23Rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Posters

World Nursing 2017 Page 148 Minju Kim et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Career maturity by self-esteem levels in Korean high school students Minju Kim1 and Ji Yeong Seo2 1Dong-A University, South Korea 2Catholic University of Pusan, South Korea

he purpose of this study was to examine career maturity in Korean high school students and identify factors associated with Tcareer maturity in the high self-esteem group and low self-esteem group. This study used the data from the Korean Welfare Panel Study, which was a national wide study and recruited samples by using the complex sampling method. A total of 496 high school students completed the survey, including career maturity, self-esteem, depression and anxiety variables regarding school life, and relationship with parents and friends. All data were analyzed with SPSS Ver. 23.0 by using complex sample analyses. In the results of bivariate analyses, gender, overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the low self-esteem group. However, school year, career consulting experience, overall grades, study stress, teacher attachment, parental participation in education and supervision, peer attachment, and depression and anxiety were associated with career maturity in the high self-esteem group. The results of logistic regression analyses showed that parental participation in education, peer attachment, and depression and anxiety were significantly associated with career maturity in the low self-esteem group, while career consulting experience, overall grades, teacher attachment, parental participation in education, and parental supervision were significantly associated with career maturity in the high self- esteem group. In conclusion, it is necessary to develop different programs by levels of self-esteem to enhance career maturity in high school students.

Biography Minju Kim has done her PhD degree from University of Illinois at Chicago in 2010. She is an Assistant Professor in Dong-A University in Busan, Korea. Her research areas are End-of-Life Decision Making and Elderly Care.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 149 Ji Yeong Seo et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Career maturity by self-esteem levels in Korean high school students Ji Yeong Seo2 and Minju Kim1 1Catholic University of Pusan, South Korea 2Dong-A University, South Korea

Biography Ji Yeong Seo has done her PhD degree from Kyungpook National University, Daegu, Korea. She is an Assistant Professor in Catholic University of Pusan.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 150 Emilia C Carvalho et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Assessment of reasoning diagnostic of nursing students in clinical simulation: The DTI contribution Emilia C Carvalho, Janaína G P Nunes and Diná Dalm Cruz University of São Paulo, Brazil

he aim of this study was to verify the difference in the diagnostic reasoning between sophomore and senior year undergraduate Tstudents in a clinical simulation, evaluated by the diagnostic thinking inventory (DTI). Nursing students participated individually in a high-fidelity clinical simulation (scenario+debriefing); the purpose was to evaluate the patient with sickle-cell disease, to diagnose an acute pain and to make appropriate interventions. The design and implementation of scenario was elaborated based in NLN/ Jeffries simulation theory. After simulation, they responded to DTI2, validated for Brazilian culture with nursing students and a semantic differential scale (6 points, score 41-246 points) was used to evaluate the flexibility in thinking (21 items) and structure knowledge in memory (20 items) which is presented as Cronbach's alpha for this sample. The scores of two groups of students were compared (total and two domains). Participants were 41 students, 90% female, mean age 23.8 years; 56% intermediate level. The average of the total DTI scores did not differ between groups (by Student's t Test; p=0.334). There was no difference between the mean responses for domain flexibility in thinking (by Student's t Test; p=0.125) and structure knowledge in memory domain (by U Mann Whitney test; p=0.765). The groups demonstrate similar performance considering the total and domains scores of DTI. Although the findings may reflect the performance of groups of students, given the sample size, similar studies are needed for new data to be integrated into these.

Biography Emilia C Carvalho is a Senior Professor of University of Sao Paulo. She was the Dean of the Ribeirão Preto College of Nursing, Brazil. She has interest in nursing education, nursing clinical, clinical simulation and nursing process.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 151 Yu-Ping Huang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Mothers’ lived experience in caring for children newly diagnosed with acute lymphocytic leukemia Yu-Ping Huang1, Yueh-Chen Yeh2 and Chen chun Fei3 1National Quemoy University, Taiwan 2National Taichung University of Science and Technology, Taiwan 3HungKuang University, Taiwan

cute lymphocytic leukemia (ALL) is the most common childhood cancer. Although advanced cancer treatments have significantly Aimproved the survival rate, parents of such children experience considerable stress when their children are diagnosed with the life-threatening illness, particularly 1 year within the diagnosis. Thus, this Taiwan-based qualitative study explored mothers’ caring experiences during 3 months to 1 year after their children were newly diagnosed with ALL. A Heideggerian phenomenological approach was adopted to explore meaning to the mothers caring for their children. Data collection involved semistructured interviews and a hermeneutic analysis was performed. Interviewees were 12 mothers. The interview content elucidated four main themes and eight subthemes: “Difficulty in associating cancer with their healthy child”, including seeking but not solving the problem and feeling troubled by the disease symptoms continuous; “Shock and fear after ALL diagnosis”, including the shock of having a child with a life- threatening disease and feeling frightened of critical and intensive medical interventions; “The need for time to deal with cancer in their life”, including the time to manage the sick child and familial emotions and conflicts and to accept and conduct the cancer care activities; and “Fighting for the child’s life”, including following health professionals’ recommendations and prioritizing the sick child and related treatments. The mothers were completely shocked when their children were diagnosed with ALL; however, they calmly followed the physician’s treatment protocol and changed their jobs to care for their children during this critical period to ensure their children’s life safety.

Biography Yu-Ping Huang has completed her PhD from Griffith University School of Nursing and Midwifery. She is an Associated Professor and teaches at National Quemoy University School of Nursing. She has published more than 20 papers in reputed journals and has been serving as a reviewer for international and national journals.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 152 Hsiu-Min Tsai et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Development of key dimensions of health literacy among multiethnic groups of women in Taiwan Hsiu-Min Tsai, Yu-Wen Chou and ChingYu Cheng Chang Gung University of Science and Technology, Taiwan

eveloping the key dimensions of females’ health literacy is critically important for providing appropriate evaluation instrument Dand improving health literacy in multiethnic groups of women in Taiwan. The purpose of this presentation is to report the strategies and results of development of the key themes and contents of females’ health literacy. Three strategies were applied including a literature review of Taiwan Health and Welfare Ministry‘s 2020 report, the content analysis of 600 females’ health websites and a modified Delphi survey. According to the review of the Health and Welfare Ministry‘s 2020 national health report and the analysis of the total of 218 effective websites from Google, Yahoo, Bing, Yam, 9 key domains and 98 content dimensions of females’ health literacy were extracted. Then, the two-round modified Delphi survey was conducted. Ten experts were invited and seven experts completed the survey and replied. Based on survey data analysis and expert adjustment, six themes and twenty-nine key dimensions were retained. The content validity of the experts was up to 0.80. The final key themes of females’ health literacy consist of menstruation, menopause, reproductive health, female’s cancer, women’s disease and gynecological examination. Based on the key themes and contents, an instrument of female’s health literacy will be designed and applied to investigate the health literacy in multiethnic groups of women in Taiwan.

Biography Hsiu-Min Tsai received her PhD in Community Health Nursing from the University of Texas at Austin, School of Nursing in 2005. She has worked at the Chang Gung University of Science and Technology, Taiwan as the Dean of Academic Affairs for 10 years. She has also worked as a Professor and was inducted as Fellow of the American Academy of Nursing in the US. She has conducted more than 10 international and national studies and has published more than 30 papers in reputed journals.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 153 Yoshiyuki Nagaya, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Health care for elderly people in rural Japan: Current position & future strategies Yoshiyuki Nagaya Kansai University of Social Welfare, Japan

Aim: Japan's elderly population, particularly in rural areas, relies heavily on health-medical-welfare services for its care. The establishment and monitoring of a comprehensive health care system is therefore critical to the future of Japanese care for elderly people. There is, however, little or no research into health-medical-welfare services and their provision in Japan. In fact, there is only limited knowledge of the issue with respect to Japan’s rural areas. In this review, we aim to identify the present state and challenges of the health care system and its role in advancing health care in rural Japan. By better understanding the current state of Japan’s health care system, efforts can be made to improve it and the quality of care for Japan’s elderly population. Methods: Electronic databases such as CiNii, ICHUSHI, PubMed, CINAHL and Google Scholar were searched to retrieve peer- reviewed primary research literature. A narrative synthesis of the findings sections of the papers was applied to identify key themes. These themes consider the relationship between different stakeholders in the comprehensive community care system: Medical care, Nursing care, Residence and home living support / Care prevention. Results: Eight papers were included in the review. Conclusions: The synthesis identifies that health-medical-welfare services in rural areas of Japan may prove effective if they are properly established, adequately managed, monitored and continuously improved. Although additional research is required to examine the issues with health-medical-welfare services, the studies undertaken to date highlight various problem areas with community health care in rural Japan.

Biography Yoshiyuki Nagaya was a registered nurse in Japan. At present, he is an assistant professor at Kansai University of Social welfare. Previously, he completed a Master of Health Services Management and planning at the University of Technology Sydney, Australia. He is concerned about health care for elderly people in rural Japan and the impact of this could have on the delivery of quality health care in Japan. This has led him to research the various issues contributing to difficulties in quality health care for elderly people in Japan.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 154 Shwu-Ru Liou et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Teaching nursing research course using flipped classroom pedagogy Shwu-Ru Liou, Ching-Yu Cheng and Hsiu-Chen Liu Chang Gung University of Science and Technology, Taiwan

o be a nurse of excellence, nursing students are expected to be prepared with the ability of identifying completed research Tevidence before graduation. However, students viewed research as boring, complex, and difficult to comprehend. It has been proposed that flipped classroom can provide students with student-centered leaning environment to meet students’ needs of learning. However, sparse literature exists on using flipped classroom pedagogy in nursing education. Therefore, the purpose of this analysis was to understand students' perception toward the flipped classroom teaching strategy applied in nursing research course. Design of the course includes three main parts: (a) curriculum, (b) teaching materials include electronic/non-electronic materials and complementary readings, and (c) learning assessments and outcome evaluations. A team was formed to establish the course design. In the end, pre-class videos; in-class tests and Q&A after tests; in-class large group literature reading, critiquing, and presenting; in- class small group discussion and writing; in general discussion; and oral presentation were activities used in classes. One-hundred- ninety-six students participated in the study. 96.4% of the participants were females and 53.4% would like to complete a task with others whereas 19.6% preferred to complete by themselves. Over 75% of students marked that the course design was flexible and easier in learning; could learn repetitively before and after classes; helped to understand and memorize; and had more time to discuss, ask questions and interact with instructors in class. Over 70% of students thought the course design helped them think independently and allowed them to concentrate on learning. 84.5% of students agree/strongly agree that the course was worth taking, 83.1% recommended the design used by other courses, 87.0% learned substantially from the course, and 70.1% perceived high achievement in the class. Students' stress level dropped from pre-class to post-class (t=-7.21, p<0.001). 58.7% of students thought that pre-class videos were the most helpful design for their learning. Flipped classroom appears to be a suitable pedagogy for nursing research course, especially pre-class videos provides students chances to self-learn repeatedly without time and space limits. The course design can be a reference for nursing educators when design courses specifically difficult courses.

Biography Shwu-Ru Liou has completed her PhD from the University of Texas at Austin, USA. She is currently teaching at the Chang Gung University of Science and Technology in Taiwan. She has been teaching for more than 20 years and has published more than 30 papers in reputed journals and conducted many researches. Her research interests focuses on nursing education, nursing administration, and women’s health.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 155 Ching-Yu Cheng et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Development of a nursing course to enhance clinical reasoning ability of students Ching-Yu Cheng, Shwu-Ru Liou, Hsiu-Chen Liu Chang Gung University of Science and Technology, Taiwan

ew graduate nurses were regarded as lacking of abilities in clinical reasoning or identifying/managing patients' critical situations Nin a quick and appropriate assessment and decision-making. This issue seriously compromised patient safety and emergency rescue. Therefore, this study purposed to develop a course to enhance nursing students’ competence in clinical reasoning, decision- making, and integrated case cares. To achieve the goal, we particularly emphasized recruiting faculties who must be comfortable with and understood the creative and challenging role of the teacher in this course, rather than traditional role of instructor. The team consisted of faculties in school, senior medical doctors and senior clinical nurse practioners who were qualified to lecture. Team members held weekly meetings to discuss and familiarize the course design including curriculum, contents, evaluation methods, and plans for implementation. The course included three major pedagogies: series and progressive case scenarios embedded with test questions, concept mapping, and team-based learning, which purposed to promote students’ ability in application of knowledge rather than the recall of isolated facts and increase students’ level of confidence and competence in diagnostic reasoning. To evaluate case scenarios, the most essential element of the course, three experts in emergency-intensive care or medical-surgical fields and owned an average of 9.2 years of clinical experience were invited. Results showed both the item and scale CVI were 1.0. In addition, all experts either responded with strongly agree or agree on questions asking about each scenario’s closeness to the clinical real situations, importance to clinical care learning, and meaningfulness to patient care learning. We compared test scores of 30 clinical nurses of more than two years of clinical experience and those of 30 student nurses. Results showed that the known-groups validity was confirmed (p<0.001). Score difference was also shown on the sub-sections of the scenarios: recognizing problems (p<0.001), diagnosing and differentiating urgency of problems (p<0.001), and managing problems (p=0.03). The two-week test-retest reliability was evidenced by nursing students' test scores (r=0.47). These findings indicated that the scenarios could adequately reflect the purport of clinical reasoning competence. The developed case scenarios apparently were close to real clinical situations and suitable for courses to enhance students' clinical reasoning ability.

Biography Ching-Yu Cheng has completed her PhD from the University of Texas at Austin, USA. She is currently a Faculty Member at the Chang Gung University of Science and Technology in Taiwan. She has published more than 30 papers in reputed journals and has conducted many researches. Her researches focused on women’s health including bio-behavioral studies and nursing education.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 156 Shu-Ming Chen, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Relationships among relocation stress, depression and glycemic control in type 2 diabetes Shu-Ming Chen Fooyin University, Taiwan

Purpose: To evaluate the relationships among relocation stress, depression and glycemic control in type 2 diabetes people in long term care facilities. Methods: This study used a cross-sectional descriptive correlation design with the purposive sampling method to recruit 126 elderly diabetic patients who had relocation to long term care facilities in one year. The modified Chinese version relocation appraisal scale (MC-RAS), depression (DASS-21) questionnaires and glycemic levels were used to measure outcomes. Results: The mean score of MC-RAS scales was 72.47 (SD23.85) and the standardized percentage were 62.47, which accounted for medium degree. In diabetes control, the mean of HbA1C after 90 days was 7.71(SD1.42), the mean of AC sugar after 14 days was 221(SD81.6). The result showed that diabetes was poorly controlled after admitted to long term care facilities. The involuntary relocating (r=0.34, p<0.05), low functional independence (r=0.66, p<0.05), poor health (r=0.25, p<0.05) and depression (r=0.25, p<0.05) associated with poor diabetes control. The significant predictors for diabetes control were low functional independence, which accounted for 67.7% of the total variance of diabetes control. Conclusion: High relocation stress and depression enhanced glycemic control levels. This finding could form a basis for caring people with type 2 diabetes and provide a reference for further research.

Biography Shu-Ming Chen has completed his PhD in 1998 from Griffith University and has worked on diabetes nursing care. She is an Assistant Professor of Nursing, Fooyin University of Nursing School. She has published more than 25 papers in reputed journals and more than 54 papers in international conferences.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 157 Y F Lien, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The care system of Taiwanese intergenerational caregiving of older people: Disruption and disharmony across the generations Y F Lien Meiho University, Taiwan

nternationally the family is pivotal to care systems designed for older people, especially in community-based care. Such systems Ifocus on the needs of older people and primary caregiver and fail to take account of other significant caregivers who contribute to and are affected by the caregiving experience. Similarly research also tends to focus on caregiver and care recipient dyadic relationship whereas, for example, in modern Taiwan changing family structures and increased life expectancy of older people has extended caregiving responsibilities beyond dyadic relationships across three or more generations. An unacknowledged aged care system has burgeoned, particularly in low income countries; reliant on intergenerational caregiving with its impact on families’ lives is unknown. A Taiwanese study aimed to explore the caregiving impact on families across multiple generations. Using a qualitative multiple case study design, 12 families (32 participants) were recruited through Taiwanese community services. Families represented three generations and included 11 frail older people; 3 spouse caregivers; 10 adult children; and 8 grandchildren caregivers. Data collection began with a genogram and eco-map to map individual participants support networks and relationships followed by individual semi structured interviews. To allow a more systematic and rigorous analytical process was used. Findings showed that the intergenerational caregiving experience was a dichotomous relationship between intergenerational disruption/disharmony and intergenerational connection/harmony. Disruptions were a result of divergent caregiving values as traditional and neo-filial norms collided leading to intergenerational disharmony. Families attempted to work around these differences by reframing the way they lived and cared to develop harmonious kinships. Formal care systems functioned on the assumption that families would provide care for the older person but contributed little to assist families maintain their expected roles. If health care services actively worked with these families then such disruption and disharmony which threatened their capacity to care could be ameliorated.

Biography Y F Lien has 10-years of experience as a Nurse and Practitioner in Acute Care Setting. In 2002, she commenced work as Lecturer in undergraduate and postgraduate nursing programs at Meiho University, Taiwan. In 2013, she completed her PhD at La Trobe University, Australia. Her research is in aged care with a particular interest in caregivers.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 158 Wen-Li Hou et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Understanding college students’ beliefs towards dating violence using the theory of planned behavioural Wen-Li Hou1 and Bih-Ching Shu2 1Meiho University, Taiwan 2National Cheng Kung University, Taiwan

ating violence frequently occurs within college students, but few examinations of their beliefs and perceptions about dating Dviolence have been conducted in Taiwan. The purpose of current study was to identify dating violence determinants for college students using the constructs of planned behavior theory. A qualitative study design using semi-structured interviews, guided by the theory of planned behavior, was used to obtain data from a purposive sample of college students. Participants were asked to identify salient beliefs underlying their attitudes (advantages/disadvantages), subjective norms (what people important to them would think), and perceptions of control (facilitators/barriers) regarding the intention of dating violence. Content analysis was used to analyze the data. Participants (n=10) were 2 male and 8 female aged between 18 to 22 year. Main advantages perceived of using dating violence were that dating partner obeyed me and I can vent pressure. Disadvantages included my relationship with him/her became worse or separated and is scolded by others. Important people who would approve were friends who were the same type as me. Important people who could disapprove were family and friends. Main facilitators were the dating partner’s bad attitude, disagreed with me, and mood out of control. Main barriers were other people present and dissuaded by important people. This study identifies salient beliefs underlying college students’ perceptions towards dating violence. These findings provide empirical evidences that might assist professionals in creating prevention and intervention programs for reducing dating violence among college students.

Biography Wen-Li Hou has completed her PhD at January 15, 2014 from Institute of Allied Health Sciences, National Cheng Kung University. She is an assistant professor at the Department of Nursing, Meiho University, Taiwan. Her research interests focus on intimate partner violence, women mental health, and psychiatric and mental health care.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 159 Shan-Mei Tang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Comparison of self-perceived nursing stress and resilience among intention to clinical nursing involvement among nursing students three types of nursing programs in Taiwan Shan-Mei Tang, Hui-Ling Wang, Li-Shu Tseng and Ching-Wen Chang 1Fooyin University, Taiwan 2Chang Gung University, Taiwan

Background: In Taiwan, there was only 58.7% registered nurses work in nursing practice. The high turnover rate of nursing staff led to lack of manpower, and the shortage rate of each hospital was 6.98%. The turnover rate of nursing graduating students was higher than general nursing staff (19.49% vs. 13.46%). How to retain the new nursing workforce is worth to inquire. Goals & Objectives: The aim of the study was to compare clinical practicum, self-perceived nursing ability and resilience, with an intention to clinical nursing involvement for nurse’s graduates. Methods: This study used a cross-sectional survey design. Participants were 247 nurses graduates (two-year college, n=45; four- year college, n=45; 5-year junior colleges, n=152) from a technology university in Taiwan. Data were collected by using structured questionnaires, including demographic data, self-perceived nursing stress, resilience and intention to clinical nursing involvement. The study was approved by the IRB board (NCKU HREC-E-105-090-2). Statistical methods included descriptive statistics, correlation coefficient and ANOVA analysis. Results & Outcomes: A total of 247 subjects, 12 male nursing students and 235 female nursing students, the average age of 20.4- 22.7 years old. There was no significant difference in nursing retention rate and nursing stress. However, emotion and optimism, emotional regulation and the total score of resilience were significantly different with intention rate in nursing. In the self-perceived nursing stress, the total score of stress (two-year college >5-year junior college; p=0.020); work load (two-year college >5-year junior college; p=0.009), work together (two-year college >5-year junior college; p=0.001) and deal with death, (four-year college >5-year junior college; p=0.022) have different educational systems reached a significantly difference. Discussions & Future Suggestions: This study found higher intention to nursing and resilience was significant. This study suggests that resilience intervention for nursing students focus on enhancing their intention to clinical nursing and increase the retention rate in future.

