Su-Fen Cheng

Background: Home-based hospice care extends palliative care into patients’ homes and requires nurses to provide clinical, emotional, practical, and existential support within family contexts. Although home-based hospice nurses play a central role in this model of care, little is known about how they develop professional identity and sustain commitment while managing the emotional and relational demands of end-of-life care. This study explored how home-based hospice nurses developed professional identity and sustained commitment across their career journeys while negotiating the emotional and relational responsibilities of end-of-life care. Methods: This qualitative narrative inquiry adopted a life-course perspective. Between November 2021 and March 2022, in-depth interviews were conducted with 10 certified home-based hospice nurses in Taiwan who were recruited through purposive and snowball sampling. Interviews lasted 50–195 min and were analyzed using Polkinghorne’s narrative analysis, supported by Kelly and Howie’s procedures for narrative organization and cross-case interpretation. Results: Participants’ career stories revealed a developmental journey from entering nursing and searching for professional direction to becoming trusted relational caregivers within patients’ homes and family contexts. Four themes were identified: searching for a place in nursing; finding meaning beyond clinical tasks; walking through the valley with patients and families; and sustaining self while caring for others. Relationships with patients and families were central to participants’ professional identity formation and sustained commitment over time. Two participants used driftwood imagery, including one who described being the family’s “last piece of driftwood,” reflecting a broader pattern of emotional responsibility, family trust, and boundary negotiation across the narratives. Conclusions: Professional identity in home-based hospice nursing is shaped through relational caregiving, repeated encounters with suffering and death, reflective practice, team support, and lifelong learning. These findings highlight the importance of educational and workforce support strategies that strengthen emotional boundary-setting, communication, relational ethics, and interprofessional collaboration to sustain the home-based hospice nursing workforce.

The global healthcare landscape is entering the data-driven era of Industry 4.0, challenging nursing with profound structural transformations within increasingly complex clinical environments. The nursing profession in Taiwan is now confronting a "dual crisis" marked by a critical workforce shortage and unsustainable clinical workloads. This crisis permeates both clinical practice and nursing education, necessitating proactive and effective reform strategies. Digital technologies, including artificial intelligence (AI), AI-driven virtual avatars, digital twins, and virtual reality offer significant potential to augment clinical decision-making, enhance educational outcomes, and optimize patient self-management. Therefore, digital empowerment, more than simply the integration of technologies, represents a strategic pathway forward to reshaping nursing values and promoting professional dignity. Topol (2019) emphasized that alleviating clinical dilemmas is the primary aim of smart technology integration in the field of healthcare. By leveraging technology to solve practical issues, clinicians can reclaim time for direct patient care, facilitating humanistic, compassionate care and elevating the intrinsic value of nursing. In clinical practice, several healthcare institutions have already implemented virtual agents and remote monitoring systems to assist in clinical problem-solving, disease progression monitoring, and the provision of individualized health education and psychological support. Furthermore, digital twin technology is emerging as a cornerstone of this transformation. Integrating electronic health records with real-time data streams to create "virtual personas" is allowing nurses to detect subtle physiological changes prior to the onset of clinical deterioration, achieving precision care and optimizing healthcare operations. Carroll and Garcia-Dia (2025) argued that digital twins are not only predictive tools but also catalysts for redefining care delivery processes. In the realm of nursing education, academic institutions are actively developing digital curricula that incorporate metaverse elements such as virtual reality and augmented reality to bolster student engagement and learning efficacy. AI virtual humans and immersive virtual reality are at the forefront of pioneering new pedagogical models designed to enable students to cultivate core competencies within engaging and targeted learning environments. Using no-code platforms, educators are increasingly able to independently develop simulation scenarios that incorporate interactive voice response capabilities. These virtual environments allow students to practice nurse-patient communication and clinical decision-making in low-stakes, repeatable settings that effectively mitigate the "reality shock" traditionally experienced during the transition from academic to actual clinical environments. Ultimately, the goal of digital empowerment is to support professional judgment and return time to nursing professionals, ensuring the core of nursing remains centered on care and compassion, aspects that technology remains largely unable to handle. We hope this column will inspire readers to reflect on how technology can be harnessed to construct a sustainable and professionally valuable future for nursing amidst the smart healthcare wave.

