Services In Taiwan Research Articles

Community Health Nursing Competency and Psychological and Organizational Empowerment of Public Health Nurses: A Cross-Sectional Survey.

Aim: This study explored the effect of public health nurses’ current community care nursing competency on the psychological and organizational empowerment of public health services in Taiwan. Design: A cross-sectional nationwide survey design was used. Methods: A self-developed structured questionnaire was administered to public health nurses. They were recruited using a purposive sampling technique, and they participated in community healthcare workshops. Results: The mean score of Community Care Nursing Competence (CCNC) was 3.92 ± 0.83. The mean score in Community Empowerment (CE) was 3.66 ± 0.90. The study revealed that age and communication competence were crucial factors in public health nurses working in the community. With age and through the accumulation of practical experience, public health nurses’ communication competence may also improve, which can further enhance their psychological and organizational empowerment in the nursing workplace.

Continuous Use of Home Care Services and Functional Performance: A Population-Based Approach.

Home care (HC) services are the foundational service in Taiwan, such as personal care, housekeeping, showers, meal preparation, and so on. We used population-representative data to evaluate the effects of HC services use on the long-term functional performance of older adults. This longitudinal study used latent growth curve modeling, measured as trajectories in activities of daily living (ADL) ability. We retrieved data for 1,851 care recipients from the Long-Term Care Service Management System database. Continuous use of HC services had positive effects on functional performance over time of declining functional capacity (β = .075, p < .05). While greater age was associated with slower increases in ADL scores, being female and living alone were associated with faster increases in ADL scores. Continuous use of the HC services provided has a significant impact on maintaining or improving functional performance among older adults in the early stage of declined functional capacity.

The Impact of Pharmaceutical Home Care on Medical Utilization for Frequent Users of Outpatient Services in Taiwan.

Due to the high-accessibility and low-copayment of healthcare system in Taiwan, the clinical visit frequency of people is relatively high, which often leads to an excessively high healthcare expenditure. The aim of this research was to explore the effectiveness of pharmaceutical home care for frequent users of outpatient service and to analyze the impact of pharmaceutical home care on medical utilization. The study was based on the Taiwan National Health Insurance Research Database. Patients with over 100 clinical visits during 2010 to 2012 were selected as subjects. Whether these patients participate the experimental plan of pharmaceutical home care in the following year and the medical utilization of the research subjects were analyzed to compare the difference between participating group and non-participating group in this plan. The generalized estimating equation was employed to examine the difference of medical utilization. A total of 3943 subjects were included in this study, including 591 patients (14.99%) participating in the experimental plan. The average number of physician visits during the following year of the participating group was higher than that of the non-participating group by 0.12 visits, and the outpatient medical expense was lower than the non-participating group by 18,302 points (1 point = 0.03 US dollars). After participating in the plan, the average number of clinical visits of frequent users of outpatient services was significantly reduced by 6.63 visits, and the outpatient expense was significantly decreased by 9871 points. After joining the experimental plan of pharmaceutical home care, the average number of outpatient visits decreased significantly and the medical expense was lower when compared with those who did not participate in the plan.

Anesthesia services in Taiwan: A nationwide population-based study.

This study was conducted to provide an overview of anesthesia services in Taiwan from 2001 to 2010. A retrospective population-based analysis was performed using data from Taiwan's National Health Insurance Research Database for the period 2001 to 2010. The results were stratified by patient sex, patient age, anesthesia type, and hospital setting. Categorical data are presented as totals and percentages. Linear regression was performed to analyze the anesthesia trends. The annual use of anesthesia increased continually from 964,440 instances in 2001 to 1,073,160 in 2010, totaling 10,076,600 cases with a total cost of 25.4 billion USD. The overwhelming majority (83.9%) of anesthesia cases was for anesthesia in an inpatient setting; general anesthesia accounted for 73.8% of anesthesia cases, and female patients outnumbered male patients (52.4% vs 47.6%). The average number of anesthesia cases was 44.2 per thousand of the population annually, but this percentage was much higher in elderly people (100.9 cases per thousand people annually). The annual number of anesthesia cases per thousand of the population increased from 104.4 in 2001 to 113.0 in 2010 in the oldest group (>80 years). By contrast, a considerable decline in use of anesthesia was discovered over the study period among those aged younger than 18 years. The use of anesthesia services in Taiwan has increased over the years. The relationships of age with anesthesia volume and cost were found to follow an inverse U-shaped pattern. Elderly people used anesthesia services more frequently. The planning of geriatric anesthesia services deserves attention, especially in continually aging societies such as Taiwan.

Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan.

Encouraging citizens to use health checkup services is a health promotion strategy. In nations with aging populations, ensuring equitable use of health check-ups by senior citizens is a public health concern. The objective of this research was to quantify income-related inequality and its effect on the use of health checkup services in Taiwan during the 2007-2008 global financial crisis. We used the 2005 and 2009 datasets of the Taiwan National Health Interview Surveys to assess how income-related inequality influenced health check-up use among older adults in Taiwan during the 2007-2008 financial crisis. Corrected concentration indices (CCIs) were calculated and decomposed to determine the influences of explanatory variables. The dependent variable was whether participants had used free senior health check-ups in the past year, and the determinant factors were health behavior, health situation, socioeconomic and demographic factors, and area health care resources accessibility factors. The study assessed 2,460 older adults from the 2005 dataset and 2,514 such individuals from the 2009 dataset. The utilization of health check-ups increased from 21.6% in 2005 to 34.0% in 2009. Income-related inequality in the use of health check-up services was generally tilted toward the higher income individuals among both women and men in 2005 and 2009, and income-related inequality decreased among women group and increased among men group with non significantly from 2005 to 2009 (women: CCI decreased from.0738 in 2005 to.0658 in 2009; men: CCI increased from.1068 in 2005 to.1256 in 2009). We analyzed the effect of explanatory factors on men's and women's intention to use health check-ups by using a probit model. After controlling for other factors, we determined that income significantly influenced women's health check-up service use in 2005 and men's in 2005 and 2009. Positive health behavior significantly increased health check-up services use among men and women group after the financial crisis, and negative health behavior significantly reduced health check-ups use among men across financial crisis. The 2008 global financial crisis strengthened the effect on health check-ups use of income-related inequality of elderly men, especially in older adults with negative health behaviors. Elderly men with negative health behaviors tended to contribute more income-related inequality in use health check-up services after the financial crisis. Health promotion initiatives should focus their efforts on elderly men with negative health behaviors.

Determinants Impacting User Behavior towards Emergency Use Intentions of m-Health Services in Taiwan.

Emergency usage intention and behavior are crucial to business service success for m-Health providers and patient healthcare service. This study aimed to identify the factors that influence m-Health acceptance and the effect of emergency use intentions on usage behavior among Taiwanese m-Health users by adopting and extending the Unified Theory of Acceptance and Use of Technology (UTAUT). This study also examines the moderating role of gender and age in the effects of the independent variables on satisfaction with m-Health services. An online questionnaire was used to collect data from 371 participants. The results revealed that performance expectancy, facilitating conditions, and trust had positive effects on user satisfaction. Additionally, m-Health knowledge and user satisfaction had positive effects on emergency use intentions. However, social influence and effort expectancy did not have a significant effect on satisfaction. Moreover, age and gender significantly moderated the effects of some predictors.

Transportation synthetic sustainability indices: A case of Taiwan intercity railway transport

Sustainable Transport faces two challenges: the first is to understand and define Sustainability Indicators (Indices) (SI); the second is to quantify and operationalize. The objective of the study was to examine the impacts of intercity railways passenger transportation service in Taiwan. By applying MCDM technologies, the study constructed Synthetic Sustainability Indices (SSI). By using the DEMATEL and DEMATEL-ANP Based method (DANP), the study analyzed the degree of mutual influence to find the causality between indicators, and identified the weight of individual indicators and the dimension. Besides, empirical analysis was conducted to collect the performance of various SI of Taiwan intercity railway transport, including high-speed rail (HSR) and Taiwan railway (TRA), and calculated the individual and integrated SSI. With SSI as a basis, we could understand the trend of the sustainability of the transportation system over the years and the correlation between each transit system. The empirical results showed the economic dimension was the core factor, and was more important than the social and environmental dimension. The social dimension came as the second, and the environmental dimension was the independent factor. Besides, both SSI of HSR and TRA were positively improving over the recent 10 years; the integrated SSI of HSR and TRA system showed higher SSI than that of individual SSI.