Biography Shan-Mei has completed her PhD from Kaohsiung University and Doctoral studies from three medical centers in Southern Taiwan. She is currently a Faculty Member in the Department of Nursing, Fooyin University in Taiwan.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 160 Chang-Chiao Hung et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nurses’ perspectives and experiences for involving patients to participate in patient safety activities Chang-Chiao Hung, RN1* and Hwey-Fang Liang2, RN2 Associate Progessor, Department of Nursing, Chung Gung University of Technology and Science, Chiayi Campus, Taiwan1, 2

Background: Patient participation in patient safety activity (PSA) has been identified as an effective strategy to improve patient safety in hospitals and the patient’s role in promoting safe care has already been affirmed internationally. However, little is known about professionals’ willingness and involvement of patients in their own healthcare activities. Purpose: The aims were to explore nurses’ perspectives and experiences of involving patients to participate in patient safety activities (PSA). Research design: This was a qualitative design. We interviewed nurses to understand their perspectives and experiences of participation in PSA. This study was conducted at a regional teaching hospital of 1,379 patient beds, located in the northern part of southern Taiwan. Because our study subjects were nurses who work in acute care units, the outpatient units, delivery rooms, operating rooms, intensive care units, and emergency departments were excluded from the study. The final number of eligible units is 12 and approximate number of registered nurses is 250. Nurses who have worked 1 year or more in these 18 units were our potential participants. Purposeful sampling will be used to identify and recruit participants from these 12 units. To aim for a focus group size of 4–8, as recommended by Kitzinger (2006), we try to recruit at least 2–3 nurses from each eligible unit. Nurses’ focus group discussions used a semi-structured interview guide and were conducted at a convenient time and place. Focus-group discussions for nurses took at least 40–50 minutes. A content-analysis approach was applied to the interview texts Result: Twenty-eight nurses participated in the study, and four categorie emerged from the focus group discussions. First, the nurses acknowledged that patients were valuable helpers if they received well training and got enough information in relation to their disease. That the nurses believe that patients have actual participation in their daily physical activities and treatment decision making is the second category. Risk reminder is the third category. Patient participation allows the nurses to rethink nursing care process or activities that avoid the adervse evens. The final category, admitting patients as interrupter, showed that patient participation obstruct nursing care process because of patients’ demographic characteristic, such as gender, age, or education. Conclusions: Nurses are paramount for involing paitnes to participate in PSA. To understand nurses’ perspective of patient participation allow health organizations to develop strategies to support nurses’ roles in patient participation. Eduction and policy design are seesntial to foster nurses’ pivotal role in ncouraging patient participation.

Biography Chang-Chiao Hung was born in Kaohsiung, Taiwan. She received her BSN from Emory University, USA, in 1997, MSN from University of South Alabama, USA, in 1999, and her Ph.D. in Nursing from University of North Carolina at Chapel Hill, USA, in 2011. She is currently an Assistant Professor of Nursing at the Chang Gung University of Science and Technology. Her research interests have been in the areas of patient safety, organizational behavior, and nursing education.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 161 Ming-Yueh Tseng et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Survival: Key components of effectiveness strategies and needs to assist transition from student to newly qualified nurse Ming-Yueh Tseng1, Shiow-Li Hwang2, Mei-Yao Ho1, Wei-Shu Lai3 and Shu-Yun Tu1 1Meiho University, Taiwan 2Asia University, Taiwan 3National Cheng Kung University, Taiwan

he purpose of this study was to explore work adaption for newly graduated nurses during their first year of nursing career. A Tqualitative approach with narrative inquiry to nurses who were graduated in 2014 and clinical preceptor with purposive sampling and snow ball sampling. A total 18 newly graduated nurses and 4 clinical preceptors were recruited, each one completed interviews between 1 to 5 times. The results derived from this study would share the knowledge about “phenomenon of adaptation”. Three stage of “phenomenon of adaptation” were: “challenge and changeable stage”, “grow up stage”, and “stabilization stage”. In “challenge and changeable stage“, the themes were revealed included a lack of support and belonging in clinical settings, insufficient career planning, insufficient nursing competences to handle various situations, challenge by various clinical situations, a lack of communication skills, value of nursing, clinical reasoning, and self-confidences. In regard to “grow up stage”; most new nurses were struggles with multiple work stress, caring severe patients and highly difficulties, and adjust the time lag with night shift. In “stabilization stage”; new nurses presented with confidence to nursing profession, recognize the hardness and achievement, fulfilled thankfulness, however, due to the hardness in nursing profession, some of them started to exam nursing career critically. The competence and preparation for newly graduated nurses would be in summed with 8 letters of alphabet: “SURVIVAL” which were “S (support network)”, “U (useful tailored plan)”, “R (resilience)”, “V (vivid scenario)”, “I (interdisciplinary communication)”, “V (value of nursing)”, “A (adjusting to environment)”, and “L (learning by doing)”. In suggestion, nursing school should reform curriculum, teaching strategies, and clinical practicum to enhance nursing students’ clinical competence and preparation.

Biography Ming-Yueh Tseng has completed her PhD in Nursing from Graduate Institute of Clinical Medicine Chang Gung University. She is an Assistant Professor in Mei-Ho University in Taiwan and has done her specialty is in Nursing Education and Long-Term Care.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 162 Myung-Haeng Hur et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Effects of aromatherapy essential oil inhalation on sleep quality of patients in intensive care unit Myung-Haeng Hur and Eun Hee Cho College of Nursing, Eulji University, South Korea

Purposes: Patients admitted to the intensive care unit are surrounded by noise from the intensive care unit, many medical staff, and various mechanical devices. Patients experienced the stress and sleep disability due to fear, uncertainty about prognosis, isolation from family, and economic burden. The aim of this study was to examine the effects of aromatherapy on nursing interventions to improve stress and sleep quality in ICU patients. Methods: This study is a non-equivalent, pretest-posttest study. The subjects were adult patients with clear consciousness who spent at least two nights in the ICU. Approval from the Institutional Review Board at the University hospital was obtained prior to data collection. Aromatherapy for the experimental group consisted of inhalation of essential oil. Stress and sleep quality were measured on pre-tests and post-tests. Homogeneity of the general characteristics between the two groups was analyzed by using the χ²-test and t-test. Post-treatment effects were analyzed with the t-test, repeated measures ANOVA, and ANCOVA. Results: The perceived stress (F =148.43, p<.001) and the stress index (F=52.91, p<.001) in the aromatherapy group were significantly lower than those in the control group. The quality of sleep in aromatherapy group were better than that in control group (F = 107.80, p< .001). Conclusion These findings suggest that aromatherapy alleviated ICU patients’ stress and improved sleep quality for the two days studied. Therefore, aromatherapy may be an effective nursing intervention for both stress relief and improvement of sleep quality of ICU patients. Keywords: Stress, Sleep, Aromatherapy, ICU

Biography Myung-Haeng Hur has completed her PhD at the age of 40 years from Catholic University. She is the professor of college of Nursing, Eulji University in South Korea. She is aromatherapist, trained in IFPA. She has published more than 60 papers in reputed journals and has been serving as a reviewer member of Journal of Korean Academy of Nursing. Eun Hee Cho is a graduate of Eulji University. She was nurse in Eulji University Hospital.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Comparing the differences of social resources knowledge of two-year RN-BSN nursing students with and without learning long-term care courses Ya-Wen Kuo Chung Hwa University of Medical Technology, Taiwan

ccording to the WHO estimation, old people aged 65 years and over account for approximately 80% of the entire disabled Apopulation. Disability in older people is often accompanied with multi-morbidity, and they have the social resources needs of continue care with long-term care. Therefore, the training courses of long-term care was important for BSN nursing students in nursing education. The purpose of this study was to compare the differences of social resources knowledge of two-year RN-BSN nursing students with and without learning long-term care courses. Methods: A quantitative design was selected to explor their social resources knowledge compared among two-year RN-BSN nursing students with learning long-term care courses, and two-year RN-BSN nursing students without learning long-term care courses. A convenience sample N = 114 included 78 learning course students, and 36 non-learning course students. The learning course group received a 18 weeks lon-term care education (2 hours per week). The control group were not participate long-term care training. Research tools include social resources scale of long-term care to assess knowledge of sercice items (KSI), knowledge of sercice subjects (KSS), knowledge of financial subsidy(KFS), and knowledge of application conditions for service items (KAC). Results: It was found that the total score of knowledge was significantly different (Mean = 29.06, SD = 6.01, p<.05). The score of KSI ( Mean = 11.7, SD, 2.87, p<.05 ), KFS ( Mean = 6.17, SD = 3.15, p<.05), and KAC ( Mean = 8.23, SD, 2.26, p<.05 ) were increased significantly different (p<.05) for the learning course group at the end of the training, as compared to the control group.The KSS (Mean =2.96, SD, 0.96, p>.05) was not significantly different. Conclusions: The results demonstrated that long-term care courses was necessity in nursing education before students become a clinical nurse. We suggest that the long-term care course should be a required courses for the pre-knowledge of long-term care needs of elderly society.

Biography Ya-Wen Kuo is an assistant professor of department of nursing at Chung Hwa Uiversity of Medical Technology. She received Ph.D. in nursing from National Cheng Kung University of Taiwan. Her research focuses on the issue with long-term care and community health care. She has served for the past fifteen years in the medical center of Chuanghua Christian Hospital (1999-2014) in Taiwan. As supervisor of community medical and nursing department. In 2013, she was awarded a Medical Contribution Award of Changhua County for outstanding contribution to promoting community health. In 2014, she was also awarded the Health Promotion Contribution Award of Health Promotion Administration, Ministry of Health and Welfare, Taiwan.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

A survey trial of long-term care need in rural eastern Taiwan- Encompassing interrelated long-term care scheme set up Yu-Chin Tai Mennonite Christian Hospital, Taiwan

Abstract: The issues on aging have been drawing attention since Taiwan became an aging society.The study be focused on the operation & practice of elderly care of one local hospital settings in eastern Taiwan, having organized and analyzed their databank retrospectively over their sociodemography, health status or background [co-morbidity index by Quan(CCI-Q) & 16 morbid conditions accelerating or pre-matured aging decay], certified status of the disabled, and their long-term care (custody) needs(LTCN; ADLs & IADLs), for some description, correlation and regression ultimately, concurrently reflecting the suitability of current scheme in Taiwan.The result showed,there had been various areas with different urbanization levels in Taiwan, the study here could showed it just in an instance. However, currently in Taiwan, it seemed those with higher disability or LTCNs leveling might stay in urbanized zones, and with care-worker (i.e. good service utilization)；conversely, those with under urbanized areas, living alone, undernourished(i.e. insufficient service utilization), those with lower disability or LTCNs leveling staying in sub-urbanized or undernourished zones. And certainly, still no definite or clear causal relationship or dependence linkage can be elucidated. Thus, originally it has been infeasible or with difficult to attain or implement the goal of “age in place” somewhere, and rather, mandatorily with strong reviewing and well- discussion on/to need/supply and resources allocation with uncertain-basis to LTC policy/ tactics contemporarily.

Biography I work as the director of long-term care department at Mennonite Christian Hospital in Taiwan. For around 21 years of experiece in registered nurse, I had worked in orthopedic ward, home care, discharge planning and telecare center. In the last decade, I dedicade to long-term care and have got the master degree from the institute of Long-term Care at National Taipei University of Nursing and Health Sciences in 2016.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Clinical practice guidelines on the assessment and management of complementary and alternative medicine use Hsiao-Yun Chang Fooyin University, Taiwan

linical practice guidelines (CPG) on the assessment and management of complementary and alternative medicine (CAM) use Care both poorly developed and ineffectively implemented. Lack of this guideline goes against nurses from successfully assessing CAM into the management of patient care and appropriately providing evidenced-informed decisions. To achieve the development and implementation of clinical practice guideline, the aim of this study is to develop evidence for recommendations, assessing the benefits and harms of CAM use, and developing clinical algorithm based on the best available evidence for point-of-care decisions. The review method was employed by systematically gathering scientific evidence and formulating recommendations using the GRADE (grading of recommendations assessment, development and evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations. The recommendations were informed by a body of evidence, the overall quality of evidence for each outcome and for all outcomes were rated after a combined judgment about confidence in estimates of effect. The recommendations included the benefits and harms of CAM and the criteria for clinical algorithm for the use of CAM among people with diabetes. The guideline provides support for diabetes nurses to facilitate the assessment of patients’ CAM use in clinical practice and improve communication between patients and nurses which, in turn, reduce the risk of potentially harmful interaction between CAM and conventional medicine, improve trust in the patient-nurse relationship and provide more appropriate and holistic nursing care.

Biography Hsiao-Yun Chang received her PhD degree in Nursing from Griffith University, Australia, in 2008. Since then, she has been working in the Department of Nursing in Fooyin University, Taiwan, where she was an Assistant Professor and became an Associate professor in 2013. Her current research interests include adult nursing, complementary and alternative medicine and diabetes and she has published more than 25 papers in reputed journals.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The experiences of adolescent substance use initiation and patterns of use in Taiwan Hwey-Fang Liang1 and Kuang-Ming Wu2 1PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan 2EdD, Assistant Professor, College of Education, Department of Early Childhood Education, National Chiayi University, Taiwan

Background: Betel nut is a familiar masticatory substance used in Far East Asia areas. In Taiwan, betel nut chewing is one of the major reasons which caused oral cancer. Purpose: The purpose of this study was to examine experiences of adolescents’ first experiences of using and chewing betel nuts. It included patterns of use and how and when started in order to explore circumstances, context of early substance use, and patterns of use it. Based on the finding, researchers may develop strategies to prevent risks of substance use for other young people. Methods: An interpretive qualitative design was chosen. Semi-structured interview guide and focus groups were completed with twenty participants who had Betel nut chewing in Taiwan. Data was analyzed by content analysis. Results: Results indicated four main themes: (1) being curious (a) being a handsome guy, (b) different with other peers (2) the same as my friends (a) my good friends had chewing, (b) easy to communicate with peers (3) full of spirit while chewing (a) for relax and loose (b) delight with peers. (4) grown up (a) same as families, or elders (b) can do what little child cannot compete. Conclusions: Research suggests that interventions targeting for this population should focus on improving parental or family education toward adolescent substance use and efforts to increase interventions for adolescents from the high-risk families.

Biography Dr. Hwey-Fang Liang came from Taiwan. She completed her Ph.D. in the School of Nursing of Duquesne University, PA, USA. She is an Associate Professor in the Department of Nursing in Chang Gung University of Science and Technology in Taiwan. She has published more than 40 papers in reputed journals with English and Chinese and still concentrate herself in nursing research.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Developing a clinical practice guideline in long-acting antipsychotic intramuscular injection Mei-Ling Lin1,2, Ya-Wen Gou3, We-Li Ho4 and Jin-Chih Chang5 1Tsaotun Psychiatric Center, Ministry of Health and Welfare, Taiwan 2Central Taiwan University of Science and Technology, Taiwan 3Chung Hwa University of Medical Technology, Taiwan 4Meiho University, Taiwan 5Jen-Teh Junior College of Medicine, Taiwan

Background: Long-acting antipsychotics injection (LAIs) is a well-established and common treatment for mental illness. Routinely, nurses are required to make numerous decisions regarding factors during injection process but the clinical practice guidelines (CPG) are not well developed in Taiwan. Purpose: The purpose of this study was to establish the process of nurses’ injection in implementing CPG to provide nurses refer in clinical practice. Methods: This study was completed through two stages. Based on the problems of clinical practice, a systematic review of the literature was conducted on studies published till March 2016. The following electronic databases were searched: CINAHL, Medline, Cochrane Library, PubMed, Joanna Briggs Institute, PsycINFO, EMBASE, and EBSCOhost for review. Then, two sessions of Delphi methods were conducted to understand experts' experiences with 8 Taiwan psychiatric nursing experts. The CPG was verified by experts of clinical methodology. Results: Based on the injection process 17 issues were developed in CPG of LAIs. All of issues of CPG was deleted the items with agreement lower than 75% after Delphi method and finally obtained 16 issues. The CPG was recommended to clinical practice by psychiatric nursing experts and evaluated by three methodology experts for CGP quality. Conclusion: It is important to update the guidelines that are available to assist nurses to make informed decisions about the injection techniques. Nurses should be encouraged to renew the injection knowledge for patient quality of care.

Biography Mei-Ling Lin has completed her PhD from the Institute of Allied Health Sciences of Medicine, College of National Cheng Kung University in Taiwan. She is a Psychiatric Head Nurse in Tsaotun Psychiatric Center of Ministry of Health and Welfare in Taiwan and is an Assistant Professor of Nursing department in Central Taiwan University of Science and Technology. Her research interests are in psychiatric nursing and clinical ethics issues.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

What do nursıng students know and practıce about complementary and alternatıve therapıes? Yasemin Altınbas* and Emine Derya Ister* *Adıyaman University School of Health, Nursing Department, Adıyaman, Turkey

Introduction: Today, many healthy individuals and patients use complementary therapies to improve health, to prevent diseases or to support medical care and treatment in the presence of medical conditions. As a result of the increased interest of the people in complementary therapies, nurses, as healthcare professionals and members of healthcare teams who are to meet healthcare demands of the society, are now inevitably required be involved in provision of complementary therapies. Complementary therapies, therefore, may be regarded as one of the roles of professional nurses with academic background and scientific problem-solving skills, within the context of independent nursing concept. Aim: This study was conducted to determine knowledge levels and practice stituations about CAT of nursing students. Methods: The study was conducted in a Health School of state university in Turkey. The sample of the study was 303 nursing students. The data collected by using questionnaire that was developed by researchers. Descriptive statistics and chi-square test were used in the study. Results: The mean age of the students were 20.59 ± 2.33. 63.8% of the students were female, 91.2% were not trained for CAT, and 33.6% were not interested in CAT. The students that used one of the CAT methods were 31.4%. 66.9% of the students stated that they wanted the education program for CAT to be added to the nursing curriculum. 53.5% of the students stated that CAT was as effective as medical treatment, and 65.7% stated that they should not be used without consulting the doctor. The students had no knowledge about CAT methods: 81.2% of ayurveda, 81.1% acupresure, 78.4% reiki, 72.6% reflexology, 71.5% taichi, 66.4% aromatherapy, 64.3% homeopathy, 63.3% fengshui, 59.5% osteopathy, 57.2% ozone therapy, 54.6% therapeutic touch, 44.0% color therapy. 39.8% of male students and 27.6% of girls thought that CAT methods should be used as a last choice and the difference between the two rates was significant (p <0.05). 38.7% of the female students and 25.2% of the male students thought that CAT methods should be used in consultation with the doctor and the difference between the two ratios was statistically significant (p <0.05). Conclusion: According to this study, information on complementary therapies and their areas of use should be included in nursing curriculums and nurses should be updated on these therapies through in-service trainings. In line with the results of this study, it is recommended that nurses carry out scientific studies on complementary therapies, investigate the benefits and possible side effects of these methods, and inform the healthy/sick person and/or his/her family and the society.

Biography Yasemin Altınbas has completed her PhD from Ege University Institute of Health Science. She had worked in Ege University Faculty of Nursing, as a Research Assistant between 2011-2016. She is working as an Assistant Professor at Surgical Nursing Department in Adıyaman University School of Health-Turkey.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Survival: Key components of effective strategies and needs to assist transition from student to newly qualified nurse Shiow-Li Hwang2 , Ming-Yueh Tseng1, Mei-Yao Ho1, Wei-Shu Lai3 and Shu-Yun Tu1 1Meiho University, Taiwan 2Asia University, Taiwan 3National Cheng Kung University, Taiwan

he purpose of this study was to explore work adaption for newly graduated nurses during their first year of nursing career. A Tqualitative approach with narrative inquiry to nurses who graduated in 2014 and clinical preceptor with purposive sampling and snow ball sampling was done. Total 18 newly graduated nurses and 4 clinical preceptors were recruited, each one completed interviews between 1 to 5 times. The results derived from this study would share the knowledge about the phenomenon of adaptation. Three stage of phenomenon of adaptation were: challenge and changeable stage, grow up stage and stabilization stage. In challenge and changeable stage, the themes revealed include a lack of support and belonging in clinical settings; insufficient career planning; insufficient nursing competences to handle various situations; challenge by various clinical situations; a lack of communication skills, value of nursing, clinical reasoning, and self-confidence. In regard to grow up stage- most new nurses struggle with multiple work stress, caring severe patients and high difficulties, and adjust the time lag with night shift. In stabilization stage- new nurses presented with confidence to nursing profession who recognize the hardness and achievement, fulfilled thankfulness, however, due to the hardness in nursing profession, some of them started to take nursing career critically. The competence and preparation for newly graduated nurses would be in summed with 8 letters of alphabet: “SURVIVAL” which were “S (support network)”, “U (useful tailored plan)”, “R (resilience)”, “V (vivid scenario)”, “I (interdisciplinary communication)”, “V (value of nursing)”, “A (adjusting to environment)”, and “L (learning by doing)”. In suggestion, nursing school should reform curriculum, teaching strategies, and clinical practicum to enhance nursing students’ clinical competence and preparation.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The effectiveness of strength training on body composition and physical performances among older people with sarcopenic obesity Shu-Fang Chang1, Shu-Ching Chiu2 and Hui Chen Lee1 1National Taipei University of Nursing and Health Sciences, Taiwan 2Central Taiwan University of Science and Technology, Taiwan

Statement of the Problem: With the coming of aging society, international groups have also developed the name of “sarcopenic obesity” for people with both sarcopenia and obesity. Previous studies showed that, the best method for improving sarcopenic obesity is exercise and nutrition. However, there has not been any study investigating elderly residents in LTC facilities with higher complication. Purpose: To understand the change in body composition and physical functions of elderly residents with sarcopenic obesity after the implementation of exercise intervention. Methodology & Theoretical Orientation: This quantitative, interventional study implements exercise intervention in elderly residents. The intervention will be implemented for 3 months. The obesity index and bioelectrical impedance analyzer (BIA) will be used in the pretest to screen the elderly residents with sarcopenic obesity. Afterwards, the elderly residents with sarcopenic obesity are randomized to the experimental group and control group. The study will analyze the variables including body composition index (lean mass, fat percentage and skin fold thickness analysis), the blood analysis (albumin, lipoproteins and cholesterol), body strength and muscular endurance function measurements (grip strength and the arms lift) and a comprehensive daily living activity functions (daily living activities and quality of life). Findings: Subjects’ attributions and correlation of the body composition index, composed of the body of blood, the performance of muscle strength and muscle endurance and comprehensive daily living functions among the group of sarcopenic obesity were significant. Conclusion & Significance: The experimental group after the implementation of interventions three months in measurement of body composition and physical function performance of sarcopenic obesity were improved. The results could be used to improve the reference plan of intervention in order to improve physical function and quality of life of the elderly people in facilities.

