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ABSTRACT: Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.
Hu li za zhi The journal of nursing 02/2013; 60(1):92-8.
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ABSTRACT: The purpose of this study was to analyze the available evidence concerning the effects of breast reconstruction (BR) on body image of women with breast cancer. BR is a potential intervention to improve the body image of women with breast cancer. Conflicting research findings about the effects of breast reconstructive surgery on body image compared to breast conservative surgery (BCS) or mastectomy exist. A meta-analysis of studies found in MEDLINE, CINAHL, PsychINFO, PubMed as well as PQDT (dissertation and theses), and other unpublished literature resources from 1970 to 2010 were searched. Comparable studies that examined the difference of body image between breast cancer women receiving mastectomy plus BR and those with BCS were included. A clear definition about the domains of body image including body stigma, body concern, and transparency were identified. Mean effect sizes were calculated. Twelve studies were included in the meta-analysis. Women with BR and BCS were no different on the body concern domain of body image. However, women with BR had a significantly worse score on body stigma domain of body image than women receiving BCS. Women with BR had a better body image score than women with mastectomy. Women who are satisfied with their body shape may still perceive deficiencies because of the stigma of mastectomy and affect on body image. Consistent application of valid and reliable measures of body image specific to breast cancer women is needed.
Breast Cancer Research and Treatment 12/2012; · 4.43 Impact Factor
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ABSTRACT: Background: Smoking cessation has been an important issue of concern for Taiwan's psychiatric nurses since promulgation of the Tobacco Hazards Prevention Act. However, Taiwan has lacked a qualified tool to evaluate the self-efficacy of nurses in providing smoking cessation services. Purpose: The purpose of this study was to validate the Chinese version of the Self- Efficacy in Smoking Cessation Service Scale (SE-SCS). Methods: A back translation approach was used to develop the SE-SCS Chinese version. We enrolled 193 psychiatric nurses from two psychiatric centers in central and southern Taiwan to assess the reliability and validity of the Chinese version scale using internal consistency, test-retest, factor analysis, and concurrent criteria validity. Results: The reliability of the SE-SCS Chinese version was assessed as good (Cronbach's α = .85) and the Pearson correlation for total test-retest score was acceptable (r = .65, p = .004). Explanatory factor analysis revealed that one factor explained 63.4% of total variance. As to the criteria validity, frequency of smoking cessation service provision was the main criterion, with a correlation of 0.25-0.26. We identified a low, but significant correlation (p < .001). Conclusion: The SE-SCS Chinese version appears to be a valid measure for assessing psychiatric nurse self-efficacy in providing smoking cessation services.
Hu li za zhi The journal of nursing 10/2012; 59(5):49-56.
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ABSTRACT: This study aimed to investigate the concurrent validity of the parent-report Taiwan Birth Cohort Study Developmental Instrument (TBCS-DI) with the Bayley Scales of Infant Development-Second Edition (BSID-II) and the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) at 6, 18, 36, and 60 months. 100 children were recruited at 6 months, 88 children followed-up at 18 months, 71 at 36 months, and 53 at 60 months. Longitudinally, the parent-report TBCS-DI, with the professional psychological assessments of the BSID-II and the WPPSI-R showed predictive validity. Looking at each time point in cross section, at 6 and 18 months the TBCS-DI had good concurrent validity with the BSID-II, and at 36 and 60 months the TBCS-DI was correlated only with the motor and performance domains of the BSID-II and WPPSI-R. With further investigation, the TBCS-DI may be used both in research and in clinical settings.
Psychological Reports 08/2012; 111(1):83-96. · 0.44 Impact Factor
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03/2012; , ISBN: 978-953-51-0574-9
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ABSTRACT: The female breast is intimately tied to social values that define the ideal body standard for women. As such, women's bodies are regarded as objects to be evaluated and judged. This paper analyzed the experience of women with breast cancer after mastectomy from the perspective of objectification theory. The authors found that not only medical technology but women themselves objectified the female body. The process of patient-physician communication also strengthened the objectification phenomenon for post-mastectomy women. We found that women with breast cancer worried about facing critical evaluation from the public after losing their breasts and needed to cope with the stress of losing a part of their physical self. Social and cultural antecedents that regard breasts as "objects" strongly influence the perspectives of women facing breast cancer. We hope this analysis may assist healthcare professionals to understand how women's bodies are objectified after mastectomy and consider how to care for this population more appropriately.
Hu li za zhi The journal of nursing 08/2011; 58(4):75-80.
