Health Care Nurses Research Articles

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia: A Cross-Sectional Study.

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

Determinants factors on Public Health Centre nurses' confidence in performing cardiopulmonary resuscitation

Background: Most cardiac arrests occur outside the hospital (out-of-hospital cardiac arrest/OHCA). Public Health Centre (PHC) nurses are one of the important components of the chain of survival. The confidence of PHC nurses in performing Cardiopulmonary resuscitation (CPR) is still questioned.Purpose: To analyze the factors determining the level of confidence of PHC nurses in performing CPR.Method: An observational analytical study with a cross-sectional approach involving 30 nurses from 2 PHCs in Banten Province, Indonesia taken using a total sampling technique.Results: A total of 30 participants participated in this study. The average age of participants was 36.4 years with an age range between 26-55 years. Most participants were male 17/56.7%, had a diploma education background of 21/70.0%, and had upgraded their BLS training 23/76.7%. On average, participants had worked for 6.5 years and managed 3.4 cases of cardiac arrest (CA) during their time as nurses. It was found that gender, educational background, and BLS training status were not associated with the nurse's level of confidence in performing CPR. While employment status has a significant relationship with confidence in performing. Age has a strong relationship with self-confidence with an r rank value of 0.447. Length of work also showed a relationship with self-confidence with an r-rank value of 0.503. Likewise, the number of CA cases ever managed has a relationship with self-confidence with an r rank of 0.419.Conclusion: Gender, educational background, and BLS training status were not associated with nurses' confidence levels in performing CPR. Employment status, age, length of work, and number of CA cases managed were associated with nurses' confidence in performing CPR.

Health Needs and Nursing Care Practices for High-Risk Pregnant Women

Health Needs and Nursing Care Practices for High-Risk Pregnant Women

Healing the Body and Soul: A Comprehensive Review of Spiritual Nursing Care

Background: Spiritual care is an important aspect of patient centered care and in healthcare research, the focus on spiritual care has been growing over the past decades. Providing spiritual care in a global, culturally entwined, and pluralistic world is complicated, as providers are sensitive to the potential variance in the secular, spiritual, and religious meaning orientations of their patients. The purpose of spiritual nursing care is to support people's spiritual health, encourage inner serenity, offer emotional support, and assist them in using their spiritual resources to get through trying times. Purpose: To identify challenges nurses face (communication, sensitivity) for improvement. Methods: In this study, we estimated ten patients from a geriatric ward in Edinburgh, Scotland, who were asked to define their spiritual requirements. Results: In our study, the majority of the patients expressed a desire to make sense of or find purpose in their lives, as well as to be loved and accepted. Conclusion: The study provides theoretical research and empirical support for nursing, creating a cumulative added value in spiritual nursing care. Future studies on spiritual care in nursing should inform changes in education and practice. This patient requirement must be prioritized alongside all other physical and mental needs. Implications for Nursing: Spiritual care in nursing practice has the potential to significantly enhance patient well-being and expand the role of nurses in healthcare. By addressing these challenges and fostering better training and education, nurses can become more equipped to integrate spiritual care into their practice. Keywords: Spiritual care, Spiritual well-being, Spiritual interventions, Nursing care, Holistic care, Spiritual health.

Effects of the PRECEDE-PROCEDE Model on Self-Care Ability and Quality of Life Among Primipara During Puerperium.

Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium.

Investigating the Impact of Mindfulness Meditation on Stress Reduction and Self-Compassion of Nursing Health Care Professionals in a Small Community Hospital in the Midwest

Coronavirus-19 exacerbated daily stressors for nurses due to long hours, understaffing, and potential burnout in health care personnel. There is evidence that nurses who participate in mindfulness activities may experience significant changes related to stress, anxiety, and mood; however, more quantitative research studies are needed to investigate and substantiate the impact of mindfulness-based interventions. This intervention investigated the impact of a 4-week mindfulness meditation on perceived stress and self-compassion. Thirty-two participants were enrolled at the beginning of the study and 26 completed the intervention (intervention group, n = 17; control group, n = 9). A 2-tailed Mann-Whitney U sample rank-sum test was used to explore differences between groups on the 2 outcome variables—Perceived Stress Scale (PSS) and the Self-Compassion Scale (SC). Postintervention assessments were conducted, and statistically significant differences were found between the intervention and control groups for 2 constructs. The intervention group was more likely to “feel confident handling problems” (PSS#4) versus the control group (median = 11.76, 16.78, respectively; P = .020; α = .05); and the intervention group tended to “take a more balanced view of life situations” (SC#3) than the control group (median = 12.50, 15.39, respectively; P =.047; α = .05). Other constructs from the PSS and the SC were not statistically different. In conclusion, this study found observable improvements in the raw data and statistically significant differences for the intervention group; however, more research is warranted.