Public perception of forest ecosystem services in Taiwan

ABSTRACT Ecosystem service assessment has become an emerging lobbying tool in recent years, relatively, less studies use non-economic methods to explore the society’s demand for ecosystem services from the perspective of human values, attitudes and beliefs. With Taiwan household registration records, this study conducted a survey involving mailing out questionnaires to ordinary households as sampling population. The purposes of this study are to understand Taiwanese people’s views on forest ecosystem services, and to analyze factors that affect people’s perception of the importance of forest ecosystem services. The results show that the respondents believe that soil conservation service is the most important. However, the non-economic cognitive analysis and economic evaluation show that the priority of forest ecosystem services is not consistent. In addition, this study shows that social and economic variables such as gender, occupation, and income have significant differences in different clusters of perception of the importance of ecosystem services. It is recommended that before any policy or protection action is taken in the future, the design should be strengthened to reflect the attitudes and preferences of stakeholders, inclusive of environmental, economic and social values to present the concept of human well-being, so that specific strategies can be more easily formulated to adapt to the actual situation.

How Gameful Experience Affects Public Knowledge, Attitudes, and Practices Regarding COVID-19 Among the Taiwanese Public: Cross-sectional Study.

BackgroundIn 2019, with the COVID-19 pandemic sweeping across the globe, public health systems worldwide faced severe challenges. Amid the pandemic, one simulation game, Plague Inc., has received substantial attention. This game has indirectly drawn greater public attention to public health issues by simulating pathogen transmission and disease symptoms.ObjectiveAgainst this backdrop, this research investigates whether the gameful experience of Plague Inc. has indirectly affected public knowledge, attitudes, and practices (KAP) regarding COVID-19.MethodsAn online survey was conducted through social networking services in Taiwan from May 6-28, 2020.ResultsA total of 486 subjects participated in this study, of which 276 (56.8%) had played Plague Inc. This study had several findings. First, participants who had played Plague Inc. demonstrated higher levels of knowledge (P=.03, median 7, IQR 7-8) and attitudes (P=.007, median 8, IQR 7-8) than participants who had not played Plague Inc. (knowledge: median 7, IQR 6-8; attitude: median 7, IQR 6-8). Second, there was a significant correlation between creative thinking (ρ=.127, P=.04) and dominance (ρ=.122, P=.04) in attitude. Finally, there was a significant correlation between creative thinking (ρ=.126, P<.001) and dominance (ρ=.119, P=.049) in practice.ConclusionsSerious games highlighting the theme of pathogen transmission may enhance public knowledge and attitudes regarding COVID-19. Furthermore, the creative thinking and dominance involved in gameful experiences may act as critical factors in public attitudes and practices regarding COVID-19. These findings should be further verified through experimental research in the future.

Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study

BackgroundThe experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals’ experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations.MethodsSemi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis.ResultsThe analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals’ self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients’ lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education.ConclusionsTo date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.

Impact of the COVID-19 pandemic on the utilization of medical and dental services in Taiwan: A cohort study

Impact of the COVID-19 pandemic on the utilization of medical and dental services in Taiwan: A cohort study

Effects on Reader Services of Applying Blogs in High School Libraries in Taiwan

The aim of this study is to explore high school library blogs in terms of its construction, purposes, contents and influences to reader services in Taiwan. Ten highly- represented high school library blogs were chosen and compared by using content analysis and interview methods. The findings suggested that the majority of the blog content in high school libraries focus on promoting reading activities. Second, the purposes of constructing library blog are to announce library-related news, provide students a reading environment, and to coordinate with teachers’ instructional activities. Third, the most distinctive influence of library blog in terms of reader services is the extension of communication channel and simplification of announcement procedure. Fourth, more than half of the high school library blogs have reached their expected goals on reader services. Finally, most of the high school libraries are intended to continuingly maintain their blogs toward multiple services direction. Based on above findings, the study has reached the conclusion that the construction of blog is indeed helpful to enhance library reader services. However, the support of school authorities is the key factor on whether the application of blog can be successful to high school libraries.

