Background: Clinical placements play an important role in helping nursing students to achieve clinical competence, but these placements can be highly challenging and stressful. It has been shown that stress can be either a trigger or aggravating factor for ill-health in general, but studies have seldom differentiated the impact of general health status on perceived stress. This study examined factors associated with perceived stress of clinical practice among nursing students with a particular focus on the effect of general health status on stress. Methods: This was a cross-sectional quantitative study conducted among 724 associate nursing degree students in Southern Taiwan. Results: Health status scores varied from 28 to 139, with an average of 68.40 (SD = 25.75). Health status was reported to be ‘good’ (scores 28–55) in 35.5% of participants, moderate (scores 56–83) in 24.6%, and poor (Scores ≧ 84) in 39.9% of participants. Perceived stress scores ranged from 0 to 95 points with an average score of 36.65 (SD ± 15.95). The classification and regression tree (CART) analysis showed health status as the most important factor linked to perceived stress with a Normalized Importance value of 100%. Those who reported general health status (measured through General Health Questionnaire (GHQ)-28) score of ≤34.5 perceived mild stress and those with a score of > 34.5–< 84.5 perceived moderate stress. A score of 84.5 was found to be the point of transition to perceptions of severe stress. When health status score was greater than 84.5, perceived stress was at a severe or extremely severe level. Conclusions: Our findings indicated health status as a potential measure to identify students who were most vulnerable to perceived stress. Given the cross-sectional design of this study and the bidirectional relationship between health and stress, more studies are needed to fully establish the predictive link between general health status and vulnerability to stress.

Peer reviewed article authored by (Lin FY, Rong JR, Lee TY). Read article or submit your manuscript for publishing.

Background: Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an “aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods: A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results: Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions: Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.

Screening the frailty level of older adults is essential to avoid morbidity, prevent falls and disability, and maintain quality of life. The Tilburg Frailty Indicator (TFI) is a self-report instrument developed to assess frailty for community-dwelling older adults. The aim of this study was to explore the psychometric properties of the Taiwanese version of TFI (TFI-T). The sample consisted of 210 elderly participants living in the community. The scale was implemented to conduct a confirmatory factor analysis (CFA) test for validity. The models were evaluated through sensitivity, specificity, area under the curve, and receiving operating characteristic (ROC) curve. CFA was performed to evaluate construct validity, and the TFI-T has a goodness of fit with the three-factor structure of the TFI. Totally, the 15 items of TFI-T have acceptable internal consistency (Cronbach’s alpha = 0.78), and test–retest reliability (r = 0.88, p < 0.001). The criterion-related validity was examined, the TFI-T correlation with the Kihon Checklist (KCL) score (r = 0.74; p < 0.001). The cutoff of 5.5 based on the Youden index was considered optimal. The area under the ROC curve analysis indicated that the TFI-T has good accuracy in frailty screening. The TFI-T exhibits good reliability and validity and can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in Taiwan among older adults.

Aim: To develop an instrument to investigate geropsychiatric psychological symptoms, health problem nursing knowledge (GPN‐K), geropsychiatric psychological symptoms and health problem nursing attitude scale (GPN‐A) in clinical practice for nursing students.Design: Instrument development and cross‐sectional study for psychometric testing.Methods: Construct validity was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), and internal consistency was calculated using Cronbach's α.Results: A total of 300 students have completed the questionnaires (85.71% response rate). The CFA of GPN‐K showed good fitness and validity. The Kuder‐Richardson 20 (KR‐20) value of the internal consistency reliability is 0.64. The GPN‐A overall content validity index is 0.95. A three‐factor structure was shown by exploratory factor analysis. The three factors are communication and care, helping others improve and problem evaluation tendency. The total variance explained is 59.01%. Cronbach's alpha of GPN‐A equals 0.84, which represents good internal consistency.