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Biomedical subjects

Huey-Ming Tzeng

Publications and source records attributed to Huey-Ming Tzeng.

At least 19 recordsLinked to original sources

Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing.

BACKGROUND: Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures. We compared treatment with plating to treatment with shorted intramedullary (IM) nailing. METHODS: Patients with AO type 43A fractures were treated with plate fixation (group A, n=14) or shortened IM nailing (group B, n = 13). We compared postoperative radiographic deformities, functional results (Iowa ankle scores), and symptoms (Olerud and Molander ankle scores). RESULTS: All fractures had healed at final follow-up (mean, 33 month). Mean union times were 27.8 week (range, 18-36 week) in group A and 22.6 week (range, 18-30 week) in group B (P<0.05). Mean postoperative valgus angulations were larger in group B (3.7 degrees ) than in group A (0.5 degrees ) (P<0.05). However, malunions did not differ between groups (P<0.05). Functional results and postoperative symptoms were similar. CONCLUSIONS: Both plate fixation and shortened IM nailing were effective for treating distal tibial metaphyseal fractures.

Adult↗

Developing a predictive model for vertigo using demographic and laboratory data: An evidence-based medicine approach.

CONCLUSION: The approach described in this paper may be helpful in establishing an early-warning, evidence-based mechanism for diagnosing vertigo, which can be utilized in medical education to reduce medical uncertainty. OBJECTIVE: To use an evidence-based medicine approach to evaluate the probability of having vertigo using laboratory and demographic data. MATERIAL AND METHODS: The study was conducted on 22 working days during July 2002. Targeted cases who visited a general hospital in southern Taiwan for routine physical examinations were asked to participate in the study and agreed to take additional tests during their visits. A total of 200 subjects were systematically and randomly selected from this data pool. We ran binary logistic regression on all these cases. RESULTS: The logistic regression model explained 71.3% of the variance in having vertigo or not. The equation for having vertigo was as follows: -21.855 + (1.132 x male gender) + (0.071 x age) + (-0.023 x systolic blood pressure) + (0.057 x diastolic blood pressure) + (0.048 x fasting glucose) + (0.051 x cholesterol) + (-0.005 x triglycerides) + (-0.361 x presence of cardiovascular diseases).

Adult↗

Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.

AIMS AND OBJECTIVES: This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system. BACKGROUND: In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis. METHODS: In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study. RESULTS: The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities. CONCLUSIONS: These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening, which might lead to a serious situation that includes malpractice litigation. It is believed that the questionnaire used in this study may be used as a diagnostic tool for assessing a crisis management system within a hospital's nursing environment.

Attitude of Health Personnel↗

Demands for religious care in the Taiwanese health system.

In order to care ethically nurses need to care holistically; holistic care includes religious/spiritual care. This research attempted to answer the question: Do nurses have the resources to offer religious care? This article discusses only one aspect--the provision of religious care within the Taiwanese health care system. It is assumed that, if hospitals do not provide enough religious services, nurses working in these hospitals cannot be fully ethical beings or cannot respect patients' religious needs. The relevant literature was reviewed, followed by a survey study on the provision of religious facilities and services. Aspects considered are: the religions influences in and on Taiwanese society; the religious needs of patients and their families; strategies that patients use to enable them to cope with their health care problems; professional motives for attuning to patients' religious needs; and hospital provision for meeting the religious and spiritual needs of patients. A survey of nursing executives showed differences between religious service provision in hospitals with and without a hospice ward. The practical implications for hospital management and nursing practice are discussed.

Attitude of Health Personnel↗

Learning to respect a patient's spiritual needs concerning an unknown infectious disease.

This article aims to help readers to learn about health care related cultural and religious beliefs and spiritual needs in Chinese communities. The recall diary of a severe acute respiratory syndrome (SARS)-infected intern working in Hoping Hospital in Taiwan during the 2003 SARS epidemic is presented and used to assist in understanding one patient's spiritual activities when personally confronted with this newly emerging infectious disease. The article also gives an overview of the 2003 SARS epidemic in Taiwan, and discusses people's general perceptions towards infectious diseases, their coping strategies concerning disease, and their spiritual beliefs, the psychological impact of the 2003 SARS outbreak in Chinese communities, Chinese myths about infectious disease, and the religious activities of a SARS-infected intern in Taiwan. Recommendations are given on how to achieve quality holistic nursing care.

