Sleep, a basic physiological need of all humans, appears to be both integrative and restorative. However, studies have reported that 33-51% of women show a dramatic increase in sleep disturbance in the mid-life years, a time when they enter menopause. The purposes of this study were to (1) explore the prevalence of poor sleep quality in menopausal women; (2) identify the relationship between sleep quality of menopausal women and its related factors; (3) predict the possible explanations of how the related variables affect sleep quality of menopausal women; and (4) provide recommendations for future strategies that aim to improve sleep quality of menopausal women. A cross-sectional, correlation coefficient design was used. Purposive sampling was employed to recruit 197 menopause women from a small town in central Taiwan. T-test, one-way ANOVA, and multiple regression were used for data analysis. The results were as follows: (1) overall, the total score for sleep quality was 5.55 ± 3.47; 57.9% of subjects were identified as good sleepers and 42.1% as poor sleepers; (2) there were significant differences in quality of sleep related to occupational situation, history of chronic disease, menopausal status, number of chronic diseases, and number of menopausal symptoms (t = -3.49, -3.37, p < .01; F = 3.62, p < .05, F = 4.95, 5.35, p < .01); (3) depression and aging were strongly related to quality of sleep (r = .57; .22, p < .01); (4) 36% of variance in quality of sleep can be explained by depression and aging.

Aim. To generate a descriptive theory framework regarding the experiences of sleep disturbances among perimenopausal women in Taiwan. Background. Although studies show that some perimenopausal women are troubled by sleep problems, little information was found about the subjective experiences of sleep disturbances among these women. Research is required to explore women's feelings or perceptions in dealing with their sleep problems. These understandings will be important to help alleviate perimenopausal women's sleep problems. Design. A grounded theory research design was applied. Method. Twenty-one Taiwanese sleep disturbed women, aged 46-57 years, participated in in-depth interviews. Results. 'Getting back a good night's sleep' was the core theme for describing and guiding the process of the women's sleep disturbance experiences. During the process, 'disturbed sleep' was identified as the antecedent condition that included subcategories: easy awakening, difficulty falling asleep, inner worries, physical discomfort and genetic and bodily constitution. Analyses showed five categories (some with subcategories) of the sleep disturbed women: (i) worsening health status -physical exhaustion, impaired social interactions, emotional swings and decreased work performance; (ii) living with lonely nights -selfhelp and endurance; (iii) a search for resources to relieve sleep difficulties -doctor shopping, trying alternative therapies, exercising and seeking support; (iv) vicious cycle and (v) acceptance of insomnia. Conclusions. Women expected to relieve their sleep disturbance by finding comprehensive counselling or by their body constitution responding to treatment. Healthcare providers need to value women's individual concerns and subjective voices. Providers must seek out sleep counselling instead of simply prescribing drugs for their sleep difficulties. Relevance to clinical practice. It is crucial to integrate perimenopausal sleep care by implementing a multidimensional approach such as sleep assessment laboratories, sleep counselling, complementary alternative medicine, sleep strategies and support groups.

This cross-sectional study explored the relationship between professional commitment and job satisfaction among nurses. A total of 132 registered nurses were recruited from a hospital in northern Taiwan. A self-reported structured questionnaire was used to collect data. Findings revealed significant differences among nurses in willingness to make an effort and their marital status, appraisal in continuing their careers, job level, and goals and values related to working shifts. Significant differences were found between inner satisfaction and work sector and marital status. Nurses' professional commitment was strongly related to job satisfaction; aspects of professional commitment explained 32% of the variance in job satisfaction. Study results may inform health care institutions about the importance of nurses' job satisfaction and professional commitment so hospital administration can improve these aspects of organizational environment.

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Background: lung cancer (LC) is the fifth of the 10 leading causes of death in the world. LC is in first place for cancer-related mortality for both males and females in Taiwan

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The quality of nurses’ work has a direct effect on patient health, and poor sleep has been positively associated with nurses’ medical errors. The aim of this study was to investigate the relationship between quality of sleep and heart rate variability (HRV) among female nurses. A descriptive cross-sectional correlational study design was used in January 2014 to study female nurses (n = 393) employed in a medical center in Taiwan. Data were obtained from several questionnaires. HRV was analyzed with five-minute recordings of heart rate signals obtained using a Heart Rater SA-3000P. Approximately 96% of the participants self-reported a poor quality of sleep. Compared to non-shift nurses, significant decreases were found in total power (TP) and low-frequency HRV among shift-work nurses. However, negative correlations were found between sleep quality and HRV, including total power, low frequency, and the low frequency/high frequency ratio (r = −0.425, p < 0.05; r = −0.269, −0.266, p < 0.05). In a stepwise multiple regression analysis, 23.1% of variance in quality of sleep can be explained by TP and heart rate. The sleep quality of female nurses was poor and this affected their autonomic nervous system, which can contribute unfavorable consequences for their health.

ObjectiveShared decision-making (SDM) enhances medical care, but an appropriate tool for evaluating nursing staff’s attitudes towards SDM in clinical practice is lacking. The objective of this study is to develop the Nursing Shared Decision-Making Attitude (NSDMA) scale and verify its psychometric properties.DesignInstrument design study.ParticipantsA sample of 451 nursing staff.InterventionThis study comprised two phases. In phase 1, qualitative research and expert content validity were adopted to develop the first draft of the scale. In phase 2, Taiwanese nursing staff were recruited through convenience sampling, and the sample was divided into a calibration sample and a validation sample. An objective structured clinical examination of SDM attitudes was administered to 100 nursing staff to determine the scale’s cut-off score.Main outcome measurementsExploratory factor analysis and confirmatory factor analysis were used to obtain the underlying factors of the NSDMA scale; McDonald’s omega value was used to determine the reliability; known-group validity was used to test the construct validity; and the receiver operating characteristic curve was adopted to determine the scale’s cut-off score.ResultsIn total, two factors were identified from the instrument results, which were termed ‘empathic communication’ and ‘mastery learning’. The McDonald’s omega value of the overall scale was 0.92. Known-group validity testing was performed based on the staff’s participation in SDM courses and experience of SDM, and the results exhibited significant differences (t=5.49, p<0.001; t=2.43, p<0.05). Based on the receiver operating characteristic curve, the optimal cut-off for SDM attitudes was determined as 48.5 points.ConclusionsThe NSDMA scale enables the evaluation of SDM attitudes among clinical nursing staff and nursing managers; the results may serve as a reference for incorporation of SDM into nursing policy formulation.