20^th World Nursing Education Conference May 22-24, 2017 Osaka, Japan

I-Hsien Li has completed her Master from Taiwan University. She is the Instructor of Junior College of Healthcare and Management,New Taipei city, Taiwan, her research major is nursing education, psychiatric nursng, and has published some papers in journals.

Background: Psychiatric mental health nursing assessments enhance the skills of nurses in assessing psychiatric patients and in the professionalization of psychiatric mental health nursing Purpose:The purpose of this study was to strengthen the students’ clinical competence of psychiatric mental health nursing assessment, we used the practical ability indicator of mental health nursing evaluation for college nursing students. Design: Used a descriptive qualitative approach and deep individual interviews, was collected eight students from a nursing college school in Taiwan in 2015, and the Republic of China Psychiatric Mental Health Nursing Association of mental health care assessment of the nine essential items as an indicator, faculties was observed the student’s performing of psychiatric mental health nursing assessment, and analysis their homework, like process recording, nursing care plan, and reflection diary. Main findings：We had collected the information of the assessment indicator through practicum in Psychiatric Nursing and develop the indicators fit for nursing college’s students, at the physiological level, students perform from novice to competent, others like psychological, intelligent, emotional, social level, students performs the degree of advanced beginner. Conclusion and recommendations：The results finally enhance not only the psychiatric nursing assessment competence of students, but also made the instructions of practicum in Psychiatric Nursing.

Chen has completed her PhD from National Taiwan University and major on women health and qualitative study. She was a professor of Department of Nursing HungKuang University. She has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute.

Nursing shortage and the university graduates unable to find a job are two major problems in Taiwanese society. The Ministry of Education had encouraged the universities to design the accelerated BSN program for solving the problems. Our school is one of the four universities permitted by the Ministry of Education to recruit students in 2015. We concerns that whether the program is well designed, whether the teachers change their teaching strategies to fulfill the students’ learning needs. Additionally, how the students perceived their learning experiences. We aim to understand the backgrounds of the students, their motivation of entry into this program, their understanding and expectation toward nursing profession and career. Data were collected from 25 students using semistructured, 3-5 focus group interviews. Recorded focus group interviews were transcribed and analysed by qualitative content analysis. This analysis identified four themes: (i) exceptation to Increase pre-entry prerequisites for biology and chemistry courses; (ii) creating a learning Environment; (iii) reduced waste through efficient use resources; and (iv) the ultimate goal of obtaining RN certification. The results of this study will increase our understanding of what and how the students perceive their experiences in the accelerated BSN program. Additionally, the knowledge from this study will also beneficial for policy makers as references for refining this program in the future.

Objective: To study and compare between 2% Chlorhexidine in water and Povidone iodine solution seeing whether there are any differences in using them to prepare skin before surgery. Design: This research used a randomized controlled trial in a Prospective cohort study. Implementation: The samples were patients undergoing opened urologic surgery during working hours at surgical operating room of Ramathibodi hospital with no differentiation in sexes, ages, and procedures. Excluded groups were patients undergoing laparoscopic surgery, unplanned re-operation, and ones with skin infection. 100 patients were randomized using computer generated random allocation and separated into 2 groups. Group 1 was applied with 2% Chlorhexidine in water and group 2, Povidone iodine solution around the site of incision. Data analysis then was done using SPSS program and Fisher’s exact test to compare differences between the groups. Results: The study comparing 2% Chlorhexidine in water and Povidone iodine solution, the results are that both could be similarly used with p-value from Fisher’s exact equaled to 0.617. Recommendation: 2% Chlorhexidine in water could be safely used to prepare skin before surgery. So it could be an alternative for surgeons to use. This could be counted as a new knowledge which could leads to changes for entire population. Keywords: Povidone iodine solution, 2% Chlorhexidine in water

Masaki Kitajima has passed national nursing examination of Japan and also obtained full-unlimited nursing licensure of Japan on 2004. He acquired certified nurse specialist in cancer nursing of Japan on 2009. He is now a associate professor in the department of nursing at the Niigata University of Health and Welfare.

Purpose: Even in a situation that discouraged just after the informed consent(I･C) by support to promote the self-determination and care to rapid anxiety, it shows the cases that could be linked to the recuperation smoothly . Method: Phenomenological case study (A patient with malignant mesothelioma) Results and Discussion: Mr. A and his wife was a state that does not conceal the appearance of disappointment. After I • C, when we were confirmed, he returns to asked "What kind of cancer?". In order to facilitate understanding of Mr. A, we explained focusing on QOL have been affected from cancer. In addition, they because that was in the pension, in consideration of the daily life situation, anxiety even in economies was assessment and has potential. Therefore, results described the benefit plans of medical expenses, they had exposed that "actually, but medical expenses was anxiety was relieved," "I want to prospectively treated if can alleviate the symptoms." After that, he was alleviate symptoms undergoing chemotherapy. Than these things, information to predict their anxiety and needs, it considered was to support, such as send the subsequent recuperation. Conclusion:Information to predict their anxiety and needs, it considered was to support, such as send the subsequent recuperation.