The Influence of Organizational Culture, Work Environment and Work Motivation on Nurses Performance with Job Satisfaction as a Mediation Variable In Public Health Center XYZ

With job satisfaction acting as a mediating variable, the purpose of this study is to evaluate the impact of organizational culture, work environment, and work motivation on nurse performance. This study involved 48 nurses and was carried out in Jakarta. A Likert scale of 1 to 5 was used for 34 questions on the questionnaire, which was distributed as part of the census sampling procedure to collect data. The SEM approach based on PLS was used to analyze the data. The study's findings indicate that the XYZ Community Health Center (Puskesmas) nurses performance is influenced by organizational culture, the work environment, and job satisfaction. This research model is still intriguing and will hopefully add to the performance literature despite a number of limitations

Exploring Clients' Experiences of Transitioning Mental Health Nursing Care from an In-Person to a Virtual Format due to the COVID-19 Pandemic.

The onset of the COVID-19 pandemic led mental health professionals to change the way they engaged with clients, often replacing in-person consultations with virtual ones via telephone or videoconferencing. While studies have investigated the delivery of virtual physical health care, only a handful have investigated the delivery of virtual mental health. These specifically focussed on the outcomes of virtual care whether experiential, practical, or empirical. The transition from in-person to virtual care delivery due to the COVID-19 pandemic has been unexplored. Accordingly, the purpose of the study was to: (1) Explore the experiences of clients who had to transition from an in-person to a virtual provision of mental health care due to the COVID-19 pandemic, and; (2) Explore the nurses' experiences of this technological transition. Using an interpretive phenomenology methodology, semi-structured interviews were conducted with nurses and clients who have experienced the in-person to virtual transition of service delivery at a tertiary mental health hospital in Ontario, Canada. In this article, we focus on the results stemming from our interviews with clients. The themes generated from the analysis of client experiences are 1) the psychosocial impact of the COVID-19 pandemic on clients, (2) mixed feelings of clients towards nursing care delivered via technological means and (3) the role of nurses regarding transitioning of in-person care to technology-mediated care. These findings are relevant as mental health care hospitals are considering how they will deliver services once concerns with the transmission of the COVID-19 virus are resolved.

The Effect of START Triage Simulation Method on the Preparedness of Puskesmas Nurses at Risk Disaster in Helping Victims in Ternate

Background: Disasters can cause deaths, injuries, damage to health facilities and public health problems. An effective approach is needed in handling victims through triage. Objective; analyzed the effect of the START triage method simulation on preparedness to help disaster victims by nurses at the Disaster Prone Health Center in Ternate City. Method: This research design is quasi experimental Pretest-posttest Control Group Design. The sample for this research is 50 nursing staff spread across 4 health centers in disaster-prone areas. The instruments used were questionnaires and observation sheets. Data analysis used the Wilcoxon test. Results: The research results showed that using the Wilcoxon test (α=0.05), the p value for the control group was 0.001 and the p value for the treatment group was 0.000. Conclusion: Providing the START triage method simulation to the treatment group had an effect on preparedness to help disaster victims by community health center nurses.