Biography Shu-Fang Chang is a Professor, School of Nursing at the National Taipei University of Nursing and Health Sciences, Taiwan. .

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Parenting behaviors in self-management of children with type 1 diabetes Chi-Wen Chang1,3, Shiaw-Ling Wang2, Yueh-Tao Chiang1,4, Hsing-Yi Yu1,5, Fu-Sung Lo3,6, Ya-Fen Wang7, Hui-Hsien Hsieh1 and Chi-Ming Chu8 1School of Nursing, Medicine of College, Chang Gung University, Taiwan;2 School of Nursing, Chung Shan Medical University, Taiwan;3 Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, Taiwan; 4Division of Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital, Taiwan; 5Department of Ophthalmology, Chang Gung Memorial Hospital, Taiwan; 6 College of Medicine, Chung Gung University, Taiwan; 7 College of Nursing, Kent State University, USA;8 Section of Biostatistics and Informatics, Department of Epidemiology, School of Public Health, National Defence Medical Center, Taiwan

Abstract: Self-management is one of the most important daily routines in the family of children with type 1 diabetes. Though, it involves not only the child, the mother’s role is even more complex and important. In the light of developmental needs of school-age children, studies on mothers’ parenting behaviors in self-management of diabetes are requiring. Since parenting is affected by social contexts, the main purpose of this study is to understand mothers’ parenting behaviors for children with type 1 diabetes in Taiwan. In-depth interviews were conducted in a purposive sample of 10 mothers of school-age children with type 1 diabetes. The mothers aged from 33 to 49 and average year of diabetes of the children was 4.1 years. There were a total of 4 boys and 6 girls at the age of 7-12. The data were processed by content analysis. Seven parenting behaviors were found: “persuading children with affection and rationality,” “positive encouragement,” “creating new situations, “exchanges,” “punishments,” “self-reflection,” and “instruction and demonstration.” The research results would enhance the understanding of parenting behaviors in self-management of children with type 1 diabetes and also provide references for developing nursing intervention in caring the children with type 1 diabetes and their families. Keywords: Type 1 diabetes, school-age children, self-management, parenting behaviour

Biography Chi-Wen Chang is an assistant Professor at Department of Nursing, College of medicine, Chang Gung University, Taiwan (R.O.C.). Her research interests are in issues of children with type 1 DM. She has published more than 10 papers in well-known journals.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Lived experiences of caregivers’ caring for their children with congenital heart diseases in Taiwan Su-Fen Cheng1, Wen-Yen Jian2*, Ju-Min Yu3, Jing-Jy Wang4 and Chu-Yu Huang5 1 National Taipei University of Nursing and Health Science, Taiwan, R.O.C. 2 Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C. 3 Taiwan Adventist Hospital, Taiwan, R.O.C. 4 National Cheng-Kung University, Taiwan, R.O.C. 5 Cederville University, Ohio, USA

Background: Congenital heart disease (CHD) is the most common type of birth defect that impacts the structure and function of the heart. In Taiwan, the mortality rate of CHD is higher than the rate in the U.S. (Yeh, et al., 2013). Primary caregivers for children with CHD may experience significant emotional impact such as worry toward their care for the children. However, only few studies in the literature that investigated on caregiver’s experience of caring for children with CHD at the home setting. Purpose: The purpose of this study was to understand the primary caregivers’ lived experience of caring their children with CHD at the home setting. Method: This descriptive qualitative study involved semi-structured interviews of 16 primary caregivers of children with CHD. An interview guide was used to guide the interviews. The average age of the caregivers were 39.07 years of age. Colaizzi's (1978) strategy of descriptive phenomenological data analysis were used to extract themes. Results: Six themes were extracted from the interviews including close observation of children’s physical changes, attempt to normalize life of the children, lack of home care resources and knowledge, worry about the impact of CHD on major life events, economic burdens, and needs for social support. Conclusion: The findings of this study provide insight into the lived experiences of primary caregivers as they care for children with CHD. Healthcare providers are encouraged to provide care knowledge and pertinent resources through innovative strategies to the caregivers who care for children with CHD.

Biography Dr. Su-Fen Cheng has earned her PhD in 2002 from University of Colorado Health Sciences Center. She used to teaching nursing students since 1994. Currently she has transferred her teaching from nursing department to Graduate Institute of Health Allied Education. She has promoted to full professor in 2016 and served as a director at Graduate Institute of Health Allied Education at National Taipei University of Nursing and Health Sciences in 2017.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The effect of an elastic-band resistance training exercise on lower limb muscle endurance among older adults Huey-Shyan Lin1 and Chia-Hui Kuo2 1Fooyin University 2Mackay Junior College of Medicine, Taiwan, ROC

Background: Good training of lower limb muscle endurance can prevent and postpone the occurrence of fall, reduce the risk of mortality, and increase the ability of independence and autonomy in daily-life activity among older adults. Objectives: The study aimed to test the effect of an elastic-band resistance training exercise on lower limb muscle endurance among older adults. Methods: The study adopted a two-group pretest-posttest quasi-experimental design. A convenience sample of community-dwelling older adults aged 65 and over in Beitou District of Taipei City, Taiwan was recruited. The 200 participants were assigned into the experimental and wait-list control group based on their own will. The baseline data of BMI, waistline, and body fat ratio were measured. The intervention of an elastic-band resistance training exercise was conducted at least one time per day at 60 minutes per practice session for one week. The 30-second chair stand test was evaluated at baseline and at the end of the study. Results: Controlling for the covariates significantly different in the baseline between two groups, the 30-second chair stand test of participants in the experimental group significantly increased 2.31 times than that of the participants in the control group at the end of the intervention (p < 0.001). Conclusions: It is recommended that elastic-band resistance training exercise be promoted in the community to improve lower limb muscle endurance in older adults. Keywords: Older adults, resistance training, lower limb muscle endurance.

Biography Huey-Shyan Lin is an associate professor of department of Health-Business Administration, school of nursing at Fooyin University in Taiwan. She received the Ph. D. in health services policy and management from University of South Carolina, USA. She now serves a consultant of Research and Development, Department of Health, Kaohsiung City Government, and research consultants of several hospitals, Taiwan, R.O.C. She also possesses a good publication record in nurse depression, stress management, health promotion, instrument development, and clinical medicine. Her biography was included in Who’s Who in the World 2014- 2016, and Who's Who in Science and Engineering® 2016-2017.

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Page 174 Shuyuan Chao, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Innovation of training program to enhance clinical nurse instructors’ teaching efficacy project Shuyuan Chao Hungkuang University, Taiwan

he purpose of this project was to develop, implement and evaluate the workshops for CNIs to facilitate with CNIs’ teaching Tpractices in clinical situations. The project included a series of workshops, which were conducted in the year of 2015. In total, there were 109 CNIs participants from three nursing schools in Middle Taiwan. The workshops were implemented in small groups which were programmed by CNIs’ expertise and were facilitated by a senior faculty for each group. Based on the adult learning theory, we set a supportive and cooperative climate for the CNIs’. The workshops were implemented in sequence every two months, as follows, (1) Introduction of facilitating group and assess CNIs’ needs, (2) challenges of clinical teaching, (3) communication between student nurses and CNIs, (4) how to provide supportive environment for student nurses; and (5) innovative teaching strategies development. The CNIs share their experiences with each other in the group and the CNIs were encouraged to upload their experiences and opinions on the website we made for communicating and exchanging ideas. A self-administered structural questionnaire including five dimensions, i.e. “environmental transformation”, “innovative teaching”, “communication”, “ implementation of teaching” and “evaluation of learning performance”, was administered at the beginning and at the end of the project to evaluate the effectiveness of this project. 94 innovative teaching plans/strategies were developed by the CNIs. The CNIs’ teaching efficacy showed significant improvement after participating in the program, and achieved statistical significance. The program enhanced the CNIs’ teaching efficacy and facilitated to develop an innovative teaching plan.

Biography Shuyuan Chao has completed her Doctoral degree in 1997 from University of San Diego, School of Nursing. She is a Professor in Hungkuang University. She is also the Director of Nursing department in the Hungkuang University, and an Associate President in Chung Gung Institute of Nursing in Taiwan. She has published more than 20 papers in reputed journals and has served as an Editorial Board Member of Journal of Nursing, Journal of Medical Informatics, and Journal of Science Education.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Improving teaching integration between academic and nursing practice: The roles of clinical educators Miaofen Yen National Cheng Kung University, Taiwan

he integration between didactic teaching and clinical practice is an important task in nursing profession. It is expected that Tnursing students would be prepared as a clinical nurse upon their graduation from a nursing program. The challenge for nursing faculty is to bridge the classroom teaching and clinical works. This paper is to present a model of using clinical educators for the integration teaching and learning among nursing students. Nursing students often faced problems with practical performance when taking their practicum in a hospital setting. They have learned didactic courses in classroom teaching. To integrate their knowledge at clinical setting, students may often need help by staff nurses. However, not all staff nurse learnt how to teach novice students. The roles of clinical educator were created and implemented to help students to learn. A series of training program was designed and implemented upon the development of the roles of clinical educators. Staff nurses who are interested in clinical teaching were recruited to the training program. The program included knowing the students characteristics, how to guide college students in clinical setting, assignments, communication, and evaluation. The program lasts for two years. Meanwhile, a mentor with didactic and clinical teaching experience guided the trainee through the training courses. Evaluations were done by multi-perspective, from students, coworkers, and the administrators. The results indicated that the roles of clinical instructors would facilitate the integration between academic and clinical for nursing students.

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Page 176 Pao-Chen Lin, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The effect of cardiopulmonary resuscitation training on the knowledge, attitude, and willingness of nursing students Pao-Chen Lin National Tainan Junior College of Nursing, Taiwan.

ardiopulmonary resuscitation (CPR) has become an integral part of hospital practice, but poor knowledge and skill retention Cfollowing cardiopulmonary resuscitation training for nursing students has been documented in previous study. CPR training is necessary for nursing students and is important as future nursing practitioners often discover the victims of in-hospital cardiac arrest. The present study was performed to identify the effectiveness of CPR Training on the knowledge, attitude, and willingness of nursing students in performing CPR. A quasi-experimental design was employed in the study, and 169 nursing students from a nursing school in southern Taiwan were recruited. These participants were cluster randomized into an experimental group, which received a 4-hour CPR training curriculum, and a control group, which did not receive any intervention. After the training, there was significant improvement in participants' CPR knowledge (P < .001), but scored significantly lower in CPR willingness than they did before receiving the training in experimental group (consisting of 85 participants). However, no significant differences were observed in the control group when their pretest and posttest results were compared. Compared to the control group, the CPR training program could significantly enhance the knowledge of CPR but decrease in CPR willingness among the experimental group. Therefore, we suggested that additional incident management with positive outcomes should be introduced in first-aid training courses to enhance the attitude and willingness of nursing students employing CPR skill.

Biography Pao-Chen Lin has completed her PhD at the age of 43 years from Kaohsiung Medical University. She is a RN, associate professor, and the director of Nursing department, National Tainan Junior College of Nursing. She has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute. Her passion lies in caring for quality of life among the elderly.

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Page 177 Li-Man Lin et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The mediator effect of social support between burden and quality of life among caregivers of children with cerebral palsy Li-Man Lin, Su-Fen Cheng, Wei-Wen Wu and Kuan-Chia Lin 1MacKay Memorial Hospital ,Taiwan 2National Taipei University of Nursing and Health Sciences,Taiwan

hildren with cerebral palsy often requires long-term home care by the primary caregivers, which results in great burden on the Cprimary caregivers and thus impact their quality of life. However, only limited studies have explored on the mediating effect of social support on the primary caregiver’s care burden and quality of life. This study used cross-sectional descriptive correlational design. Total of 120 primary caregivers for children with cerebral palsy participated in this study. The results showed: (1) six variables were identified as the predictors for the primary caregivers’ quality of life: CP children did not receive schooling, CP children’s attendance of the special education class in regular schools, primary caregivers’ experiences of severe family dysfunction, total care burden, need for social support and sufficiency of social support. The above six variables were significant in predicting the primary caregivers’ quality of life (F=12.37, p<0.001) with an explained variance of 58.1%; (2) Baron and Kenny’s mediation analysis revealed that “level of needs for social support”, “level of sufficient social support received”, “level of need for material support”, “level of sufficient social support received” and “level of sufficient emotional support received” produced mediating effects on the primary caregivers’ care burden and impacts on the primary caregivers’ quality of life. Sobel test analysis indicated indirect effect and was statistically significant (p<0.05). The researchers suggest further assessment needs to be conducted on the fulfillment of the social needs and social support among the CP children’s primary caregivers.

Biography Li-Man Lin is a Head Nurse at Pediatric Intensive Care Unit of MacKay Memorial Hospital in Taiwan.

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Page 178 Hui-Chen Huang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The perception of nursing students’ cultural care Hui-Chen Huang1, Kuang-Ming Wu2 and Hwey-Fang Liang3 1Master student, Department of Nursing, Fooyin University, Taiwan 2EdD, Assistant Professor, College of Education, Department of Early Childhood Education, National Chiayi University, Taiwan 3RN, PhD, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan.

Background: Due to the increasing of cultural diversity among clients’ populations, nursing education area is impacted and nursing students were confronted new challenges. Therefore, exploring and preparing nursing students to provide competent care for the increasingly heterogeneous immigrant populations, is an important education goal. Objective: To explore the perceptions of nursing students’ cultural conflicts and adequate cultural care. Method: Qualitative research method was conducted in this study. A purposive sample of sixteen nursing students was selected to participate in in-depth audio-taped interviews. A semi-structured interview guide was applied to explore and obtain the data from participants. Data were analyzed by applying Colaizzi's (1978) method as a qualitative content analysis. Results: Nursing students’ perception of cultural conflicts and adequate cultural care providing were generalized in 4 themes: (1) cultural care burdens; (2) empathy-same age with caregivers; (3) innovation - multi-culture learning innovation; (4) dilemma of deliver culture care. Nursing students were stressful of lacking skills and confidence in providing adequate care for immigrant patients. Several strategies were used to overcome culture conflicts including the use of relatives, or friends from same home country to interpret, nonverbal communication, gestures and graphic illustrations. Conclusion: This study indicates the strengths and weaknesses of student nurses in managing the care of immigrant patients, and the need for a background of transcultural nursing. The study indicates the importance of teaching transcultural nursing, cultural diversity, and culturally competent care in professional education programs for nursing students. It should emphasize cultural care knowledge, cultural care skills and communications.

Biography Hui-Chen Huang is a graduate student of the Graduate Nursing program in the Fooyin University. She is major in the lifelong learning and health promotion. She have had clinic experiences in nursing including as an instructor of nursing interns of the Kaomei Healthcare Junior College and the Hsin Sheng Medical College for 6 years and as a lead nurse at Puzih Hospital for 25 years. These clinical practices enable her to well intergrade in active aging learning and health promotion and future advancement.

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Page 179 Estela Arcos Griffiths et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The social support of pregnant immigrants with psychosocial risk in primary health care, Santiago de Chile Estela Arcos Griffiths1, Antonia Vollrath1, Ximena Sánchez2, Christine Bailey2, Ximena Prieto1, Amélia Simões Figueiredo3 and Sílvia Caldeira3 1Andrés Bello National University, Chile 2Playa Ancha University, Chile 3Catholic University of Portugal, Portugal

Background: Having a social support structure helps women face migratory processes to integrate and adapt to society, especially when faced with unforeseen circumstances. Methods: Descriptive study of 37 pregnant immigrant women, with psychosocial risk was done. A social survey was conducted, prior to the signing of the informed consent, which identified variables of the background of each woman, their partner and family. Through self-report, the women identified the primary and secondary relationships. Secondary information was used for prenatal control information. Results: 75% of the women had an unplanned pregnancy and one in two had depression. The available social support network was reduced to the family network and the health center. Discussion: The interactions that occur with the social network contribute to the well-being and self-esteem of the person, aspects that should be considered in prenatal care, because of the implications it has for the health of women and children.

Biography Estela Arcos have developed postgraduate studies in Public Health and Social Development at the University of Chile and the Universidad Austral. The lines of research are related to health equity, public policies on health and social protection, sexual and reproductive health, gender. I have published about 40 papers in indexed journals and have presented papers in national and international congresses. I participate in academic activities of undergraduate and graduate. Currently, I am a Director of Postgraduate and Research.

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Page 180 Ya-Ling Lin et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The factors of medication omission Ya-Ling Lin1 and Hsiao-Yun Chang2 1Kao-Mei Junior College of Health Care and Management, Taiwan 2Fooyin University, Taiwan

edication administration drew out concerns on the matter which contains unpredictable risks resulting in patients’ injury Mor death in Taiwan and other nations. The most common error is omitting medications for patients. Literatures pointed out that omitting medications occupied high rate in medication administration errors. Nonetheless, the majority of researches used questionnaires survey to figure out awareness and causes of medication errors but there are few by using chart audit to describe the medication omission. The purposes of this article are to discover the incidence, causes, and the associated factors of medication omissions in Taiwan. This research is a retrospective study through chart audits, which enrolled 300 inpatients from a medical center of Southern Taiwan in 2013. The results revealed that the medication omission rate is 6.2%; the duty shift affected the medication omission rate, 70 patients (50.4%) were found in the day shift, the average on each inpatient is 0.84 times of medication omission. The most common omitted medications are for gastroenteric system (21.8%), the least are for diuretics and anti-diabetic medications (5.2%). The most common route of omitted medication is via mouth (82.5%). In terms of frequency, “once-per-day” medication was the most common omitted medication, which accounts for 36.5%. The most common reason for omission is unknown (34.5%). Medication omission could be decreased in the future as designing in-service education, monitoring medication administration, and standard procedure for healthcare system. By implementing the correction of medication administration, patient safety can be ensured for better health outcomes.

Biography Ya-Ling Lin has completed her Master’s from the School of Nursing, Fooyin University and has worked at Kao-Mei Junior College of Health Care and Management. She has published five articles in domestic journals and has presented two papers at international conferences.

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Page 181 Cristina Mara Zamarioli et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Safety evaluation of a topical formulation containing microparticles of Chamomilla recutita (L.) Rauschert coated with chitosan Cristina Mara Zamarioli, Danielle Cristina Garbuio, Maisa Oliveira de Melo, Patrícia Maria Berardo Gonçalves Maia Campos, Luis Alexandre Pedro de Freitas and Emilia Campos de Carvalho University of São Paulo, Brazil

kin lesions are the target of nursing research and because of its impact on patients’ life the prevention of these injuries is of great Sinterest. In previous studies, a formulation to protect the skin against injuries was developed. However, before it can be applied for this purpose, a preliminary safety test is needed. Thus, the aim of this study was to evaluate the safety of a topical formulation containing microparticles of chamomile coated with chitosan on healthy volunteers’ skin. It is an experimental, controlled and double blind study conducted with 35 volunteers. After approval of the Ethics Committee on Human Research of the Ribeirão Preto School of Nursing, participants applied the formulation with microparticles in a forearm and the same formulation without microparticles in the other forearm during four weeks. The evaluation was performed by objective measurements of erythema, melanin, and skin pH using biophysical skin techniques and also was evaluate to burning, itching, heat and pain. The results showed a slight increase in erythema in all skin areas evaluated. The amount of melanin decreased slightly in the area of formulation application. There was a pH increase in all skin areas evaluated. Regarding the subjective parameters of pain, burning, itching and heat only one participant at the end of the evaluation reported mild pain sensation on the area where the microparticle formulation was applied, which was rapidly, alleviated a few minutes after application. There was no change in evaluation of discoloration and edema parameters. We can conclude that the formulation is safe for skin application. In addition, more studies involving prevention of skin injuries will be carried out.