Yuta Mitobe has passed national nursing examination of Japan and also obtained full-unlimited nursing licensure of Japan on 2010. The main research direction is in critical care. After earning master’s degree in health science of the University of Niigata in 2017, he is in a health science doctoral course from the University of Niigata. He is now a research associate in the department of nursing at the Niigata University of Health and Welfare.

To compare quality of life (QOL) and fatigue in long-term cancer survivors and healthy subjects. We also investigated the differences in relationships of QOL and fatigue between long-term cancer survivors and healthy subjects. Methods Seventeen cancer survivors (breast: 10, gastric: 4, lymphoma: 1, lung: 1, colorectal: 1) and 15 healthy subjects were enrolled in this study. All were evaluated for health-related QOL and fatigue. Health-related QOL was assessed using the Medical Outcome Study 36-item Short-Form Health Survey. Fatigue was measured using the Brief Fatigue Inventory (BFI). Results No significant differences were found for all 8 subscales of QOL and all 9 subscales of BFI between cancer survivors and healthy subjects. In cancer survivors, 6 of 8 QOL subscales were correlated with fatigue (p < 0.05). In healthy subjects, 3 of 8 QOL subscales were correlated with fatigue (p < 0.05). Conclusions QOL is related to fatigue in cancer survivors more than in healthy subjects. Thus, relieving fatigue might contribute to higher QOL in cancer survivors. We believe that the findings of this study will be relevant in the context of planning rehabilitation for cancer survivors.

Shu ,Yen Lee is currently attending the National Taipei Nursing Health University Doctoral Course and service Tri-service service general hospital nursing department supervision as long has 25 years of seniority, the main areas of critical care nursing quality and nursing education, is also the Taiwan Nursing Association critical care group members, and served as a reviewer and nursing project source journal the Committee.

Shu ,Yen Lee is currently attending the National Taipei Nursing Health University Doctoral Course and service Tri-service service general hospital nursing department supervision as long has 25 years of seniority, the main areas of critical care nursing quality and nursing education, is also the Taiwan Nursing Association critical care group members, and served as a reviewer and nursing project source journal the Committee.

Wu Chiahan National Tainan Junior College of Nursing lecturer,is the Taipei Nursing University doctoral students.

The purpose of this study was to explore the relationship between practicum-related stress and health status in nursing students. A cross-sectional research design was used in this study. Data were collected using two questionnaires, namely the perceived stress scale for nursing students in clinical practice and general health scale. The subjects of this study were fourth and fifth grade nursing students at the junior college in Tainan. The data were analyzed by t-test, one-way ANOVA, Pearson's Correlation, Scheffe's method. The result showed that the average score of perceived stress scale was 37.62(SD=16.03). The findings indicate that practicum-related stress was on medium-low level. The most common stressor was “Inexperience of lack of judgement on patient’s condition and management.” During clinical placement, students’ average score of general health scale was 68.98(SD=25.60). That indicated that students’ physical and mental health status during practicum was on medium level. Comparing to different level hospitals, students practiced in medical centers had highest stress level. There were significant differences among hospital level and practicum-related stress (F=39.808, p<0.05), health status(F=21.545, p<0.05). Practicum-related stress of nursing student had a significant positive correlation (r=0.673, p<0.01). In other words, a higher practicum-related stress level was correlated with higher score of general health scale. That means poor health status. The findings in this study could help clinical nursing teachers understand nursing students' stressor and mental health during clinical practice. It could also provide practicum units and the clinical nursing teachers with more information about correcting practicum g program and teaching strategies.

Ms. LAW is a nursing student studying Bachelor Degree of Health Sciences (Major in Applied Gerontology) at Tung Wah College in Hong Kong. Ms. LAW is the representative of the group to give the presentation in the conference. Her research interests include ageing, elderly care, and community care/service for elderly

Ageing leads to changes in bio-psychosocial status. Since ageing is a process in which people are preparing for dramatic psychosocial changes due to retirement. Those who are working may preparing for their retirement and experience some degree of psychosocial needs and changes. Understanding psychosocial status of this specific population helps develop strategies targeting healthcare and community services for active and healthy ageing after retirement. A survey adopted a cross-sectional design was used to examine psychosocial status among people aged 45 to 64. Data collection was done via Google survey. The validated short-version of Copenhagen Psychosocial Questionnaire was used. A total of 193 eligible subjects joined this study. Most of them aged from 45 to 60 years old (92.2%) with mean age 54.03 years old (SD=4.99). More than half (~72%) were female and had obtained secondary or higher education (96.9%). Most of participants were still working (72.5%). and only 37 of them (19.2%) were retired. Of 193 participants, about 60% of participants did not intend to have early retirement. Regarding their psychosocial status, the most significant psychosocial aspects were achievement of career goals and perception of their career. It indicates that people aged 45 to 64 were still in working mood. They eager to fufill their career goals and concentrate on their career. Promotion programme can increase their awareness of pre-retirement plan. Government needs to give adequate support to this specific population for better active and healthy ageing.