Impact of a New Home Care Payment Mechanism on Growth of the Home Care Workforce in Taiwan.

Taiwan implemented its first National 10-Year Long-Term Care Plan in 2008 and its second in 2017. Over the first 10 years, the number of home care workers grew too slowly to meet demand. To increase the home care workforce, the government introduced 2 new payment mechanisms in 2018. This study assesses these mechanisms' impact on growth in numbers of home care workers and use of home care services in Taiwan. Data were collected from the Ministry of Health and Welfare (2014-2019) and the Division of Long-Term Care (2017-2019). Generalized estimating equations compared rates of growth in the number of home care, institutional care, and foreign care workers and the number of care recipients receiving care from each group before and after 2018. Before 2018, rates of growth in all three groups of care workers increased slowly. After 2018, the rate of growth for home care workers increased to 31.8% from 9%, while growth in the other two groups remained stable. While there was greater workforce growth among home care than institutional care workers post-implementation of the payment mechanisms (p < .05), the number of home care recipients (p < .05) and monthly home care visits (p < .05) also increased. The new payment mechanisms improved home care workers' autonomy and salaries and appear to have contributed to immediate increased recruitment and retention. Whether this increase continues over the long run will need to be determined.

Exploring Customer Participation and Value

Emerging marketing perspectives show that customer participation creates new opportunities for value creation. A perspective in the marketing section should be highlighted, a new opportunity must be emphasized, and customer participation should be used as a means to define the relationship benefits through their participation. The goal of customer participation is to create a high-value service process by creating cooperation with customers. This study describes and develops hypothesis verification. In the context of professional financial services in Taiwan, this study explores the effect of customer participation on value creation and satisfaction from customer and employee perspectives. It also analyzes the effects of different customer capabilities and employees’ emotional intelligence. The source of data collection is a total of 383 customer questionnaires from domestic financial institutions of two types of bank (public and private) to verify (1) how customer participation affects customer satisfaction and employee job satisfaction through relationship value creation, (2) how customer ability affects the relationship between value creation and satisfaction, and (3) how employees’ emotional intelligence affects the relationship between relationship value creation and job satisfaction. This study uses the structural equation model to verify the research hypothesis and obtains the following results through empirical research: 1. Customer participation affects customer satisfaction through relationship value creation. 2. Customer participation does not completely create positive employee relationship value, which may increase work pressure. 3. Interference results show that customer ability can promote customer satisfaction, whereas employee emotional intelligence does not necessarily affect the relationship between employee relationship value creation and job satisfaction. These results contribute to the banking industry. Customer participation can promote value creation by arranging customers and financial specialists to have an appropriate interactive relationship and professional services

Towards people-centric smart city development: Investigating the citizens’ preferences and perceptions about smart-city services in Taiwan

City administrators hoping to achieve people-centric smart city (SC) development require a clear understanding of citizens’ preferences and perceptions about SC services. This study fills that need by presenting evidence-based research on such preferences and perceptions from the perspective of need theories, taking Taiwan as a case study. Specifically, we investigated Taiwanese citizens’ preferences for 35 SC services of seven dimensions classified in two domains, as well as their three perceptions of the usefulness of these SC services in the realization of human needs. The results show that most of our respondents clearly perceived SC services as both important and useful to their existence, relatedness, and growth needs, and that they expressed relatively higher preferences for such services to operate in the “hard” domain – e.g., smart energy, smart transport, or smart safety –than the “soft” one, e.g., smart living. Based on these findings, this study provides policy recommendations that, if implemented, could be expected to advance SC development by increasing citizens’ usage of SC services in both the hard and soft domains, and serve the wider aim of improving their well-being and quality of life.