Biography Cristina Mara Zamarioli has completed her undergraduation course and Master’s degree from the University of São Paulo at Ribeirão Preto College of Nursing and specialization in Clinical Oncology from the National Cancer Institute. She is a PhD student, and has interest in nursing Cancer and Nanotechnology studies

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Page 182 Francine Lima Fulquini et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Instructional modulus effect for the teaching of lymph node examination: A pilot study Francine Lima Fulquini, Cristina Mara Zamarioli, Barbara Gadioli, Natália Chantal Magalhães da Silva and Emília Campos de Carvalho University of São Paulo, Brazil

ymph node evaluation helps to identify signs of health changes, justifying the relevance of their teaching. Considering the Limportance of acquiring skills to identify and document the presence and characteristics of lymph nodes, a teaching aid for this evaluation was built by us in an instrucional module, which consists of a physical prototype for skills training and a recording instrument. At this experimental, randomized-controlled study, we examined the contribution of this instructional module in teaching assessment and documentation of lymph node characteristics in nursing students. In the experimental group, palpation in prototype A and free annotation of the observed characteristics was performed followed by training with the instructional module (palpation in the prototype B+standardized instrument record). The control group palpated prototype A and made the notes freely. After, a new prototype C was offered to the groups for palpation and free annotation. Twenty-seven nursing students participated in this phase, out of which 96% were females and 3.57% were males, with an average age of 20 years. Comparing the two groups, it was noticed an increase in the correctness according to the register of consistency characteristics (112% and 50%), mobility (300% and 128.57%) and coalescence (225% and 0%) among the experimental and control groups, respectively. In the experimental group there was an increase in the percentages of correct answers in all evaluated characteristics. In the control group, the increase only occurred in two of the evaluated characteristics and was less evident when compared to the experimental group.

Biography Francine Lima Fulquini has completed a Bachelor's degree in Nursing at Ribeirão Preto College of Nursing, PAHO/WHO Collaborating Center for Nursing Research Development - University of São Paulo, Brazil. She is currently a MSc student at University of São Paulo, Brazil. Since 2014, she has been a member of the Sigma Theta Tau-Honor Society of Nursing.

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Page 183 Meng-Ling Shih et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

A preliminary study of quality of life in patients with heart failure Meng-Ling Shih and Fan-Hao Chou Kaohsiung Medical University Hospital, Taiwan

eart failure (HF) is a common condition affecting patients’ quality of life (QOL) significantly, due to its severe physical and social Hfunction deficiency. One of the major goals of healthcare team is to evaluate their level of QOL in patients with HF, which is frequently considered the effect of medical treatment, environmental design and clinical care. This article aimed to explore the quality of life in patients with heart failure. A cross-sectional and correlational research design was conducted using quality of life assessment (WHOQOL-BREF). In this study we recruited 200 patients with heart failure from a medical center in southern Taiwan. The study showed the mean score of the WHOQOL-BREF Taiwan was 83.94 (28-140), with index score of 63.0. The highest subscale score was that for environment domain and the lowest was that for psychological domain. There was a significant difference between gender, marriage, occupation, education level, family income per month, numbers of complication, and number of treatment and QOL of physical domain. There was a significant difference between marriage, occupation, family income per month, numbers of treatment and QOL of psychological, social relationships and environment domain. There was a significant negative correlation(r=-0.218; p=0.002) between age and QOL of physical domain. The study findings suggest that assessing quality of life are relatively major in physical and psychological status in heart failure patients is important. Nurses should pay attention to clinical characteristics, such as patients with old age, no married, illiterate, no occupation, families without income, combined diabetes mellitus, hypertension, acceptance of injection or medication or need oxygen supplying are more likely to be associated with risk factors for low QOL.

Biography Meng-Ling Shih has completed her MSN from Kaohsiung Medical University. She is the RN in the Department of Nursing, Cardiovascular Ward and has published 5 papers in international journals.

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Page 184 Yen-Hua Cho et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Prevalence and related factors associated with fall accidents in pediatric patients Yen-Hua Cho1 and Hsiu-Min Tsai2 1Chang Gung Memorial Hospital, Taiwan 2Chang Gung University of Science and Technology, Taiwan

he fall accidents in hospitalized pediatric patients is a critical issue not only for pediatric patients and their families, but also Tfor nursing professionals. Understanding the prevalent rates and related factors associated with in-hospital pediatric patients is crucial for protecting and controlling pediatric patients against fall accidents. The aim of the study was to examine the prevalence of fall accidents and to identify their associated factors among pediatric patients in Taiwan. This was a secondary analysis of the data from the Northern Medical Center in-patient database from 2010 to 2013. The study sample included 40,703 pediatric patients aged under 18 years old. The data were collected using the modified hospitalized children high-risk fall screening scale and demographic data including age, gender, physical condition, medicine use and experience of fall. Data analysis was conducted using frequency, percentage, mean, standard deviation, independent t-tests and logistic regression analyses. The prevalence of in-hospital fall accidents were 0.03% (N=52). The experiences of fall accidents and age were significant predictors of the high-risk fall screening scores in hospitalized pediatric patients (p<0.05). Patients aged under 3 years and experienced fall in past year showed significantly higher rates of falling accident compared to the counterparts. There was no significant difference in the fall rate by gender, physical condition, and medicine use. The information of this study can be used as a reference for health care providers to prevent fall accidents among pediatric in-patients in Taiwan.

Biography Yen-Hua Cho is a Graduate student in Nursing School at Chang Gung University of Science and Technology. In 1998, she has worked in the Department of Nursing at the Chang Gung Memorial Hospital as a Head Nurse. She has been interested in health research among the pediatric patients with chronic diseases.

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Page 185 Ni Biyu, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Current situation of evidence-based nursing in patients with dysphagia after stroke Ni Biyu West China Hospital of Sichuan University, China

wallowing dysfunction is one of the common symptoms of stroke patients, resulting in malnutrition, aspiration pneumonia and Sother complications. Therefore, it is particularly important to standardize nursing care for patients with dysphagia after stroke. As most of the Chinese nurses have not accepted the system of swallowing related knowledge training, and the scholars have different views, therefore, evidence-based practice is particularly important. The aim of this paper is to analyze and report the current domestic and foreign scholars on the application of evidence-based nursing in patients with dysphagia after stroke, so as to provide a more scientific and reasonable basis for clinical nursing.

Biography Ni Biyu has completed her Bachelor's degree from Chengdu University and is now working at the Sichuan University. She is a Primary Nurse in the Rehabilitation Center and has experience in rehabilitation nursing of brain injury. She has published 2 papers in reputed journals. She has participated in many research projects on family rehabilitation of patients with stroke, multidisciplinary health education in patients with stroke and assisted in carrying out intermittent oro-esophageal tube feeding.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 186 Chun Hsiao Kuo et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Concept analysis of problem wound Chun Hsiao Kuo and Shu-Ming Chen Fooyin University, School of Nursing & Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Fooyin University, School of Nursing, Kaohsiung, Taiwan

he purpose of this study was to recognize the conception of problem wound. The author used eight steps of concept analysis, Twhich was proposed by the Walker and Avant' methods. The concept of problem wound was definited: what a problem wound was, confirm what reason affect the problem wound and what results would problem wound trigger. The results showed that definition of problem was, when we treated the injured soft tissue by normal medical treatment, but the wound could not heal. It causes the wound healing late or recovering imperfectly. Skin is the largest organ in our body. Besides, skin is the first defense to prevent us from bacteria irrupting. A healthy wound healing process countered less interfering treat. When healing process was damaged, it would cause problem wound or futile wound. Both of them would make wounds recover badly. At this time, systemic evaluating and managing wounds is very important. We should evaluate the wound on its exterior, size, depth, infection and tissue perfusion. Then, we treat it with comprehensive management to make it recover. In conclusion, this concept can help nurses understand what problem wound is and learn the knowledge about systemic evaluating and managing wounds. Also, from empirical reference, we can know the development of problem wound concept.

Biography Chun Hsiao Kuo is Fooyin University Master degree nursing student. She also works in Kaohsiung Veterans General Hospital as a clinical care staff. The research interesting is in wound care field.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 187 Nam Mi Kang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Content analysis of Korean human milk bank donors and recipients’ experiences Nam Mi Kang1, Min-Seon Koh2, Lim Byung Joo3 and Jeoun Mee Wha4 1College of Nursing Konkuk University, South Korea 2Chung- nam National University, South Korea 3Kkotdongnae University, South Korea 4College of Nursing Konkuk University, South Korea

Purpose: This study was done for the content analysis about the experiences and needs of donors and recipients. Methods: Convenience sampling was done total 20 donors and recipients, personal interview was done by using a smart-phone and the text was recorded and fully transcribed, then the full text was analyzed into 4 categories. Result: The 4 categories are motivation, aspects (duration, amounts, feeling, difficulties, satisfaction), knowledge, and demands including education, operational aspects. Conclusion: The donors and the recipients want the community based human donor milk bank be established and operated, for this the public relations for the increase the public awareness is prerequisite, providing information and educational supports from the nursing care providers are needed generally. This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIP) (No. 2015R1A2A1A15056046) Keywords: Human milk bank, human milk donor, human milk recipient, categorical content analysis

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 188 Su-Chao Lin, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The effectiveness of applying auditing management to reduce infection intensity in intensive care unit Su-Chao Lin Puzi Hospital, Ministry of Health and Welfare, Taiwan

uditing is part of the management, and through audits process could determine which of the systems implemented does not meet Aregulatory requirements and needs to be improved. To apply the audit system in the infection control of medical institutions could maintain the inpatient safety in intensive care unit , improve the quality and reduce cost of medical care, provide a safe working environment. This study method based on the current situation analysis and literature review, applying system diagram to summarized three main problems: 1. inappropriate management of care team members. 2. Inadequate environmental cleaning. 3. insufficient of dressing carts. Applying quality control circle PDCA approach, the improvement strategies were including: 1. developed audit checklist of hand hygiene and hand bacterial colony collection 2, implementation bedside equipment and environmental sterilizing in three shifts 3 for the isolation patients, using a simple dressing plate to avoid cross-infection. The audit inaccuracy rate decreased from 7.82% to 3.41%, the infection density decreased from 10.06 ‰ to 7.60 ‰, and the average cost of medical supply was reduced 3,580 NT / month. Antibiotics use DDD decreased from 15g per person per day to 10g, the use of the amount of drugs accounted of hospital expenses from 46%to 30%.Infection control is an ongoing task for the intensive care unit, from establishment of the concept, supervision, audit to habits developed, from cleaning workers to department directors, whether it is a brief contact with the radiologist, pharmacist, dietitian, or physician, respiratory therapist, or close contact with the 24-hour care staff, all health care deliverer need to work together to provide a high quality and safety medical environment.

Biography Su-Chao Lin has National Chiayi University, Executive MBA, EMBA. Chung Hwa University of Medical Technology, Department of Nursing. Fooyin Junior college of Nursing. Nursing Director of Puzi Hospital, Ministry of Health and Welfare. Head Nurse of Chiayi Branch, Taichung Veterans General Hospital. RN -Kaohsiung Veterans General Hospital (VGH-KS). Acute Care, Long Term Care, Nursing Administration.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 189 Emilia C Carvalho et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

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Correlation between state-trait anxiety and sociodemographic variables in patients with colorectal cancer in preoperative Emilia C Carvalho1, Ana Cláudia Mesquita1, Ana Maria P Carvalho1 and Maria Das Graças P Alves2 1University of São Paulo, Brazil, 2University of Minho, Portugal

nxiety is one of psychopathological comorbidity most frequent in cancer patients. Thus, the identification of the feeling of Aanxiety and related factors is important to treat this condition. The proposal of this cross-sectional study is to investigate the correlation between state and trait anxiety and the socio-demographic variables of patients with colorectal cancer in the preoperative. Fifty patients hospitalized for surgical treatment of colorectal cancer filled a form about sociodemographic questions (age, gender, education, socioeconomic and marital status, and religion) and the State-Trait Anxiety scale. Statistical analyses were performed using the Spearman correlation coefficient and the Pearson correlation coefficient. We observed that women have higher levels of trait anxiety that men (r=0.401; p=0.004). Regarding the state anxiety, older people have lower levels of anxiety (r=-0.302; p=0.033), women are more anxious than men (r=0.333; p=0.018). Literature says that younger people live certain situations, such as worries about the children and career, which can generate more anxiety. Regarding sex, men tend to have more difficulty to express their feelings and admit their weakness or vulnerability due to social standards. According to the data of this study, it is concluded that women have higher levels of trait anxiety and state anxiety than men and older people have lower levels of state anxiety than younger. Nurses should observe the characteristics of the patients so that they can provide more appropriate care to the profile of each patient.

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Page 190 Yu-Ping Huang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Roles of health professionals during hematopoietic stem cell transplantation in children with Cancer Yu-Ping Huang1, Shou-Yu Wang2 and Pinhua Lin3 1National Quemoy University, Taiwan 2Asia University, Taiwan 3Taichung Verternas General Hospital, Taiwan

ematopoietic stem cell transplantation (HSCT) is the preferred treatment over chemotherapy and radiotherapy for children Hwith recurrent cancers. However, HSCT has adverse side effects such as infection, sepsis and graft-versus-host disease. Hence, HSCT is performed in isolation wards; this can cause immersive stress in the treated children and their primary caregivers. Thus, a phenomenological study was conducted using semi-structured interviews to explore the roles and functions of health professionals from the perspectives of mothers who took care of their children with cancer in isolation rooms during HSCT. The time between HSCT preparation and leaving the isolation room after HSCT completion was considered the HSCT period. This study recruited 34- to 54-year-old mothers (n=12) of children aged 11 months to 14 years. The results revealed that the roles and functions of health professionals were as follows: (1) trainer, teaching mothers the necessary skills and knowledge to take care of their children in isolation rooms; (2) supporter, listening and offering encouragement to the mothers and providing them with emotional support; (3) experience guide, sharing with the mothers their experiences of certain symptoms in their children during HSCT; (4) companion, undergoing the entire process with the mothers to provide a sense of security; (5) eyewitness, witnessing and understanding the meanings of HSCT and the mothers’ involvement; (6) monitor and detector, identifying early signs or symptoms of HSCT complications; and (7) care provider, administering drugs and providing care. The mothers’ anxiety and distress were reduced when they encountered caring and supportive health professionals.

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J Nurs Care, an open access journal Volume 6, Issue 4 (Suppl) ISSN: 2167-1168 World Nursing 2017 July 10-12, 2017

Page 191 Chiang-Hisng Yang, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Total laparoscopic-assisted hysterectomy among healthcare professionals: A population-based study in Taiwan Chiang-Hisng Yang National Taipei University of Nursing and Health Sciences, Taiwan

Abstract: Little is known about the surgical decision-making of well-informed patients associated with the different types of procedures. This study aimed to compare the rate of total laparoscopic-assisted hysterectomy between healthcare professionals and the general female population in Taiwan based on different access to medical knowledge. A retrospective population-based study was retrieved from Taiwan’s National Health Insurance Research Datasets (NHIRD). We identified 74,251 women undergoing total laparoscopic-assisted hysterectomy compared with 107,429 those with total hysterectomy without laparoscopic assistance between 1998 and 2006. Rates of total laparoscopic-assisted hysterectomy were determined according to patient, hospital, and attending gynecologist characteristics. Univariate and multivariate logistic regression models were used to estimate the likelihood of performing total laparoscopic-assisted hysterectomy in relation to healthcare professionals and the general female population. Healthcare professionals, especially physicians (OR 0.55; 95% CI 0.33–0.91) and other healthcare professionals (OR 0.69; 95% CI 0.54–0.88) were significantly less likely to undergo total laparoscopic-assisted hysterectomy than the general female population after adjusting for characteristics of patient, hospital and attending gynecologist. However, nursing staff had a similar likelihood as the general female population. Lower total laparoscopic-assisted hysterectomy rate among Taiwanese physicians and other healthcare professionals was attributable to superior medical information, familiar with the healthcare system, and varied practice patterns.

Biography Chiang-Hsing Yang has completed his PhD in 1994 from University of Albanama at Birmingham . He is currently a professor at National Taipei University of Nursing and Health Sciences. He has published more than 25 papers in reputed journals, including Social Science & Medicine, Health Services Research, Enviormental Health Perspectives, Environmental International, and PloS etc.

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Page 192 Jui-Chun Feng et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The long-term care needs of main caregivers caring for children with adrenoleukodystrophy Jui-Chun Feng, Su-Fen Cheng, Wei-Wen Wu, Miao-Ju Chwo and Chu-Yu Huang MacKay Memorial Hospital, Taiwan National Taipei University of Nursing and Health Sciences,Taiwan

drenoleukodystrophy (ALD) is a rare recessive hereditary metabolic disease. At the disease onset, the child exhibits gradual Adeterioration of physical functions. The child ultimately relies on the primary caregiver for long-term home care until death. Purpose is to understand the care needs of the primary caregivers as they care for the ALD children. This qualitative study used semi-structured interview for data collection. There were six primary caregivers of ALD children who participated in this study. The results revealed there were three themes of care needs emerged during the phase of “onset of disease to confirmation of diagnosis”: “facing parental perception of child’s abnormal behaviors”, “needs for collaborative outpatient care”, “prompt confirmation of diagnosis”. During the second phase “deterioration after confirmation of diagnosis”, three themes of care needs were identified: “swift comprehension of the disease information and resources”, “learned accurate knowledge, skills and application of facilitating equipment”, and “received timely assistance”. There were three themes of care needs during the phase of “long-term bedridden to death”: “provision of individualized care during hospitalization”, “provision of long-term homecare service”, and “provision of hospice care at home”. The researcher hopes to provide mental support and palliative accompaniment through the establishment of a collaborative pediatric palliative care team, a care management system for children with rare diseases, and integrated care between discharge preparation and home care. Recommends development of temporary childcare services at nursing home of the university hospital so that the primarily caregivers and the family may rest and improve the quality of home care for the ALD children.

Biography Ms. Jui-Chun Feng is a head nurse at pediatric ward at MacKay Memorial hospital in Taiwan.

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Page 193 Jo-Tzu Shang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Systematic reviews of symptoms distress in patients with dengue fever Jo-Tzu Shang1 and Hsiao-yun Chang2 1Graduate Student, Graduate Institute of Nursing, Fooyin University, Kaohsiung & Kaohsiung Amed Forces General Hospital, Taiwan 2Assocaite Professor, School of Nursing, Fooyin University. Kaohsiung, Taiwan.

engue is transmitted between people by the mosquitoes which are found throughout the world. According to WHO estimated, Dabout 2.5 billion people live in dengue epidemic regions and 50 to 100 million people are infected with dengue virus each year. Of which about 50 million people need to be hospitalized, is one of the most challenging public health problems. Smptoms typically begin three to fourteen days after infection. The course of infection is divided into three phases: febrile, critical, and recovery. However, Dengue fever is also called break-bone fever, because it can cause so much pain to the patients. There is limited information on the review of symptoms distress in patients with dengue fever; therefore, the purpose of this article to understand its symptoms. The author used the following keywords: dengue fever, dengue symptoms, and symptoms distress to search the following five databases: CEPS, CINAHL Plus with fulltext, Google Scholar, and PubMed. A total of 24 related articles were searched and 17 articles were included with 11 descriptive study, 4 correlational study, 1 experimental study, and 1 discussion paper. The results indicated that two classifications of disease, three prognosis of disease and 15 symptoms distress. The finding allow healthcare professionals to better understand their symptoms and provide an appropriate individual care to enhance patient comfort and the quality of care.

Biography Jo-Tzu Shang is a Master student at Graduate Institute of Nursing, Fooyin University and works as a nurse at Department of Nursing, Kaohsiung Amed Forces General Hospital, Taiwan.