Hui-Lian Che is an assistant professor. Her specialties are Geriatric nursing, patient education and nursing ethic. She got a Master degree in Nursing in 2002 from National Taipei University of Nursing and Health Sciences, Taiwan. Now, she has eight publications in referred journals. Huei-Ling Huang is an associate professor. She got PhD in 2010 in Graduate Institute of Clinical Medical Sciences in Chang Gung University in Taiwan. Pen-Chen Kung had completed her Master in 2010 from School of Nursing College of Medicine, National Taiwan University in Taiwan. Hui-Lian Che, Huei-Ling Huang and Pen-Chen Kung they are colleagues of Department of Gerontological Care and Management, Chang Gung University of Science and Technology in Taiwan. Tzu-Hsin Huang is Director of Department of Nursing of Taoyuan Chang Gung Memorial Hospital in Taiwan.

Taiwan, with an aging index reaching 96.34% (2016), has a critical need for increasing long-term care (LTC) manpower. In recent years, schools at all levels have set up LTC-related departments and programs and have trained growing numbers of LTC students. However, students’ willingness to work as long-term care providers for the elderly after graduation remains low. They have concerns about not being capable enough. Consequently, investigating how to adapt to the role of a long-term care provider as a newcomer, from the perspective of nurses and nurse aides’, may provide a reference point for better assisting students in making a smoother transition to the workplace. Between October 12, 2015 and March 17, 2016, eight respondents were recruited using purposive sampling from an LTC facility in northern Taiwan. Interviewing was individual, and the collected materials were converted into verbatim transcripts for analysis using content analysis. A total of 4 nurses and 4 nurse aides participated in this study. The results revealed that all respondents claimed they chose to work in LTC because they enjoyed spending time with the elderly. They admitted that it had not been easy to adapt to the role in the beginning. However, they believed that as long as one can maintain a “learning by doing” attitude, as well as “not giving up” on challenges, and encouraging oneself with a positive mindset, such as “changing a negative mood to a positive one and looking forward,” then in the end “practice will eventually make perfect, and one should be able to handle everything with ease.” In addition, they mentioned that a mindset focused on “treating patients as family” was the key to remaining in the role for the long term. The present study findings may serve as a reference point for gerontology and long-term care training programs. Likewise, they may aid managers of LTC institutes in designing counseling policies aimed at assisting students during their adaptation phase, both before and after they join the workforce.

Mr. YIK Tak Wai is a nursing student studying Bachelor Degree of Health Sciences (Major in Nursing) at Tung Wah College in Hong Kong. Mr. Yik is the representative of the group to give the presentation in the conference. His research interests include antibiotics use, primary health, and nursing education.

Antibiotics are important treatment for infections. Since Penicillin was discovered, antibiotics resistance has become an important health concern because antibiotics misuse is evidenced as a major leading cause of antibiotics resistance. Public awareness on antibiotic resistance and antibiotic use is reported relatively weak. This study was to examine knowledge, attitude, and practice (KAP) about antibiotics use and how patient-doctor relationships (PDR) in Hong Kong population. A cross-sectional design was used with a convenience sample. A structured face-to-face interview was conducted using a validated questionnaire. A total of 259 subjects were eligible to join this study. Most of them aged from 20 to 29 years old (42.5%) with mean age 37.44 years old (SD14.42). More than half (~64%) were female and had obtained tertiary or higher education (63.3%). A majority of participants perceived their personal health fair to good (91.5%). Knowledge about antibiotics use was relatively better (mean 7.51 SD 2.50) but the PDR was poorer (mean 3.20 SD 1.60). Of 259 subjects, about 40% were at least prescribed to have antibiotic treatment. Most of the subjects (~80%) had good practice of antibiotics use. The results showed that knowledge (r=0.133, p=0.032) and attitudes (r=0.136, p=0.029) of antibiotic use were significantly associated with PDR. Their good practice can be attributed to their better knowledge and attitudes on antibiotics use. Since PDR has positive effects on knowledge and attitudes of antibiotics use, it is crucial to promote PDR in order to increase the awareness of appropriate use of antibiotics in public.