Aim: This study evaluated the effectiveness of virtual reality (VR) simulation training in enhancing emergency room (ER) nurses’ preparedness for air‐to‐ground patient handoff and psychological safety, defined as participants’ perceived confidence and comfort within the training environment. Background: Aeromedical transport is critical in regions with complex terrain or limited resources. The reception phase poses time‐sensitive and environmental challenges, and insufficient training increases the risk of handoff errors and patient harm. Existing programs focus mainly on in‐flight care, with little attention to reception. VR offers an immersive, standardized, and safe platform for reception training. Design: A quasiexperimental design using a nonrandomized, sequential cohort allocation by training date with two‐group repeated measures was employed. Methods: Seventy‐six emergency nurses from a northern Taiwan medical center were assigned by training date to a traditional drill group ( n = 33) or a VR simulation group ( n = 43). The “H.A.N.D.O.F.F.” curriculum, based on the 2024 CDC air‐to‐ground handoff protocol, was implemented. Outcomes included the Air‐to‐Ground Patient Handoff Preparedness Inventory and Psychological Safety Scale. Data were collected at baseline, postintervention, and 8 weeks and analyzed using generalized estimating equations. Results: Baseline score refers to participants’ initial preparedness prior to the intervention, and no significant differences were found between groups at baseline ( p > 0.05). Postintervention, the VR group reported significantly higher preparedness and psychological safety than controls ( p < 0.001), and these improvements were sustained at the 8‐week follow‐up ( p < 0.001). Conclusions: This study demonstrated that VR simulation significantly improves preparedness for air‐to‐ground patient handoff, highlighting its practical value. Future applications may extend to military, police, and fire departments to foster interprofessional collaboration and enhance emergency response capabilities.

BACKGROUND Hepatitis C virus (HCV) transmission rates are high among men who have sex with men (MSM) living with human immunodeficiency virus (HIV), a group with low awareness and limited skills in HCV prevention. However, few educational interventions are specifically designed for this population. OBJECTIVE This study aimed to evaluate the effectiveness of digital educational interventions on HCV prevention knowledge and self-efficacy among MSM living with HIV. METHODS PWH who are MSM were randomly assigned in a 1:1:1 ratio to receive three different HCV educational modalities using serious game interventions (SG), web browsing (WB), or verbal/printed pamphlet (VP). The participants underwent a uniformed questionnaire interview to assess their knowledge and self-efficacy in preventing HCV infection at pre-intervention. The evaluations were repeated 1-week post-intervention and 12-week follow-up after randomization. RESULTS 207 PWH were enrolled: 71, 67, and 69 in the SG, WB and VP groups, respectively. At pre-intervention, there were significant differences in the knowledge level among the three groups: 10.51 in SG group (95% CI, 9.60-11.41), 10.93 in WB group (95% CI, 10.16-11.69), and 11.83 in VP group (95% CI, 11.19-12.46) (p<0.05). There were no significant differences in self-efficacy among the three groups. Using GEE models to analyze the effects of different HCV education interventions at different observation points, only SG group were significantly associated with an increase of HCV knowledge score at 12-week follow-up (???? = 1.16, p = 0.02). Analysis of the difference-in-differences estimates also yield similar results. CONCLUSIONS All three educational interventions improved HCV knowledge and self-efficacy, with the SG approach enhancing knowledge retention, implying the benefit of digital educational intervention. CLINICALTRIAL Approved by the National Taiwan University Hospital Research Ethics Committee (registration number: 202206084RIN). Registered on July 28, 2022, at National Institutes of Health ClinicalTrials.gov, identifier: NCT05497388

Aims and Objectives: This study evaluated the effectiveness of an educational board game compared with online lectures in enhancing nursing assistants' (NAs) empathy and learning motivation. Background: NAs play a vital role in patient‐centered care; however, training programs often prioritise technical skills over the development of empathy. Game‐based learning has shown potential for fostering empathy, but its application to NAs remains underexplored. Methodological Design and Justification: A quasi‐experimental design was adopted to compare the two instructional strategies in a real‐world setting. Ethical Issues and Approval: This study received approval from the University‐Affiliated Institutional Review Board. Written informed consent was obtained from all participants, and measures were taken to ensure confidentiality and anonymity. Research Methods, Instruments and Interventions; Outcome Measures: Eighty‐three NAs were recruited and assigned to a board game group ( n = 35) or an online lecture group ( n = 48). Empathy, learning motivation and satisfaction were assessed at baseline, immediately after the intervention, and at the four‐week follow‐up using validated scales. Results: The board game group showed significantly greater improvements in empathy at both post‐test and follow‐up compared with the online lecture group. Both groups reported increased motivation, with intrinsic motivation notably higher in the board game group. Learning satisfaction was also significantly greater among board game participants. Study Limitations: Convenience sampling, reliance on self‐reported measures, the single‐session intervention and the short follow‐up period may limit generalizability and long‐term interpretation. Conclusions: Educational board games provide an effective and engaging strategy to enhance empathy, intrinsic motivation and learning satisfaction among NAs. Their interactive and immersive design fosters emotional awareness, perspective‐taking and compassionate care. Nursing administrators are encouraged to integrate board games into empathy training programs. Future research should involve more diverse samples and longer follow‐up periods to examine sustained effects. Reporting Checklist: This study adhered to the TREND checklist for nonrandomized intervention studies.