Coping strategies, psychological resilience, and professional commitment among nurse-aide students in Taiwan: A cross-sectional study.

The impact of psychological resilience on professional commitment among caregiving students in Taiwan: A cross-sectional study.

BackgroundInternationally, the population is rapidly aging with a strong demand for aged care services. In Taiwan, both recruiting and retaining staff to aged care poses difficulties. Good clinical role models can positively impact students' confidence and professional development and influence their willingness to enter the long-term aged care workforce. ObjectivesTo clarify clinical mentors' roles and competencies and assess the effectiveness of a mentorship program for improving students' professional commitment and self-efficacy in long-term aged care. DesignA mixed-methods study with a quasi-experimental research design and qualitative interviews. SettingsPurposive sampling was used to recruit long-term aged care professional clinical mentors with preceptor qualifications and nursing and aged care students enrolled in a two-year technical program in a Taiwanese university's gerontology care department. ParticipantsFourteen mentors and 48 students participated. The student control group received regular education; the experimental group received mentorship guidance. MethodsThis study included three phases. Phase one involved qualitative interviews to identify clinical mentors' roles and competencies. Phase two involved expert panel meetings to establish the clinical mentorship program's content and implementation. Phase three involved the program's evaluation. Quantitative questionnaires were administered before the program and subsequently at 6, 12, and 18 months to assess mentors' effectiveness and students' professional commitment and self-efficacy in long-term aged care. Qualitative focus groups solicited participants' feelings and suggestions for the program. ResultsClinical mentors' roles and competencies centered on two themes: professional role model and establishing good rapport. Quantitative analysis showed that mentoring effectiveness initially recorded a decline, followed by a subsequent increase. Both groups' professional self-efficacy and commitment followed an increasing trend. While the experimental group's professional commitment score was significantly higher than the control groups, their professional self-efficacy scores did not differ significantly. ConclusionsThe clinical mentorship program improved students' long-term aged care professional commitment and self-efficacy.

The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans and care programs has not been established yet. In this paper, we propose models for designing long-term care service plans and care programs for older people, both by incorporating the technical issues from previous studies and by redesigning the total methodology according to these studies. Our implementation model consists of “Function,” “Knowledge Structure,” and “Action Flow.” In addition, we developed the concrete knowledgebases based on the Knowledge Structure by visualizing, summarizing, and structuring the inherent knowledge of healthcare/welfare professionals. As the results of the workshop and retrospective verification, the adequacy of the models was suggested, while some further issues were pointed. Our models, knowledgebases, and application make it possible to ensure the quality of long-term care for older people.

The Long Road Home: Neonatal Long-term Care

BackgroundPrevious research has demonstrated that nursing students’ professional commitment is less than ideal. However, a clear theoretical model to explain or mediate the factors influencing their professional commitment is currently lacking. Building on Social Cognitive Theory (SCT), this study aimed to describe the current situation regarding the professional commitment of undergraduate nursing students and examine its relationships with psychological resilience, medical education environment, innovation ability, and self-directed learning ability.MethodsA total of 813 undergraduate nursing students were recruited through convenience sampling for a cross-sectional study at a medical university in Anhui province. Participants completed the General Information Questionnaire, Professional Commitment Scale, Innovation Ability Scale, Self-Directed Learning Ability Scale, Psychological Resilience Scale, and Dundee Ready Educational Environment Measure (DREEM). Structural equation modeling was used to analyze the hypothesized relationships.ResultsNursing students’ total professional commitment score averaged 93.36 ± 13.63. Medical education environment, self-directed learning ability, and innovation ability all significantly and directly associated with professional commitment (β = 0.294, β = 0.167, β = 0.358, respectively). Self-directed learning and innovation ability mediated the effects of psychological resilience (β = 0.114, 0.054, respectively) and the medical education environment (β = 0.089, 0.063, respectively) on professional commitment. Additionally, self-directed learning and innovation ability exhibited a significant chain mediating effect between psychological resilience and the influence of medical education environment on professional commitment (β = 0.114, 0.054, respectively).ConclusionsOur study reveals that self-directed learning and innovation ability mediate the effects of psychological resilience and educational environment on nursing students’ professional commitment.These findings suggest nursing educators could focus on fostering students’ self-directed learning abilities in teaching and enhancing students’ professional commitment by optimizing the educational environment and strengthening mental toughness training.