Ya-Hui Cheng has completed her M.D. at the age of 39 from Mei Ho University in Taiwan and is studying her Master’s degree in I-Shou University in Taiwan. She has been a nursing staff in Kaohsiung Chang Gung Memorial Hospital for 18 years.

American Heart Association (AHA) suggests primary percutaneous coronary intervention (PPCI) is the preferred treatment for ST-elevation myocardial infarction (STEMI) patient. Non-transfer patient, PPCI should be done within 90 minutes after hospital arrival. Our hospital, over 90% of STEMI patients door-to-balloon time (D2B) < 90 min; but over 20% patient door-to-electrocardiogram time (D2E) is > 10 min. Motivation to accelerate the protocol and shorten D2E time is our concern. A retrospective cohort research enrolled non-transfer STEMI patients from 2011-1-1 to 2014-12-31. Focus on team resource management (TRM) model with ISBAR (Introduction,Situation,Background assessment,Recommendation) structural strategy to enforce team work in care training and mutual communication. As patients arrives hospital with chief chest complaint, chest tightness, breathing shortness and epigastric pain (over 30-yrs), triage nurse immediately send patient to chest pain area (bed, monitor, ECG machine and emergency packs). Brief communications ISBAR to nurse practitioners to medical history and perform ECG. Follow by ISBAR to emergency attending physician. Reading ECG, ER physician decide to activate protocol for PPCI. We construct the protocol on 2013-1-1. Patients enrolled from 2011-1-1 to 2012-12-31 group previous, and 2013-1-1 to 2014-12-31 to group afterward. Among 354 patients, 180 were in previous group, and 174 were in afterward group. Medical chart data recorded: baseline clinical characteristics and angiographic findings, time interval difference and 30-days mortality. Two groups showed no difference regarding median time of D2E, D2B and door-to-cath lab (D2C). But the percentage of D2E < 10 minutes in afterward group is significantly than previous group (90.2% vs. 67.2%, p <0.001). Furthermore, both groups D2E < 10 minutes increased percentage of D2C < 50 min and D2B < 70 min. Afterward group , patients D2E <10 minutes is significantly than D2E < 10 minutes (3.8％ vs. 17.6％，p = 0.045) in 30-days mortality. Our study focus on constructing rapid protocol and TRM strategy to shorten D2E, reduce D2B and decrease 30-days mortality. Previous studies developed strategies in reducing D2B time, included: 1) ED physicians activate the catheterization laboratory; 2) call central page operator to activate laboratory; 3) active catheterization laboratory bases on prehospital ECG; 4) attending cardiologist always on-site. Some strategies require money, manpower but benefits less expectations. Our goal is to use TRM and achieve quick protocol without increase human and resources.Rapid diagnosis STEMI as chief complaints confirmed, perform ECG immediately is the most crucial step. Our protocol combine triage and ECG to reduce D2E time, accelerate procedures and obtain greater prognosis.In conclusion, our study demonstrates a method of using TRM strategy to shorten D2E is beneficial to reduce D2B time and decrease 30-days mortality.

Yung-Mei Yang had completed her PhD at Queensland University of Technology, School of Nursing, Australia. She is a associate professor, PhD, RN and the director of Head of Research & Global Affairs Division Kaohsiung Medical University. Dr Yang published more than 25 papers in reputed journals such as SSCI SCI and has been serving as an Expertise International Council of Nursing ( ICN) in the area of Home/ Community. Her teaching interests included: Transcultural nursing, community health nursing and trying to innovate new teaching strategies. Research interests:Transcultural nursing, community health, research method: Mixed method.

Following the trends of globalization, the increasing numbers of immigrants transform Taiwan become a multicultural society. Health care professionals havefaced the significant challenges in providing cultural competence healthcare to multi-ethnic groups. This purpose of this study is to design, conduct and evaluation of cultural competence curriculum development- Base on Anchor-Situated teaching strategies. The curriculum was 2 credit/ 36 hours. Convenience sampling be used for the recruitment of the subjects. The subjects are the university nursing students. A total of 58 subjects completed the course. The study design was one group pre and post-test comparison. This study was approved by the institutional review boards of Kaohsiung Medical University ( KMUH-IRB-10514043). The instrument of this study included Demographic inventory, Intercultural sensitivity scale (ISS)；Inventory for assessing the process of cultural competence, (IAPCC) and Cultural diversity/ cultural competence self-assessment check list (CCSCL). The Cronbach’s α of the cultural sensitivity scale was 0.88 and the multicultural self-assessment scale was 0.91, showing that each scale possessed favorable internal consistency and expert content validity. SPSS version 17 for data analysis. The result of this study showed the intervention of multicultural care competence curriculum development- Base on Anchor-Situated teaching are significant difference between pre and posttest, ISS p< .000； IAPCC p<.000﹔CCSCL p < .003.The finding conclued that “having attended education courses related to cultural competence” was the most important predictor of multicultural care competence of nursing students.The findings of this study not only can assessment the cultural competence educational program effectiveness and influencing factors, but also can provide department of education references in making appropriate cultural education policies and suggest to development of curriculum for multi-cultural care for the undergraduate students.