Effect of Work Related Stress on the Wellbeing of Nurses: A Descriptive Study

Work-related stress is reportedly a very common issue among nurses in health care. This study was aimed at assessing the level of work-related stress among nurses in University of Port Harcourt Teaching Hospital. Objectives were to: assess the level of work-related stress, compare the level of work-related stress among nurses across units/wards and assess for availability of stress reduction support systems. Cross sectional descriptive survey design was adopted with a sample size of 288 nurses. A self-structured questionnaire was used to collect data and data was analyzed using frequencies and percentages with the aid of SPSS version 23 and difference between variables was tested using T test. Majority (86.3%) of the nurses experienced severe stress, all respondents (100%) lacked support systems, and there was significant difference in the stress level between the units/wards. It was suggested, therefore, that a special reward/recognition should be introduced to nurses who were dedicated to their work, and more nurses employed to share the work burden, with occupational health services provided in the study center.

Measuring the Level of Work Related Stress among Nurses in University of Port Harcourt Teaching Hospital: A Descriptive Study

Work-related stress is reportedly a very common issue among nurses in health care. This study was aimed at assessing the level of work-related stress among nurses in University of Port Harcourt Teaching Hospital. Objectives were to: assess the level of work-related stress, compare the level of work-related stress among nurses across units/wards and assess for availability of stress reduction support systems. Cross sectional descriptive survey design was adopted with a sample size of 288 nurses. A self-structured questionnaire was used to collect data and data was analyzed using frequencies and percentages with the aid of SPSS version 23 and difference between variables was tested using T test. Majority (86.3%) of the nurses experienced severe stress, all respondents (100%) lacked support systems, and there was significant difference in the stress level between the units/wards. It was suggested, therefore, that a special reward/recognition should be introduced to nurses who were dedicated to their work, and more nurses employed to share the work burden, with occupational health services provided in the study center.

Resiliensi Perawat Puskesmas dalam Menghadapi Kondisi Pandemi COVID-19

This research aims to identify Puskesmas nurses' resilience in facing the COVID-19 pandemic in Bandung City. The method used is quantitative descriptive. The research results showed that the majority of Bandung City Health Center nurses had moderate resilience (41.2%), others had low stability (35.3%), and a small number had high strength (23.5%). The aspect of resilience with the highest average is spiritual influence, and the lowest is trusting one's instincts, tolerance for negative things, and the strength to deal with stress. In conclusion, in facing the COVID-19 pandemic, most Bandung City Community Health Center nurses have good resilience.&#x0D; &#x0D; Keywords: COVID-19, Nurse, Community Health Center, Resilience

Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs.

The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.

Impact of essential newborn care education on knowledge and practice of new-born care among nurses in rural primary health centres in Ebonyi state of Nigeria

Background: This study was designed to determine the level of knowledge and the extent of practice of the components of essential new-born care (ENC), and the effects of a training programme on the knowledge and practice of ENC among nurses in rural primary health cares (PHCs) in Ebonyi state Nigeria. Methods: This study was a one group pre-test and post-test intervention design. The components of ENC considered were: New-born initiation of breastfeeding, thermoregulation, new-born cord care, newborn eye care, initiation of breathing and administration of vitamin K. A neonatal care knowledge and practice assessment (NCKPA) questionnaire tested for validity and reliability, with a Spearman’s correlation coefficient of 0.81, was used for data collection among the (48) available nurses (All female). Results: There was significant improvement in the level of knowledge and extent of practice of the components of ENC following the training programme. Despite the improvement, there were gaps in knowledge and practice of the components of ENC amongst the nurses in rural PHCs and affected were the level of knowledge of eye care 20 (41.6%) pre-intervention, and least knowledge of cord care 35 (72.9%) and eye care 45 (93.8%)-post-intervention. Conclusions: Increase in knowledge corresponded with increase in good practice of ENC. The concern with knowledge transfer and translation of knowledge into practice could be achieved by pre-service and in-service education, update courses and workshops, and this will empower the nurses, getting them familiar with current trends and practices for improved child survival rate.

PELATIHAN COMMUNITY MENTAL HEALTH NURSING (CMHN) BAGI PERAWAT DAPAT MENINGKATKAN PENANGANAN MASALAH KESEHATAN JIWA DI MASYARAKAT

Community-based psychiatric nursing care is a nursing approach to mental patients, which is carried out directly to patients and their families at home by health center nurses who have received previous training. Nurses who have been trained are expected to have competence, one of which is being able to provide nursing care to patients with mental disorders in the community, so that patients with mental disorders can be handled optimally. This research is to see the relationship between the Effectiveness of CMHN Training Implementation in 31 Public Health Centers in North Aceh District. The study was conducted at 31 Community Health Centers in North Aceh District. The research design used a correlational design with a total sampling technique. Data collection was carried out by distributing questionnaires online via the Google form to respondents in July 2022. Data analysis used the Chi Squere test with a 95% confidence interval. The research results obtained p value = 0.000, α = 0.05, p value ≤0.05, the statistical results are significant, meaning that there is a relationship between the effectiveness of implementing CMHN training on improving the handling of mental health problems in North Aceh District.