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Page 194 Hsiao Wen Chien et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The related factors between percutaneous transluminal angioplasty and surgical reconstruction after the vascular access failure among hemodialysis patients Hsiao Wen Chien1, Chiou chou ping 2, Zhang jin wei3 and Chang ya ling 4 1RN, MSN, I-Shou University 2RN, PhD, Professor Department of Nursing I-Shou University 3RN, Psychiatrist Department of Nursing Cishan Hospitol 4RN, Medicine Department of Nuclear Yuan's General Hospitol

Introduction: Hemodialysis patients related to the total population prevalence rate is still high. Hemodialysis patients mainly rely on vascular access for treatment, the vascular access can be regarded as the second lifeline of patient. Objective: The purpose of this study was to explore the cost and timing between Percutaneous Transluminal Angioplasty (PTA) and surgery reconstruction, and making an appropriate guideline for PTA and surgery reconstruction. The objective of this study is to reduce the failure rate of fistula and the maintenance cost. Methods: There were 129 hemodialysis patients who had vascular access failure participated in the study. Medical records were reviewed and analyzed. Data was analyzed with logistic regression and chi square test by applying SPSS 22.0. Results: In PTA, there is no significant in gender. However, age, diabetes (HbA1c＞5.5), the emboli of artificial vascular graft (AVG) and dynamic venous fistula tube (AVF), PTA cost is higher than rebuilding the fistula tube, fistula flow ≦670 cc/min easily embolism and PTA are significant (P＜0.05). Conclusion / Practical for application: The results of the study suggest that health care providers have to monitor and record the blood flow of A-V fistula, and making a guideline for the surgery reconstruction and PTA regularly. They still need to provide the rationalization of medical expenditure and extension the life expectancy of fistula in order to enhance the quality of patients’ life.

Biography Huiau Wun Cian has nursing qualifications for 20 years, including 17 years of haemodialysis career with the investigation team of the hospital to do research, and completed master's degree from I-Shou University at the age of 41-year-old. I have published more than 6 papers in reputed journals including Taiwan Society of Kidney Medicine 104th Annual Conference and Academic Presentation and 104th Annual Promotion of Integral Medical Integration Services and PACE and PAC International Science and Technology Symposium.

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Page 195 Ying-O CHEN, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Improving the completeness of home care skills for primary caregivers Ying-O CHEN Puzi Hospital, Ministry of Health and Welfare, Taiwan

rimary caregivers are the main care providers at home. If primary caregivers are equipped with correct and completeness home Pcare skills, reoccurrence of hospitalization could be avoided. The purpose of this project was to enhance the completeness of home care skills for primary caregivers. According to current surveys conducted from January to July 2016, the completeness of home care skills among primary caregivers was 63% whereas patients’ hospitalization rate was 6.42%. Main relevant reasons were: (1) lacking of integrations in home health care team, (2) inconsistent operating procedures and evaluation guidance for caregivers, and (3) poor adoption of home care skills due to difficulty to comprehend and memorize home health care education content and skills. The transdisciplinary team consisting of physicians, pharmacists, nutritionist and nurses developed strategies to solve the problems. First, established health education counseling guidance to develop criteria of operating procedures. Second, setup evaluation guidelines to assess what caregivers got from the health education and what they needed to be reinforced. Third, designed illustrative leaflets for obtaining home health care skills handily. Forth, made health education sheet for caregivers to recall health education content to enhance their comprehension. After completing the project, the completeness of home care skills for primary caregivers increased to 88% and patients’ hospitalization rate was decreased to 4.4%.Transdisciplinary team provided integration of home care education to enhance the ability and completeness of home care skills and reduced patients’ hospitalization rate successfully. Patients’ quality of home care was improved.

Biography My name is Ying-O Chen. I have 26 years of clinical nursing experiences in emergency, operating ward, delivery room, baby room, nursing home care services. I also has participated the domestic poster presentation 5 times in Taiwan, and the 23rd International Conference on Health Promoting Hospitals and Health Services Poster presentation.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The effects of hot water footbath on sleep disturbances in stroke patients Mei-Hui Chen1,2, Shu-Ming,Chen3, Cui-Yuan Huang4, Hui-Xian Lin3, Yi-Hui Li2 and Shu-Hwa Chen2 1Graduate Student, Graduate Institute of Nursing, Fooyin University, Taiwan 2Nursing department, Kaohsiung Chang Gung Memorial Hospital, Taiwan 3Department of Nursing, Fooyin University, Taiwan 4Department of Nursing, Chang Geng University of Science and Technology,Taiwan

his research aims at discussing over the effects of using hot water foot bath enhancing parasympathetic nerve activity to relax and Tincrease body comfort, improve the sleep disorder of stroke patients.This research was Experimental design , The stroke patients and scoring greater than 5 in Pittsburgh Sleep Quality Index (PSQI) test as research objects. random into Group A and B with 30 participants, respectively. Group B was implement hot water foot bath at the first night which lasted for 20 minutes, and the water temperature ranking from 41 to 43 ℃, the second night given general nursing measures, The order of intervention measures provided for Group A was however, in reverse,they went through finger temperature, blood pressure, VSH sleep scale, body comfort and collected the sleep data with wearable mobile devices, scale measurement in intervention measures before and after .According to research results, 1.with 30 females (50%) and 30 males (50%) and an average age of 66±14.05; 2. The pretested and post-tested finger temperature , blood pressure , Body Comfort, and VSH sleep scale prewith experience of hot water foot bath interventions presented a significant difference;3. There wereremarkable differences regarding to sleeping hours with wearable mobile devices, total hours of trouble sleeping and number of interrupted sleep with or without hot water foot bath.It’s expected to improve the sleep disorder of stroke patients by hot water foot bath and provide future empirical and practical reference for clinical

Biography I am incumbent Current position Educational administration Nurse and Graduate Student, Graduate Institute of Nursing, Fooyin University, Taiwan, Department of Nursing Room, Chang Gung Memorial Hospital.Professional Clinical areas to Neurology nursing care.Personal profile Professional nurse with more than eight years of progressive nursing and four years Nursing Education Administration Experience.

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Page 197 Shu-Chen Wang, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Long term care development and nursing progress connection in Taiwan Shu-Chen Wang Dercome Nursing Home, Taiwan

Abstract: As with the population aging rapidly, long-term care (LTC) needs have increased remarkable all the way; however, related social value, scheme and coping policy & system seemed not very pertinently due. Based on the developing experiences from the advanced countries, in addition to policy planning & legislation, finance arrangement and insurance designing….etc. there be professional team and (semi-) professional care workers staying in first line practical service. Nevertheless, through more than 2 decades’ development in Taiwan, we can’t still keep the steps for granted, possibly ascribed to the cross-linkage with chronic medical care, long-term nursing, so no mandatorily progressing except nursing can be anticipated. The study be conducted via qualitative approaches, thru’ multiple deeply interviews among 14 samples (12 LTC workers, 1 LTC recipient or resident, and 1 family). Naturally, the saturation has not been reach easily, unless introducing foreign advanced experiences. The study findings：1. LTC & nursing discipline development intermingling, crossing, or running parallel, but never to be one issues; 2. Nursing practitioner as professional worker or further manager, rather than supervisors or leaders. We hope our study results can evoke much more deeply constructive thinking & discussion; rather, at heart, reviewing with self-criticism, to face the barriers and solving for the country.

Biography I am a head nurse in the nursing home in Taichung City. My working experience included clicinal nursing care and clinical Instructors. I'm very interested in long term care field. I got a master degree from the institute of Long-term Care at NationalTaipei University of Nursing and Health Sciences in 2015.

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Page 198 Yi-Hsin Liao, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nutritional status of patients with lung adenocarcinoma associated with systemic chemotherapy care of research Yi-Hsin Liao Nurse Practitioner of Veteran General Hospital, Taichung, Taiwan

his study investigated the correlation between the nutritional status of patients with lung adenocarcinoma during chemotherapy Tand systemic chemotherapy care.Analysis of data from the Taichung Veterans General Hospital of lung cancer patients in 2011 AD until 2014's "cancer case management database," In this study,over 20 years old, suffering from lung adenocarcinoma for the first time, performed systemic chemotherapy correlation analysis 81 cases.Research analysis showed that hemoglobin and body mass index before and after chemotherapy via a paired t correlation analysis of significant discrepancies in the statistics.Use Super Mix mixed model analysis software of multi-level mode (MLM) Maximum likelihood estimate of the results of the analysis of smoking,body mass index and hemoglobin three variables have a significant impact on the absolute neutrophils,with logistic regression analyze nausea,vomiting, poor appetite,oral ulcers with variable results,found that hemoglobin,nausea and poor appetite have negative and significant impact,and that the results of Odds ratio,each additional unit of hemoglobin,nausea 0.677 times less chance of generating less chance of loss of appetite 0.583 times.Although this study is limited to secondary data,the number of samples in a few studies,it may result in statistics on the number of samples is too small bias,but use of higher statistical test force (power) analysis software to accurately investigate the findings.In the future we shall establish a comprehensive nutrition care plan and implement care for the direction of the team in order to benefit patients.In addition, the future research will need to be more rigorous experimental design,the nutritional status and chemotherapy care correlation analysis.

Biography I work as Nurse Practitioner of Veteran General Hospital which I work for around 22 years. My working experience including critical nursing care,cancer nursing care. I'm interested in cancer and palliative nursing care.I got a master degree from the institute of Long-term Care at National Taipei University of Nursing and Health Sciences in 2016.

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Page 199 Chin Wei Chang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Weight loss maintenance after participating a health promotion based program in Taiwan Chin Wei Chang1, Tsai Chia Ching2, Yue Ci Gao3, Wen Chien Hsiao4, Pi Ying Chu5, China Jung Wu6, Chun Mei Han7, Pei Chi Chen8 and Ya ling Chang9 1RN, Psychiatrist Department of Nursing Cishan Hospitol 2RN, Assitant Head Nurse Psychiatrist Department of Nursing Cishan Hospitol 3RN, PhD, Professor, Department of Medical Management, I-Shou University 4RN, MSN,I-Shou University 5RN, Director of Nursing Department of Nursing Cishan Hospitol 6RN, Supervise of Nursing Department of Nursing Cishan Hospitol 7RN, Assitant Nurse Psychiatrist Department of Nursing Cishan Hospitol 8RN, Medicine Department of Nursing Donggang Antai Hospital 9RN, Medicine Department of Nuclear Yuan's General Hospitol

Introduction: Gaining weight is a serious health-related issue around the world currently. Weight loss interventions have been studied widely. However, weight loss maintenance is still a challenge. Objective: The aim of this study is to examine the prevalence and correlates of weight loss maintenance factors in Taiwan. Methods: A cross-sectional survey through structured questionnaires was conducted to analyze 130 adult subjects who had been participated in a weight loss program in a hospital in Taiwan. All subjects met the following two criteria: BMI> 25 and aged from 20 to 65 years old. They were participated in the weight-controlled program at least 6 months, and reduced weight more than 5% compared with their original weight at the end of program. Results: Among all these 122 valid samples, with a mean age was 37.29, 76.2% was female, and 52.5% was college graduate level. Within the female participants, the higher the degree of supports; the maintenance of weight control was higher. There was positively significantly correlated family supports and the maintenance of weight (r=.22*, p <.05). There was a positive significant correlation between the education level and the maintenance of weight (r=.185*, p <.05). In addition, there was positively correlated between the income and maintenance of weight (r=.315*, p <.05). Conclusion: According to the results of the study, family support, personal monthly income, education level were factors that affect the maintenance of weight. It is recommended that staff of health promotion hospital could hold charged health promotion activities in hospitals and communities to help monitor the weight control. Within the activities, participants’ families and friends are welcome to join the program because social and family supports are helpful to achieve health promotion and weight reduction to fit weight maintenance goals.

Biography My name is Chin Wei Chang,. I am a graduate student of the Medical Management Institute of I-Shou University in Taiwan. I am currently preparing a lecturer's work and future doctoral examine. I have worked in Taiwan Kaohsiung Cishan Hospital and with 10 years of experiences in psychiatric ward. I have published an academic paper and a poster. I am eager myself actively to write projects and make contributions for my future academic career.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Non-pharmacological managements of pain from heel stick in neonates: An evidence-based study Pei-Hsin Yang and Yun Shan Tseng Chang Gung Memorial Hospital, Taiwan

Background: Studies indicated that neonates may receive painful procedure more than five times a day during their hospitalization. Infants may feel pain or physical discomfort while undergo these invasive medical processes. Consequently, the analgesic intervention may play an important role in pain management, which including drug and non-drug methods. Many studies have pointed out that using non-pharmacological analgesic measures can effectively relieve neonatal pain. However, studies that examine operating procedures of non-pharmacological pain managements while undergo heel stick were rare. The purpose was to establish standard operating procedures of non-pharmacological pain reduction for the newborn while taking blood samples from the heel. Methods: This study was a crossover, quasi-experimental research design. 262 neonates were enrolled. Each infant in the experimental group was his/her own control group. The pain reduction measurements were performed by (1) providing nutritional sucking and nesting care before invasive medical procedures; (2) giving wrapped, containment care and non-nutritional sucking during heel stick; (3) offering containment care and non-nutritional sucking after the procedures. The interval of each measurement was 24 hours. Neonatal Infant Pain Scale (NIPS), heart rate, respiratory rate and duration of crying time were used to measure neonatal pain. Furthermore, the effectiveness of measurements was evaluated simultaneously. Results: The results indicated that the pain scales was significantly decreased from 4.3 to 3.8 points (p<.01). The non-pharmacological pain managements was significantly decreased neonatal pain (p<.05). The change in the mean of heart rate, respiratory rate, and duration of crying time were significantly decreased while providing nutritional or non-nutritional sucking (p=.02). Neonatal heart rate, respiratory rate, and duration of crying time were also significantly decreased when nesting or containment care, wrapped infant were given (p<.05). There were no statistically significant differences between the executive time (before, during and after) of the processes (p>.05). Conclusion: Pain is subjective, the fifth vital sign, and usually use as a daily physical assessment. It is not easy to observe neonatal pain. However, non-pharmacological analgesic measures were found to relief newborn pain, further research may apply the interventions to moderate neonatal pain during invasive medical processes. The results of the study can serve as a guiding principle for clinical nursing care. Keywords: Pain, neonatal heel stick, non-pharmacological pain management

Biography Pei-Hsin Yang has completed her MSN from Fooyin University in 2016. She is a nurse manager at neonatal intermediate unit (IMU) in Kaohsiung Chang Gung Memorial Hospital, Taiwan. Her specialties are premature and children with severe diseases. Her researches focus on neonatal and parental care.

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Page 201 Ying-Lan Tseng, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Early physical rehabilitation for lung cancer lobectomy: Randomized controlled trial Ying-Lan Tseng MSN, RN, NP, Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC Tsae-Jyy Wang, Wei-Ling Hsiang, Jin-Shing Chen & Wen-Chien Huang MSN, RN, NP, Department of Internal Medicine. Cardinal Tien Hospital, New Taipei City, Taiwan, ROC Professor, School of Nursing, National Taipei University of Nursing and Health Sciences MSN, NP, Department of Nursing, National Taiwan University Hospital Professor, Department of Surgery, National Taiwan University, School of Medicine MD. PhD, Department of Thoracic surgery, Mackay Memorial Hospital

Background: Early rehabilitation designed to enhance endurance and aerobic capacity may help to promote recovery from lung cancer lobectomy. The purpose of the study is to test the effects of an early physical rehabilitation for lung cancer patients to improve their muscle endurance, aerobic capacity, and health-related quality of life after lobectomy surgeries. Methods: The study uses an experimental design. 150 patients scheduled for lung cancer surgeries were recruited and randomly assigned to the intervention or the control group. The intervention includes preoperative homebased rehabilitation for 5 days, postoperative in-hospital rehabilitation for 5 days, and homebased exercise program for three months after discharged from the hospital. The main components of the intervention were aerobic and strength exercises as well as breathing training by using an incentive spirometry. The outcomes on muscle endurance, aerobic capacity, and health-related quality of life were measured 1 week prior lobectomy surgery, 1 week, 6 week, and 12 week post operation. The study outcomes were evaluated by using 30-second arm curl test, 30-second chair sit-to-stand test, six-minute walk test, and the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire. Results: The patients’ demographics and baseline measures were equivalent between groups. Results of GEE showed a significant group by time interaction effect on 30-second chair sit-to-stand test. As for the parameter estimates, from 1th week to 12th week, the 30-second chair sit-to-stand test improvement in the intervention group was 1.79 times (Wald X2 =7.93, p = 0.005) more than in the control group. Results of GEE showed a significant group by time interaction effect on six-minute walk test as well as on FACT-L. However, results of GEE showed no significant effect on 30-second arm curl test. Conclusion: The study results support the effects of the early physical rehabilitation program on improving muscle endurance, aerobic capacity, and quality of life for lung cancer patients after lobectomy. Keywords: lung cancer, early physical rehabilitation, muscle endurance, aerobic capacity, quality of life

Biography Ying-Lan Tseng is an acute care nurse practitioner. She has worked in acute care settings for more than twenty years. Nephrology and dialysis care are her clinical specialty areas. She has great passionate on proving evidence based care to her patients. She has also put great efforts on developing patient care knowledge.

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Page 202 Hui-Chun Chung, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Cross-cultural adaptation and validation of the Chinese CARE Scale of caring nurse–patient interaction competence Hui-Chun Chung Hualien TzuChi Hospital, Buddhist Tzu Chi Medical Foundation, Institute of Medical Sciences, Tzu Chi University, Taiwan

urse–patient interaction is a critical factor for improving nursing care quality. The CNPI scale was recently developed for Nassessing the educational training outcomes of nursing students. However, there has been no relevant validated instrument for assessing CNPI competence applied in clinical practices yet. The study adapted and validated the Chinese CNPI scale; the results can serve as a basis for improving the quality of clinical patient care. This study verified the construct reliability and validity of the Chinese version of the CARE scale, which can be used to determine clinical nurses’ CNPI (Caring Nurse–Patient Interaction) competence. Psychometric analysis of the four major constructs Chinese CARE scale was conducted on a sample of 356 nurses from a medical center in Taiwan. Item analysis and explorative factor analysis were adopted to extract the main components, both the internal consistency and correlation coefficients were used to examine reliability, and a confirmatory factor analysis was adopted to verify the construct validity. The results of the goodness-of-fit of the model were fit well (0.91), all standardized factor loadings for each construct ranged from 0.73 to 0.95, the reliability and validity of this instrument was favorable, and the extracted 12 items could explain 95.9% of the measured content of the Chinese CARE scale. The results serve as empirical evidence regarding the reliability and validity of the Chinese CARE scale. Future research will focus on verifying the correlation between external validity and patient satisfaction. Clinical research can examine the scores of nurses on the Chinese CARE scale for elevating CNPI confidence and improving inpatient satisfaction and quality of care.

Biography Hui-Chun Chung has completed her master of nursing from Tzu Chi University and still in PhD studies at Institute of Medical Sciences. She is also the vice director of department of nursing in TzuChi general hospital, incharge the nursing administration. She has published a little papers in journals and has been serving as an editorial board member of TzuChi nursing jouranl.

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Page 203 Sheng-Fen Sung et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The inqury of family meetings holding by medical teams with terminally cancer patients and their significant others in Taiwan Sheng-Fen Sung*1, Wan-Ping Yang2, Ming-Chu Feng1, la-Ling Chen1 and Hsiu-Chu Chiang1 1Department of Nursing, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan 2Department of Nursing, Fooyin University, Kaohsiung, Taiwan

urpose: Family meetings are used to facilitate communication concerning end-of-life issues with patients and their families. The Ppurpose of our study was to obtain preliminary information on the characteristics of family conferences that take place in ward of a hospital. Methods: Qualitative method is adopted and 125 written texts of individual interview during a 24-month period are gualitative content analysis in this study. Results: The study results indicated that there were five types of family meetings such as “truth telling and prognosis”, “palliative care and do-not- resuscitate ”, “the goals of the end-of-life”, “discharge planning and care tips” and “artificial nutrition” to address seventeen issues, including “give an ultimatum and set the bottom line”, “be neutral and ask the significant others to make decisions”, “(th defense against challenges”, “make the claims to the medical authority”, “the fear of making wrong decisions”, “evaded the challenges due to their lack of abilities to make decisions and thus passed the buck to the medical teams”, “the significant others alienated the terminal cancer patients from the medical teams and evaded mutual communications”, “entrusted themselves to the medical teams due to their confidence in the team”, “be concerned about current challenges and looked for consolations”, “left the fate to God and prayed for rest-in-peace”, “sorrowed over their end-of-lives and left no means untried”, “be reluctant to give up, but eventually compromised due to sympathies”, “felt powerless, money is crucial and inevitable”, “sought for medical treatments out of love, even had to be in debt”, “the selection of home- or institution-based care depended on the availability of manpower”, “the pros and cons of intravenous supplements or nasogastric feedings”, “the existence of alternate day fasting diet”. Implications for practice: Further prospective studies that use validated tools to assess the content of the meetings and their impact on alleviating distress in patients and their family are needed.