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ABSTRACT: The Taiwan Birth Cohort Study (TBCS) is the first nationwide birth cohort database in Asia designed to establish national norms of children's development. Several challenges during database development and data analysis were identified. Challenges include sampling methods, instrument development and statistical approach to missing data. The purpose of this paper is to describe the pilot study underpinning the TBCS, testing of the TBCS developmental instrument and the resolution of methodological challenges. Bayesian analysis fill in missing data, three-step regression analysis for the investigation of mediating and moderating effect, the use of structural equation modeling in a large scale investigation, investigating direct and indirect effects, confounding factors and reciprocal relationships in children's development, and used latent growth model in longitudinal observations are described. The TBCS will provide ongoing longitudinal information regarding the predisposing and maintaining factors affecting the long term outcome of pediatric illnesses.
Research in developmental disabilities 07/2011; 32(6):2697-703. · 4.41 Impact Factor
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ABSTRACT: The aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women.
One hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ).
By multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05).
In conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority for these women, particularly the Indonesian and Vietnamese spouses. From these findings, we have a better understanding of how to assist these female foreign spouses in future.
BMC Psychiatry 01/2011; 11:4. · 2.55 Impact Factor
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ABSTRACT: A total of 934 patients with schizophrenia and 433 controls were genotyped for the interleukin-10 (IL-10) promoter and DRD4 uVNTR polymorphisms. DRD4 long-form variants (namely, those with ≥5 repeats), homozygosity for the 4-repeat allele, and the IL-10 haplotype ACA were associated with schizophrenia, respectively. No obvious interactions among the potential polymorphisms were found, which suggests that IL-10 and DRD4 confer vulnerability to schizophrenia independently.
Psychiatry Research 01/2011; 188(2):294-6. · 2.52 Impact Factor
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ABSTRACT: The parental report instrument is the most efficient developmental detection method and has shown high validity with professional assessment instruments. The reliability and validity of the Taiwan Birth Cohort Study (TBCS) 6-, 18- and 36-month scales have already been established. In this study, the reliability and validity of the 60-month scale was tested. The gender differences in children's longitudinal gross motor, fine motor, language and social development were also investigated. Using the dataset from the Taiwan Birth Cohort Pilot Study (TBCS-p), 2048 infants were followed up when they were 6-, 18-, 36- and 60-month-old. At the final stage, 1620 children were followed up. Development of the children was measured using the TBCS 6-, 18-, 36-, and 60-month developmental scales. The reconstructed TBCS 60-month scale yielded 16 items measuring children's development in the four dimensions of gross motor, fine motor, language and social. The scale yielded an internal consistency of 0.39-0.71. Structural equation modeling also showed good construct and predictive validity, in that the 6-, 18-, and 36-month scales were predictive of the 60-month scale. No gender differences between the gross motor dimension was found. Gender had an effect on the fine motor dimension at 36 and 60 months, language dimension at 36 months, and social dimension at 18, 36 and 60 months. Gender had a transient effect in language development and social development a continuous effect from 18 to 60 months. Thus different gender norms may need to be established to prevent misdiagnosis. The TBCS scale is a valid and reliable developmental screening instrument that can be used in continuous surveillance of children's development in community and clinical settings from 6 months to 5 years of age.
Research in developmental disabilities 10/2010; 32(1):100-6. · 4.41 Impact Factor
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ABSTRACT: Understanding the role of sociocultural factors on women's experiences of breast reconstruction is needed to provide better care and avoid erroneous assumptions of these women's needs.
The purpose of this study was to understand the lived experiences of Taiwanese women with breast cancer who receive breast reconstruction following mastectomy in Taiwan.
A qualitative research design, guided by the philosophy of hermeneutic phenomenology, was selected to guide the study. In-depth interviews were conducted 1 to 2 times with each participant and explored the women's experiences related to making decisions about, undergoing, and recovering from breast reconstruction.
Seven women who received either autologous breast reconstruction or saline implants were recruited in southern Taiwan. Five themes were identified, including "dream of a wonderful future," "unexpected reality," "struggling to accept," "balancing vanity with life priorities," and "coming to terms: no regret."
Taiwanese women felt ambivalent about their new breasts, which failed to meet their expectations. This ambivalence, combined with a culture that values selflessness and the placement of family first, resulted in many women feeling guilty, vain, and superficial for requesting breast reconstruction.
Clinical implications include the importance of regular and authentic patient-health care provider communication throughout the process of breast reconstruction, including recovery, and better acknowledgement of Taiwanese women's body image concerns associated with breast reconstruction.
Cancer nursing 05/2010; 33(5):E1-11. · 1.88 Impact Factor
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ABSTRACT: Early detection of developmental delay and childhood disorders are important for early intervention. This study aimed to describe the distribution of responses in a large population-based survey, identify cutoff points for the parent concern checklist (PCC) suitable for the Chinese language and culture, and explore how many children were identified as having evidence of problems at age 18 mo different from those at age 6 mo. Using a national randomly selected sample, the overall development of 21,248 children was investigated using the Taiwan Birth Cohort study instrument, and the PCC, a problem-oriented screening instrument. The Newton-Raphson iteration showed that the PCC should be separated into three groups, those scoring 1-2 in the first group, 3- 6 in the second group, and 7- 8 in the third group.Structural equation models showed that 6-mo development was predictive of 18-mo development; additionally, 18-mo development and the PCC showed good concurrent validity. This study identified three groups with distinct developmental trajectories and two cutoff points of 2/3 and 6/7. Thus, the PCC can be used as a first-stage screening instrument in a two-stage window screening procedure. Further studies are needed to investigate the factors, which contribute to the differences among these groups;follow-up on the typical and atypical development of these children is necessary.