Hsuan-Yu Chen has completed her Master from Chang Gung University. She is the Instructor of Cardinal Tien Junior College of Healthcare and Management, New Taipei city, Taiwan. Her research major is mental health, psychiatric nursing, and she has published some papers in journals.

Background: Owning good therapeutic relationship skill is the basis of taking good care of psychiatric patients in community. Necessary teaching strategies to enhance nursing college students in practicum of psychiatric nursing would help students build good therapeutic relationship. Purpose:The purpose of this study was to strengthen the students’ clinical competence of community psychiatric mental health therapeutic relationship, we used the practical ability indicator of mental health nursing evaluation for college nursing students. Design: Educational action research design and qualitive study were applied in this study from 2014 to 2015. 24 participants of the study were our fifth grade nursing students who were taking psychiatric nursing practicum. History story cards of the community psychiatric patients were designed to reduce anxiety when approaching the patients, and to inspire students’ self-awareness, empathy and positive attitudes; furthermore, to enhance student’s skill of good therapeutic relationship. The Republic of China Psychiatric Mental Health Nursing Association of mental health care assessment of the eight essential items was an indicator, With the informed consent of the 24 participants were observed through their homework, like process recording, nursing care plan, and reflection diary. Main findings：Nursing college students’s skill of therapeutic relationship are at the degree of either novices or advanced beginners according to Dreyfus model. Conclusion and recommendations：To abandon bad impression on the community psychiatric patients is an important factor to establish good therapeutic relationship. Good teaching strategies can reduce college nursing students anxiety when approaching community psychiatric patients.

Magdalene Ho-Asjoe has diverse experiences as a community health nurse, and a clinical instructor. Magdalene is passionate about facilitating students to integrate skills and knowledge acquired in community health nursing into their practice. She continues to utilize well researched educational strategies to yield effective learning outcomes, and incorporate valuable student feedback to make ongoing improvements.

Nursing students in a Bachelor’s educational program in Canada are introduced for the first time to the practice of community health nursing in a 16 weeks’ clinical course. A community health nurse (CHN) works with people where they live, work, learn, worship, and play to promote health (Community Health Nurses of Canada, 2009). CHNs partner with individuals, families, groups, communities, systems, and populations in various settings (Stamler, Yiu and Dosani, 2016). These nurses view health as a dynamic process of physical, mental, spiritual, and social well-being and as a resource for everyday life that is influenced by circumstances, beliefs, and determinants of health (CHNC, 2011) In the beginning of the clinical course, students are guided to conduct a Windshield Survey. The Windshield Survey is used as an educational strategy to effect community health nursing clinical outcomes. The survey provides students with a scan on the community, where students collect objective data, but also “notice” what they see, hear, smell and perhaps touch. The Population Health Promotion model is used as a framework to guide information collection. Students ask relevant questions which affect populations, such as: What is public transportation like? Is the community accepting of diversity? Are health resources accessible? Are housing and food sources affordable? The Windshield Survey assists students to “think like a CHN”. This strategy provides students with opportunities to appreciate complex determinants, roles of team partners, and community strengths and capacities. Students learn to appreciate each community has a life of its own and every individual in this community as unique. During our presentation, the authors will share details of the Windshield Survey, including evidence based research, content in the survey, how the survey is conducted, results of the survey as a teaching and learning strategy, and pre and post evaluation by nursing students.

YuChun Yao is an assistant professor in Department of Nursing, I-Shou University in Taiwan. Her specialties are nursing education, nursing leadership and management. She got a Master degree in Nursing in 2004 and Doctor Degree in Education in 2011 from Spalding University, Kentucky, United States of America. Now, she has 4 publications in referred journals. Shu-Hua Huang is an associate professor in general education center, Air Force Institute of Technology in Taiwan. Her specialties are psychology and education. She got a PhD in Institute of Educational Entrepreneurship and Management in National University of Tainan in Taiwan. Now, she has 14 publications in referred journals. I-Ju Pan had completed her PhD in 2006 from Queensland University of Technology School of Nursing. She is a teacher of I-Shou University since 1999. She has published papers in reputed journals and has been serving as an review board member of repute. After 8 years working as RN in Chung Gung Memorial Hospital (Children’s Hospital), Yi-Hui Liu went to Boston College in 2002 and has completed her MSN and PhD from School of Nursing of Boston College in 2008. She is an assistant professor of I-Shou University since 2008. She has published papers in reputed journals and has been serving as a review board member of repute.