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Page 204 Chou-Ping Chiou, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nurse practitioners’ evidence-based practice: Belief, implement confidence and barrier Chou-Ping Chiou I-Shou University, Taiwan

he objectives of this study were to describe nurse practitioner (NPs’) belief, implement, and barriers regarding EBP. The study Tadopted a correlational research design. One hundred and twenty NPs from a regional teaching hospital in southern Taiwan completed the questionnaires. The collected data were analyzed using the SPSS 20.0 software program. T-test, one-way ANOVA, correlation, and multiple regressions were used to analyze the data. The results showed that NP staffs had insufficient knowledge about EBP. Only 5% indicated their belief to implement EBP. The findings showed that attending EBP class has statistically significant difference on EBP belief (R2=0.28). EBP belief has statistically significant differences on EBP implement 2(R =0.28). The identified EBP barriers included: lack of time, lack of English ability, lack of statistic knowledge, and lack of research knowledge. The study suggests that medical institutions should strengthen NPs' habit of reading professional journals, encourage in-service training and participation, pay attention to educate and train junior staff. NPs in clinical settings need to be able to use research findings and incorporate EBP into their clinical practice to enhance patient outcomes. NPs must be provided with information that strengthens their attitudes about EBP improving care and patient outcome to accelerate EBP.

Biography Chou-Ping Chiou has completed her PhD from University of Pennsylvania School of Nursing. She is a Professor at the I-Shou University School of Nursing in Taiwan. She has published more than 50 papers in reputed journals and has been serving as an Editorial Board Member of Taiwan Nursing Association.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Effects of tuberculosis prevention and control education on nurses at colleges in Taiwan Hsiu- Li Huang, MSN, RN2 and Shu-Fang Chang, PhD, RN2 1,2School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

Objective: This study investigated the effects of tuberculosis (TB) educational intervention on school nurses’ knowledge, attitude, perceived behavioural control, and behavioural intention. Methods: A quasiexperimental one-group pretest–posttest design was adopted in this study. Participants were nurses at colleges who had attended the TB prevention workshop. The educational intervention workshop program included TB diagnosis and prevention, TB control on campus, and sharing of practical experiences. Data were collected using pretest–posttest questionnaires, and SPSS 20.0 was employed for data analysis. Results: There is significantly different between pre- and after test in knowledge (paired t=-9.41, p< .01), perceived behavioral control (paired t=-9.26, p< .01), and behavioral intention (paired t=-2.19, p< .05). However, attitude was non-significantly different between pre- and after test. The determinants that affected the behavioural intention in the post test were attitude and perceived behavioural control. Conclusion: Continuously providing prevention programs contributes toward the school nursing personnel’s knowledge, skills, and motivation for preventing tuberculosis. The major factors for behavioural intention were attitude and perceived behavioural control. Keywords: tuberculosis, quasi-experimental study, knowledge, attitude, perceived behavioral control, behavioral intention

Biography Hsiu Li Huang is a lecturer at National Taipei University of Nursing and Health Sciences, Taipei, ROC. She has practiced clinical and school nursing for 9 years and been involved in nursing education and research for 20 years.

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Page 206 Derya Akca et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

What should diabetics pay attention when traveling? Derya Akca* and Derya Bicak** *Uludag University Faculty of Health Sciences, Turkey **Istanbul University Faculty of Nursing, Turkey

Objective: This review is written to give advice about the issues that diabetics need to be careful about to avoid the negativity that they experience during and after the trip. Travel is an indispensable part of human life. It is anticipated that international travel, including diabetic individuals, will increase in the coming years. Travel can affect glycemic control. Especially international travel can pose special problems for diabetic individuals, especially insulin users. Patients with diabetes must make special travel arrangements differently from other individuals. Planning travel ahead will facilitate the diabetic individuals' lives, prevent possible complications, protect their health in the area they are in, and provide a pleasant travel experience. The planning should depend on the questions and answers that the individual will go to where, for how long, whether or not he will pass the time slots, when and what type of food will be more or less active than ever. People with diabetes often seek help with treatment management during travel from the primary care provider. Patient education in planning can help to reduce the frequency of travel-related problems in diabetic patients. This planning should include, in particular, pre-travel medical examination, adjustment of insulin and oral antidiabetic agents, nutrition during the journey, immobility, effect of weather conditions, regular foot control and care, how to keep insulin and use of insulin pump. It should also be noted that these patients should have simple carbohydrates for use in the case of hypoglycemia, blood glucose monitoring for glucose monitoring devices, drugs used, a copy of prescriptions and a card for diabetes. Travel is a fun and productive part of human life as long as health continues. People with diabetes have special difficulties when traveling. However, such difficulties can be easily anticipated or avoided in advance. For that reason diabetes should not hinder what you want to do. Keywords: Diabetes, nursing, planning, travel.

Biography Derya has completed her master at the age of 24 years from İnönü University Faculty of Health Sciences. She is continuing her Ph.D at İstanbul University Faculty of Nursing . She works as a research assistant at the Uludağ University Faculty of Health Sciences.

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Page 207 Basma Alyazeedi, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The sustained outcomes of school-based dietary interventions among primary school children: A systematic review Basma Alyazeedi University of North Carolina- Chapel Hill School of Nursing, USA

romoting nutrition intake in children is critical to sustaining behavior. School-based dietary interventions are effective in Ppromoting immediate dietary outcomes. However, the sustained dietary outcomes are unclear. The purpose of this review is to evaluate the sustained outcomes of school-based dietary interventions among primary school children. PubMed, CINAHL, and EMBASE databases were used to search related articles published in the past ten years (2007-2017). The search resulted in 11 eligible articles for review. Educational, environmental, parental involvement, and rewarding intervention components were identified in this review. The interventions varied in number of components involved (1- 3), length (6 weeks – 2.5 years), and sustained outcome measurement time (3 weeks – 1 year post-intervention). Overall, school-based dietary interventions found to be more effective immediately post intervention compared to period of time after the stop of the intervention. Although some reviewed articles reported significant positive sustained outcomes, most of the gained significant positive immediate outcomes declined dramatically a period of time later. Gradual cessation of a multicomponent intervention, rewarding children’s healthy eating behavior with tangible prizes, and combining educational intervention with parental involvement and or environmental component may enhance the sustained dietary outcomes in children. Saying that, no intervention type, involved components number, or length was noted to be dominant in producing sustained dietary outcomes. This could be secondary to issues related to study design, treatment fidelity, implementation rate, and validity or reliability of outcome measurement tools used. School-based dietary intervention should be planned and implemented carefully to reflect more accurate results and conclusions.

Biography Basma Alyazeedi has completed her MSc in Nursing (Pediatric Nurse Practitioner Program) at the age of 28 years from Case Western Reserve University School of Nursing. She is a current Ph.D. student at the University of North Carolina- Chapel Hill School of Nursing. Basma holds an academic position in Oman, where she is originally from, as a lecturer in Sultan Qaboos University College of Nursing at the Department of Maternal and Child Health Nursing.

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Page 208 Tin Wai Chang et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nurses in street attire: Facilitator of recovery process? Tin Wai Chang, Daniel Bressington, Lok Yan Chu, Tsz Yuet Dai, Lok Hui, Hei Tung Ip, San Yuet Kwok, Kin Long Ying and Fung Man Chan Hong Kong Polytechnic University, Hong Kong

he recovery model has been introduced in Hong Kong since 2010. Recently, the policy of uniformity in rehabilitation ward has Tchanged to allow staffs to wear their own clothes to better fit the recovery model. The effects of nursing staff wearing street attire have been under discussion over the past decades in the USA, the UK and Australia. However, this literature is of limited value to the psychiatric services in Hong Kong, where no related research has been conducted. The aim of the study was to explore Hong Kong mental health nurses’ views about wearing street attire within an in-patient rehabilitation unit with regards to facilitating patients’ recovery process. A qualitative descriptive study method, utilizing individual in-depth semi-structured research interview, was employed in this study. Interview data were content analyzed from the perspective of post-positivism. A total of 11 interviews were conducted with nurse participants. The analysis process initially identified 177 open codes, which were merged into 81 nodes. Finally, 3 main themes and 9 sub-themes were identified. Main themes were ‘building up rapport with patients’, ‘street attire helps deinstitutionalization’ and ‘different approaches to maximize the benefit and to minimize the risk’. A majority of nurse participants positively viewed the policy of wearing street attire in a psychiatric rehabilitation unit; they felt the policy was potentially beneficial to patients’ recovery process. Street attire is not the only key to recovery; nurses are recommended to be aware of their skills in taking care of patients, to further maximize the benefit of the policy.

Biography Tin Wai was born and raised in Hong Kong. She is a year 5 student of Mental Health Nursing. Last summer, she completed a leadership course and a nutrition course in Alverno College in the US under the student exchange programme offered by the School of Nursing. In 2014, she went to Hui Long Guan Hospital for clinical placement for three weeks in Beijing. In her free times, she likes to have quality chats with her friends, making little improvisation on some songs, reading theological books and playing with her lovely Chinchilla and Scottish Fold.

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Page 209 Hei Tung Ip et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nurses in street attire: Facilitator of recovery process? Hei Tung Ip, Daniel Bressington, Lok Yan Chu, Tin Wai Chang, Tsz Yuet Dai, Lok Hui, San Yuet Kwok, Kin Long Ying and Fung Man Chan Hong Kong Polytechnic University, Hong Kong

Biography Hei Tung Ip is currently a final year candidate of Bachelor of Science (Honours) in Mental Health Nursing in The Hong Kong Polytechnic University. She has involved in a research concerning nurses in street attire as a facilitator of patients’ recovery. She also joined different activities related to nursing, a service program, “growing resilience of children in post-disaster contexts”, to hold activities for children in Sichuan in 2015. She has been a member of the Dance Society. She enjoys singing and occasionally performs with her band mates in campus.

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Page 210 Kin Long Ying et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Nurses in street attire: Facilitator of recovery process? Kin Long Ying, Daniel Bressington, Lok Yan Chu, Tin Wai Chang, Tsz Yuet Dai, Lok Hui, Hei Tung Ip, San Yuet Kwok and Fung Man Chan Hong Kong Polytechnic University, Hong Kong

Biography Kin Long Ying is going to complete his undergraduate degree at the age of 22 years from the Hong Kong Polytechnic University. He is a student of mental health nursing program. He has accomplished clinical placement in medical and surgical unit, psychogeriatric unit, admission unit and substance abuse unit.

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Page 211 Hsiu-Chen Liu et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Application of cross-disciplinary learning in teaching clinical reasoning *Hsiu-Chen Liu, **Ching-Yu Cheng and **Shwu-Ru Liou *Chang Gung University & Chang Gung University of Science and Technology, Taiwan **Chang Gung University of Science and Technology, Taiwan

raditionally, nurse and physician educations took place in silos and nurses had been regarded as auxiliaries working under doctors. TStudies found that skills of communicating with physicians, developing relationships with colleagues, responding appropriately to emergencies, and handling new situation are meaningful stressors for new graduate nurses. However, nurses and physicians need to work closely to enhance patient health. Thus, developing a course that provide opportunities for nursing students for not only receiving interdisciplinary knowledge, but also experiencing interaction, communication, and cooperation with clinical professionals, especially physicians, to learn each other’s professional roles and responsibilities is important. The study applied cross-disciplinary teaching to develop clinical reasoning course with nursing faculty, nurse practitioner, and medical doctors in classroom and clinical setting. After taking the course, nursing students gain interdisciplinary knowledge in patient care as well as communication skills and cooperation with physicians as a team. The course was based on Avraham’s statements about cross-discipline teaching. The course is a 3 credit elective course taught in 18 weeks including 8 units (respiratory system, cardiovascular system, endocrine system, renal system, liver, cranial neural system, sepsis and septic shock, multiple traumatic injuries, and multiple organ failure syndrome), 4 hours for each unit (2 in-class and 2 clinical) and concept mapping and evaluation. In class, students learned from lectures, case scenarios and team-based, concept mapping learning. In clinical, 4-5 students teamed up and were instructed by physicians and nursing lecturers. Each group of students observe and join assessment and management with medical colleagues interdisciplinarly. Panel discussions/ debriefing were held during clinical with physicians and with nursing lecturers after clinical when concept maps were drawn. Evaluation of student course performance included in-class observations and team-reflections as well as cocept-maps, oral presentations, and self-evaluation. Via these activities, students practiced interprofessional interaction, communications and cooperation, and finally, promoted their clinical competence. Additionally, interprofessional interactions helps to relieve tensional and uncomfortable relations between nurses and physicians and that benefs students’ successful survival in their future work. Interdiscipline learning could be the future teaching/learning model.

Biography Ms. Hsiu-Chen Liu is currently a PhD student at Chang Gung University as well as a senior faculty at Chang Gung University of Science and Technology in Taiwan. Her clinical specialty is in the field of critical care and she teaches critical care nursing for more than 20 years. Her research interests focus on nursing education and critical patient care.

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Page 212 KuoYa-Fen, J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Reducing rate of unplanned extubation of endotracheal tube in intensive care unit KuoYa-Fen National Taiwan University Hospital, Taiwan

xtubation of endotracheal tube in ICU is one of the dangerous medical accidents. Endotracheal tube is an important device in Erespirators that sustain the respiration of patients. If endotracheal tube extubate, patients will be under the risk of hypoxia and may lead to the extension in the in-hospitalization time period, which increases medical costs. The incidence rate of extubation of endotracheal tube was 2.3% during January through June in 2016. In order to improve the medical caring quality, programs were designed to collect data and to conduct investigations for finding out the reason for the slipping off of the inner tracheal. Team group were established to stipulate standardized medical caring measures, to edit pocket books, to throw in-service education and training for different units, to audit, and to review and analyze. After implementing measures, effectiveness evaluation was conducted in October and November. The occurrence rate for the extubation of endotracheal tube was decreased from 2.3% to 0%. With the setting of standard, educational promotion, and application of management techniques and team resources, colleagues can aggregate consensus for cooperation and notify each other in advance. Discussion after the incidences also promotes the communications of the team group.

Biography Kuo Ya Fen has done her Master’s degree from Taiwan Graduate Institute of Medical Management, China; she works as a MICU Nurse at the National Taiwan University Hospital. She has experience working in Intensive Care Unit and was also elected as the Superior Nursing Head.

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Page 213 Hui-Ting Tu et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Effects of life album intervention in drug abuse unmarried young woman-a case study Hui-Ting Tu and Shu-Ming Chen FooyinUniversity, School of Nursing & Paochien hospital RN, Taiwan FooyinUniversity, School of Nursing, Kaohsiung, Taiwan

he drug addiction problems care are challenged healthcare provider for decade. The case study de-scribed a twenty three year-old Tdrug abuse unmarried woman who suffered from to get rid of drugs and uncetant in future life. The author used the method of life album skills within Ekson's Erikson development stage to take care for patient's psychosocial support. The life album for¬mat presented patient's childhood stage and adolescent stage. The life album was used nonverbal skills, time for happiness, favorite person, the most memorable experience. Author also used 5W (Where, When, Who, What, How), method to share the life album after watching the past and now, the future of their own, whether there was a different idea and inspiration is not the same as the new life, willing to play from the heart to get rid of drug addiction, daily review of previous photos, think of family, lead to change the idea, encourage postive life style in the future. The rsults showed that patients described her positive experience about reflection her own life from life ablum. She also look forward to the positive life in the future. The self reflection give her hope and power to face her familes and friends. Finally, she decided to get rid of drugs. In conclusion this study have pointed out the important outcoms that life album skills could help this patient r¬eflec¬tion and reset her life.

Biography Hui-Ting Tu works in nursing department for ten years, hepatobiliary and stomachcare experience for two years, internal, surgical intensive care unit for five years. Currently in the pediatric ward as a nurse teacher. She also study in FooyingUniversity of Nursing for master degree.

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23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The differences between the importance and practical ratio of clinical competency among nurse practitioners: Using Q-sorts Su-Jung Wei1, Hsiao-Yun Chang2 and Li-Hui Yang1 1Chang Gung Memorial Hospital, Taiwan 2 Fooyin University, Taiwan

he advanced roles of nurse practitioner are generated in response to the shortage of physicians and to the cost consideration of Thealth care. However, the specifications of the practices and the roles of the nurse practitioners continue to lack a clear definition which creates a gap in perception concerning the degree of competency of the nurse practitioners, causing the nurse practitioners to question themselves about their clinical judgment and clinical ability. We conducted a cross-sectional study design using “nurse practitioner role capacity questionnaire”. Two topics of the ideal role and practical role were investigated separately in two weeks apart. Data was collected using the Q method which prioritizes the input information. The results showed a significant difference between nurse practitioners ideal role and actual clinical role, the expectation and practice role were difference in medical assistance (t: 5.62, p<0.001), clinical research (t: 4.14, p<0.001), professional consultation (t: 2.29, p<0.005) and direct care (t: 2.21, p<0.005). In conclusion, the nurse practitioner’s ideal duties and actual clinical duties differed most significantly in the auxiliary services, and this is likely due to the lack manpower of residence physicians. This negatively affects the nurse practitioner training, making it very difficult for them to receive a complete, organized training. Impairing their ability perform advanced nursing roles including providing direct care, carrying out research studies and providing professional consultation.

Biography Su-Jung Wei has completed her Master’s from School of Nursing, Fooyin University and has worked in the Department of Pediatric, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan. She is a Nurse Practitioner in Pediatric department.

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Page 215 Ya-Ping Lin et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Application of transitional theory in the exploration of life adaptation on the transition to long-term care among elderly: A correlation study Ya-Ping Lin and Hsiaoyun Chang Fooyin University, Taiwan

he main purpose was using the theory of relocation to investigate the relationships of relocated pressure, health status and life Tadaptation among new residents in long-term care institutions. This correlational study used a convenience sampling method to recruit 108 who resided institution least than a year from 11 Kaohsiung long-term care institutions. The questionnaire contained personal information, symptom checklist for relocated pressure and life adaptation scale. The SPSS/PC version 18.0 software was used for statistical analysis. The relocation and life adaptation was correlated with the following factors: economic status (p=0.006), payment source (p=0.026), residence status (p<0.001), residence time (p=0.004), morbidity (p<0.001), Barthel index scores (p<0.001), the number of relocated pressure (p<0.001), degrees of knowing institution (p=0.005), degrees of willing to be relocated (p<0.001) and decision ownership (p<0.001).The results can help care team understand the problems of life adaption for elderly’s relocation in advance and provide appropriate care in order to enhance life satisfaction and health promotion. The most important thing is to make individual live a meaningful and purposeful life in future.

Biography Ya-Ping Lin is a Master student at Graduate Institute of Nursing, Fooyin University and has worked as a nurse in the Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University.

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Page 216 Leung Shuk Ching et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Knowledge, attitude of Cervical cancer and acceptability towards Human Papillomavirus (HPV) Vaccination among Hong Kong Citizens Leung Shuk Ching, Chow Peggy Pik Kei, Tsang Mei Yuk, Wong Ka Man, Pang Chi Wing, Man Ka Yi, Chung Pui Pui and Ho Tak Chung Tung Wah College, Hong Kong

ervical Cancer is commonplace for women. It is triggered by some categories of human papillomavirus (HPV). It has been proved Cthat HPV infection is a preventable disease with HPV immunization. The earlier the age in receiving the inculcation, and prior to sexual intercourse experience, the higher rate of protection against the infection. According to the Hong Kong Cancer Registry, the numbers of newly diagnosis of cervical cancer were around half of a thousand in 2013. The figure posed cervical cancer at seventh common disease in Hong Kong among female. There are three types of HPV vaccines had been approved by Centre for Health Protection. They are Cervarix (2-valent), Gardasil-4 (4-valent), Gardasil-0 (9-valent) in preventing cervical cancer or the majority of cervical cancer attributed by HPV types 16 and 18. This study was a cross-sectional research and was conducted throughout districts in Hong Kong. Data was collected through self- report questionnaire. In total, 397 interviewees were randomly picked and were invited to finish the questionnaire which is composed of 39 questions. Data analysis is still in progress. The preliminary result showed that more than 80% of the participants had heard of HPV before which was approximately 6 times more than those who did not (15%). Their mean knowledge score towards HPV, cervical cancer and HPV vaccine was 5.65 in which respondents who had heard HPV before doing the questionnaire had higher level of it. The preliminary result would offer suggestions to the government in formulating strategies for preventing cervical cancer. (249 words)

Biography Ms. Leung Shuk Ching is nursing student studying Bachelor Degree of Health Sciences (Major in Nursing) at Tung Wah College in Hong Kong. Ms. Leung Shuk Ching is the representative of the group to join in the conference. Her research interests include Human Papillomavirus (HPV), HPV vaccine, knowledge, attitude of Cervical cancer and acceptability towards Human Papillomavirus (HPV) Vaccination.