Adaptation, Psychological↗

Nurses' fears and professional obligations concerning possible human-to-human avian flu.

This survey aimed to illustrate factors that contribute to nurses' fear when faced with a possible human-to-human avian flu pandemic and their willingness to care for patients with avian flu in Taiwan. The participants were nursing students with a lesser nursing credential who were currently enrolled in a bachelor degree program in a private university in southern Taiwan. Nearly 42% of the nurses did not think that, if there were an outbreak of avian flu, their working hospitals would have sufficient infection control measures and equipment to prevent nosocomial infection in their working environment. About 57% of the nurse participants indicated that they were willing to care for patients infected with avian influenza. Nurses' fear about an unknown infectious disease, such as the H5N1 influenza virus, could easily be heightened to levels above those occurring during the 2003 severe acute respiratory syndrome outbreak in Taiwan.

Adult↗

[Crisis management and medical disputes related to nursing practice].

The number of medical dispute cases has been increasing, due to uncertainties about medical care quality and outcomes as well as the increased influence of consumer-centered ideology. This situation has created difficulties in the relationships between patients/family members and health care providers. This paper focuses on discussing crisis management and medical disputes as related to nursing practice. Reviewed literature was organized into four parts: understanding crisis management; crises in medical institutions; nursing practice, medical disputes and crisis management; practical implications. The information included in this paper might improve nurses' and administrators' knowledge of crisis management, enhance the implementation of crisis management strategies in medical disputes, and reduce financial losses and psychological distress resulting from inappropriate crisis management.

Malpractice↗

Nurses' self-assessment of their nursing competencies, job demands and job performance in the Taiwan hospital system.

This exploratory study investigated nurses' self-assessment of their own nursing competencies, job demands and job performance in Taiwan. Nurses' self-evaluation on their own job performance was conceptualized as an indicator of nursing care quality. A total of 21 competencies were clustered into three groups: basic-level patient care skills, intermediate-level patient care and fundamental management skills, and advanced-level patient care and supervision skills. Nurse subjects were randomly selected from the member roster of Kaohsiung Nurse Association; 850 nurses were invited to participate and questionnaire packets were sent to their homes. The overall response rate was 35.8%. Multiple regression analyses found that nurses' self-assessment of intermediate patient care skills, the difference between nurses' self-assessment and job demands for basic patient care skills, and nurses' overall satisfaction with their own nursing competencies were three significant predictors of overall satisfaction with nurses' own job performance. Nurses' self-assessment on basic patient care skills and advanced patient care skills contributed to nurses' levels of overall satisfaction with their own nursing competencies. These results suggest a relationship between competency and performance. These findings may serve as a guide to amend academic nursing courses and on-job training programs as appropriate to place a greater emphasis on the competencies desired for providing high quality of nursing services.

Adult↗

Nurses' professional care obligation and their attitudes towards SARS infection control measures in Taiwan during and after the 2003 epidemic.

This study investigated the relationship between hospital nurses' professional care obligation, their attitudes towards SARS infection control measures, whether they had ever cared for SARS patients, their current health status, selected demographic characteristics, and the time frame of the data collection (from May 6 to May 12 2003 during the SARS epidemic, and from June 17 to June 24 2003 after the SARS epidemic). The study defines 172 nurses' willingness to provide care for SARS patients as a professional obligation regardless of the nature of the disease. A conceptual model was developed and tested using ordinal logistic regression modelling. The findings showed that nurses' levels of agreement with general SARS infection control measures and the lack of necessity for quarantining health care workers who provided care for SARS patients were statistically significant predicators of the nurses' fulfilling of their professional care obligation. Suggestions and study limitations are discussed.

Adult↗

[Analyses of criminal judgments as related to nursing services in the cases of the Supreme Court in Taiwan].

This paper briefly reviewed literature relating to medical disputes and investigated the criminal judgments of the Supreme Court in Taiwan in cases involving nurses and the delivery of nursing services. Past studies of criminal judgments involving medical dispute have usually been presented in the form of case studies. By contrast, this study used a retrospective data, and analyzed the judgments by content analysis and the quantitative research design method. The original written verdicts were obtained from two major online law databases. There have been a total of 70 criminal judgments related to medical disputes since 1927. Among them, 7 cases involved nurses and the delivery of nursing services. These 7 cases were analysed, and the findings will be instructive to those interested in lawsuits related to medical disputes.