In former times, nursing instructors have utilized the conventional lecture format in nursing education. In recent years, many studies have showed that inquiry teaching strategy have better learning outcomes than traditional teaching strategy. Although nursing instructors have rarely utilized the inquiry teaching strategy in nursing education, many studies suggest that nursing instructors should explore more innovative approaches to improve nursing students’ experience and fitness for practice, especially in higher education. Therefore, the purpose of this study was to explore the influences of inquiry teaching strategy on college students’ learning performance in nursing education. A quasi-experimental design was used in this study. There were 46 college students in the control group (traditional teaching strategy) and 42 college students in the experimental group (inquiry teaching strategy). The Inquiry Process Model (IPM) was utilized to design the medical-surgical nursing curriculum. The Motivated Strategies for Learning Questionnaire (MSLQ) and Assessment Technologies Institute - Standardized Comprehensive Medical-Surgical Assessment (ATI-SCMSA) were utilized to evaluate college students learning performance. The findings of this study indicated that college students who accepted inquiry teaching strategy performed higher learning motivation than traditional teaching strategy. However, the college students who accepted traditional teaching strategy performed higher score on the ATI-SCMSA than inquiry teaching strategy. The recommendations of this study is that inquiry teaching strategy may be an effective teaching strategy for college students’ learning motivation; however, it may not be an effective teaching strategy for college students’ score in medical-surgical nursing examination.

Shu-Hui Peng has completed her M.D. at the age of 36 from Mei Ho University in Taiwan and is studying her Master’s degree in I-Shou University in Taiwan. She has been a nursing staff in Kaohsiung Chang Gung Memorial Hospital for 25 years.

Alcohol-related trauma, which including drunk driving, fighting or a fall after drinking alcohol, is the main reason for sustaining trauma injury. To provide objective evidences and more complete therapeutic algorithm, this study was designed to investigate the relationship of alcohol-related trauma and the injury severity as well as medical expenses in adults. A retrospective study of the medical records and registered data in Trauma Registry System from 2009 to 2014 was performed at a medical center in southern Taiwan. The patients whose blood alcohol concentration (BAC) level≧50mg/dl was considered as alcohol intoxication group while those whose BAC level less than 50mg/dl and those who were not required for an alcohol test were deemed as patients without alcohol intoxication group. Of the total 11,033 adult patients, 929 patients with BAC (+) and 10,104 patients with BAC (–) were enrolled in this study. atients with alcohol intoxication had significantly higher rates of head/neck injury, face injury, thoracic injury, and abdomen injury, lower Glasgow coma scale (GCS) score (12.6±3.7 vs. 14.5±1.9, p＜0.001), higher injury severity score (30.8±17.8 vs. 7.7±6.5, p＜0.001), higher short-term mortality (3.6% vs. 1.2%, p＜0.001), longer hospital stay (11.4 days vs. 9.1 days, p＜0.001), and higher proportion of admission to the intensive care unit (ICU) (35.4% vs. 15.0%, p＜0.001) than those without alcohol intoxication. Alcohol-related trauma is associated to a higher injury severity and increase the cost of medical expenses.

Ming-Yueh Tseng has completed her PhD in Nursing from Graduate Institute of Clinical Medicine Chang Gung University. She is the Assistant Professor in Mei-Ho University in Taiwan, and specialty is in nursing education and long-term care.

The purpose of this study was to explore work adaption for newly graduated nurses during their first year of nursing career. A qualitative 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.

Fernan N. Torreno, is a Filipino Nurse-Midwife and Academician is currently working as a Part-Time Clinical Instructor of Urdaneta City University-School of Midwifery. He is holding positions as Secretary of the University Health Watch, Secretary of the University OJT and Internship Office. Mr. Torreno completed his Master of Arts in Nursing, Major in Nursing Administration at Lyceum-Northwestern University, and currently studying for hid Doctor of Philosophy, Major in Science Education. He plans to pursue a Doctor of Naturopathy or Juris Doctor after finishing his Ph.D. He is also a former Senior Emergency Room Staff Nurse in the State of Libya.