Pediatric Research 02/2010; 67(2):226-31. · 2.70 Impact Factor
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ABSTRACT: Autism is a neurodevelopmental disorder with a strong genetic background that has been suggested to be associated with a susceptibility gene, engrailed homeobox 2(EN2), which maps to chromosome 7q36. Our study was aimed to explore the association between EN2 intronic single nucleotide polymorphisms (SNPs) with autism in an ethnic Han Chinese population.
A total of 193 autism cases and 309 controls were recruited. Five SNPs including rs3824068, rs3824067, rs1861972, rs1861973 and rs3830031 in the intron 1 region were genotyped by using the TaqMan SNP assay.
Both the allelic frequencies and genotype distribution of the EN2 intronic SNPs were found to have statistically significant differences between cases and controls, except rs1861972, rs3024067 and rs3824068. According to the constructed linkage disequilibrium plot using genotype data, it was suggested that further haplotypic analyses can be performed on rs3824068, rs1861972 and rs1861973. After completed analyses by the Unphased and Phase programs and logistic regression analysis, one 2-marker haplotype A-C (beta = -2.897; p = 0.013; OR = 0.055) and one 3-marker haplotype G-A-C (beta = -0.491; p = 0.015; OR = 0.612) were identified that were plausibly associated with autism in the ethnic Chinese population.
The haplotype A-C of rs1861972 and rs1861973 is the core element of the observed haplotype association in this study, which plays a role as a protective factor against autism; in addition, the haplotype G-A-C is less frequent in male cases compared to controls (38.64 vs. 52.51%), which plausibly modulate disease vulnerability to autism. However, further evidence of the haplotype association of EN2 intronic SNPs and uncertain transcription factor interaction is warranted for further clarification.
Neuropsychobiology 01/2010; 62(2):104-15. · 2.67 Impact Factor
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ABSTRACT: A reliable and valid assessing tool to detect the problem before the child becomes deviant is very important.
This study aimed to further test the reliability and validity of developmental screening instrument for follow-up of thirty-six months children in Taiwan. Also, the stability and changes in the development of children from six to thirty-six months were investigated.
A total of 1751 infants were administered the six-month scale, which included levels of Gross and Fine Motor, Language/Communication, and Social ability. At eighteen months, 1267 infants were followed up, and at thirty-six months, 1630 infants were followed up.
Item analysis showed the thirty-six months scale had a Cronbach's alpha of 0.793. By confirmatory factor analysis, the correlations of the four dimensions in this scale were within the range of 0.38 to 0.61. Structural equation modeling showed that the six month scale could directly predict the eighteen months scale, and the gross motor, language, and social dimensions in the thirty-six months scale. The eighteen-month scale was also predictive of the thirty-six months scale. The six, eighteen and thirty-six-month scales all had acceptable reliability and validity, including content, construct and predictive validity. Additionally, the language development at six months was predictive of the language and social development at thirty-six months. The predictive model showed there were correlations between each dimensions at different ages.
This study is the pilot of a large and scientifically robust longitudinal first national birth cohort study in Taiwan, and the findings should provide useful reference for future studies.
Early human development 01/2010; 86(1):17-21. · 2.12 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate whether the adherence concerns related to follow-up were different between groups of women after abnormal screening results of mammography (Mam) and Papanicolaou (Pap) test. Taiwanese women with abnormal Mam screening results (n = 42) and abnormal Pap test results (n = 109) provided data via a self-administered survey. Data were collected in 2005. After providing informed consent, women completed the AFAR, an 18 item questionnaire that measured the Adherence concerns of Follow-up after Abnormal screening Results. The results showed that (1) for both Mam and Pap test groups, the most important adherence concern for clinical follow-up after abnormal screening results is disease related, followed by others' response and resource accessibility; and (2) in these 2 clinical follow-up groups, women in the Mam group were more likely to be concerned with all of the 18 adherence factors than those in the Pap test group (OR, 2.46-9.86). The most important adherence concern on clinical follow-up after abnormal screening results for Mam and Pap test women is disease related. Mammography women considered significantly more adherence concerns than Pap test women. These differences imply that improving follow-up after Mam or Pap screen may require different interventions.
