interviews were tape-recorded and transcribed to develop data categories. Findings: participants amply demonstrated that the core experience was 'jubilant apprehension' (Yu-Shee-Zhun-Ben in Mandarin). Five subcategories were expressed among pregnant women over 35 years of age. These were 'surprise and worry about childbirth outcomes;' 'embarrassment about being outside the societal age norm for pregnancy;' 'ambivalence about impending lifestyle changes;' 'loneliness and lack of support;' and 'concern about the safety of pregnancy and childbirth'. Conclusion and implications for practice: although pregnancy was a pleasant surprise for these women, they were concerned that their childbearing was beyond the social expectation for their age. We highlight new aspects of midwifery professionalism that should address the childbearing experience of women over 35 years of age, and provide a basis for care of this group.

Effectiveness of mental health website intervention on stress and depression for women with recurrent miscarriage: A randomized controlled trial

Health Care for Women International

Body Image, Social Support and Depression in Gynecologic Cancer Patients

Effects of group qigong exercise on modifying risk factors in adults with ischemic heart disease

Outcomes of a walking exercise intervention in postpartum women with disordered sleep

Journal of Obstetrics and Gynaecology Research, 2021

Good sleep quality is essential to physical and mental‐health‐related quality of life. The purpos... more

Message from the Editor

Journal of Nursing Research, 2017

Knowledge-economy building, a national movement that is focused on improving quality of life, is ... more Knowledge-economy building, a national movement that is focused on improving quality of life, is not only grounded in data and information but also embraces knowledge innovation and effective use in practice as core values. When I was an undergraduate student in nursing, biostatistics and nursing research were not part of the curriculum, and my research work after graduation was built on the accumulated experience of exploration and self-study. My academic career began from the position of assistant instructor. I published my first case report in 1980, my first overview paper in 1981, and my first original research paper in 1982, all in the Journal of Nursing. Research at that time was a way to enhance my professional knowledge. Having the opportunity to study for a Master of Science and PhD at the University of Pittsburgh in the United States was the turning point in how I conceptualized my research career. I began to perceive research as ‘‘an ongoing reflection of the process of deduction / induction that highlights the power and limitations of science.’’ To be honest, being a scientist is hard work. Congratulations to all authors for establishing their academic legacy.

The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan

Archives of Suicide Research, 2018

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Gro... more In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.

Effects of Qigong Exercise on Biomarkers and Mental and Physical Health in Adults With at Least One Risk Factor for Coronary Artery Disease

Biological research for nursing, Jan 20, 2015

Current medical technology permits the early detection of risk factors for coronary artery diseas... more Current medical technology permits the early detection of risk factors for coronary artery disease (CAD) in adults, and interventions are available to prevent CAD-related morbidity and mortality. The goal of this study was to determine the effectiveness of a Qigong exercise intervention in improving biomarker levels and mental and physical health outcomes in community-dwelling adults diagnosed with CAD risk factors, in a southern Taiwanese city. Participants were randomly assigned to an experimental (n = 84) group that participated in a 60-min Qigong group session 3 times per week for 3 months or a control (n = 61) group that did not receive the intervention. Self-perceived mental and physical health assessed with the Chinese Health Questionnaire-12, and body fat percentage were measured at baseline and 6, 12, and 16 weeks. Blood samples were collected at baseline and 12 weeks for analysis of lipid profiles, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin (HbA1c), ...

Predictors of Antenatal Psychosocial Stress in Taiwanese Women

The journal of nursing research : JNR, Jan 18, 2015

Antenatal stress has been associated with adverse outcomes in mothers and their children. However... more Antenatal stress has been associated with adverse outcomes in mothers and their children. However, little research has been conducted to identify the factors associated with psychosocial stress in pregnant women. This study explored the predictors of psychosocial stress during pregnancy. A convenience sample of 136 second-trimester and 164 third-trimester pregnant women were recruited from a medical center in southern Taiwan. Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Edinburgh Prenatal Depression Scale, Pittsburgh Sleep Quality Index, Maternal-Fetal Attachment Scale, and Interpersonal Support Evaluation List. The results of this study found positive correlations between PSRS and both Edinburgh Prenatal Depression Scale (r = .368, p < .01) and Maternal-Fetal Attachment Scale (r = .168, p < .01) and negative correlations between PSRS and both gravidity (r = -.137, p < .05) and Interpersonal Support Evaluation List (r = -.266, p < ....

The effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy

Complementary Therapies in Medicine, 2015

Objective: While music listening has been studied as an intervention to help reduce anxiety in pr... more Objective: While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancyspecific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. Design: A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n = 145) and a control group (n = 151). Interventions: The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. Main outcome measures: Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS). Results: The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups.

Revision and validation of a scale to assess pregnancy stress

The journal of nursing research : JNR, 2015

Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune ... more Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune systems, has been implicated in the etiology of prenatal complications or postnatal psychiatric disorders, and may adversely affect fetal health. The 30-item Pregnancy Stress Rating Scale (PSRS), initially developed in 1983 by Chen and colleagues, is the only measure to date designed specifically to evaluate prenatal stress. The purpose of this study was to reconsider and revise the 30-item PSRS and validate the new PSRS. A cross-sectional design was used. Adding new items of pregnancy stress generated from clinical experience and expert recommendations resulted in a 40-item revised PSRS that was more reflective of current social conditions. Three hundred pregnant women, recruited from the antenatal clinic of a medical center in southern Taiwan, completed the revised PSRS to assess its internal consistency, test-retest reliability, construct validity, and convergent and discriminate vali...

[The affect of gender on caregiving: a study of male nurses]

Hu li za zhi The journal of nursing, 2010

Caring, the essence of nursing, is widely viewed as a feminine activity. Therefore, determining t... more Caring, the essence of nursing, is widely viewed as a feminine activity. Therefore, determining the existence and extent of differences in caring shown by male nurses in comparison with their female counterparts is a matter that requires further discussion. This article discusses the effects of gender differences on nursing care provided by male nurses according to analyzing the essential elements of caring. Findings indicate that certain caring behaviors performed by male nurses differ from their female colleagues due to extant internal conflicts between masculine and caring concepts. This article proposes two suggestions to nursing educators: 1. When training male nurses, in addition to emphasizing the value of caring, instructors should also emphasize teaching caring competence; 2. Based on an acceptance of diversity, instructors should accept the existence of differences between male and female nurse caring behaviors due to fundamental gender differences.

[Nursing knowledge: the evolution of scientific philosophies and paradigm trends]

Hu li za zhi The journal of nursing, 2010

Different aspects of philosophy are derived from different paradigms that contain various main po... more Different aspects of philosophy are derived from different paradigms that contain various main points, some of which are repeated or overlap. Belief and practice are two components of a paradigm that provide perspective and framework and lead to nursing research. Changes in healthcare have popularized empirical and evidence-based research in the field of nursing research. However, the evidence-base study approach has given rise to a certain level of debate. Until now, no standard paradigm has been established for the nursing field, as different professionals use different paradigms in their studies. Such provides certain limitations as well as advantages. The quantitative aspects of a nursing paradigm were developed by Peplau and Henderson (1950) and Orem (1980). Such remained the standard until 1990, when Guba and Parse proposed qualitative viewpoints in contextual features. Therefore, the nursing paradigm has made great contributions to the development of knowledge in nursing care...

[Applying the transtheoretical model to tobacco prevention education in adolescence: a literature review]

Hu li za zhi The journal of nursing, 2009

The Transtheoretical Model (TTM) is a contemporary psychological model of behavioral change emplo... more The Transtheoretical Model (TTM) is a contemporary psychological model of behavioral change employed to develop efficient interventions to promote healthy behavioral changes. Interventions can be individualized to the needs of individuals in order to achieve optimal results. No integrated plan currently exists in Taiwan for reducing cigarette use among children. This article presents a systematic review of TTM, with the goal of constructing a model for protecting teenagers against tobacco-related health risks. Analysis results are hoped to be useful as a reference for developing systematic interventions aimed at reducing the health risks posed to teenagers by cigarette smoking.

