Yueh-Chen Yeh

Women with gynecological cancers experience physical and mental distress due to their diagnosis, surgery, adjuvant chemotherapy, and radiotherapy, all of which have adverse physical, mental, social, and spiritual impacts on their quality of life. This study was designed to examine the correlations among symptom distress, social support, spiritual well-being, and quality of life as well as the predictors of quality of life in women with gynecological cancers. This was a cross-sectional correlational study. A total of 91 women with gynecologic cancer were recruited from a medical center in central Taiwan. A demographic characteristics questionnaire, the World Health Organization Quality of Life Brief Questionnaire Taiwanese version, the Chinese Modified Symptom Distress Scale, the Chinese Simplified Social Support Scale, and the Spiritual Well-Being Scale were used for data collection. Correlation and multiple regression analyses were performed on the data. Symptom distress was found to correlate negatively with spiritual well-being as well as with the physical health, psychological health, and environmental health domains of quality of life. Social support and spiritual well-being were found to correlate positively with all four domains of quality of life. Social support was identified as the main predictor of quality of life. Symptom distress, social support, and spiritual well-being should be incorporated into nursing education to improve medical staff awareness of these issues and promote the timely evaluation of patient needs. Moreover, medical staff should provide appropriate social and spiritual support and multi-disciplinary care as well as make referrals when necessary to related support groups to improve clinical care quality to enhance patient quality of life.

Many studies have reported that gynecologic cancer diagnosis, surgery, adjuvant therapy, and survivorship can be extremely stressful for many people during their cancer journey, and most cancer survivors have experienced stress after cancer, which impacts their quality of life. Importantly, healthy stress management will assist patients in overcoming obstacles in their lives and enhance both the quality of life and the cancer adjustment process. This study aimed to investigate the relationships between stress, coping strategies, and quality of life among gynecologic cancer survivors and to assess the mediating effects of coping on the relationship between quality of life and stress. A series of regression models and Sobel test were conducted to investigate whether coping strategies mediated the relationship between stress and quality of life. Stress was a predictor of quality of life. Acceptance was the mediator between stress and quality of life. Tailored programs that foster coping strategies, such as the strategy of acceptance, to reduce stress and maintain quality of life in this vulnerable group need to be developed.

The purpose of this mixed-methods study was to investigate the influential factors of student satisfaction with online digital audio-visual flipped classroom learning. A total of 103 students enrolling in the two-credit compulsory code course participated in this flipped classroom research. Descriptive data analysis and grey relational analysis demonstrated that student respondents were most satisfied with repeated practice (1st), followed immediately by peer learning (2nd), and active learning (3rd). In terms of qualitative data, three themes emerged from the focus group analysis, including: improving independent learning, enhancing peer learning, and increasing teacher–student interaction. The flipped classroom model provided opportunities for students to strengthen their self-directed learning capabilities, improved students’ learning motivation, and to be a team player among third-year nursing students. The results were consistent with the actual circumstance. The results integrated descriptive data, the mathematic model, and interviews to validate the accuracy and rationality of the data. According to this study, an online digital audio-visual flipped classroom could improve student independent learning and enhance peer communication. The results provide an accurate assessment tool suitable for Taiwanese nursing students’ flipped classroom model learning experience.

Anxiety and depression are common emotional distresses experienced by women during gynecologic cancer treatment. These often have dangerous effects on physical and mental health and may impact quality of life (QoL). To investigate the factors influencing anxiety, depression, social support, and QoL in women with gynecologic cancer. This was a cross-sectional correlational study. A total of 111 women with gynecologic cancer receiving treatment at a medical center in central Taiwan were selected as subjects using convenience sampling. A demographic characteristics questionnaire, the World Health Organization Quality of Life-Brief-Taiwan version (WHOQOL-BREF-Taiwan version) questionnaire, the International Support Evaluation List (ISEL), and the Hospital Anxiety and Depression Scale (HADS) were used for data collection. Of the 111 subjects, 41.4% and 24.3% had tendencies for anxiety and depression, respectively, and a moderate QoL score (mean = 3.46; SD = 0.73). The physical health domain had the highest mean QoL score (14.93; SD = 2.24), followed by environmental health (14.76; SD = 1.97), social relationships (14.13; SD = 2.33), and psychological health (13.92; SD = 2.44). Anxiety, depression, marital status, and social support respectively explained 18.5%-37.0% of the total variation in QoL scores. Of the four QoL domains examined in this study, anxiety was the most significant predictor of QoL. It is recommended that healthcare professionals strengthen the early assessment of anxiety, depression, and social support in women with gynecologic cancer. In addition, sensitivity towards emotional status should be increased in these cases. Healthcare professionals should provide care, support, and timely completion of referrals. Finally, psychological and social support and related interventions should be provided based on patient needs in order to maintain QoL.

Because of the growing expectations for novice nurses to be adequately prepared to work in complex healthcare settings, pressure has dramatically increased for nursing schools to deliver better training. Nurse educators must explore innovative teaching methods to link the gap between knowledge and practice in order to enhance the students' ability to function as competent nurses. Researchers stated that simulation has the potential to help nurse educators better train students, especially when faculty members understand issues connected with students increased preparedness for actual clinical environments. The use of high-fidelity simulation has been increasing in the nursing curricula internationally; however, high-fidelity simulation in the nursing classroom is still new in Taiwan. It is important to understand students' simulation learning perceptions in order to formulate appropriate learning techniques.