Cancer nursing 10/2009; 32(6):437-45. · 1.88 Impact Factor
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ABSTRACT: Domestic violence has a history that stretches back before recorded time. It frequently has a lasting and traumatic impact on victims, families, and communities. According to the official statistics of many countries, most domestic violence victims are women who were assaulted by intimate male partners. This issue is gaining increasing attention in Taiwan's current society.
The purpose of this study was to gain an empathic understanding of domestic violent abuse experienced by women in southern Taiwan. Perspectives were provided through the personal descriptions and views of the women interviewed.
P.F. Colaizzi's (1976) descriptive phenomenological method was applied to conduct this study. A total of eight abused women from the southern Taiwan Domestic Violence and Sexual Assault Prevention Center participated in this study and associated in-depth interviews, which were tape-recorded, transcribed, and reviewed for accuracy by the interviewee. Verbatim manuscript transcriptions were then analyzed. Finally, major themes from extracted data were summarized.
The following four themes emerged: feeling sorry about their marriage, living in an unsafe environment, economic difficulties, and enduring unhappy lives.
These results may help health professionals understand the assault experiences and the nature of domestic violence from victims' viewpoints. This may also help health professionals obtain a comprehensive assessment and develop appropriate interventions for these abused women.
The journal of nursing research: JNR 10/2009; 17(3):153-60. · 0.69 Impact Factor
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ABSTRACT: The purpose of this study was to survey the prevalence of women's depression during menopause and investigate the relationships between menopause depression and variables including self-concept, menopause attitudes, life-event stresses, climacteric physiological symptoms, and demographics. Research was conducted using a cross-sectional study and self-administered questionnaires. We randomly selected female participants between the ages of 45 and 55 years from Tainan City in southern Taiwan using the cluster method. Two hundred sixty-six valid questionnaires were analyzed. Results were as follows: (a) The prevalence of depression among participants was 31.2%; (b) depression was positively associated with life-event stresses and climacteric physiological symptoms (r =.23 and .34, respectively) and was negatively associated with attitude toward menopause and self-concept (r = -.31 and -.65, respectively); and (c) by logistic regression analyses, climacteric physiological symptoms and self-concept were associated with menopause depression. This preliminary survey suggests that low self-concept and increased climacteric physiological symptoms are closely related to depression among menopausal women. Larger scale follow-up studies are warranted to investigate factors that predispose women to depression during menopause.
The journal of nursing research: JNR 07/2009; 17(2):128-35. · 0.69 Impact Factor
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ABSTRACT: This study investigated the reciprocity between parental mental health and the different stages of child development at 6, 18, and 36 months. As the pilot of a birth cohort study, this study comprised 2048 children and their parents who were randomly selected and invited to participate. The development of these children and the mental health of their parents were followed at 6, 18, and 36 months postpartum. Child development was assessed using the Taiwan Birth Cohort Study instrument, and parental health was assessed using the Taiwanese version of the 36-Item Short Form Health Survey. Complete responses for all three stages were received from 844 families. Our results showed that parental mental health had a direct effect on language and social development; however, this effect did not become significant until 36 months. The reciprocity between child development and parental mental health and proper intervention are vital.
Journal of Perinatal Medicine 04/2009; 37(4):397-402. · 1.70 Impact Factor
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ABSTRACT: The aim of the present study was to investigate the prediction of development among 6-, 18-, and 36-month-old infants on the Bayley Scale of Infant Development (BSID).
One hundred infants were assessed using the BSID at 6 months; of these, 70 completed the 18 and 36 month assessment at follow up.
Multivariate regression and structural equation modeling were used to determine predictive validity in the mental and psychomotor developmental scales. Structural equation analysis also confirmed the conceptual scheme of the stability of development from 6 to 36 months for boys. Boys had a steadier overall developmental trajectory compared to girls.
The validity of BSID was consistent with previous studies. The language spurt in girls, however, from 6 to 18 months affected the stability of the BSID. Thus, the gender difference in language development should be considered in clinical assessment.
Pediatrics International 04/2009; 51(5):666-9. · 0.63 Impact Factor
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ABSTRACT: Background: The aim of the present study was to investigate the prediction of development among 6-, 18-, and 36-month-old infants on the Bayley Scale of Infant Development (BSID).Methods: One hundred infants were assessed using the BSID at 6 months; of these, 70 completed the 18 and 36 month assessment at follow up.Results: Multivariate regression and structural equation modeling were used to determine predictive validity in the mental and psychomotor developmental scales. Structural equation analysis also confirmed the conceptual scheme of the stability of development from 6 to 36 months for boys. Boys had a steadier overall developmental trajectory compared to girls.Conclusions: The validity of BSID was consistent with previous studies. The language spurt in girls, however, from 6 to 18 months affected the stability of the BSID. Thus, the gender difference in language development should be considered in clinical assessment.
Pediatrics International 03/2009; 51(5):666 - 669. · 0.63 Impact Factor