Long-term care (LTC) workers face complex challenges requiring enhanced professional commitment and resilience. Virtual reality (VR) teaching modules provide immersive training, yet their effects on this workforce remain underexplored. This study examined the effectiveness of a VR-based module in enhancing professional commitment, psychological resilience, and coping strategies among LTC workers. A randomized waitlist-controlled trial was conducted with 92 LTC workers, divided equally into experimental and control groups. The experimental group received VR-based training, while the control group received the same intervention 4 weeks later. Data were analyzed using generalized estimating equations (GEE) and t-tests. The VR module significantly improved professional commitment (B = 7.24, p = .021). No statistically significant changes were observed for resilience or coping strategies.Conclusions and Application to Practice:VR-based training modules appear to enhance professional commitment among LTC workers. Integrating VR modules into mandatory training may help enhance job satisfaction, reduce burnout, and potentially improve care outcomes. Tailored VR training with workshops and peer engagement offers a practical approach to strengthening occupational health in LTC.

Taiwan is currently an aging society and will be a super-aging society in the near future. The purpose of this research is to use two models of data envelopment analysis (DEA)—the slacks-based measurement (SBM) model and the dynamic slacks-based measurement (DSBM) model—to analyze the efficiency of long-term care (LTC) in Taiwan. This analysis aims to explore the current situation of LTC in Taiwan and provide policy recommendations for LTC. The computation empirical result on the LTC efficiency score presents that the DSBM model exhibits higher efficiency than the SBM model after considering the carry-over variable in the former model. The result from the SBM model indicates that Taiwan’s outlying islands display the worst LTC efficiency, but this result does not appear in the DSBM model. Lastly, these two models both indicate that the number of elderly people being serviced in institutions exhibits higher efficiency and lower slack than those serviced in homes in 2017 and 2018. This paper concludes that the DEA approach is a viable method for examining the performance of the LTC services system as Taiwan approaches a super-aged society.

Despite the return of college students to campus in the post-pandemic era, the deep influence of COVID-19 on learning approaches persists. Existing research has explored fewer mechanisms underlying academic self-efficacy and learning engagement. In line with social cognitive theory, the psychological resilience framework, and vocational socialization theory, this research investigated academic self-efficacy, professional commitment, psychological resilience, and academic engagement among college students in the post-pandemic era. In this research, the focus was on understanding the impact of academic self-efficacy on learning engagement, taking into account gender as a moderator and psychological resilience and professional commitment as mediators. We conducted a survey with 1,032 college students in Henan Province, China, utilizing the Psychological Resilience Scale, Academic Self-Efficacy Scale, College Student Learning Engagement Questionnaire, and College Student Professional Commitment Scale. SPSS and the Process plugin were used to assess mediating and moderating effects. Academic self-efficacy significantly and positively correlates with college students' commitment to learning. The positive anticipation of learning engagement facilitated by academic self-efficacy exerts its effect through the fully parallel mediation of psychological resilience and professional commitment. Notably, the mediation effect of professional commitment was greater than that of psychological resilience. Further research found that the mediation of professional commitment was moderated by gender, with female students demonstrating stronger perceptions of professional commitment associated with elevated levels of learning engagement. Gender did not exhibit a significant moderating effect on psychological resilience. College students' academic self-efficacy, professional commitment, and psychological resilience must be addressed to enhance their learning engagement.