[Behavioral responses of an older woman receiving tocolysis after repeated failed pregnancies]

Hu li za zhi The journal of nursing, 2007

The purpose of this study was to explore the behavioral responses to tocolysis of an older woman ... more The purpose of this study was to explore the behavioral responses to tocolysis of an older woman who has experienced two failed pregnancies. As a participant observer the primary researcher simultaneously provided care and recorded the woman's verbal and nonverbal behaviors. After repeated data analysis, it was found that the woman's stress mainly resulted from her un certainty about a safe passage through pregnancy and about the health of her fetus. In her effort to ensure a successful pregnancy and good fetal health, she exhibited the following behaviors: worrying about the status of her pregnancy, adopting effective strategies to ensure the success of the tocolysis, complying with medical procedures and nursing instructions, establishing the time marks of the pregnancy for the purpose of self-encouragement, and attaching importance to oral intake for the sake of good fetal health. The article concludes that medical personnel should actively identify the needs of pregnant ...

[Application of empowerment in the organization]

Hu li za zhi The journal of nursing, 2006

Rapid changes in modern society require organizations to innovate and reform to keep up with and ... more Rapid changes in modern society require organizations to innovate and reform to keep up with and adequately address needs. A competitive organization must retain employees who are devoted to and satisfied with their work. Empowerment of employees by organizational managers is one way by which to motivate employees and thereby increase their productivity and effectiveness within the organization. This article presents meanings, contents, structures and models related to the concept of empowerment and the process of its application. An extensive literature review was conducted. Study results are hoped to provide to nursing leaders a reference in order to execute empowerment concepts effectively within their organizations.

The effectiveness of a relaxation training program for women with preterm labour on pregnancy outcomes: a controlled clinical trial

International journal of nursing studies, 2012

Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been publish... more Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been published on the effectiveness of relaxation techniques focusing on women with preterm labour. The object of this study was to examine the effectiveness of a relaxation training program on pregnancy outcomes in women experiencing preterm labour. A single-blinded, controlled clinical trial was used. The study was conducted in two hospitals. Both of the study hospitals located in northern Taiwan are also large teaching hospitals and share the same treatment protocols of preterm labour. Inclusion criteria were being pregnant and diagnosed with preterm labour, singleton, hospitalized at time of entry into the study, at gestation between 20 and 34 weeks, and having a cervical dilatation of less than 3 cm. Exclusion criteria were if they had one or any combination of the following: antepartum hemorrhage, infection, hypertension, gestational diabetes mellitus, or immunologic disease. The experimental ...

Taiwanese Women's Process of Recovery From Stillbirth: A Qualitative Descriptive Study

Research in Nursing & Health, 2014

The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanes... more The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth.

Evaluation of a caring education program for Taiwanese nursing students: A quasi-experiment with before and after comparison

Nurse Education Today, 2009

Background: Caring is an essential component in nursing curricula. However, how caring can be acc... more Background: Caring is an essential component in nursing curricula. However, how caring can be accomplished effectively has rarely been taught to nursing students. Objectives: To examine acceptability and preliminary efficacy of a caring education program for nursing students in Taiwan. Methods: Students were recruited to participate in a pre-post-test quasi-experimental study. Students self-selected into a control group (n = 33) or an experimental group (n = 35). The experimental group registered for a 13-week caring education program based on Watson's 10 creative factors through multiple teaching strategies. The Caring Behaviors Assessment (CBA) was used to collect data at weeks 1 and 13. Content analysis was used to reach the main descriptions of caring education from an experimental group of nursing students. Results: The experimental group reported a significantly higher score of caring behaviors after participating in the education program (t = 3.4, p = .00). The score of each CBA subscale in the experimental group was significantly enhanced from week 1 to week 13, except in the existential/phenomenological/spiritual dimension. Qualitative results supported that a caring education could help nursing students by building caring behaviors which could be adapted to clinical situations. Conclusions: The findings support the credibility of caring-focused teaching strategies and such focused caring programs are acceptable and show efficacy for nursing students.