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Page 217 Chow Vincci Wing Sze et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

A study of parents-of-minor-age-daughters’ knowledge of HPV as well as barriers toward the HPV vaccine in Hong Kong Chow Vincci Wing Sze, Cheng Winnie Lai Sheung, Cheung Shu Man, Li Chung Yan, Kwok Wing Yu, Ku Ching Man, Tang Tsz Mui and Wong Kuk Fung Tung Wah College, Hong Kong

ervical cancer has always been known as one of the most common cancer type globally. Human Papillomavirus, HPV in short, is Cnearly 100% the cause of cervical cancers and can enter a person’s body through sex. High- risk types HPVs are responsible for causing cervical cancer and type 16 or 18 HPV are responsible for almost 70 percent of cervical cancer cases. In 2013, Hong Kong had 503 new cervical cases diagnosed. Nowadays in Hong Kong, 2-valent, 4-valent and 9-valent HPV registered vaccines are available and aim to help with the prevention against HPV type 16 and 18. A cross-sectional, quantitative and questionnaire-based study was used for this research. 413 Hong Kong residents who can read traditional Chinese and have at least one daughter aged 9 - 17 years old at the moment were recruited. Chosen Participants were recruited at four selected Health Care Centres and were invited to finish a set of questionnaire which is composed of 27 questions. Data analysis is still in progress. The preliminary result showed that around 80% of the subjects had heard of HPV which is relatively high rate among Asian, however their mean score of knowledge towards HPV is 2.4 which revealed an unsatisfactory knowledge level on the topic. Cost of vaccine and risk perception were main barriers that hindered parents’ willingness to vaccinate their daughter. The preliminary result could act as a reference for the Hong Kong Government to help in raising the HPV vaccination rate by strengthening HPV vaccine promotion. (249 words)

Biography Ms. Chow Vincci Wing Sze is a nursing student studying Bachelor Degree of Health Sciences (Major in Nursing) at Tung Wah College in Hong Kong. Ms. Chow Vincci Wing Sze is the representative of the group to give the presentation in the conference. Her research interests include Human Papillomavirus (HPV), HPV vaccine, knowledge, barriers and attitudes of parents-of-minor-age-daughters.

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Page 218 Cristina Mara Zamarioli et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Application of the knowledge of semiology in the practical field: The critical incidents reported by nursing students Cristina Mara Zamarioli, Idila Letícia Justiniana de Macedo and Emilia Campos de Carvalho University of São Paulo, Brazil

his study aimed to identify the critical incidents reported by students during activities in a practical field, involving knowledge Tacquired in the discipline of semiology and semio-technics (anamnesis, physical examination and nursing process). It is a study with a qualitative approach, using the technique of critical incident, used to identify relevant events for the individual. The elements of the critical incidents (situation, behaviors and feelings generated) were obtained in cursive written form about positive or negative experiences. Students enrolled in the nursing undergraduate course (n=62); 25.8% of the intermediate years and 74.2% of the final years; 90.3% female; age group of 19 to 35 years (mean of 23.2 years). There were mentioned situations related to: anamnesis and the physical examination of patients in different scenarios, clinical conditions and age ranges; the development of the nursing process; and the interaction of the student with patients, care team (with the teacher or supervisor). The reports that portrayed student behavior were analyzed. The positive feelings identified (61.3%) include self-satisfaction and recognition and predominated among the students. The negatives were related to the technical difficulty, represented by impotence, anxiety and insecurity, predominating among intermediate students. These reports portray the use of the knowledge of semiology in different experiences throughout the course. Also, they allow the improvement of the work plans of the disciplines, especially for the identification and prevention of stressful situations that generate negative feelings. Hence, it should be the goal of the teacher to offer teaching that will generate student satisfaction and lower stress load.

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Page 219 Li-Man Lin et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

Factors influencing care burden, social support and quality of life among caregivers of children with cerebral palsy Li-Man Lin, Su-Fen Cheng, Chi-Wen Chen, Nan-Chang Chiu and Che-Sheng Ho 1MacKay Memorial Hospital, Taiwan 2National Taipei University of Nursing and Health Sciences, Taiwan

hildren with cerebral palsy often require long-term home care by the primary caregivers, which results in great burden on the Cprimary caregivers and thus impact their quality of life. Thus, the purpose of this study is to explore the relationships among care burden, social support and quality of life among the primary caregivers for children with cerebral palsy. This study used cross- sectional descriptive correlational design. The following instruments were used for data collection: demographic information form, a care burden scale, a social support scale and a quality of life scale. A total of 120 primary caregivers for children with cerebral palsy participated in this study. The results showed: (1) the primary caregivers’ perception of total care burden was at the level of moderate and above. Among the aspects of total care burden, perception of psychological burden had the highest score and the perception of social burden receive the lowest score; (2) in the areas of total social support, amount of sufficient social support received had the highest score, whereas the amount of social assistance received had the lowest score; (3) the primary caregivers’ perceptions of total quality of life revealed a moderate to low level of satisfaction. Among the aspects of quality of life, the physical aspect of quality of life received the highest score, whereas the psychological aspect received the lowest score. Through provision of social support, the CP children’s primary caregivers may receive material, informational and emotional assistance, reduce the care burden and indirectly improve their quality of life.

Biography Li-Man Lin is a Head Nurse at Pediatric Intensive Care Unit of MacKay Memorial Hospital in Taiwan.

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Page 220 Jui-Chun Feng et al., J Nurs Care 2017, 6:4(Suppl) conferenceseries.com DOI: 10.4172/2167-1168-C1-050

23rd World Nursing and Healthcare Conference July 10-12, 2017 Berlin, Germany

The lived experiences of main caregivers caring for children with adrenoleukodystrophy Jui-Chun Feng, Su-Fen Cheng, Wei-Wen Wu, Miao-Ju Chwo and Dat-Shong Lin MacKay Memorial Hospital , Taiwan National Taipei University of Nursing and Health Sciences,Taiwan

drenoleukodystrophy (ALD) incurable once diagnosis is confirmed, and the child ultimately relies on the primary caregiver for Along-term home care until death. Purpose is to understand the primary caregiver’s lived experience. This study used qualitative study . There were six primary caregivers of ALD children who participated in this study. The results revealed with regard to the perceptions of the primary caregivers, five themes and fourteen sub-themes were identified. There are four sub-themes under the theme of “chaos/helplessness while seeking medical attention and forced acceptance”: “seeking medical attention for an unknown disease”, “panic about inability to determine the current status of the illness”, “shock and frustration upon confirmation of the diagnosis”, and “objection to the recommendation of palliative care”. There were three sub-themes under the theme of “maternal self-blame, worry and guilt”: “distressed and felt own it to the child”, “frustrated by inability to care for other siblings”, and “worried about other siblings may have the disease”. There were three sub-themes under the theme of “inspired maternal resilience”: “ongoing search for possible treatment options”, “commitment to care for the ill child”, and “manifestation of maternal resilience”. There were two sub-themes under the theme of “gradual family adaptation to the new norm”: “making best effort to accompany the child for resolution of self-guilt”, and “re-organization of family and social life”. There were two sub-themes under the theme of “palliative accompaniment until death”: “anticipates the child to receive the best care during bedridden”, and “gradual acceptance of palliative care”. The researcher hopes to provide mental support and palliative accompaniment through the establishment of a collaborative pediatric palliative care team and a care management system for children with rare diseases.

Biography Ms. Jui-Chun Feng is a head nurse at pediatric ward at MacKay Memorial hospital in Taiwan.

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The use of inpatient care bundle to lower catheter-associated urinary tract infection in an academic medical center Shu-Hui Lin1, Hsiao-Yun Chang2, Yi-Jung Liu1 and Yu-Chen Cheng1 1Kaohsiung Medical University, Taiwan 2Fooyin University, Taiwan

rinary tract infections are the most common infection sites in many hospital care-related infections, accounting for about 30- U40% of all medical care-related infections, of which about 90% are associated with long-term indwelling catheters. Therefore, we conducted pre and post-test quasi experimental study and a longitudinal study at the medical center in the South of Taiwan. The design of care bundle is to reduce the number of days of urinary catheter retention and urinary catheter associated with urinary tract infection and improves the quality of medical care, including the checklists of catheter placement and prevention of daily care for urinary tract infection. The intervention started from November 2015 till December 2016 and we audited the practice of intervention monthly in each unit at least in two patients. We compared the infective rate of catheter-associated urinary tract infection before and after the intervention. The rates with daily catheter population density for the catheter-associated urinary tract infection infectious was 5.1‰ before the implementation of combined intervention measures, and the infection rate decreased to 3.7‰ (P<0.00) after intervention. Care bundle has significantly improved the infection rate; therefore, it is important to educate healthcare professionals the concept of catheter-associated urinary tract infection and to audit the clinical practice of catheter placement and daily care which can result in the improvement of patient safety and quality care.

Biography Shu-Hui Lin has completed her Master’s degree from School of Nursing, Fooyin University and has worked in the Department of Infection Control, Kaohsiung Medical University Hospital, Kaohsiung Medical University. She has published three articles in domestic journals and one paper in international journals. Currently, she also delivers lectures in the Nursing School.

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The relationships among physical symptoms, fatigue, depression, social support, spiritual wellbeing and health-related quality of life in lung cancer survivors Chin-Yen Wu, Fei-Chen Lai and Tsae-Jyy Wang MSN, Nurse Practitioner, Department of Nursing, Changhua Christian Children’s Hospital, Changhua, Taiwan, ROC MSN, Supervisor, Department of Nursing, Changhua Christian Children’s Hospital, Changhua, Taiwan, ROC PhD, Professor, School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan, ROC

he purpose of the study was to investigate the influence of symptom distress fatigue, depression, and social support on health- Trelated life quality of lung cancer survivers. The study was a descriptive correlational research design. Participants were recruited from a medical center in middle Taiwan. There were 85 lung cancer survivers answered the study quessionnaire which included the basic information, the Functional Assessment of Cancer Therapy – General (FACT-G) Scale, FACT Lung Symptom Index 12 item version (FLSI-12) Scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale, Center for Epidemiologic Studies Depression (CES-D) Scale, Medical Outcome Study Social Support Survey (MOS-SSS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, (FACIT-Sp) Scale. Data were analyzed using SPSS 19.0 software. The average age of the participants were 59.6 (SD=10.6) with a range 37~80 year old. There were 41 male and 44 female. The participants’ cancer stages were 68 (80%) in stage I, 10 in stage II (11.8%) and 7 (8.2%) in stage III. Among the 85 participants, sixty (70.6%) of them had lobectomy,, 18 (21.2%) had segmentectomy, and 7 (8.2%) had wedge resection. The results showed that the participants’ average score on health related quality of life (HRQOL) was 82.21 (SD=12.32).Person correlation coefficient analysis showed that health-related quality of life were significantly correlated with symptom distress and fatigue but were not correlated with depression or spiritual well-being. Results of stepwise linear regression analysis showed that symptom distress and social support together explained 58.3% of the variance in health-related quality of life. Lung cancer survivors who had higher symptom distress and lower social support reported lower level of health related life quality. Therefore, interventions which reliefing symptom distress and increasing social support may help to improve life quality in lung cancer survivors.

Biography Chin-Yen Wu is an acute care nurse practitioner. She has worked in acute care settings for more than twenty years. Thoracic surgical nursing and critical care are her clinical specialty areas. She has great passionate on proving evidence based care to her patients and developing nursing knowledge.

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Applying MRM theory in the nursing care for a teenager with Ewing Sarcoma Guang-Mao Lee1 and Hsiu-Fang Hsieh2 1Graduate Student, Graduate Institute of Nursing, Fooyin University, Kaohsiung & E-DA Hospital, Taiwan 2Assocaite Professor, School of Nursing, National Quemoy University, Quemoy, Taiwan

his nursing care experience described a 18 year old male patient who was diagnosed with Ewing sarcoma. During the care period Tfrom April 11, 2016 to April 27, 2016, nursing care was provided based on the “modeling and role modeling” and Maslow’s need theory. After collecting data through observations and interviews, three major health problems were identified including hopelessness, acute pain, and ineffective protection. Under the guidance of MRM theory, individual care was provided to build a trusting relationship, to improve positive orientation and strengths, and to set mutual goals with the patient. The nurse also used several complementary and alterative therapies including mindfulness-based interventions, aromatherapy, meditateon, music therapy, and life review. In the end, the patient ultimately achieved goals of positive adaptability and coexistence with the disease .

Biography Guang-Mao Lee is a Master student at Graduate Institute of Nursing, Fooyin University and works as a nurse at Department of Nursing, E-DA Hospital, Taiwan.

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The incidence and influencing factors of elder abuse and neglect Hakime Aslan and Behice Erci Inonu University Faculty of Health Sciences, Turkey

Introductıon: The increase of the elderly population throughout the world has brought various health problems. In the last few years, one of the main topics for discussion has been the abuse and neglect of the elderly, which has psychosocial aspects (1, 2, 3). Abuse of the elderly is a form of domestic violence that has been observed more in the last thirty years. Abuse can be found in every society, culture, and at every economic level. It is not only a domestic or a nation-wide problem; it is a serious social problem. Elder abuse is evident in institutions providing health and social services. In such places, elder abuse results in physical and psychological damage, and in exploitation of the elderly (1, 4). This research is carried out to identify the incidence of abuse and neglect of individuals over the age of 65, who live in the city center of Malatya in Turkey, and the related factors. Method: The population of this research consists of 4,291 individuals age 65 and over who were registered in Family Health Centers in “Göztepe, Kernek, Taştepe, and İstasyon” located in Malatya. The sample is identified as 451 elderly through use of the sample size determination formula, with a 95% confidence interval and a 0.05 significance level. Findings: Of the elderly people in the study, 1.3% stated that they consistently experienced physical abuse, 0.8% noted that they regularly encountered financial exploitation, and 2.9% held that they werefrequently sexually abused. Also, 5.3% of the respondents noted that they were always neglected and that they experienced moderate emotional abuse. It was found that the level of abuse that elderly individuals regularly experience is low. It was observed that the study participants who were older, single women, poorly educated and low-income experienced the most abuse. They also had broken families.

Biography Completed master's degree in public health nursing at the age of 23. I am a doctoral student in nursing at Inonu University and research assistant at Inonu University.

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Intensive care nurses’ knowledge, attitudes, and practices for the use of physical restraints Hakime Aslan and Rukuye Aylaz Inonu University Faculty of Health Sciences, Turkey

Purpose: This study was conducted to determine the nurses’ knowledge, attitudes, and practices for the use of physical restraints. Introduction; Security and being safe are among basic needs of human. The fact that an individual experiences any limitation in his/ her movements means that the status of being safe is in danger. There are many risk factors in the hospital environment putting the status of patients' safety in jeopardy. The most threatening situation for the individual in the hospital is falling and injury. Especially individuals, who are overweight, are elder, cannot keep their balance, are weak, are agitated, and have orientation disorder, are at high risk for maintaining safety in the hospital environment. Physical restraints are used at the rate of 24-40% in intensive care patients. Recent studies have drawn attention to physiological, psychological, and social complications of physical restraint application which are reported to be useful for patient safety. Method; This descriptive study was conducted with nurses working in the intensive care units at Inonu University Turgut Ozal Medical Center between July and September 2016. It was aimed to reach the whole population without the sampling selection in the study. 103 nurses, who were voluntary to participate in the study, were included in the study. The data were collected by using a questionnaire evaluating the demographic characteristics of the nurses and the "Knowledge Levels, Attitudes, and Practices of Nurses Regarding Physical Restraints Questionnaire”. The data were assessed by using the SPSS 21 packaged software. Number, percentage, mean, analysis of variance (ANOVA) in determining the correlation between the independent variables, and independent samples t-tests were used to evaluate the data and the significance level was accepted as p<0.05 in the study. Results; It was found that the average age of the nurses participating in the study was 28.6, 79.6% of them had bachelor’s degree, 52.4% were single, 48.5% had a working period of less than 5 years, 81.6% worked as day and night shift (mixed) and 69.9% did not receive any education about the use of physical restraints. It was determined that the mean score of knowledge of the nurses, participating in the study, regarding physical restraint was 7.39±1.65,their attitude mean score was 28.84±4.77, and their practice mean score was 21.46±3.94. Conclusion; It was determined according to these results that the knowledge levels of the nurses about the physical restraints were high, their attitudes were positive, and their practices were moderate.

Biography Completed master's degree in public health nursing at the age of 23. I am a doctoral student in nursing at Inonu University and research assistant at Inonu University.

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Fatigue and its associated factors in Taiwanese women with systemic autoimmune diseases Hsuan-Man Hung1 and Ming-Fu Chen2 1Department of Nursing, Tajen University, Taiwan. 2St. Joseph Hospital, Kaohsiung, Taiwan.

ystemic autoimmune disease (SAD) occurs mainly in women population, and fatigue is the common clinical complains and Shas a negative impact on their quality of life. Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and Sjogren's syndrome have the higher prevalence other than SADs, which often attack the women with 30-50 years old. The cross-sectional study design was used. A convenience sample of 239 Taiwanese women with SAD were recruited. Data were collected from April 2015 to March 2016 using structured questionnaires including demographic characteristics, Fatigue Severity Scale (FSS), Mental Component Summary, Physical Component Summary, Perceived Stress Scale, Interpersonal Support Evaluation List, and Taiwanese Depression Questionnaire. The results reveal that above the FSS cutoff score of 36, indicating severe fatigue, 125 (52.3%) participants were categorized as sever fatigue. The mean score of the FSS was 38.55 ± 13.92. The best subsets for predicting the criterion variable of fatigue included depression, role overload, physical health status, regular exercise, age and educational level. Women with SAD who had depression, higher role overload, poor physical health status, sedentary life style, getting older, and higher educational level reported more fatigue, thereby adding to existing knowledge of the factors involved in fatigue of women with SAD.

Biography Hsuan-Man Hung is an Assistant Professor in Department of Nursing at Tajen University (Taiwan), and provides education in community health nursing and women's health education to undergraduate nurses, and I hold a Ph.D. degree in nursing from the Institute of Allied Health Science at National Cheng Kung University. My research interests focus on the field of community health nursing and women's health..

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Prevalence, characteristics and related factors of chronic pruritus in older adults in Taiwan Jong-Ni Lin Da-Yeh University School of Nursing, Taiwan

his cross-sectional study explored the prevalence and characteristics of chronic pruritus, and the factors which cause chronic Tpruritus of the elderly. A total of 930 non-demented Taiwanese participants, aged 65-96, were recruited. The“5D Itch Scale” was primarily used to collect data relevant to the characteristics of chronic pruritus. The prevalence rate of chronic pruritus was 24%. Of those 226 participants with chronic pruritus, 51% were females with a mean age of 75 (SD = 77), and 49% were males with a mean age of 73 (SD = 70). A mean score of pruritus in females was 10.8 (SD =3.6) (> 5 indicates having pruritus) higher than a mean of 9.9 (SD = 2.9) in males, and this finding was statistically significant (t = -2.09; p = .03). Sixty percent, 25% and 11% of them had mild, moderate, and severe pruritus respectively. Seventy-eight percent of them had at least one type of chronic disease, and this was significantly associated with chronic pruritus (p =.001). Sixty percent of the participants reported age-related xerosis as a common factor to cause their pruritus, but this finding did not reach statistical significance (p = .06). The most common three areas where the participants experienced pruritus were legs (64%), arms (61%), and back (39%). In conclusion, chronic pruritus is a common problem that often occurs on elderly extremities. Chronic pruritus is commonly caused by xerosis, and its characteristics significantly differ in females and males. Future research can focus on exploring what causes such a difference.

Biography Jong-Ni Lin earned a PhD degree in 2013 from the University of Washington in the U.S. She is an assistant professor at the Nursing Department of the Da-Yeh University in Taiwan. Her specialty is geriatric nursing and long term care. The research projects which she is conducting include inventing an “Anti-Pruritus Icy Roller” to decrease pruritus, developing exercise programs to improve elderly physical fitness and quality of sleep and an intervention to lessen elderly constipation.

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The Influences of chronic pruritus on quality of sleep, daytime sleepiness and depression in Taiwanese elderly Jong-Ni Lin Da-Yeh University Department of Nursing, Taiwan

hronic pruritus (> 6 weeks) is a frequent skin complaint in older adults, but little attention has been paid to the effects of the Ccomplaint in elderly population. This cross- sectional study aimed to investigate the impact of chronic pruritus on sleep and depression in older adults. Convenient sampling and snowball sampling were used to recruit 930 community-dwelling adults, aged 65-96, from northern and central Taiwan. None of the participants suffered from dementia. The “5D Itch Scale,” “Pittsburgh Sleep Quality Index,” and “Epworth Sleepiness Scale” were utilized to collect data. Twenty-four percent of all the participants reported chronic pruritus, with a mean age of 74 (SD = 7.4), and a mean pruritus score of 10.3(SD = 3.3)(> 5 indicates suffering from pruritus). The mean scores of quality of sleep, daytime sleepiness, and depression were 6.9(SD =4.0), 5.4(SD = 5.3), and 1.7(SD = 2.3) respectively. The linear regression analyses indicated that chronic pruritus significantly affected quality of sleep (p = .000), daytime sleepiness (p = .028), and depression (p = .000). However, the percentage of chronic pruritus that can explain the changes in quality of sleep, daytime sleepiness, and depression scores was less than 10% (R2 < .10). This reveals that chronic pruritus may not be the main factor that causes poor quality of sleep, daytime sleepiness, and depression. Future research should take more factors into consideration and exam their causal relationship.