Dialogues with human books to promote professional commitment and learning among first-year nursing students: A mixed-methods study

This study aimed to explore the level of nursing professional commitment and its influencing factors among graduating nursing students in Taiwan. This was a cross-sectional study. This study was conducted with 359 graduating nursing students at a technological university in northern Taiwan. The data were collected using paper-and-pencil questionnaires. The Nursing Professional Commitment Scale (NPCS), Perceived Stress Scale (PSS), Coping Behaviour Inventory (CBI), and Clinical Competence Scale (CCS) were used. Multiple linear regression analysis was performed on the data. A p < 0.05 was considered statistically significant. The professional commitment of graduating nursing students was at a moderate level. The results of the regression analysis showed that the most significant factor associated with nursing professional commitment was engaging in nursing in the future, followed by clinical competence, interest in nursing, and avoidance behaviour. Graduating nursing students demonstrate a moderate level of professional commitment that requires improvement. Therefore, it is imperative for nursing educators to comprehensively consider and understand the various factors influencing nursing students' professional commitment and implement targeted interventions. Recommended interventions include competency-based instructional designs and the integration of professional values and emotional intelligence into the curriculum to strengthen students' core competencies, enhance adaptive coping skills, and reinforce beliefs in the professional roles. No patient or public contribution.

The effect of nursing internship program on burnout and professional commitment

This study compares total expenditures between beneficiaries enrolled in traditional Long-Term Care (LTC) and beneficiaries enrolled in Home and Community Based Services (HCBS) in a Quasi-Experimental Simple Ex Post Facto study utilizing multiple linear regression with inverted propensity score weighting. The results demonstrated, during the two years of the study period, that total expenditures were on average $14,565.03 (with a p-value oflessfor the total two years of the study, for HCBS beneficiaries when compared to their LTC counterparts. There remains today a belief that expenditures of elderly, dual beneficiaries electing to age-in-place for supported self-care expend less than that of elderly, dual beneficiaries electing traditional institutional LTC. Of forty-one peer reviewed periodicals, there is one that supports that belief, all other literature supports a counter-intuitive reality that LTC is less costly. In, Q4 of 2013 Florida’s Medicaid agency, the Agency for Health Care Administration (AHCA) in collaboration with the state’s Department of Elder Affairs (DOEA) consolidated its six aging/elderly programs[1] into their new Statewide Medicaid Managed Care (SMMC)-Long-Term Care (LTC) program. AHCA outsourced these programs through competitive procurement to managed care organizations. Compared to previous studies this study has three unique distinctions: Composition of expenditure categories–Nine of the eleven other studies compared only LTC costs directly to only HCBS costs. This study includes seven expenditure categories: Ancillary; Institutional–Acute; Institutional–Other; LTSS; Miscellaneous; Pharmaceutical; and, Professional. Managed care programs–Florida’s SMMC-LTC program is MLTSS with reimbursement methodologies including capitated payment schedules, FFS, pay-for-performance and risk/value agreements; and, Application of a Domicile Adjustment–In an attempt to adjust for Medicaid’s ‘room and board’ benefit differences between the two cohorts’, a domicile adjustment of -$831.00 was developed and applied to each month of enrollment for each LTC beneficiary. [1] The State of Florida had six different aging/elderly programs that were consolidated into the SMMC_LTC program, those six programs were: Nursing Facilities, Aged and Disabled Adult waiver, Assisted Living waiver, Nursing Home Diversion waiver, Channeling waiver and Frail Elder option.