Nurses' perceptions of preceptorship of undergraduate students in clinical context.

Nurses' perceptions of preceptorships for undergraduate nursing students are crucial for designing effective and tailor-made strategies to improve nurses' involvement, motivation, commitment, and satisfaction in preceptorships. The aim of this study was to determine nurses' perceptions of preceptorships for nursing students in two hospitals located in northern Spain. This study was conducted in two highly specialized, medium-large, university tertiary care hospitals, including one public and one private hospital, located in northern Spain. The participants of this study were clinical nurses in private and public health centers who had been preceptors for at least one year. A descriptive cross-sectional study was carried out between October 2021 and April 2022, with a total sample of 307. The validated "Involvement, Motivation, Satisfaction, Obstacles and Commitment" (IMSOC) questionnaire was used. Descriptive statistics and bivariate analysis were carried out. The variables included sex, age, educational level, preceptorship training, professional experience, work sector, work setting, and type of contract. The mean global questionnaire score was 115.25±33.86 (95% CI: 111.62-123), with the highest score obtained for the "Involvement" dimension (29.96; SD: 9.23; 95% CI: 29.01-34.87). Age showed statistically significant negative correlations with the overall and dimension scores (p<0.05). Comparisons by work sector and type of contract reflected that nurses working in the private sector and those with permanent contracts had higher motivation and commitment scores. Preceptors had positive perceptions of their role in undergraduate nursing students' education. Age, work sector, type of contract and time allocation should be considered when designing strategies to enhance the involvement, motivation, commitment, and satisfaction of nurses in their experiences as preceptors for undergraduate nursing students. Improving the preceptorship experience will benefit both nurses and students by improving preparation, satisfaction, and retention.

Pengaruh Workplace dan Manajemen Stres terhadap Burnout pada Perawat di Masa Pandemi Covid 19

During the COVID-19 pandemic, nurses have a high risk of burnout, due to high work stress, workload, risk of COVID-19 infection, through close contact with patients. This study aims to analyze the effect of workplace factors and stress management on burnout in UPT Tarogong Health Center nurses during the COVID-19 pandemic. This research is a verifiative descriptive research, with a census sampling method or whole sampling, namely all nurses at UPT Puskesmas Tarogong. Primary data were collected through interviews and surveys using the Maslach Burnout Inventory questionnaire, Quick Burnout Assessment questionnaire, and stress management questionnaire. The workplace questionnaire for aspects of workload, control, reward, and fairness is at a sufficient level, while community values and values are at a high level, meaning that improvements are still needed in workload management, decision making, communication, and a more transparent reward system for nurses at UPT Puskesmas Tarogong. Nurses tend to use individual stress management methods, primarily using personal relaxation techniques as well as discussions with spouses or families to manage work stress levels. Burnout is at a considerable level that is characterized by a degree of depersonalization and a mild decrease in performance. Workplace and stress management affect the burnout of nurses UPT Puskesmas Tarogong, and the effect of workplace on burnout is greater than the influence of stress management so that improvements are needed in workload management, decision making, and effective communication with nurses, also workplace intervention and stress management are needed in Puskesmas to reduce the level of burnout, so management needs to implement a stress management program, both organizationally such as holding recreation for nurses, and it is necessary to divide the distribution of workload fairly and actively discuss with nurses.

Nurses' Challenges to Developing Interpersonal Relationships During Integrated Care for Complex Patients.