This study assessed the Citizens’ Satisfaction Index on the Health Services of the Local Government Unit of Binalonan, Pangasinan. The descriptive, quantitative cross-sectional method of research was employed with the use of survey questionnaire as the main data-gathering instrument. Slovin’s Formula was used to determine the sample size. Frequencies and percentage distributions were used to present the descriptive characteristics of the respondents, while a Pearson r correlation was employed to determine significant relationships. The respondents composed of 395 registered voters with ages 41 and above, mostly females, married, high school graduates, Roman Catholic and residing for 21-30 years, employed as professionals within the barangays with monthly incomes of Php15, 100 and above, majority suffered an illness for the past 12 months and pneumonia topped among other diseases. Results revealed Low Awareness (31.33) and Availment (39.20) net scores on the health services, Fair for Satisfaction net score (59.77) and High for the Importance net score (70.77). There was a positive association between Level of Awareness and Level of Availment. (r=0.827) but a negative significant relationship between Importance and Satisfaction (r=-0.945) and Importance and Availment (r=-0.946). Majority of the respondents are not aware of the health services provided by the local government unit. The type of job and monthly income of the respondents affect their availment of health services. The proposed measures should be observed and implemented for the purpose of improving the level of awareness and availment of health services by the people of Binalonan, Pangasinan. Due to the limitations of the study, findings cannot be claimed to be definite, hence, similar studies focusing on health services should be conducted to include other categories under health which are not included in this study.

Zhi-Xuan Lin is Graduate Student, Chang Jung Christian University, Tainan, Taiwan, RN Disease Manager, Cancer Center, Chi Mei medical center, Liouying at work for ten year.

Purpose Therefore, recently the case management model has been actively implemented in Taiwan to achieve synergy between resource, communication, and coordination. By using the case management model as an analytic framework, Therefore, this study aimed to identify reasonssevere adverse events (AE) of three epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in patients with EGFR mutant on lung cancer patients. Methods From January 2014 to December 2015, patients with lung cancer treated in a teaching hospital in southern Taiwan were recruited as the research participants, retrospectively analyzed the patients with advanced or metastatic EGFR mutation-positive Non-Small Cell Lung Cancer (NSCLC) who received gefitinib, erlotinib, or afatinib as first-line treatment. Results: The analysis median age of the 88 patients (37 males, 51 females) was 63 years (range, 29-94 years). Sixty-two patients (70%) never smoked. 84 (95%) had adenocarcinoma. The objective response rate was 58% and the disease control rate (partial response plus stable disease) was 80%. Common adverse events in all three EGFR-TKIs , mainly grade 3 or 4 toxicity, including rash (10.2%), diarrhea (11.4%) and hepatotoxicity (6.8%). frequency of Adverse events in 6 cases of hepatotoxicity, 3 cases of diarrhea, and 2 cases of skin toxicity, the total frequency of AE that resulted in treatment withdrawal was 12.5% (11 out of 88 evaluable patients). Conclusion First-line target therapy a preferred standard treatment in advanced NSCLC harboring sensitive EGFR mutations. Informing the patient and management Of these side-effects is very important to reduce discomfort and as such to increase compliance to therapy.there support for case management and health education, patients can get more comprehensive treatment and Improvements to problems associated of treatment.

Sevim Çelik has completed her PhD at the age of 28 years from Istanbul University, Turkey She is the director of Bülent Ecevit University Zonguldak School of Health. She has published more than 20 papers in reputed journals and has been serving as an rewiever of international repute journals.

Purpose: The aim of this research is to determine the body image perception and views about aesthetic surgery of nursing students. Methods: The study was designed as a descriptive study. The sample of the study consists of 600 nursing students. This study was carried out between February and April 2016. Data collected by Personal Information Form, Views about Aesthetic Surgery Questionnaire designed by researchers and Multidimensional Body-Self Relations Questionnaire (MBSRQ). In the evaluation of the data, numerical and percentage distribution, correlation coefficient, analysis of variance and Post-hoc significance tests were used. Results: Of the students 25.3% were male, 74.7% were female; 42.3% were in the first year, 23.8% in the second year, 18.3% in the third year and 15.5% in the fourth year. It was determined that 27.5% of the students were indicated that they do not like some parts of their body, and 2% had aesthetic surgery. It was seen that the total score of the students' Views about Aesthetic Surgery Questionnaire was 53.13 ± 11.87. The evaluation of students' sub-scores of the MBSRQ were; Appearance Evaluation 3.58; Appearance Orientation 3.57; Fitness Evaluation 3,60; Fitness Orientation 3,28; Health Evaluation 3,41; Health Orientation 3,42; Body Areas Satisfaction 3.59. When the relationship evaluated between Views about Aesthetic Surgery Questionnaire and the MBSRQ sub-dimensions; it was found that there was negative weak correlation between Appearance Evaluation, Fitness Evaluation, Health Evaluation, Body Areas Satisfaction and there was positive weak correlation between Appearance Orientation. Conclusion: As a result of this study, nursing students had higher MBSRQ sub-scale scores, and nursing students have positive views about aesthetic Surgery related to the scores. Key Words: Nursing student, body image, aesthetic surgery

Renee Martin-Thornton is the Director of Student Health and Psychological Services at Riverside City College, in California. She holds master degrees in nursing and health care management. Renee obtained her PhD from University of Phoenix-School of Advanced Studies in 2014. She has 28 years of nursing experience, which includes 3 years as an Officer in the Army Nurse Corps. She maintains California Board of Registered Nursing instructor approvals in the following subjects: Obstetrics, Pediatrics, Gerontology, and Medical/Surgical. She presented the topic of “Cultural Competence in Nursing” to the California Vocational Nursing Educators in 2010 and to the Nursing Congress in 2016. Her research interests include health disparities, maternal-child issues, cultural awareness, transcultural nursing, nursing education, and simulation in nursing education.