BackgroundInfertility is a major reproductive health issue affecting childbearing-age couples worldwide. Factors contributing to its increasing prevalence include delayed marriage and childbearing decisions, as well as exposure to environmental pollutants. In addition to directly causing fertility problems, infertility also negatively affects family relationships by causing psychological trauma, such as anxiety and depression, thereby reducing quality of life. Emotional state, fertility-related stress, fertility quality of life (FertiQoL), and coping strategies are associated with psychological resilience. However, according to existing studies, the relationships among coping strategies, FertiQoL, and psychological resilience, as well as the synergistic pathways between the former two and psychological resilience, remain unclear. The purpose of this study is to investigate the associations among coping strategies, FertiQoL, and psychological resilience. Additionally, it aims to investigate whether different coping strategies serve as a mediator between FertiQoL and psychological resilience.MethodThis study employed a cross-sectional research design and purposive sampling method. A total of 222 patients with infertility who visited a tertiary-level hospital in Hunan Province between January and December 2019 were selected as the study subjects. We measured psychological resilience specifically in those who reported an unfulfilled wish for a child. Additionally, FertiQoL and coping strategies were assessed. We used Pearson’s product moment correlation to examine the association of psychological resilience, FertiQoL and coping strategies. Using the Process v4.1 model, we examined the mediating function of various coping strategies in the association between psychological resilience and FertiQoL, and employed stratified multiple regression analysis to investigate the factors influencing psychological resilience.ResultsIn total, 222 patients with infertility presented psychological resilience scores that were below the Chinese norm (M = 66.34; SD = 13.90) and were moderately low (M = 60.42; SD = 12.18). Pearson’s correlation analyses revealed significant bivariate associations among the study variables. FertiQoL demonstrated a weak but statistically significant negative correlation with psychological resilience (r =-.149, p < .05), whereas both positive coping (r = .261, p < .05) and meaning-based coping strategies (r = .377, p < .05) showed moderate positive correlations. In contrast, neither active avoidance (r =-.029, p > .05) nor passive avoidance strategies (r = .115, p > .05) were significantly associated with psychological resilience. In the mediation analysis adjusted for covariates, introducing positive and meaning-based coping strategies as mediators significantly attenuated the standardized coefficient of the FertiQoL-resilience association, which decreased from B=-0.172 to B=-0.329. These results demonstrate that both coping strategies play a significant mediating role in the relationship between FertiQoL and psychological resilience, with positive coping strategies having an indirect effect on psychological resilience of 0.074 (95% CI [0.010, 0.140]) and meaning-based coping strategies having an indirect effect of 0.083 (95% CI [0.030, 0.149]). The magnitude of the mediated effect was 34.81% overall.ConclusionInfertility patients’ psychological resilience and FertiQoL are related, and positive coping and meaning-based coping strategies have some mediating effects on this relationship, indicating that these strategies may be important in reducing the detrimental effects of FertiQoL on psychological resilience. Positive coping and meaning-based coping strategies have been shown to be effective at preserving patients’ psychological well-being. These findings serve as a foundation for future research into focused intervention programs.

The factors influence demand and supply of long term care were explored by numerous previous research. Demand and supply, however, are both economic terms. There is a need to incorporate the economic activity such as demand and supply within the general framework of health and social care. This is because it is a challenge to use them in the health and social care in which their characteristics are far from those in a free market. Firstly, the demand and supply used on issues of health and social care and their limits to achieve the social objectives are explored. Then, the case of long term care in Taiwan is discussed by describing the characteristics of long term care market in Taiwan and the forms that government policy may take in its efforts to realize social objectives more fully. As noted, the factors that influence demand and supply of long term care are dynamically intricate. Any interpretation should be used with caution in considering of how and why the demand and supply having been used on issues of long term care and their limits.

Large increases in the need for long-term care (LTC) services are expected as baby boomers age. Little has been published about patient and caregiver preferences for information about LTC. However, our qualitative research findings suggest that potential consumers may find it difficult to obtain accurate and timely information about LTC programs and services. In-person, semistructured interviews were conducted with 47 subjects, including patients (n = 25) within 90 days of their referral to a LTC placement (including NH, assisted living, home care, and community) and their caregivers (n = 22). Interview questions addressed the events that seemed to trigger their need for a LTC referral, the resources they used to become more informed about LTC options and the issues they confronted with the LTC referral process. Qualitative analyses identified a number of patient and informal caregiver-reported barriers to making decisions about LTC services, including insufficient information about LTC programs and community resources, unclear funding requirements and inadequate funding, and difficulty knowing how to plan for LTC or make LTC decisions. A potential solution may be an online LTC Guide designed to provide accurate information about the range of LTC services, with an emphasis on home and community-based services. This Guide was developed to address the gap in comprehensive LTC information identified in the findings of this study.