Individuals with multimorbidity and complexity have multifaceted care needs requiring integrated and collaborative care from nurses, families, and health care teams. Nurses, as the frontline care professionals, should develop therapeutic relationships with patients and their families and professional relationships with health care team members to ensure the delivery of effective integrated care. Failure to develop effective interpersonal and professional relationships can negatively affect patient care. The purpose of this study was to explore nurses' challenges with developing interpersonal and professional relationships during integrated care for individuals with multimorbidity and complexity. A descriptive qualitative design was used. We interviewed a purposive sample of 19 nurses with experience of caring for individuals with multimorbidity and complexity across two hospitals in Pakistan. Semi-structured interviews were used for data collection, and data were analyzed using reflexive thematic analysis. Two challenges were identified affecting the relationships between patients' families and nurses, and two challenges influencing the professional relationships within the team. Families withheld information, controlled care access of their relatives, posed unrealistic demands, and abused nurses, affecting nurse-family relationships. Power struggles to demonstrate authority in decision-making were common within health care teams, affecting nurses' professional capacity to provide effective care. Health care team, patient, and family collaboration is instrumental in improved care for individuals with multimorbidity and complexity. Nurse leaders and health care organizations should take initiatives to address nurses' interpersonal confrontations to support them in the provision of quality care.

The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial

BackgroundEthical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity.MethodsIn this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals.ResultsAdjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009).ConclusionsThe results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students.RegistrationThis randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016.

Changing Mindsets to Create a New Mental Health Nursing Care Landscape

Perception of change is a real and profound out come of the recently ended COVID-19 pandemic. The course of this pandemic was unpredictable and subject to change with no clear end in sight. Thus, "uncertainty" became the only certainty in daily life. The realities of the pandemic necessitated that changes and adjustments be made in our physical, psychological, and emotional states as well as life and work styles, which tested everyone's resilience. Change interpreted through Buddha Siddhartha's "Theory of Dependent Origination" is normal and to be expected. The Buddha believed all "conditioned dharmas" in the world (things that can be seen with form) were not created from nothing and could not exist alone. Instead, they must have been formed through a combination of various causal conditions and, once these conditions disappear, must return again to nothingness. Thus, "All dharmas arise due to conditions, and all dharmas cease due to conditions (Sina Buddhism, 2017)". Because of this, the Buddha believed all things and all phenomena to be impermanent and changing (Master Sheng Yen, 2002). According to the Buddha, change is normal and impermanence is permanent. As such, the practice of mental healthcare has not been passively changed by the epidemic, but has always been changing continuously and proactively. The process of treating and restoring to health in patients with mental illness is actually a long and arduous journey, and mental health nurses play a very important role throughout this long process of recovery. We abandon the traditional treatment and care model that only focuses on mental disorders and symptoms, and instead adopt the concept of holistic healthcare (Mandal et al., 2020), which focuses on patient physical, psychological, social and spiritual aspects, helping them achieve whole person wellness (Swanson et al., 2019). Each patient should be regarded as a unique individual not only in terms of their disease diagnosis, symptoms, physical and mental states, understanding, and communications but also in terms of their socioeconomic status, family support, and social resources. Because of this, nursing care plans should not be institutionalized or mechanistic, but rather allow flexibility to address each patient's current condition. Through comprehensive and integrated care and consultation and interdisciplinary teamwork, the psychiatric and mental health nurses work hard to ensure every patient and family member who receives care is satisfied in terms of their physical, psychological, social, and spiritual needs. Another aspect of change is the adoption by mental health nurses of a more active, more professional, larger pattern, and broader vision of their professional services. After all, mental patients may not necessarily fully understand their needs. As mental health professionals, we can develop our professional sensitivity. Moreover, while devoting ourselves to helping patients move towards holistic health and providing holistic care for patients, we should also try our best to detect and pay attention to whether current mental-health-related policies, medical system norms, or usual modes of operation may be ignoring patient needs or increasing the obstacles encountered in the rehabilitation process. In addition, we should try to seek strategies to change the situation, advocate for the health and well-being of patients, and improve the quality and effectiveness of overall mental healthcare. In this issue, four professors respectively discuss issues related to mental health policy, clinical practice, community rehabilitation and employment support, and the expansion of the professional role and service field of mental health nursing. These authors share how the field and functions of mental healthcare can change and evolve along a positive path forward. They not only provide direction and light but also show the results of their efforts.