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Concept analysis of medication non-compliance Kai-Jen, Cheng1 Hsiao-Yun,Chang2 and Ya-Ling, Lin3 1Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddist Tzu Chi Medical Foundation, Chiayi , Taiwan 2Associate Professor, School of Nursing,Fooyin University,Kaohsiung City, Taiwan 3Lecturer, School of Nursing, Kao-Mei Junior College Of Health Care And Management,Kaohsiung City, Taiwan

edication therapy is a common and necessary treatment for chronic illness; however, good compliance needs to depend on Mpatients’ habits, foods, and sleep. Medication compliance is a common problem for a patient with chronic illness. It might not only result in serious complications but also medical-economic waste. A study found that only 15% patients with type 2 diabetes have a good medication compliance in a year.Analyze the concept of medication non-compliance and identify its defining attributes, antecedents and consequences and list cases to clarify this concept. It was defined as patient disobeys the healthcare advices with active or passive non-compliance behaviors and the rate of medication compliance less than 80% .This study searched literature from the following databases: MEDLINE、PubMed、CINAHL、ProQuest and CEPS for the concept analysis of medication non-compliance. The data analysis was using Walker and Avant’s (Walker & Avant, 2005) eight steps of concept analysis, including:1.Select a concept；2. Determine the aims or purposes of analysis；3. Identify all uses of the concept；4. Determine the defining attributes；5. Construct a model case；6. Construct borderline、related、contrary, and invented cases；7. Identify antecedents and consequences；8. Define empirical referents. Evidence-based data is to examine the real phenomenon of the concept, and questionnaires and laboratory tests are used as value tools. By analyzing the concept of medication non-compliance, we hope to define the antecedents and consequences of this concept which can help the healthcare workers to deal with the patients with this problem.

Biography Kai-Jen,Cheng is a visiting staff of Division of Nephrology in Dalin Tzu Chi Hospital. I have published 2 articles in domestic journals and one poster in international Conference.

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The effect of depression levels of the mothers with infants hospitalized in intensive care unit on maternal attachment Kevser Isik, Hilal Yildirim and Behice Erci Inonu University, Turkey

Background: One of the important factors that prevent the infant from interacting with the mother is the hospitalization of infant. This situation preventing the development of a satisfactory relationship between the mother and the infant makes maternal-infant attachment process difficult and causes the mother to experience depression. This study was conducted to determine the effect of depression levels of mothers, having infants hospitalized in the neonatal intensive care unit, on maternal attachment. Methods: Population of this descriptive study consisted of mothers having infants who were hospitalized in the neonatal intensive care unit of Inonu University, Turgut Ozal Medical Center. The sample consisted of 312 mothers calculated with 0.95 of representative power of population and effect size of 0.5 at confidence interval of 0.95 and errors of 0.05 with power analysis. Mothers were considered for the study by using random sampling method, one of the improbable sampling methods. Results: The average age of mothers participating in the study was 29.31±5.83. Mean score of maternal attachment scale was 74.77±33.75, and mean score of Edinburgh depression scale was 15.22±6.88. It was determined that while maternal attachment was affected by the mode of delivery and the period of stay in the hospital, it was not affected by the variables like educational level, number of pregnancies and the presence of a helping person. Depression level was found to be affected by the mode of delivery but it was not affected by the educational level, number of pregnancies, the presence of the helping person and the duration of stay in the hospital. It is determined that there was a negative correlation between the maternal attachment and depression and as maternal attachment increased, the depression level decreased. Conclusion: It can be concluded that mothers’ depression levels affected the maternal attachment.

Biography Kevser Isik was born in Gaziantep. I completed the training in Gaziantep. I graduated from Sutcu Imam University in 2010. I started graduate education in 2011 in Malatya Inonu University. I have been working as research assistant at the Faculty of Health Sciences at Inonu University Since 2013.

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A phenomenological study on the lived experiences of Korean students learning an English context based- instruction Maria Monica D Espinosa Woosong University, South Korea

ived experiences of nursing students learning an English context based-instruction (CBI) provide greater insight to develop an Leffective classroom teaching strategy in nursing education. The main objective of this study was to investigate the Freshmen Korean nursing student’s experiences in the classroom as they learn the nursing subjects taught in English language. Interview as a method of research was used to explore the views, experiences, beliefs and motivations of individual participants. The researcher extracted the different facets from the 9 students of Woosong University, Department of Nursing who were selected randomly based on their grades. To analyze the data, the method used to code and categorize the interview data were adapted from approaches to qualitative data analysis. Five themes emerged from the interview. The Nursing students stories showed that learning an English context based-instruction (CBI) maybe attained by having the following traits, “readiness to learn”, “hard work”, “devotion to study amidst difficulty”, “determination to pass the subject”, and “staying focused”. Hence, the significance of this study is both educational and cross-cultural in nature. In conclusion, nursing students learning an English context based-instruction (CBI) is affected by their readiness to learn and the level of their English comprehension. They experienced some degree of difficulty in understanding the subjects taught in English that leads to anxiety. Furthermore, this study extended the data in the field of second language research in South Korea, as it has implications that directly encroach upon nursing students’ preparation and readiness for globalization in the nursing field.

Biography Maria Monica D Espinosa has completed her Doctor of Education in Educational Administration from the University of Manila. She is an Assistant Professor at Woosong University, College of Health and Welfare, Department of Nursing. She is actively involved in research and has presented in the following countries: USA, China, Thailand and Philippines. She has won the Best Paper Award at the International Conference on Management Science and Management Innovation (MSMI) held in Changsha, China in 2014. She is the author of the book “Just Ordinary People from Trials to Triumphs”, published by Xlibris publication, Australia.

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Knowledge and practıces of mıdwıfery students about complementary and alternatıve therapıes Emine Derya Ister* and Yasemin Altinbas* *Adıyaman University School of Health, Nursing Department, Adıyaman, Turkey

Introduction: Complementary and Alternative Terapies (CAT) extensively has been used with varying from individual to individual from country to country in the worldwide to treat or prevent various diseases for centuries. The use of CAT methods can affect the prognosis of diseases either positively or negatively. For this reason, midwiferies, which provides patient care and treatment services that prefer these methods, approaches related to information, opinions and practices are important in terms of ensuring patient safety and providing quality services with a holistic approach to illness. Aim: This study was conducted to determine knowledge levels and practice stituations about CAT of midwifery students. Method: The study was conducted in a Health School of state university in Turkey. The sample of the study was 158 midwifery students. The data collected by using questionnaire that was developed by researchers. Descriptive statistics and chi-square test were used in the study. Results: The mean age of the students was determined as 20.54 ± 1.62. It was stated that 93.3% of the students were not educated about CAT and 47.7% were not interested in CAT. 19.9% of the students stated that they used one of the CAT and 91.1% stated that they used plants as CAT. 59.1% of the students stated that CAT was as effective as medical treatment and 71.4% of them should not be used without consulting a doctor. The students had no knowledge about CAT methods 88.6% ayurveda, 80% reiki, 79.7% reflexology, 78.8% acupressure, 74.6% taichi, 68.7% fengshui, 65.4% homeopathy, 64.1% osteopathy, 61.2% aromatherapy, 59.0% therapeutic touch, 57.5% ozone therapy, and 53.7% treatment with colors. It was determined that CAT usage rates were statistically significantly higher that students thought medical treatment would be better by CAT and CAT prepared the body for defense (p =0.013). The using of CAT was statistically significantly higher of students who thought that more scientific evidence had to be obtained before CAT were used (p =0.006). Conclusion: According to the results of this study, the majority of midwifery students generally unaware of CAT methods and they think that scientific evidence needs to be established before these methods can be used therapeutically. In line with the results of this study, it is recommended that addition of CAT methods and practices to the midwifery curriculum and that be supported for use by midwifery students in the clinics.

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Accepted Abstracts

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How to increase international patients’ satisfaction level by 17% with an unexpected (and cheap!) change Andres Molina Universidad EIA Escuela de Ingenieria de Antioquia, Colombia

5% of failure in international relationships is due to intercultural clashes. Healthcare practitioners are faced with unexpected 8pain expressions and care requirements more often, due to the proliferation of international patients, both as migrants and as medical tourists. This speech opens discussion on what should institutions and practitioners explore and include to build better International Patient’s experience. With anthropological and psychological perspectives and an encouraging speech style, Andres demonstrates cross-cultural skills are not intuitive and shows how easily they can be acquired. Although not a breakthrough technique by itself, bringing cross-cultural skills into the healthcare world would help practitioners address the needs of particular cases. The more culturally coherent for involved parties a given treatment or procedure, the smoother the interaction with patients and caregiving relatives.

The effect of the preoperative anaesthesiological interview on the levels of stress and anxiety of the heart surgical patient Androula C. Karaolia1, GeorgiosI. Tagarakis2, Elena Argyriadou3, Ilias Bonotis4 and Nikolaos Tsilimingas5 1Anaesthesiology Department, University Hospital of Larissa, University of Thessaly, Greece 2Department of Cardiothoracic Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Greece 3Department of Anaesthesiology, AHEPA Hospital, Aristotle University of Thessaloniki, Greece 4Department of Psychiatry, University Hospital of Larissa, Greece 5Department of Cardiothoracic Surgery, University Hospital of Larissa, University of Thessaly, Greece

Background: Stress and Anxiety are commonly observed before major surgical procedures, such as heart surgical operations. Aim of the current study is to investigate the effect of the preoperative anaesthesiological interview on these parameters. Methods: We prospectively included in the study 152 patients planned to undergo elective heart surgery. All patients were examined with the State-Trait anxiety inventory (STAI) scale on admission and again before surgery (prior to the anaesthesiological interview for the control group and after the latter for the intervention group). Results: Members of the control group had significantly higher levels of stress based on the test results, on the day prior to surgery. On the contrary, the members of the intervention group had significantly lower levels of stress on the same day. Conclusions: The anaesthesiological interview has a positive influence as it lowers the preoperative levels of stress and anxiety.

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Attentional bias toward emotional stimuli in accidentally injured Chinese patients with different posttraumatic growth levels Annuo Liu1,2, Xiaohong Liu1, Lulu Wang3 and Tingting Yan4 1School of Nursing, Second Military Medical University, No.800 Xiangyin Rd., Shanghai, 200433, China 2School of Nursing, Anhui Medical University, No.81 Mei Shan Rd., Shu Shan District, Hefei, Anhui Province, 230032, China 3First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China 4Shanghai Jiguang Polytechnic College, Shanghai, China

xtensive evidence has been obtained that supports an association between an attentional bias toward negative stimuli and Evulnerability to stress-related psychopathology. Little is known regarding whether biased attention toward positive stimuli relates to mental health and posttraumatic growth (PTG). The current study investigated whether accidentally injured Chinese patients who had different levels of PTG showed different patterns of attentional bias toward either positive or negative stimuli. A sample of 202 patients completed questionnaires measuring PTG and the modified dot-probe task. Participants were split in three groups based on the 20th percentile on the Posttraumatic Growth Inventory: high-PTG, medium-PTG and low-PTG. Patients who scored low levels on the PTGI did not exhibit attentional bias toward negative or positive stimuli, patients with medium levels of PTG had difficulty disengaging attention from negative stimuli, and finally, patients with high levels of PTG had difficulty disengaging attention from positive stimuli. An implication of this finding is that the understanding of information processing biases in PTG and therefore suggest a novel target for prevention and treatment interventions, such as attentional bias training addressing stress-related psychopathology.

The work of the rehabilitation nurse after catastrophe: earthquake in Haiti Rita Aquarone University of Sao Paulo School of Nurse, Brazil

n January 12, 2010 the earth trembled. Port-au-Prince, capital of Haiti, has been reduced to rubble. About 220,500 people Odied and 500,000 were left homeless (1). Immediately, informal caregivers appeared people without basic training to act with the population, who call themselves nurses, rehabilitation technicians, rehabilitators. Rehabilitation, such as nursing care should be developed with precociousness, in this case at the scene of the tragedy. Many people with disabilities need rehabilitation especially in situations of natural disasters.The literature (1, 2) presents the work of nurses from different countries focused on wound care, emergency and surgical assistance in the event of catastrophes. This work presents a Brazilian experience with emphasis on catastrophe rehabilitation, through the training of informal rehabilitation agents in Haiti, and the discussion of the transcultural factors involved in the educational process of these human resources. The objective of this work is to report the experience of a rehabilitation nurse in the training of human resources in Haiti. Post-earthquake relief efforts have attracted a significant number of foreign health professionals, and at least 90% of the population has close access to health care (only 60% had access before the earthquake). The rehabilitation nurse has the technical and attitudinal competence, derived from his / her practice and academic practice, to implement quality assistance to people with physical disabilities, either in hospitalization units, outpatient clinics and at home. These characteristics make it eligible both for specialized assistance and for the conduct of educational programs aimed at empowering professionals and community agents.

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Nursing diagnoses associated of depression indices and capacity mental in elderly people in a geriatric ambulatory clinic of Brazil Cris Renata Grou Volpe , Karolina Vicenzi Andrade, Yuri Gustavo de Sousa Barbalho, Lucas Barbosa Aguiar, Walterlânia Silva Santos and Marina Morato Stival University of Brasilia, Brazil

he present study aimed to identify the most prevalent nursing diagnoses in elderly patients in a geriatric outpatient clinic in Tthe Federal District, Brazil, according to NANDA Taxonomy II relating them to the depression and mental scales. This is a descriptive, observational study of 40 elderly people over 65 years attended at the geriatric clinic. Data collection took place in March 2010 for 60 days. The scales of EDG and MEEM were used. The Pearson's chi-square were used for associations and the significance level of p <0.05. The Geriatric Depression Scale (EDG) and the Mental State Mini Exam (MMSE) were used. This study was approved by the Ethics Committee of the Health Department of the Federal District. The most prevalent nursing diagnoses were: disturbed sensory perception; decreased cardiac output; Impaired dentition; Impaired memory; Risk of falls and insomnia. The indexes of depressive symptoms by EDG were 35% and the cognitive alterations by the MEEM were 60%. There is a significant association between social isolation, risk of loneliness, chronic sadness and hopelessness in relation to the depression indexes demonstrated by the scale. SDs significantly associated with cognitive impairment by MMSE were: poor knowledge and impaired memory. Older people tend to have cognitive deficits and depressive symptoms, especially older ones, and dependence on how much wings activities of daily living. The most prevalent related factor with impaired memory was excessive environmental changes and poor cognition was cognitive limitation.

A culture of change: Examining the relationships between Critical Care Nurses’ perceptions of a healthy work environment and intent to transfer following health system mergers Georgia D Harrison USA

Background and Significance: The June 2014 acquisition merger of an American Nurses Credentialing Center (ANCC) Magnet- accredited major urban academic institution, and an ANCC Magnet accredited suburban, community hospital in the Northeast United States, had a significant impact on the improved quality and availability of resources to the population it serves. The merger acquisition of the community hospital by the urban hospital created a one-hospital two-campus organization, with the urban hospital being the flagship hospital in the health system. In 2015, the nurses verbalized feeling even more dejected and devalued. It was observed where senior and mid-level unit nursing leadership dismissed staff nurses as they verbalized their concerns regarding inappropriate staffing levels, not having meaningful recognition, and not feeling valued. Aims and Objectives: The aim of the project is to explore the factors that relate to critical care nurses’ perceptions of a healthy work environment (HWE), and intent to transfer after two health system mergers. The specific objectives of the project are to assess the American Association of Critical Care Nurses six standards of a HWE, and explore factors that may have an impact on critical care nurses’ intent to transfer. Methodology: A descriptive correlational survey design used to explore factors related to critical care nurses’ perception of a HWE and intent to transfer following two hospital mergers. Outcome Measures: The HWE instrument utilized will identify the six essential standards to ensure a HWE; appropriate staffing, skilled communication, authentic leadership, meaningful recognition, nurse satisfaction, and availability of resources. The Anticipated Transfer Scale instrument focus on potential job turnover and intent to transfer among nurses in an acute care setting. Nursing Implications: The intent of the project is to create awareness about the negative, unhealthy behaviors that may impact nursing units going through mergers.

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Evaluation of nursing approach in pediatric services in terms of family centered care MSc.Fatmagül Özcan* PhD. Assist.Prof.Dr.Gülzade Uysal** * Secretary General of Public Hopitals Administration of Hatay, Education R-D Unit Hatay, Turkey **Okan University, Faculty of Health Sciences, Nursing Department, Istanbul, Turkey

valuation of Nursing Approach in Pediatric Services in Terms of Family Centered Care: The study was carried out as a descriptive Estudy in order to evaluate the nursing approach applied in pediatric services in terms of family centered care. The universe of the research was formed by the parents of 1153 children who stay in the pediatric services of Şişli Hamidiye Etfal Education and Research Hospital of the last one year. The sample size of the study was determined by the sample of which the individuals number of the population is known, and the sample was composed of 305 mothers. The data obtained from the study were transferred to the SPSS 22.0 package program, and examined using appropriate statistical analyzes. 52.1% of the children of the mothers participated in study are girls and 66,6% are in the 0-5 age group. 28.2% of the mothers are between 26-30 years old and 90.8% is housewife. 65.9% of the mothers who participated in the study stated that staying of their children in hospital have not placed the financial burden on them; 86.6% of them stated that their personnel cares were affected from this situation. As long as they stayed in hospital as companions it was seen that 78.4% of mothers were participated in feeding activities, 89.8% of them participated in self-care activities and 99.3% of them participated in activities of bed making up. Mothers stated that they satisfied with most of the practices they participated. The mean score of family centered care of mothers participating in the survey was found as 34.98 ± 0.24, and the average score of family centered care consistency was 30.73 ± 5.47. The difference between the means of significance and consistency scores was found statistically significant (p<0.05). As a result of the study, it is seen that significance score of the mothers' family centered care has a higher than the score of consistency. It is suggested that the standardization of the model should be ensured by planning the in-service trainings concerning family centered care towards the pediatric nurses in order to development of the family centered care whose importance is undeniable for the child and family in pediatric clinics.

Attentional bias toward emotional stimuli in accidentally injured Chinese patients with different posttraumatic growth levels Annuo Liu1,2, Xiaohong Liu1, Lulu Wang3,2 and Tingting Yan4 1School of Nursing, Second Military Medical University, No.800 Xiangyin Rd., Shanghai, 200433, China 2School of Nursing, Anhui Medical University, No.81 Mei Shan Rd., Shu Shan District, Hefei, Anhui Province, 230032, China 3First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China 4Shanghai Jiguang Polytechnic College, Shanghai, China

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Probable posttraumatic stress disorder among Australian midwives: Prevalence and risk factors Julia Leinweber, Debra Creedy, Heather Rowe and Jenny Gamble Protestant University of Applied Science Berlin, Germany Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia

Background: Midwives are frequently exposed to traumatic birth events. There is a growing body of evidence that posttraumatic stress is a risk of exposure to birth trauma among maternity professionals. Posttraumatic stress may affect midwives’ professional functioning and thus reduce the quality of midwifery care. Little is known about specific risk factors for the development of posttraumatic stress among midwives. Main Objective: To identify prevalence and risk factors for probable PTSD among Australian midwives. Methods: A national internet survey of Australian midwives registered with the Australian College of Midwives was conducted between March and June 2014. Trauma symptoms were assessed with the PTSD Symptom Scale Self Report (PSS-SR). Probable PTSD was assessed as meeting DSM IV PTSD diagnostic criteria B, C and D (a score of at least 'one' on the four point frequency scale for a minimum of one intrusion, three avoidance and two arousal symptoms) and a total PSS-SR score ≥14. Personal, trauma event-related and environmental risk factors were assessed using multivariate analysis. Preliminary Results: 707 surveys were completed (estimated recruitment fraction 15.4%). The prevalence of probable PTSD was 17% (n=102) (95% CI 14.2, 20.0). Multivariate analysis identified three factors independently associated with probable PTSD; each factor more than doubled the risk for probable PTSD: (1) feelings of horror during the traumatic birth event witnessed (AOR=2.57, 95% CI 1.20, 5.51); (2) feelings of guilt associated with the traumatic birth event (AOR=2.14, 95% CI 1.12, 4.08) and (3) a personal history of a traumatic experience when giving birth (AOR=2.12, 95% CI 1.24, 3.64). Conclusions: Almost one fifth of Australian midwives meet criteria for probable PTSD. Posttraumatic stress in midwives should be acknowledged as occupational stress by health services and professional associations. Trauma informed care and practise (TICP), which acknowledges and responds to the impact of trauma among women and their care providers, are recommended.

Nurse executive leadership in ASCs pearl’s Asmait Yohannes Mount Sinai Department of Surgery-Icahn School of Medicine at Mount Sinai, USA

mbulatory services require more Nurse Executives to oversee operations focus on including items such as unit improvement, Acost containment, keeping physicians content, maintaining a high level of satisfaction and quality care for patients and patient’s families. As surgical patient care moves from inpatient to outpatient settings, ASCs Nurse Executive leaders are charged with developing creative solutions to address complex and challenging issues in a most competitive arena. They bring clinical expertise that will allow them to demonstrate a capacity to analyze and synthesize both qualitative and quantitative information in order to reach executive decisions.

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