A correlational study focused on determining if relationships existed between the integrated cultural curricula and the graduating associate degree-nursing student’s level of cultural awareness. The theoretical framework highlighted the importance of culture, knowledge, and care as vital and obligatory to nursing education and practice (Chitty & Black, 2010). The literature implied integrated cultural curricula increased the level of cultural awareness (BRN, 2012; NLN, 2008). In this study, the Pearson r correlation coefficient revealed statistically significant relationships exist between the integrated cultural curricula and the level of cultural awareness among graduating associate degree nursing students. Based on the results of the 51 nursing students surveyed, the cultural awareness level may be attributed to several factors, including the integrated cultural curricula. Student’s learning style, student’s perception of faculty, student’s personal experiences, and cultural encounters contributed to the cultural awareness level. Additionally, the ANOVA results revealed no statistically significant differences based on gender, age, and ethnicity.

Cheng-I Yang was a psychaitric nurse and has completed his PhD at the age of 40 years from Nottingham University in UK. He is currently the associate professor and the director of department of nursing, Da-Yeh University in Taiwan. He has carried qualitative research in a wide range of health service settings and nursing schools, often involving topics of nurse and patient experiences, psychiatric care, and nursing education etc. He has published more than 30 papers in reputed journals and has been serving as an editorial board member of repute.

The five year college nursing graduates occupied 45.6% of all nursing graduates each year in Taiwan. However, most of them prefer to study in the technological university to obtain a bachelor degree, only 41.22% of them work in the health care system. In 2015, the Ministry of Education in Taiwan authorized six nursing schools to design an innovate program called “Five plus Two nursing program”. This program was viewed as a strategy to guide the nursing graduates to work in hospitals and study in the university at the same time to partially release the tension of nursing shortage. However, whether the designs of this program can fulfill the needs of the students require further examination. The purpose of this study was to explore nursing students’ experiences and concerns of enrolled in the “Five plus Two” nursing program. A qualitative research approach and focus group interviews was used in this study. Ten nursing students of a 5 year junior nursing college in the central Taiwan who enrolled into this program participated into this study and interviewed twice by the researcher. Data collected were transcribed then analyzed using thematic analysis. Four themes were emerged, which are (a) the motivation for entry, (b) decision making process, (c) worry about the maladjustment, (d) seeking for information and certainty. Students in this program need more support both from the schools and hospitals to reduce their anxious before and after the decition making process. Knowledge from this study will beneficial for policy makers and administrators to refine this program in the future.

My name is Ssu-Ya Liao, from Taipei Taiwan. I am studying at National Taipei University of Nursing and Health Sciences. I’m also a full-time RN at Taipei Veterans General Hospital and I have worked for 12 years.

This report described the nursing practice for a systemic sclerosis subject with Raynaud’s phenomenon combing digital ulcers. Systemic sclerosis is a rare auto-immune disease, and Rayuaud’s phenomenon is often presented as first onset symptom. The peripheral limbs tend to demonstrate ischemic ulceration gangrene, if not under appropriate treatment, it will be a medical emergency. Gordon health functional assessments were utilized to provide a comprehensive evaluation covering physical, mental and spiritual dimensions from October 16, 2013 to December 9, 2013. In the nursing period, health issues included impaired tissue integrity, change of ability to maintain health and powerless. Individualized and feasible nursing care plans were implanted along with integrated health resources and disease related knowledge; in order to control infection, heal the wound, elevate health maintain ability and decrease powerless. Not only helping the subject to positively face the threats from disease, but also enhance self-care ability about the disease and its complications. Continuing follow-ups after discharge were aiming to help building appropriate health promotion behaviors and increase quality of life. This experience of nursing practice could provide a good reference for future case.

Srisuda Eklakkanarat has completed her MNS at the age of 36 years from Mahidol University Thailand .She is the nursing instructor in Boromarajonani College of Nursing, Sawanpracharak, Nakhonsawan

Srisuda Eklakkanarat has completed her MNS at the age of 36 years from Mahidol University Thailand .She is the nursing instructor in Boromarajonani College of Nursing, Sawanpracharak, Nakhonsawan