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Jane Lee-Hsieh
National Taipei University of Nursing and Health Sciences
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the quizzes, with 40 minutes for the videos, for a total of ducting the study. The head nurse then set up a meeting be-
50 minutes for 1 credit hour. The Taiwan Nurses Asso- tween the principal investigator and the ward’s 14 nurses to
ciation Continuing Education Credit Regulations define introduce the purpose and procedures of this research. The
a credit hour as 50 minutes of instruction (Department of nurses then took the course online during their free time.
Health, 2008). Third, five live-action videos were created
using the stories from the exemplary nurses. Fourth, the Evaluation
materials developed in the first three steps were sent for Reflection Quizzes. On completion of the unit, the an-
review to the same expert panel that reviewed the objec- swers to the quiz questions were downloaded, printed,
tives, learning strategies, and content in the design stage. and analyzed with a constant comparative method.
The panel evaluated content validity using the four criteria Course Evaluation Questionnaire. All of the 14 nurses
of representativeness, appropriateness, completeness, and who worked on the obstetrics-gynecology ward com-
importance. Fifth, the content was revised according to pleted a questionnaire to evaluate their experiences and
the recommendations and suggestions of the expert panel. perceptions of the course during the period from May 20
to June 20, 2013.
Implementation Focus Groups. Invitations were sent to all 14 nurses
The research project began after the hospital’s institu- asking them to participate in focus group interviews held
tional review board approved the study. All participants, on July 25 to 26, 2013. Eight nurses participated, five in
both nurses and patients, signed consent forms and were the first group (interview time: 100 minutes) and three
informed that they were free to leave the study at any in the second (interview time: 60 minutes). Open-ended
time. Nurses were informed that participation would not questions that were used included: “Please share your ex-
affect their clinical practice evaluation. Because patient periences with taking this online course”; “What insights
evaluations were collected by the research assistant, the and recommendations do you have?” and “Which unit or
nurses did not know the results of the patient evaluations. scenario most deeply impressed you, and why?” Permis-
The educational team first obtained permission from the sion was obtained to record and transcribe the interviews.
hospital nursing department to conduct this research. The Self-Evaluations. The nurses completed the CBM.
nursing department selected the obstetrics-gynecology ward The questionnaires were distributed anonymously and
for the pilot test. The principal investigator approached the returned to the research assistant between August 25 and
head nurse of the obstetrics-gynecology ward about con- August 31, 2013.
RESULTS OF EXEMPLARY NURSE AND PATIENT INTERVIEWS: CARING/UNCARING THEMES AND SUBTHEMES
CATEGORIZED WITHIN THE SHARE FRAMEWORK
Nurses Patients/Family Members
SHARE Framework Caring Themes Caring Themes Uncaring Themes
Sense patient’s Fulfilling the patient’s physical, Taking the initiative in caring for the Routinizing nursing tasks (failing to
needs. psychological, social, and spiritual patient’s physical condition (checking consider patients as individuals/fail-
needs. on the patient without being asked). ing to observe the patient’s rehabili-
Providing nursing interventions that fulfill tation status/failing to show concern
patient needs (providing individualized for the patient’s condition).
nursing care/providing assistance with
bathing/actively offering pain relief inter-
vention/changing intravenous lines).
Help patients out. Resolving problems (providing Resolving bothersome problems Ignoring physical care (not changing
hands-on nursing care/using social (coming as soon as the call button the patient’s position/not cleaning
resources). is pressed/regularly changing the the catheter).
patients’ position at night/using the Refusing patient requests (telling the
hospital’s resources to resolve issues). patient to hire someone to help care
for them/ignoring calls).
Providing support (offering recog- Providing encouragement (expressing
nition/accompanying the patient/ confidence, hope, and recognition/
listening). accompanying and comforting the
patient).
Acknowledge pa- Being sincere. Expressing kindness (smiling/speaking Expressing impatience (showing
tient’s feelings. warmly/answering patiently). indifference when taking vital signs/
frowning impatiently/speaking disre-
spectfully in front of patients).
Behaving carelessly and insincerely
(chatting in front of patients/repeat-
ing interventions that were already
performed).
Empathizing (showing under- Ignoring the patient’s condition and
standing of the patient’s experi- feelings (interrupting sleep/speaking
ences and feelings). too fast/not showing consideration
for the patient).
Showing acceptance.
Respect the dignity Respecting the patient’s privacy, Respecting autonomy and privacy Neglecting the patient’s privacy and
and privacy of pa- dignity, religious beliefs, culture, (keeping the patient’s hospitalization dignity (entering a room without
tients. and language. confidential/allowing the patient to knocking/opening privacy curtains
choose among alternatives). without warning/speaking to pa-
tients without looking at them).
Explain what’s hap- Instructing and explaining (ex- Actively explaining current and upcom- Failing to give patients instructions
pening. plaining the patient’s condition, ing interventions (providing an expla- when performing nursing tasks (giv-
medical procedures, hospital rules, nation before any action is performed/ ing medication without explanation/
the use and effects of medica- helping patients to understand the not teaching patients how to care
tions, and legal documents, such content of consent forms). for themselves/not notifying patients
as consent and do not resuscitate ahead of time so that they can
forms). prepare psychologically).