Legislation, Nursing↗

Demand for nursing competencies: an exploratory study in Taiwan's hospital system.

Along with increasing complexity of nursing services, hospital employers are demanding qualified and competent staff nurses for high quality clinical care. In Taiwan, disparities in the demand for competent nurses by employers and the supply produced by nursing educators still exist and require attention. A comprehensive understanding of the specific needs of Taiwan's medical care system for nursing services would help bridge the current gap between demand for and supply of competently trained nurses. This exploratory study investigated hospital employers' perceptions of the extent to which the nursing skills identified by Cleary et al. [Image: Journal of Nursing Scholarship (1998)20(4):39-42] were needed for staff nurses in Taiwan's medical care system. There were a total of 21 nursing competencies and classification on these items was also implemented. A cross-sectional, quantitative, survey design was conducted. Subjects' participation was voluntary, an information leaflet and an informed consent form was included in the questionnaire. A total of 89 nursing employers (nursing directors, associate directors, supervisor, or head nurse) participated, resulting in a 42.6% response rate. Factor analysis grouped these skills into three factors: basic-level patient care, intermediate-level patient care and basic management, and advanced-level patient care and supervision. This study confirmed that levels of nursing competencies needed differed by type of hospital accreditation. These levels also varied depending on types of services provided, employers' professional titles and tenure of currently employed nurses. The questionnaire developed for this study could be used as one of the tools to communicate demand and supply of nursing competencies between nurse educators and employers. These competencies could be used to develop a checklist for evaluating adequacy of nursing programmes in order to meet nurses' new roles and responsibilities and improve nursing care quality in the fast-changing health care environment in Taiwan.

Adult↗

The influence of nurses' working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan.

The present era of cost-containment pressures indicates that nursing executives have to ensure that, their nurses have a work environment with the work characteristics known to be linked to job satisfaction and good outcomes. The research hypothesis investigated here was: the higher nurses' levels on general job satisfaction, overall satisfaction with their professional role, and general job happiness, the lower their intention to quit would be. The controlling variables included demographic characteristics, working motivation, and nine job satisfaction subscales. This study was conducted in 3 hospitals located in southern Taiwan. All nurses working for these 3 hospitals were the target subjects. The overall response rate (648 completed questionnaires) was 82%. The nurses' Job Satisfaction and the perceptual degree of its importance questionnaire was used. Ordinal logistics regression analyses were utilized. General job satisfaction, general job happiness, satisfaction with salary and promotion, institution, educational background, and age of nurses' youngest child were proved to be significant predictors of nurses' intention to quit. Suggestions for future studies and administrative strategies in decreasing nurses' intention to quit were discussed.

Attitude of Health Personnel↗

The relationship between nurses' job satisfaction and inpatient satisfaction: an exploratory study in a Taiwan teaching hospital.

This exploratory study sought to test the relationship between nurses' job satisfaction and inpatient satisfaction with quality of nursing care in Taiwan. Patient and nurse data were collected from six inpatient care wards in a teaching hospital. Statistical results showed that nurses' general job satisfaction, general feelings of happiness when they are doing their jobs, and their job satisfaction are significantly correlated with at least one of the inpatient satisfaction factors studied, except for the factor of patient education. The results provide partial support for a linkage between nurses' job satisfaction and inpatient satisfaction with nursing care.

Adult↗

Roles of nurse aides and family members in acute patient care in Taiwan.

To improve the nursing care quality in acute care hospitals in Taiwan after the 2003 SARS epidemic, the Taipei City Government Department of Health has allocated about US dollars 6 million for nurse aides' salaries and costs for recruitment, training, and administration of this program. Yet, there have been no corresponding changes in payments for nursing services by the National Health Insurance system in Taiwan such as increasing nurse fees for inpatient services. This article examines the roles of nurse aides and family members in providing acute patient care in Taiwan and discusses issues of nursing care quality as related to nurse staffing in acute care hospitals.

Acute Disease↗