Implementation of connection scan algorithm in tourism intermodal transportation journey planner: a case study

Accessibility to tourist destinations is an important component in a tourism system, especially for natural tourist destinations located in suburban areas. Good linkage of travel information and physical connections with local transportation services for intercity travel can facilitate more people to travel and promote national tourism destinations. This research takes the popular national tourism destinations and their public transportation service in Taiwan as a research object due to the unavailability of integrated public transport information service. Free Independent Travelers (FIT) demand is growing. This research aims to integrate intermodal public transportation information to support FIT by proposing a seamless way journey planner. In this scenario, the journey planner requires timetable data as input. The Connection Scan Algorithm is used to find the earliest arrival time routes at their destinations. This journey planner is built in PHP language and can complement the official tourism travel information website by Tourism Bureau, MOTC. Hence, the FIT could get the quickest routes to reach the destinations without compiling the public transportation information provided independently.

Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture.This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

Developing an assessment scale for long-term care reablement literacy in home care workers in Taiwan using a modified Delphi method

BackgroundReablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in LTC research. This study aimed to develop a scale for the assessment of long-term care reablement literacy (LTCRL) and employ this scale to assess the performance of home care workers in Taiwan.MethodsTo develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from northern, central, and southern Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire that included items related to basic demographic characteristics and questions to assess LTCRL.ResultsBased on the experts’ consensus on the procedure of the modified Delphi technique, the LTCRL assessment sale consists of 29 questions on four aspects of knowledge acquisition: the abilities to access/obtain, understand, process/appraise, and apply/use. The results revealed that higher education levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers.ConclusionsThe LTCRL assessment scale based on a modified Delphi technique is useful and feasible for evaluating LTCRL in home care workers who provide reablement services in Taiwan.

Utilization of emergency ophthalmology services in Taiwan: a nationwide population study

The aim of this study was to conduct a nationwide survey of the use of emergency ophthalmology services using a sub-dataset of one million beneficiaries sampled from Taiwan’s National Health Insurance Research Database (NHIRD) for the years 2008 through 2012. By analyzing this population dataset, the study illustrates the disease landscape of emergency eye care services. The five-year, one-million-person NHIRD sub-dataset for 2008 through 2012 was used to explore emergency visits and ophthalmology specialty visits and to analyze the associated demographics and diagnosis codes based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Diagnoses were categorized into three groups: urgent, non-urgent, and intermediate. A total of 2454 emergency eye care visits were identified. The mean age of the patients who made these visits was 34.6 years old, and their sex ratio was 1.36 men to women. The percentages of urgent, non-urgent, and intermediate eye care visits in this study were 48.2%, 30.9%, and 20.9%, respectively. The leading diagnoses in the urgent category were corneal abrasions, foreign bodies in the eyes, eye burns, and blunt eye injuries. The leading diagnoses for the non-urgent visits were conjunctivitis, subconjunctival hemorrhages, trichiasis, and dry eye disease. Those for the intermediate category were superficial punctate keratitis, corneal opacity and degeneration, and lid, orbital, and lacrimal drainage infections. The urgent visit category accounted for nearly half of all the visits identified in this study. Compared to outpatient department visitors, the emergency ophthalmology service patients were younger and more predominantly male. These results were consistent with those of previous reports. Low copays have made emergency ophthalmology services highly accessible in Taiwan. However, future policies can be designed to more effectively allocate resources to urgent cases.

My Pilgrimage in Mission

As a missionary among the aboriginals in Taiwan, I wondered why this people’s response to the gospel was so open, compared with that of the Chinese of my youth and the Taiwanese majority population. This question became almost an obsession for me. After sixteen happy years in service in Taiwan still holding my question, I began another stage in my pilgrimage in mission in graduate school seeking for answers. I continued my ministry in America, writing articles and then a series of books trying to answer my question regarding receptivity or nonreceptivity to outside religions, especially Christianity.